Research on the motivation of young patients′ medical electronic word-of-mouth sharing on internet platforms / 中华医院管理杂志

Objective:To explore the facilitating and inhibitory factors influencing the behavior of young patients to share medical electronic word-of-mouth (eWOM) on internet platforms, so as to provide insights for the improvement of healthcare quality.Methods:In May 2022, 271 undergraduate students from universities in Zhejiang province were selected by convenient sampling to survey their motivations to share eWOM with a self-designed questionnaire. Multiple regression analysis was used to examine the impact of different motivational factors on the sharing intention of young patients.Results:Only 16 respondents (5.9%) had previously published medical eWOM. Egoistic motivation, altruistic motivation, medical experience, and comment habits were significant factors that promoted patients to share eWOM, with egoistic motivation ( β=0.212, P<0.001) having the greatest impact and comment habit ( β=0.139, P=0.003) having the least impact. Distrust, low self-efficacy and involvement, perceived reluctance, and perceived uselessness were significant factors inhibiting patients from publishing eWOM. Of them, distrust ( β=-0.161, P<0.001) and perceived reluctance ( β=-0.161, P=0.001) had the greatest impact, and low self-efficacy and involvement had the least impact ( β=-0.134, P=0.003). Conclusions:To enhance the positive attitude of young patients towards sharing eWOM, it is important to focus on their personal benefits and provide high-quality healthcare experiences. Building trust among patients in the platform is crucial, and efforts should be made to reduce operational barriers. Additionally, educating and raising awareness among young patients regarding the significance and influence of healthcare reviews is important.

Analysis of patients′preferences for medical treatment on an online medical platform from 2016 to 2020 / 中华医院管理杂志

Objective:To understand the preference of patients for online medical services, so as to improve the development of internet-based healthcare.Methods:The data came from the online medical cases and online medical orders of the Hao Daifu online platform from 2016 to 2020. The reasons for medical treatment, disease severity, consultation type, time of medical service, patient′s region, and the price of medical services were covered in such an analysis. Data were analyzed descriptively, and chi-square test or t-test was used for comparison between groups.Results:This study covered 41.228 6 million online medical cases and 26.683 2 million online medical orders. The diseases receiving online medical services were mainly common ones, and the distribution of disease severity in different years was statistically different( P<0.001); There was a significant difference in the distribution of inquiry forms of online medical orders in different years( P<0.001); Online medical service time was concentrated from 8: 00 to 22: 00 every day; The number of online medical visits per 10 000 population in the eastern region was significantly higher than that in the central and western regions( P<0.05); The price range of online medical treatment was concentrated in 1-100 yuan. Conclusions:In China, the types of online medical services were mainly common ones, and the medical service time and price range were relatively stable. The number of online medical services in the eastern region is higher than that in the central and western regions. In the future, the online medical platforms are expected to focus on online services for chronic diseases, improve the responsiveness of such services, establish a scientific doctor scheduling system, narrow the regional digital divide of such services, and optimize their rational pricing.

Analysis of " Internet plus healthcare" related policies in the eastern, central and western regions of China before and after the COVID-19 pandemic / 中华医院管理杂志

Objective:To analyze the commonalities and differences of " Internet plus healthcare" related policies in the eastern, central and western regions of China before and after the COVID-19 pandemic and to provide references for further improving China′s " Internet plus healthcare" policy.Methods:Collecting the policies of " Internet plus healthcare" promulgated by 31 provinces(autonomous regions, municipalities)in China from April 2018 to December 2020 on the websites of various government departments, extracting keywords based on content analysis methods, and calculating degree centralities using UCINET 6 software. A comparison of the policies of the eastern, central and western regions between the pre epidemic stage(April 2018 to December 2019)and the COVID-19 pandemic stage(January 2020 to December 2020)was carried out.Results:In the pre epidemic stage, Internet diagnosis and treatment, " Internet plus medical service price" and quality supervision were the focus of attention in all regions. But the eastern region paid more attention to the policy planning of Internet hospital operation and Internet medical application, the central region focused on the transformation and efficiency improvement of medical service process by Internet technology, and the western region paid more attention to encourage the application of telemedicine to solve the difficulty of seeing a doctor. In the pandemic stage, the " Internet plus service price" was the policy focus in all regions, mostly in medical insurance payment, and the policy difference was not obvious among the eastern, central and western regions.Conclusions:Before and after the COVID-19 pandemic, the policy of " Internet plus healthcare " promulgated by the local governments in eastern, central and western regions had different emphasis and different characteristics. Our suggestion was to improve the policy system, standardize industry supervision, strengthen information security, orderly interconnect medical insurance, and actively promote the exchange of policy experiences among the provinces.

Analysis of 5G enabling the whole medical service chain and key supporting factors / 中华医院管理杂志

5G technology featuring high speed rate, low delay, wide connection and other characteristics can optimize the whole-process medical service chain of " pre-, during-and after-medical services" and improve the efficiency of medical service. 5G optimize pre-medical services such as home-based health monitoring and pre-hospital emergency; 5G can optimize during-medical services such as remote diagnosis, remote consultation, remote ultrasound and remote surgery; 5G can optimize in-hospital medical monitoring, mobile medical care, and intelligent drug delivery and non-contact services. The improvement of perceived usefulness and ease of use of 5G enabling the whole medical service chain needs the support of several key elements: the integration of 5G medical service multiple technologies, the improvement of 5G technology itself and related technologies and the continuous promotion of 5G medical standardization. Only by promoting the deep integration of information technology and medical service, and providing patients with the whole process and intelligent services covering pre-, during-, and after-diagnosis, can the patient′s medical experience be further improved.

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 of the modernization path of contemporary hospital management system / 中华医院管理杂志

The modernization of contemporary hospital management system embodies such five aspects as clear-cut responsibilities, scientific management, reasonable governance, efficient operation and powerful supervision. The first calls for clarifying the powers and responsibilities within and beyond the hospital and those of its external " regulation and administration" . The second calls for check and balance in internal supervision, and the external supervision to extend from results supervision to that of medical service performance. The third calls for modernization of hospital governance system and governance capabilities. The fourth calls for explorations of both the rules of action to achieve hospital objectives in practice, and hospital management patterns in theory. The fifth calls for inner dynamism of efficient operations resulting from performance appraisal and remuneration system reform. Fundamentally, enhanced construction of the Party paves the way for enhancing modernization of such management system.

Synergy dilemma of healthcare alliances and trust-based countermeasures / 中华医院管理杂志

Synergy is key to the formation of a community of interests and responsibilities for a healthcare alliance.This paper analyzed the management synergy dilemma and countermeasures of the alliance, in such terms as its model selection, function orientation and governance;its two-way referral, drug interchange and homogeneity of medical quality;its human resource two-way flow, equipment resource sharing and information platforms unification;as well as its medical insurance policy, financial subsidy and personnel system.On such basis, countermeasures were proposed based on trust.

Capacity building pathways for primary healthcare in the hierarchical medical system / 中华医院管理杂志

Based on an analysis of the capacity bottleneck and boundaries of the valid delivery of primary healthcare service, the author proposed the capacity enhancement pathways for valid delivery of primary healthcare service. Such pathways refer to enhancing primary healthcare service by means of pairing assistance,medical consortiums and telemedicine;and motivating primary practitioners for higher capacity by means of performance appraisal and position management.

Third-party mediation mechanism for medical disputes in Ningbo City / 中华医院管理杂志

Ningbo City has established a third-party mediation mechanism for medical disputes,attempting to resolve medical disputes by a third party independent of doctors and patients in a fair manner.Such a third party refers to the people's mediation committees for medical disputes and medical disputes compensation centers at various levels.This mechanism features advantages more than one,and has its challenges to address as well.Tasks to perform include study of the existing laws and regulations on compensation,appropriate increase of present compensation level for medical damages,improvement of the medical responsibility insurance mechanism,clarification of the nature of the people's mediation committee,and promotions for an ideal social environment.

Ethical Reflection on Protecting the Neutrality of a Third-Party in Medical Dispute Mediation Mechanism / 中国医学伦理学

First,the neutrality of a third-party mediation in resolving medical disputes can not be automatically achieved.Ethically analyzed,the protection of the neutrality of a third-party mediation can be conducted from the following three steps,including going beyond the ethical error of personal emotional bias,following the ethical principles of avoidance principle,the adversarial principle,and openness mediation principle,and carrying out the countermeasures of being independent from administrative institutions,public media,conciliation officer independent of the intermediary,remote selection of mediators,mediation officers as security personnel disciplinary system for mediation,conciliation of officers with moderate barriers to the hospital.

Sensitivity Training-a Measure to Improve the Doctor-Patient Relationship / 中国医学伦理学

The sensitivity training is the training of interaction.After training,the medial personnel will be more considerate and thoughtful.They will sympathize with patients.This article illustrates what is sensitivity training,why we need it,and how to apply it.

Several Strategies on the Success of Mangerial Career in the Hospital / 中国医学伦理学

The medical staff wanting to acquire the success of managerial career in the hospital must master some basic strategies which means they should work well and keep the visibility and support superiorly and look for tutors and set up the interpersonal network and axquire the control of the hospital resources and understand the power structure of the hospital.

Crisis of SARS:the Chance of the Autopsy / 中国医学伦理学

SARS is the crisis rolling up the whole country. The crisis means, danger for us and disaster. But an enormous crisis also usually contains many new opportunities. As for us still very low in rate of autopsy, the variety of public motion of crisis of SARS for bringing is a big chance. We should comply with the surrounding the benefit leads, to publicize strongly the importance, necessity of the autopsy that conquer SARS, at the same time to publicize strongly the law guaranteeing perform of autopsy.