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The construction of a countywide community for medical and health services is designed to upgrade the service capacity of primary medical and health institutions, to promote resource sharing and collaborative services, and promote the hierarchical medical system. Huzhou of Zhejiang province has launched its initiative in building a countywide community for medical services since 2018. The authors summarized its main practices in promoting the integration of the management system and optimizing operating mechanism of countywide medical and health institutions, promoting the reform of the county medical and health governance system, as well as the achievements and shortcomings, with a view to providing reference for promoting the high-quality development of the countywide medical and health service system.
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Objective:To analyze the impact of Beijing Medical Reform on inpatient costs of medical and surgical patients in a hospital, and to provide reference for the hospital to explore the path of patient cost control.Methods:Based on the data of medical and surgical inpatients′ expenses from June 2016 to December 2019 in a hospital in Beijing, breakpoint regression method was used to analyze the impact of the two reforms(namely the comprehensive reform of separation of medicine and pharmacy and the comprehensive reform of medical consumption linkage)on the level of medical and surgical inpatients′ expenses and the cost structure of drugs and consumables.Results:The two reforms controlled the rapid rise of hospitalization expenses and reduced the proportion of drugs and medical consumption. The effect of the reforms on the total cost control of internal medical patients was better than that of surgical patients.For internal medical patients, the reform of separation of medicine and pharmacy played a greater role in the proportion of medicine; For surgical patients, the two reforms had effectively reduced the proportion of consumables, and the proportion of drugs had gradually decreased.Conclusions:The two reforms have effectively controlled the growth trend of hospitalization expenses, and changed the cost structure of drugs and consumables.
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The comprehensive establishment of the basic medical and health system with Chinese characteristics is key to the healthcare reform. Taking the basic medical and health system as the specific research object, this paper elaborated the system examples of various countries' health systems. It also, using the classic system theory as the theoretical research basis, defined the connotation of the basic medical and health system with Chinese characteristics and described such characteristics. The purpose is to lay a theoretical foundation for the development of such a system, and provide references for the healthcare reform and Healthy China initiative.
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This paper introduces the background, implication and construction of the county health services community (County medical alliance) model in Anhui Province under the background of new medical reform,and briefly introduces the relationship between medical insurance, enhancing the ability to upgrade and standardize services and medical treatment integration of the typical experience.It also analyses the challenges faced in the construction of medical syndicate, such as the mechanism of regional environmental restriction, compensation and assessment mechanisms which have not been established yet, and the sustainable development of information technology that has lagged behind, and put forward the policy suggestion to improve the construction of medical community, with a view to providing reference for the next work.
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This paper introduced overseas experiences and theories of health systems in view of the ongoing medical and health system reform in China.It proposed the super health ministry reform,justified its necessity,and clarified key issues of such a reform,in addition to discussing how to improve the system of macro-health.
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Objective:To study on regional differences of technical efficiency under medical and health system in China, and analyze on the influence factors of technical efficiency. Methods: Based on the provincial panel data from 2002 to 2011, the stochastic frontier production function of healthcare system was established for empirical analysis. Results and Conclusion: Overall, the average technical efficiency of medical and health system in China presented an increasing tendency, however, a significant difference was found in regional efficiency. The non-efficiency of medical and health system in different areas could be reduced by the proportion of tertiary hospitals in all medical institutions, the ratio of profit-making medical institutions in all medical institutions and the population density;while the influences of highway density and per capital education year on technical efficiency in different areas are different.
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Wuhu City has been exploring,since 2007,an innovative health and medical system featuring both the reform of public hospitals and that of the primary care system.This reform aims at strengthening the public health service system,improving the basic medical service system,speeding up the construction of the medical security system,and improving the drug supply system.It is characteristic of a core,two wings,and four-wheel drive,which tells the essence of Wuhu' s reform practices and outcomes.
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The author earmarked institutional defects as the key to China's medical and health system reform during the economic reform.Main progress and fruits of this reform during the past three years are listed as follows:theory and system innovation,initial establishment of the primary healthcare security system of nationwide coverage,establishment and implementation of the essential drug system,establishment and perfection of the primary healthcare system,equity of primary public health service,and general startup of public hospitals reform.In addition,the author identified such reform roadblocks and challenges as growing conflicts between the demand and supply of healthcare services,resistance for furthering the system reform,conflicts in drug production and circulation,lack of top-tier design for public hospital reform,and lack of systematic planning for talent development.
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Medical clinical education is really the beginning of clinical work,and it should be reformed accordingly based on actual changes in health care.This article discusses that the clinical medical education should be reformed to face serious medical problems.
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OBJECTIVE: To discuss the goal and the measures that should be taken in the reform of Chinese medical and health system. METHODS: The changes of Chinese medical and health system were briefly reviewed and the current problems in which were analyzed, then the goals and the corresponding measures in the future medical and health system reform were put forward. RESULTS & CONCLUSION: The reform of Chinese medical and health system should in line with medical insurance reform and drug circulation system reform. The central financial expenditure system should be reformed by carrying out the principle of “common benefits” and eliminating differential treatment between city and countryside or among areas so as to implement equalization in medical and health service. The concerned departments should improve resource management system and optimize medical resources allocation. The government should strengthen the monitoring on medical and health service industry to facilitate its healthy development.
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Proceeding from the problems confronting hospitals, the paper first offers an analysis of the relationship between the coordination of the "three reforms" and the reform of the management system of public hospitals and then provides some views on the steps for the coordination of the "three reforms" including the reform of the management system of public hospitals, the breakthrough point of the issue in particular. The author holds that the breakthrough point of the coordination lies in reforming the mode of payment and the compensation mechanism of hospitals. The current method of payment by service items ought to be changed into the mode of total quantity control and payment by the amount of service so as to form a policy and operational environment wherein hospitals will seek substantial development on their own initiative. Under such an environment, hospitals can achieve maximum benefits only by minimizing the costs and the primary goals of the coordination of the "three reforms" can thus expect to be attained. On the basis of this, relevant models for the reform of the management system of public hospitals can be promoted. system; Public; Reform