Discussion on the legal attributes of provincial Chinese herbal pieces processing norms / 中国药房

OBJECTIVE To provide a reference for the definition of the legal attributes of the provincial Chinese herbal pieces processing norms and the improvement of legal expression for the drug standards in Drug Administration Law. METHODS Based on the legal evolution of local drug standards in China， the composition of national drug standards for Chinese herbal pieces and the composition of current provincial Chinese herbal pieces processing norms were analyzed； at the same time， based on the method of legal interpretation， the legal connotation of the provincial Chinese herbal medicine processing norms in Drug Administration Law was investigated. RESULTS & CONCLUSIONS In the practice of drug supervision， the provincial Chinese herbal pieces processing norms are essentially local drug standards. The newly revised Drug Administration Law defines the drug standards specifically， but does not stipulate the legal attribute of drug standards for the provincial Chinese herbal pieces processing norms， and there are certain legislative technical defects. It is suggested that when amending the Drug Administration Law， the legal attributes of the drug standards of the provincial Chinese herbal medicine processing norms should be clarified.

Hospital Civil de Santiago de Cuba: una historia de cambios, dificultades y realizaciones / Civil Hospital of Santiago de Cuba: a history of changes, difficulties and realizations i: en

El Hospital Civil de Santiago de Cuba fue fundado en 1863 y, desde entonces, se ha mantenido prestando asistencia a pacientes de esta provincia y de toda la región oriental. En 1960 fue trasladado a su sede actual y se convirtió en pilar fundamental del inicio de la docencia médica superior para todo el oriente de Cuba. Es mencionado en varios textos desde el siglo XIX, mas se desconoce su creación y trayectoria. En ese sentido, luego de una revisión exhaustiva de documentos y periódicos de la época, se realizó el presente artículo con el objetivo de describir la evolución de este centro y los contextos históricos fundamentales.

The Civil Hospital of Santiago de Cuba was founded in 1863 and, since that time, it has given assistance to patients of this province and of all east region. In 1960 it was transferred to the current head office and became fundamental column in the beginning of higher medical teaching for the whole east of Cuba. It is mentioned in several texts from the XIX century, but its creation and trajectory is not known. In that sense, after an exhaustive review of documents and newspapers of that time, the present work was carried out aimed at describing the evolution of this center and the fundamental historical contexts.

Analysis of Formulation and Characteristics of Provincial Standards for Traditional Chinese Medicine Dispensing Granules / 中国实验方剂学杂志

In order to standardize the quality control of traditional Chinese medicine（TCM） dispensing granules， the Chinese Pharmacopoeia Commission has promulgated and implemented 200 national drug standards for TCM dispensing granules， but there are still varieties of TCM dispensing granules without unified standards. Many provinces have actively invested in the formulation of provincial standards for TCM dispensing granules to make up for the gaps in standards for varieties of traditional Chinese medicine dispensing granules other than the national standards. By the end of July 2022， 29 provincial-level administrative regions have successively promulgated and implemented a total of 5 602 provincial standards for TCM dispensing granules， involving more than 400 varieties. In order to better understand the formulation and characteristics of provincial standards， this study took 105 provincial standards that have been promulgated and implemented in Henan province as an example， and comprehensively analyzed the formulation and characteristics through quality control indicators such as dry extract rate of raw materials， contents of index components and their transfer rates， specifications and so on. The formulation and characteristics of the same TCM dispensing granules in the provincial standards of different provinces were further analyzed， in order to provide reference for the formulation of provincial standards of TCM dispensing granules and the implementation of national standards.

Clasificando mujeres: diagnósticos psiquiátricos y subjetividad femenina en el Manicomio Provincial de Málaga, España, 1909-1950 / Classifying the women: psychiatric diagnoses and female subjectivity in the Manicomio Provincial de Málaga, Spain, 1909-1950

Resumen Las historias clínicas de manicomios de mujeres permiten ahondar en la brecha que se abre entre la ilusión positivista de la psiquiatría durante la primera mitad del siglo XX en España y la vivencia subjetiva del internamiento psiquiátrico de las mujeres-locas doblemente subalternas. Las clasificaciones diagnósticas fueron claves en este intento de positivización. El objetivo de este trabajo es señalar qué elementos subjetivantes participaron en la aplicación de diagnósticos como esquizofrenia, psicopatía y oligofrenia en la sala de mujeres del Manicomio Provincial de Málaga, y mostrar cómo el ideal hegemónico de feminidad estableció un límite permeable entre la cordura y la locura de las mujeres, entre asimilaciones y resistencias.

Abstract The clinical histories of women's asylums allow us to deepen the gap between the positivist illusion of psychiatry during the first half of the 20th century in Spain and the subjective experience of the psychiatric internment of doubly subaltern crazy women. Diagnostic classifications were key in this attempt at positivization. This paper aims to point out which subjectifying elements participated in the application of diagnoses such as schizophrenia, psychopathy, and oligophrenia in the women's wards of the Manicomio Provincial de Málaga, and to show how the hegemonic ideal of femininity established a permeable limit between sanity and madness of women, between assimilations and resistances.

The effect of national tertiary public hospital performance assessment on the functional orientation of provincial public hospitals / 中华医院管理杂志

Objective:To analyze the impact of the national tertiary public hospital performance assessment(hereinafter referred to as the national examination) on the functional orientation of the provincial public hospitals in Zhejiang province, for reference to improve the allocation of provincial medical resources and high-quality development of public hospitals.Methods:The data came from the hospital financial data of 17 provincial tertiary public hospitals in Zhejiang province from 2012 to 2021 and the DRG quality performance analysis report of the tertiary hospitals in Zhejiang province from 2020 to 2021. The information of the number of employees and actual number of beds at the end of the period, etc., were extracted to analyze the overall operation of the hospital. The ratio of outpatient times to discharged times and the proportion of discharged patients undergoing surgery, as well as the proportion of discharged patients′ day surgery and level-4 surgery in hospital and in province were took as evaluation indicators to analyze the functional positioning of tertiary public hospitals.Results:Compared with 2012 to 2018, the average number of employees at the end of the period and actual number of beds in 17 hospitals from 2019 to 2021 increased by 761 and 303 respectively, and the average number of hospitalization days decreased by 2.26 days. The average ratio of outpatient times to discharged times in the hospital decreased from 175.76 in 2012 to 67.51 in 2021. The average proportion of discharged patients undergoing surgery in general hospitals increased from 0.39 in 2012 to 0.46 in 2021, and that in non-general hospitals decreased from 0.67 to 0.43. The average proportion of discharged patients undergoing day surgery in hospital and in province increased from 0.20 and 0.03 in 2020 to 0.23 and 0.04 in 2021 respectively, and the average proportion of discharged patients undergoing level-4 surgery in province increased from 0.04 to 0.05.Conclusions:The national examination could be conducive to strengthening the functional orientation of public hospitals. After the national examination, the ratio of outpatient times to discharged times in the provincial tertiary public hospitals in Zhejiang province had declined as a whole, the proportion of discharged patients in general hospitals had increased, but the proportion of level-4 surgery in hospitals needs to be further improved. The author suggested that we should continue to strengthen the operation mechanism of functional positioning of provincial public hospitals, improve the service capacity of hospitals for difficult and critical diseases, and improve the performance evaluation system of tertiary public hospitals.

Bibliometric and visual analysis of Chinese-language scholarly journal papers published by China provincial centers for disease control and prevention from 2011 to 2020：based on CSCD data / 环境与职业医学

Background By analyzing the publication of scientific and technological papers of the provincial centers for disease control and prevention (CDCs) in China, we can understand their scientific research strength, dominant disciplines, research hotspots, and talent development, which is conducive for further optimizing the scientific research construction of the disease control system. Objective To conduct a bibliometric analysis and draw a visual map of the Chinese Science Citation Database (CSCD) sourced papers published by 31 provincial CDCs in China from 2011 to 2020, to understand the scientific research status of China's provincial CDC system in the past ten years. Methods In April 2021, China National Knowledge Infrastructure was used to retrieve CSCD sourced papers published by 31 provincial CDCs (excluding Taiwan Province, Hong Kong and Macau Special Administrative Regions) in China as the primary unit from 2011 to 2020, and finally 5231 CSCD papers were included. Bibliometric analysis indicators include number of CSCD papers published and financial support rate, proportion of CSCD papers to total Chinese papers, distribution of CSCD papers published in high-volume journals, and number of papers for a specific CDC that their first authors affiliated with. Citespace 5.8.R1 software was used to draw author's cooperation network map, keyword co-occurrence map, keyword clustering information table, and keyword emergence map. Results The number of CSCD papers published every year showed a stationary trend, and the total funding rate was 61%, showing an year-by-year upward trend (increased from 49.3% in 2011 to 68.7% in 2020). Jiangsu Province, Fujian Province, and Beijing CDCs ranked the top three in the total number of CSCD papers contributed by a specific CDC. The Chinese Journal of Epidemiology, Chinese Journal of Public Health, Chinese Journal of Zoonoses, Chinese Journal of Preventive Medicine, and Chinese Journal of Endemic Diseases were the top five high-volume journals. The top three authors of CSCD papers (counted as co-authors) were Xu Bianli of Henan Provincial Center for Disease Control and Prevention (110 papers), Yan Yansheng of Fujian Provincial Center for Disease Control and Prevention (72 papers), and Wang Quanyi of Beijing Center for Disease Prevention and Control (71 papers), and they studied the epidemiology of parasitic diseases and infectious diseases, the prevention and treatment of natural epidemic diseases and AIDS, and the epidemiology of infectious diseases, respectively. The keyword co-occurrence map showed that AIDS, zoonotic diseases, hand-foot-mouth disease, etc. (frequency ≥90) were the key research directions of provincial CDCs in the past ten years. The keyword clustering categories were closely related, although there were subtle differences, the topics focused on virus and chronic disease research. The keyword emergence results suggested that the frontiers of research had gradually shifted from infectious diseases such as enterovirus, hantavirus, and Zika virus to food-borne diseases and chronic non-communicable diseases such as tumors and senile diseases over time. Conclusion The number of papers issued by the provincial CDCs in China in the past ten years has shown an overall steady and rising trend. The leading themes of researchers and institutions are infectious diseases, parasitic diseases, etc., while food-borne diseases and elderly diseases are the hot frontiers.

A preliminary study on the system construction for evaluating the professional capability of provincial radiological health institutions / 中华放射医学与防护杂志

Objective:To construct a system for evaluating the professional capability of provincial radiological health institutions.Methods:Based on the Donabedian model and the main professional responsibilities of provincial radiological health institutions, the logical framework and indicator database of the capability evaluation system were initially constructed, the Delphi expert consultation method and analytic hierarchy process were further used to determine each indicator and its weight. The self-assessment test was carried out throughout the provincial radiological health institutions by using the system established in this study.Results:The evaluation system included 3 primary-class indicators, 11 second-class indicators, 30 third-class indicators and 76 fourth-class indicators. Taking 100 points as the full score, the self-assessment scores of the 29 provincial institutions ranged from 28.7 to 97.7 with an average of 78.7, and the scores conform to the normal distribution.Conclusions:The system established in this study are scientific, comprehensive and operable, which can be used as an effective tool to evaluate the professional capability of provincial radiological health institutions.

A content analysis of the provincial laws and regulations for voluntary blood donation / 中国输血杂志

【Objective】 To perform quantitative analysis on the sample provincial laws and regulations for voluntary blood donation, and provide reference for further revision of laws and regulations. 【Methods】 31 study samples were current provincial laws and regulations for voluntary blood donation that can be collected from open sources. The issue date and the revision date of each sample were recorded. With "The Blood Donation Law of the People’s Republic of China" as reference, 5 categories were formed and additional clauses in samples were coded and rated following content analysis procedures. Sample provinces were divided into two groups based on donation rate and their differences in evaluation scores of categories were examined using rank sum test. 【Results】 Until December, 2021, 31 sample provinces had issued and implemented provincial laws and regulation for voluntary blood donation, and 14 of which had been revised. Many detailed clauses (total score 9.32±3.09) were added in sample provincial laws and regulations, more clauses were added in the categories of 'related government agencies and their responsibilities’, 'management of clinical blood use’ and 'rewards and punishment’. Sample provinces were divided into two groups according to the donation rate per 1 000 people recommended by World Health Organization(10‰). Compared to lower donation rate group, the total score and sub score in the categories of 'basic principles’, 'management of blood collection and supply’ were significantly higher in higher donation rate group. 【Conclusion】 In revision and improvement of provincial laws and regulations, 'basic principles’ and 'management of blood collection and supply’ could be considered. This assay mainly tries to provide a new research perspective and perform quantitative analysis on content of sample provincial laws and regulation for voluntary blood donation, the actual effect of the results in this study need longer time to be examined, and we will keep following its new advances.

Plan Provincial Integral de salud mental: hacia un sistema solidario e integrado de salud 2022-2027 / Comprehensive Provincial Mental Health Plan: towards a supportive and integrated health system

La integración del sistema de salud de la Provincia de Buenos Aires implica, entre muchas otras cosas, la firme decisión de la integración de la salud mental a la salud en lo que hace a su definición política, comprensión problemática y organización de respuestas frente a las demandas y necesidades. No hay salud sin salud mental, y no es una frase vacía. El Plan Provincial de Salud Mental condensa la decisión y el compromiso del Ministerio de Salud para cuidar la salud mental de nuestra población, conociendo que las formas de sufrimiento y padecimiento mental, entendidas desde su determinación social, obstaculizan la vida de las personas y su necesario aporte a una sociedad inclusiva. Representa a su vez un hito histórico, por ser la primera vez que una gestión provincial elabora un documento de estas características, en donde se plasma la voluntad política de transformar el modelo de atención en salud mental. El plan pretende ser un instrumento que formalice, desencadene y estructure procesos de trabajo colectivos, que requerirán de la participación del conjunto de actores, que en vinculación puedan garantizar más salud y más comunidad. Este Plan ha sido construido receptando un conjunto de necesidades, demandas y vacancias históricas de la política pública. Ha sido producto del diálogo e intercambio con el conjunto de actores que componen el campo de la salud mental. Refleja principios, valores y formas de concebir a la salud mental y, a la vez, convoca a otros actores a sumarse a la tarea de garantizar una atención en salud mental y consumos problemáticos digna y de calidad para los y las bonaerenses.

The integration of the health system of the Province of Buenos Aires implies, among many other things, the firm decision to integrate mental health into health in terms of its political definition, problematic understanding and organization of responses to the demands and needs. There is no health without mental health, and it is not an empty phrase. The Provincial Mental Health Plan condenses the decision and commitment of the Ministry of Health to take care of the mental health of our population, knowing that the forms of suffering and mental illness, understood from its social determination, hinder the lives of people and their necessary contribution to an inclusive society. It also represents a historical milestone, as it is the first time that a provincial administration has prepared a document of these characteristics, where the political will to transform the mental health care model is reflected. The plan intends to be an instrument that formalizes, triggers and structures collective work processes, which will require the participation of all the actors, who in connection can guarantee more health and more community. This Plan has been built by accepting a set of historical needs, demands and vacancies in public policy. It has been the product of dialogue and exchange with the group of actors that make up the field of mental health. It reflects principles, values ​​and ways of conceiving mental health and, at the same time, summons other actors to join in the task of guaranteeing decent and quality mental health care and problematic consumption for the people of Buenos Aires.

A integração do sistema de saúde da Província de Buenos Aires implica, entre muitas outras coisas, a firme decisão de integrar a saúde mental à saúde em sua definição política, compreensão problemática e organização das respostas às demandas e necessidades. Não há saúde sem saúde mental, e não é uma frase vazia. O Plano Provincial de Saúde Mental condensa a decisão e o compromisso do Ministério da Saúde em cuidar da saúde mental de nossa população, sabendo que as formas de sofrimento e doença mental, compreendidas a partir de sua determinação social, dificultam a vida das pessoas e suas necessidades contribuição para uma sociedade inclusiva. Também representa um marco histórico, pois é a primeira vez que uma administração provincial elabora um documento com essas características, onde se reflete a vontade política de transformar o modelo de atenção à saúde mental. O plano pretende ser um instrumento que formalize, acione e estruture processos de trabalho coletivo, que exigirão a participação de todos os atores, que em conexão podem garantir mais saúde e mais comunidade. Este Plano foi construído acolhendo um conjunto histórico de necessidades, demandas e vagas nas políticas públicas. Tem sido produto do diálogo e da troca com o conjunto de atores que compõem o campo da saúde mental. Reflete princípios, valores e formas de conceber a saúde mental e, ao mesmo tempo, convoca outros atores a se unirem na tarefa de garantir cuidados de saúde mental dignos e de qualidade e consumo problemático para os portenhos.

Study on the construction status and countermeasures of Shandong Provincial Clinical Research Center / 中华医学科研管理杂志

Objective:By analyzing the development purpose and goals, status quo and achievements, characteristics, and problems identified of Shandong Provincial Clinical Research Center, tailored measurements and suggestions are put forward in this paper, to serve for better development of Shandong Provincial Clinical Research Center, and construct a more efficient clinical research transformation platform.Methods:Carrying out statistical analysis of the annual reports of the first two batches of 12 Shandong Provincial Clinical Research Centers to identify similarities and uniqueness; Benchmarking with the construction goals of Shandong Provincial Clinical Research Centers to figure out achievements and space for improvement; SWOT analysis was conducted to analyze opportunities and challenges, and experiences were summarized.Results:After two years’ construction, the centers have remarkable achievement by facilitating resources, establishing research platforms, and setting up collaborative research networks. However, common problems are still existed, such as: weak innovation foundation, insufficient attention from supporting institutions, lacking of compound talents in clinical research, peak discipline should be developed at provincial centers to promote the capacity building, and the ability to promote innovation at local level also needs to be improved.Conclusions:The construction of Shandong Provincial Clinical Research Center is facing a great deal of opportunities and challenges. By boosting attention of the supporting institution, enhancing continuing investment, implementing annual evaluation system, guiding the outstanding provincial centers to apply for national centers, and strengthening the achievement transfer and promotion, the construction of the provincial centers will be improved, and further enhance the clinical research capacity at provincial level.

Analyses on horizontal scientific research projects from 2015 to 2019 by provincial Center for Disease Control and Prevention in China / 中华医学科研管理杂志

Objective:To analyze the horizontal scientific research projects from 2015 to 2019 by the provincial Centers for Disease Control and Prevention (CDC) in China, and to compare the regional differences, in order to provide the suggestion on the scientific management of CDC.Methods:The horizontal scientific research projects from 2015 to 2019 were retrospectively analyzed by questionnaire survey. Multiple linear regression models were adopted to examine the trend, and variance analyses were used to test the differences in horizontal scientific research projects among the Eastern, Central, and Western regions.Results:From 2015 to 2019, provincial CDC have received RMB 124.3 million of horizontal scientific research project funds totally, of which 51.9% were funded by enterprises, and 86.9% were undertaken by provincial CDC themselves. There were no statistical significance in the change of research project funds obtained by provincial CDC ( F=0.46, P = 0.764) during this period.The number of horizontal scientific research projects undertook or participated by provincial CDC in the Eastern region were more than that of the Central and Western region ( F = 5.85, P = 0.004; F = 5.03, P = 0.008). Conclusions:The horizontal scientific research projects obtained by the provincial CDC remained stable in recent years while distribution was unbalanced in the region areas. It is suggested to innovate the management mode of scientific research projects with strengthening the trans-agency, trans-department and trans-regional cooperation.

Practice and exploration on the talents working mechanism of " provincial hospital recruit staff and county hospital get experts" / 中华医院管理杂志

In the context of the construction of " double sinking and double upgrading" in Zhejiang province, a provincial hospital explored a pilot talent working mechanism of " provincial hospital recruit staff and county hospital get experts" in the process of cooperating with county hospitals. In view of the problem that high-quality medical human resources were difficult to sink, with the flexibility of the reform of post filing and staffing, we put forward the idea of " provincial hospital recruit staff and county hospital get experts" , established key support disciplines, recruited staff by provincial hospitals, and arranged experts to precisely " sink as needed" to help disciplines of county hospitals. It helped to explore the establishment of a long-term mechanism to promote the flow of excellent medical talents to remote mountain areas, built a " specialized community" of provincial and county hospitals, and improved the medical service capacity, medical quality and discipline construction of county hospitals.

CHINA PH ARMACY Volume 33，Number 16，August 30，2022 Semimonthly Table of Contents Analysis of trans-provincia l distribution supervisio n of TCM decoction pieces in accordance with provincial standards from the perspective of benefit and risk / 中国药房

OBJECTIVE To provide ideas for solving the dispute of trans-provincial distribution of traditional Chinese medicine （TCM） decoction pieces in accordance with provincial standards （hereinafter referred to as “local TCM decoction pieces”）. METHODS Through simulation scenarios and collecting actual cases ，the conditions of trans-provincial distribution of local TCM decoction pieces were listed ；the official websites were searched or relevant personnel of drug supervision were interviewed；the current situation of trans-provincial distribution supervision of local TCM decoction pieces in China were sorted out. Based on the stakeholder theory ，the benefits and risks of main stakeholders were discussed to put forward relevant suggestions from the perspective of benefit /risk balance. RESULTS & CONCLUSIONS The conditions of trans-provincial distribution of local TCM decoction pieces in China included enterprises in B province produced TCM decoction pieces according to the A provincial standards，sold and used them in A province ；enterprises in B province produced TCM decoction pieces according to the B provincial standards ，sold and used them in A province ；enterprises in B province produced TCM decoction pieces according to the C provincial standards ，sold and used them in A province. At present ，there are no clear relevant provisions of national laws about trans-provincial distribution supervision of local TCM decoction pieces. Local regulatory opinions mainly come from the reply of the official website of drug regulatory department to online consultation ，and only Shandong ，Shanghai，Liaoning and Jiangxi have issued replies or normative documents. Totally 41.9％，38.7％ and 32.3％ of the provinces respectively allow the trans-provincial distrbution of local TCM decoction pieces in the above 3 conditions；in addition ，32.3％，16.1％ and 22.6％ provinces have unclear regulatory attitudes towards the 3 conditions. The benefits and risks analysis of relevant stakeholders shows that it is more in line with the scientific regulatory concept of benefit/risk balance to conditionally allow trans-provincial distribution of local TCM decoction pieces ，but the regulatory effect depends on the scientificity of the regulatory strategy. It is suggested that the drug regulatory departments clarify the relationship between the national and local standards for TCM decoction pieces and dingrl375@163.com differentiate the varieties of collection ；clear the regulatory requirements for trans-provincial distribution of local TCM decoction pieces by issuing high-level legal d ocuments；enrich regulatory measures and means ，and gradually adjust the requirements of trans-provincial distribution of local TCM decoction pieces .

Provincial differentials of the effect of internal migration on teenage fertility in South Africa

This study investigated the association between internal migration and teenage fertility in South Africa. Data were from the 2007 and 2016 South African community surveys, N2007= 89800 and N2016=239733, age range 12 to 19, black teenagers= 81.5% and 89.4%, respectively. Results showed that between 2007 and 2016 internal migration levels decreased by 2% nationally, but increased for Gauteng, Western Cape and KwaZulu Natal provinces. Teenage fertility levels decreased in all provinces except the Northern Cape in the study period. In both years teenage fertility was observed at higher levels among girls that were older, heads of households, and who were in secondary schooling. Random-intercept multilevel binary logistic regression revealed that the risk of teenage fertility differed between more rural and urban provinces. In provinces that were predominantly rural the risk of teenage pregnancy increased as community-levels of internal migration increased while the risk decreased as internal migration increased in provinces that were predominantly urban. Findings suggest that the effects of internal migration on teenage pregnancy are largely dependent on the local context making it necessary to create interventions that are context-specific at sub-national levels.

Analysis on the filing mechanism for cross provincial immediate reimbursement of medical insurance in China / 中华医院管理杂志

Objective:To analyze the filing mechanism for cross provincial immediate reimbursement of medical insurance in China, so as to provide reference for optimizing the filing mechanism and improving the filing accessibility of insured personnel.Methods:Taking the filing policy of cross provincial immediate reimbursement of medical insurance in 2019 as the research object, on the basis of a comprehensive understanding of the national filing policy background, 90 coordinating regions in Zhejiang Province, Hubei Province and Ningxia Hui Autonomous Region were taken as survey samples to evaluate the relevant policies and extract key parameters, including filing identification methods, filing-related settlement benefits and filing ways. The parameters were compared and analyzed by using descriptive statistical methods.Results:The results of the survey showed that in terms of identity recognition methods, the provision of various supporting materials(residence permit, work certificate, etc.)was still the main way to carry out identity recognition for medical insured persons in different places.Filing-related reimbursement benefits were mainly adjusted by limiting the area of medical insurance treatment and adjusting the benefits parameters(reimbursement ratio). In terms of filing channels, 51(56.7%)sample co-ordination areas had realized at least one remote filing mode.Conclusions:The inclusiveness of filing identity verification mechanism for the floating population needs to be further improved, the filing-related treatment policies need to be further improved, and the convenience and standardization of filing channels need to be strengthened.

Status and analysis of the capabilities of the provincial level radiological health technical institutions in China from 2014 to 2018 / 中国辐射卫生

Objective To fully grasp the professional technical capabilities of provincial level radiological health technical institutions, and so as to provide the basis for giving full play to the role of provincial level radiological health technical institutions, exploring and planning the development direction of radiological health technical institutions in China. Methods From September to December, 2019, National Institute for Radiological Protection, China CDC issued questionnaires to 37 provincial level radiological health technical institutions. The basic situation of department setting, number and composition of professional and technical personnel, equipment and radiological health work of the institutions that undertake radiological health related responsibilities were investigated, summarized and analyzed. Results Thirty-seven provincial level institutions participated in this survey, including 24 centers for Disease Control and Prevention, 11 institutions for Occupational Disease Control and Prevention, and 2 other institutions related to radiological health.Most of the institutions were qualified for radiological health related testing or evaluation; Thirty institutions had set up independent radiological health departments. There were 627 people engaged in radiological health professional and technical work, 83.4% of whom were officially on the staffs, and 16.6% are contract staffs.The distribution of gender, age, qualifications, professional title and working years in the radiological health was relatively reasonable, but only 25.8% of the staffs had the radiological education background. From 2014 to 2018, the number of radiological health professional and technical personals inflows and outflows was 164 and 65, respectively. Each institution undertakes 14.6 radiological health responsibilities in average. The annual workload of provincial level institutions was large, but there were relatively few laboratories and instruments for radionuclide measurement and internal radiation measurement. Conclusion The provincial level radiological health technical institutions still need to strengthen the capability building and make up the short board, play the leading and guiding role in provincial regions, so as to promote the further development of the national radiological health work.

Evaluation of Measles Surveillance System in Provincial Health Office, East Java, Indonesia

@#Introduction: Measles is one of the infectious diseases which is very easy to spread and can even cause death. There are frequent outbreaks of measles in East Java province, Indonesia. Therefore, this study was conducted to evaluate case-based measles surveillance system (CBMS) in Provincial Health Office, East Java, Indonesia. Methods: This study was conducted on October 21, 2018 to November 17, 2018. To obtain data and information systems related to the implementation of measles surveillance system at East Java Provincial Health Office, an interview was undertaken to surveillance officers and study documents originating from the 2014-2017 of Provincial Health Service Annual Report, and CBMS performance reports and Regency/City Laboratory Results in 2018 (per 1st May 2018) were used. The goal of this research was to evaluate the measles surveillance system at Provincial Health office, East Java, Indonesia by comparing the indicators and attributes of surveillance to Technical Guide for Measles Surveillance 2012. Results: The study showed that there were still several weaknesses related to Human Resources (HR) in terms of quantity. There was a low flexibility attribute especially the implementation of CBMS was constrained due to limited stock of reagents and inadequate specimens. Simplicity, data quality, acceptability, Positive Predictive Value (PPV), and timelines were relatively low. Conclusion: The current issues were on HR due to low quantity and understanding about good measles surveillance among officers. Poor allocation of funds for training and supporting infrastructure especially for the reagents and procurement of bulletins might possessed additional effect.

Economical operating and technical efficiency of provincial hospitals in Zhejiang: based on Stochastic frontier analysis / 中华医院管理杂志

Objective To analyze the economical operation and technical efficiency of Zhejiang provincial hospitals, and give references for deepening public hospitals reform.Methods We compiled data from 17 provincial public hospitals from 2013 to 2017 in Zhejiang, then used descriptive analysis to study hospitals′operating performance, and used stochastic frontier analysis( SFA) to analyze hospitals′ technical efficiency.Results From 2013 to 2017, the 17 provincial hospitals′ annual growth rate of outpatients and discharges were 5.2% and 9.5% , the number of outpatients and discharges at the general hospitals were 1.8 times and 2.5 times of those in specialized hospitals respectively.In these hospitals, service efficiency had been improved, and the income structure had become more reasonable.However, internal and external factors of the hospitals lowered technical inefficiency in their economic operation. Conclusions The economic operation mechanism of provincial hospitals should be further strengthened, and their external environment be improved as well.Only in this way can the hospitals achieve their operational goal of " doing the right thing and in the right way".

Analysis and Discussion on Quality Standard of TCM Preparation in Guangdong Provincial Medical Institution Preparation Specification / 中国药房

OBJECTIVE： To provide reference for perfecting the quality standard revision of TCM preparations in medical institutions， and improving the quality standard of TCM preparations in medical institutions. METHODS： By sorting out the quality standards of TCM preparations in Guangdong provincial medical institution preparation specification， this paper summarized the main problems and put forward suggestions for improvement. RESULTS & CONCLUSIONS： There are 897 kinds of TCM preparations included in the Guangdong provincial medical institution preparation specification. The recent quality standards （2017 edition） have been greatly improved compared with those of the first edition （1985 edition）； however， there are still some problems in the overall quality control of preparations， quantitative control of indicative components， project specificity， source control of medicinal materials， control of medicinal materials not included in the Chinese Pharmacopoeia and quality standards of the same series of varieties. It is suggested that on the premise of considering both advancement and applicability， the quality control of the whole， local and toxic preparations of TCM hospitals should be strengthened， the detection methods with good specificity and reproducibility should be properly updated， the control of key parameters of production process should be strengthened， the quality standard of TCM preparations in medical institutions should be fully improved， so as to provide the products with safe， effective and controllable in quality products in medical institutions.

Experience and reference to China's trans-provincial healthcare from European cross-border healthcare management / 中国卫生政策研究

With the development of integration process, how to manage citizens' cross-border healthcare be-tween member countries in an organized way has become a major agenda for European Union (EU). Through great efforts over years,a well-functioning mechanism has been established by EU's social health insurance and has been of global interest. It's believed that China's trans-provincial healthcare management can learn a lot from this mechanism. This study aims to provide experiences and reference to China's trans-provincial healthcare management by overview EU's mechanism for cross-border healthcare and then analyzing the differences between China and European Union in terms of object of management,authorization,service institutions,types of healthcare services,and reimbursement of medical insurance in different places. This study suggests that it's necessary for each province to officially introduce relevant policies in order to speed up and facilitate the establishment of trans-provincial healthcare management mech-anism. Moreover,to achieve orderly seeking medical treatment, health insurance agencies should be endowed with approval power to authorize patient trans-provincial application. Meanwhile, the network of health institutions which are entitled to provide services to trans-provincial patients should be expanded. Along with such expansion,and given the lack of understanding on behaviors of health institutions in different provinces for a specific local health insurance agency,it's required that national trans-provincial healthcare management system should take an active role in putting such health institutions under supervision.