Study on the construction and countermeasure of health-centered integrated health care service system / 中华医院管理杂志

Building an integrated health care service system is key to the Healthy China strategy. Based on the integrated health care service conceptual framework, the authors took two pilots regions of health-centered medical alliances in Zhejiang province as an example, and analyzed their conception framework, organizational structure, operation elements and effects. The study found initial success of the two alliances in terms of the contents, capabilities, effects and satisfaction of primary health care service. Such alliances feature a health-centered multi-entity participation mechanism, carry out health care and prevention integration leveraging the information platform, hence conducive to the effective governance of the alliances. However, the contents of their health related services are expected to be broadened and deepened; functionalities of health-related institutions need to be clarified and refined, while their performance appraisal needs to be further improved.

Analysis on performance of primary medical service in Zhejiang′s county-level medical alliances from the perspective of supply and demand balance / 中华医院管理杂志

Objective:Based on the perspective of supply and demand balance, to analyze the implementation effects of primary-feature medical services measures in medical alliances.Methods:From July to September 2019, two regions with different levels of economic development were chosen, and from each region one leading hospital and two community health service centers/township hospitals were selected from its medical alliance. A total of 213 medical staff and 703 residents were surveyed, to learn their awareness and performance appraisal of these feature services.Frequency and proportion were calculated in a descriptive statistical analysis. The scores of the performance appraisal of both supply and demand sides were tested by independent sample t. Results:In the performance appraisal of such measures, the average scoring by medical staff was 4.39±0.07, and that by residents was 3.85±0.06; the residents were more concerned with service capabilities and contents, while medical staff were more concerned with service content and delivery mode; supply and demand sides were found with consensus in terms of improving the medical service quality of chronic diseases in primary level and service accessibility.Conclusions:The county-level medical alliances should focus on enhancing their capacity of primary medical services, and improving their primary service mode with the help of medical insurance institutions. Meanwhile, it is imperative to optimize the primary medical service policy in view of supply and demand balance.

Equity of outpatient service utilization for hypertensive patients in community / 中南大学学报(医学版)

To analyze the equity of outpatient service utilization for hypertensive patients (HPs) under 3 kinds of social medical insurance, and to explore its influential factors.
 Methods: A total of 8 670 HPs (aged at 15 years old from 28 sub-centers) in 14 provinces were selected. Indirectly standardized method and concentration index were used to analyze the equity of outpatient utilization in HPs, and decomposition analysis was used to explore the impact factors of outpatient treatment among the whole sample population, population with urban employees' basic medical insurance (UEBMI), and population with urban residents' basic medical insurance (URBMI) and new rural cooperative medical systems (NCMS).
 Results: The overall concentration index (CI) for the whole sample population was 0.2378. After the standardizing "need" variable, horizontal inequity (HI) was 0.2360, indicating that the outpatient service of HPs was inequity and that the higher economic level, the more outpatient services received. The decomposition of overall CI results showed that the positive factors for contribution were gross domestic product (GDP) level, retired, UEBMI and URBMI, and the negative factors for contribution were NCMS. The CI of UEBMI, URBMI and NCMS was 0.2017, 0.1208 and 0.0288, respectively; the HI was 0.1889, 0.1215 and 0.0219, respectively. The inequity in UEBMI is the most serious, followed by NRCMS and URBMI. The economic level was the main factor that caused inequity in the outpatient services utilization in three social medical insurance. In addition to the economic level, a common positive factor for the contribution to UEBMI and URBMI was district of residence, and the age was the positive factor to UEBMI as well.
 Conclusion: There are different levels of inequity in the HPs covered by 3 kinds of social medical insurance, and the inequity of UEBMI is the highest one among 3 kinds social medical insurance. The economic level is the main factor that affects the equity of outpatient in the HPs under 3 kinds of social medical insurance.

Discussion of the Practical Significance and Path of the Cultivation of Humanistic Quality of Medical Staff / 中国医院管理

The paper expounds the practical significance of the humanistic quality of medical staff,and probes into the cultivation path according to the problems existing in the humanistic quality of medical staff,aimed at promoting the new health care reform orientation,in order to better practice the modern biological-psychological-social medical model,and to provide a useful reference for constructing harmonious doctor-patient relationship.

Influential factors of treatment cost of antihypertensive drugs for hypertensive patient in community / 中南大学学报(医学版)

OBJECTIVE@#To explore the influential factors of treatment cost of antihypertensive drugs for hypertensive patient in community.@*METHODS@#A total of 220 community health centers (CHCs) from 15 provinces were selected across China in view of geographical location, economic level and previous cooperative experience to implement standardized blood pressure management for hypertensive patients for 1 year, based on guidelines for prevention and control for hypertension in China (2009 Community-based revision). Baseline and follow-up information for each hypertensive patient under the care of these CHCs was collected. A total of 22 683 hypertensive patients in hypertension community standardization management were enrolled in this study. We used multivariate linear regression model to analyze the influential factors of treatment cost of antihypertensive drugs.@*RESULTS@#Cultural degree, regional distribution, medical security system, the blood pressure classification, complications, and treatment options were statistically significant independent variables.@*CONCLUSION@#In hypertension community standardization management, the blood pressure of hypertensive patients should be controlled in advance to reduce the economic burden, , the occurrence of complications should be reduced, and economic factors should also be considered when selecting a treatment option.

Efficiency characteristics and changes of county hospitals / 中国卫生政策研究

Objectives:To study efficiency characteristics and changes of county hospitals based on data envel-opment analysis model from 2008 to 2012 . Methods:A three-stage DEA model which can exclude the external envi-ronment variable on its efficiency is also added along with the C2 R and BC2-DEA traditional model. Results: From 2008 to 2012, the technical efficiency value was ranging between 0. 723 and 0. 681 in county hospitals, the pure technical efficiency was 0 . 785~0 . 771 and the scale efficiency value scaled between 0 . 908 and 0 . 897 . These values showed a low efficiency, but had annually improved. This reflects that the new health care reform policies have played an important role in improving county hospitals efficiency. Development of medical service ability is behind the development of hospital scale. How to improve the service and management capabilities has gradually become a major direction to improve the county hospital efficiency.

Evidence-based Policy Study of National Heath Budget Mode in Some Countries / 中国卫生经济

From the perspective of government health budget management system, health budget decision-making and health budget reform, to make a systematic introduction of government health budget reform’s characteristics, measurement and related experiences in some countries, especially Organization for Economic Cooperation and Development(OECD) countries, so as to provide references for the improvement of government health budget management in China.

On Medical Cultural Quality and Its Thought of Education / 中华医学教育探索杂志

s Medicine is a kind of culture. The ideal settlement of practical medical problems must be built on medical cultural platform. The higher demand of modern medical practice to the talents is to cultivate their medical cultural quality. The medical cultural quality and its education is regular. Therefore, only by integrating medical humanistic education into medical cultural education can the medical humanistic education come into being and be enforced.