How Can China's New Health Care Reform Promote the Balance of Interest Game?-Based on Game Evolution and Simulation Analysis.

Purpose: The new round of medical reform is a significant exploration of reform in the public service sector in China. Health insurance regulatory departments, medical institutions, and patients, as critical stakeholders in China's medical reform, play a crucial role in the success of the reform through their strategic interactions. Patients and Methods: Starting from the perspective of bounded rationality, applies evolutionary game theory to establish an evolutionary game model for the collaborative governance of health insurance regulatory departments, medical institutions, and patients and analyzes the stability of each party's strategy and the sensitivity of parameters in the tripartite game system. Results: The study shows that an equilibrium point will be formed when medical institutions provide reasonable treatment, patients choose to accept treatment, and health insurance regulatory departments adopt a lenient regulatory strategy, maximizing the interests of all parties involved in the game. Factors such as the benefits of unreasonable treatment by medical institutions, fines, and regulatory costs impact the decision-making of health insurance regulatory departments. To maximize social welfare, health insurance regulatory departments should reform payment methods, adjust medical service behaviors of medical institutions, and guide the rational allocation of medical resources; the government should increase subsidies for the operation of medical institutions and the intensity of penalties; regulatory departments should reduce regulatory costs and introduce third-party forces to strengthen health insurance supervision further. Conclusion: The research findings of this paper will provide valuable insights into some countries' medical and health reform.

Hot spots and prospects of medical quality and safety management in China since the new medical reform / 中华医院管理杂志

Objective:To analyze the hot spots and frontiers of medical quality and safety management since the new medical reform, and to provide reference for the continuous improvement of medical quality and safety management.Methods:Chinese literatures related to medical quality and medical safety management in CNKI database from April 2009 to December 2022 were retrieved, and the included literatures were processed and analyzed by CiteSpace software and Excel software.Results:1 921 literatures related to medical quality management and 2 497 literatures related to medical safety management were included. The publication trend showed a " double peak", showing a downward trend. The research hotspots in literature related to medical quality and safety management in China since the new medical reform have focused on practice exploration and influencing factors. The trend of future research is to closely follow the background of the times in medical quality and safety management research and intelligent medical quality and safety management evaluation system research.Conclusions:In the future, research on medical quality and safety management should be more in line with the changes of medical reform policies, focus on high-quality development to deepen the research on micro issues, promote information construction to continuously improve the indicator evaluation system, so as to promote the sustainable and high-quality development of medical quality and safety management in China.

Analysis on the change of hospitalization rate in China from 2009 to 2019 / 中华医院管理杂志

Objective:To analyze the changes of hospitalization rates in different regions, medical institutions and populations in China from 2009 to 2019, so as to provide reference for the country to make relevant decisions.Methods:The data of China′s health statistical yearbook from 2009 to 2019 were obtained, and the changes of hospitalization rate and the number of hospitalizations per 100 outpatient and emergency admissions in different regions and medical institutions, and hospitalization rate of different populations and different diseases were analyzed. Descriptive analysis and frequency analysis were used.Results:The hospitalization rate in China continued to rise, from 9.95% in 2009 to 19.03% in 2019. Among them, the hospitalization rate in the eastern, central and western regions increased from 9.7%, 9.9% and 10.8% to 17.0%, 19.3% and 21.5% respectively, with an average annual growth rate of 5.8%, 6.9% and 7.1% respectively. The number of inpatients in public hospitals increased by 1.2 times and that in private hospitals increased by 4.5 times. The number of inpatients in tertiary, secondary and primary hospitals and primary medical institutions increased by 292.9%, 80.8%, 166.4% and 4.5% respectively.From 2009 to 2018, the number of hospitalizations per 100 outpatient and emergency admissions in the hospital increased from 4.5 to 5.7, and decreased to 5.6 in 2019. The increase of hospitalization rate of urban residents was less than that of rural residents. The hospitalization rate of residents aged 0-4 and ≥55 years increased the fastest. In recent years, the discharge diseases were mainly common diseases, chronic diseases and frequently occurring diseases, including pneumonia, acute upper respiratory tract infection, diabetes, and hypertension.Conclusions:During the ten years of medical reform, the hospitalization rate in China has continued to rise, and the overall trend is reasonable. There are significant differences in the changes of hospitalization rates between urban and rural areas, regions and populations in China.

New Health Care Reform and Impoverishment among Chronic Households in China: A Random-Intercept Approach.

High out-of-pocket (OOP) payments for chronic disease care often contribute directly to household poverty. Although previous studies have explored the determinants of impoverishment in China, few published studies have compared levels of impoverishment before and after the New Health Care Reform (NHCR) in households with members with chronic diseases (hereafter referred to as chronic households). Our study explored this using data from the fourth and fifth National Health Service Surveys conducted in Shaanxi Province. In total, 1938 households in 2008 and 7700 households in 2013 were included in the analysis. Rates of impoverishment were measured using a method proposed by the World Health Organization. Multilevel logistic modeling was used to explore the influence of the NHCR on household impoverishment. Our study found that the influence of NHCR on impoverishment varied by residential location. After the reform, in rural areas, there was a significant decline in impoverishment, although the impoverishment rate remained high. There was little change in urban areas. In addition, impoverishment in the poorest households did not decline after the NHCR. Our findings are important for policy makers in particular for evaluating reform effectiveness, informing directions for health policy improvement, and highlighting achievements in the efforts to alleviate the economic burden of households that have members with chronic diseases.

Analysis of the Regional Health Planning of Public Hospitals Under the Background of the New Health Care Reform / 现代医院

To analyze and research the number and size of public hospitals of our country at the present stage, and explore the regional health planning of public hospitals under the background of China's new medical reform, provide the scientific basis for our further layout of regional health planning for public hospitals of our country. Methods Mainly use the method of the document analysis, by collecting and analyzing the literature related to the regional health planning of public hospitals under the new health reform. And relevant data on China Health Statistics Yearbook 2011 were analyzed. Results The irrational regional health planning and layout design of public hospitals not only seriously affect the efficiency of health care resources, but also exacerbate the difficulty and high cost of people getting medical service. Conclusion Under the new health care reform, the definition of public hospitals and the positioning and functionality of public hospitals need to be re-examined. The following three aspects will solve the problem of regional health planning of public hospitals. First, to moderately reduce the number and size of public hospitals; second, to determine and adjust the number of public hospitals at all levels; Third, to reasonably lay out urban and rural public hospital.

Investigation and Analysis on Satisfaction Degree and Influence Factor in Grassroots Hospital Patients during New Health Care Reform / 中国医学伦理学

Objective:To understand the present situation of the grass-roots hospital patient satisfaction and influence factors after the implementation of new health care reform, and to put forward the rationalization proposals of improving degree of satisfaction. Methods:Conducted a questionnaire survey to 310 Grassroots hospital patients in Shandong province, and make data statistics and analysis. Results:After the implementation of new health care reform, satisfaction degree of medical services is relatively high in the mass, but there are also some problems. Through the investigation and analysis, the factors influencing patients satisfaction mainly include medical treatment cost, The doctor's technical level, the doctor's service attitude, diagnosis and treatment effect, The cost perform-ance of paying the medical costs and getting medical service price, The situation of meeting the work -up with medical equipment. Conclusion:From the perspective of new health care reform, the ascension of hospital patient satisfaction need to improve the level of basic hospital's medical technology, improve the medical service attitude, strengthen the management and control of medical expenses, and strengthen the government's financial investment.

Dilemma and policy proposal for the ethical value of new health care reform：From the per-spective of Diagnosis Related Groups / 中国卫生政策研究

Health care policy should follow principles of total efficiency, no-harm, fairness and justice as ethi-cal standards for public policy. Diagnosis Related Groups( DRGs) as a sign of new health care reform ( NHCR) is implemented as a pilot program across the country, with the obvious function of suppressing excessive growth in medi-cal costs and over-treatment. From the dimension of ethical values, the DRGs has avoided unethical individuals, fol-lowed the principle of total efficiency and achieved the equalization of social security. However it has also increased ethical risks and been adverse to the development of medical research. To realize the reasonable development of DRGS, the construction of DRGs must be improved, and security policies must be reasonable and feasible; orderly measures must be established to ensure promotion and implementation;the government’s financial investment must be increased to protect the social welfare of public hospitals;a sound communication mechanism must be implemented, and interaction between medical institutions and insurance institutions must be strengthened.

Investigation and Analysis on Degree of Job Datisfaction of Grassroots Medical Personnel and Influencing Factor from the Perspective of New Health Care Reform / 中国医学伦理学

Objective:To understand the present situation of the grassroots medical personnel satisfaction during the implementation of new health care reform , and compared with the survey of 2011 , to further analysis the main factors of affecting the job satisfaction .Methods:Conducted a questionnaire survey to 326 employees of basic medi-cal institutions of Weifang city , Dongying city and Yantai city in Shandong Province , and study with the method of qualitative analysis and quantitative analysis .Results:The number of satisfied with the current basic medical work only is 5.2%, and the overall satisfaction rate is 38.04%.The overall satisfaction to compensation rate is 31.3%. The overall satisfaction to the relationship between doctors and patients is 36 .19%.The overall satisfaction to the hospital management system and performance appraisal is respectively 44 .17%and 40 .79%.Conclusions:Com-pared with the investigation results in 2011 , the overall satisfaction of the grassroots medical personnel has im-proved, but the overall satisfaction is not high .It puts forward constructive countermeasures: strengthen grass -roots hospital ability and talent building;strengthen the policy stability;improve the grassroots personnel′s reasona-ble salary;improve the occupation environment;protect the doctors′interests.

The Characteristics and Influencing Factors of Doctor-patient Trust in Township Hospitals under the New Health Care Reform / 中国医学伦理学

This paper analyzed some policies of new health care reform from the perspective of doctor -patient trust.The implementation of the policy of income and expenses in two lines has changed the management mode of township hospitals , eliminated some factors harming the doctor -patient relationship .The policy of equalization of public healthand other policies have guided the hospitals to change the way of service , service and health man-agement into the village increased the degree of doctor -patient trust .But at the same time , to ensure the new health care reform run smoothly , township hospitals introduced various ways of prescribing restraints .In addition , the policy of zero profit for basic drugs also brought some restrictions and regulations , resulting in a decline of satis-faction of patients , who have a tendency to blame the hospitals and doctors for these inconveniences .This misun-derstanding has becomed the new difficulties for doctor -patient trust as policy running .

Comparative Study on the Construction of Rural Doctors under the New Health Care Reform:A Study Based on 6 Provinces and Cities in China / 中国医学伦理学

Objective:Based on the survey of qualitative and quantitative on rural doctors in 6 provinces and cities in China , this paper aimed to compare the present situation of construction of rural doctors under the new health care reform and explore the impact of the new health care reform as well as to propose some suggestions . Methods:Based on the survey of questionnaire and in -depth interviews on rural doctors in 6 provinces and cities in China .Results:The problems existed for rural doctors in China such as insufficient number of personnel , ag-ing, lack of young rural doctors supplement , low level the requirements and situation of professionalism , etc.Con-clusion:It should accelerate the process of the cultivation of rural doctors , promote the education level of rural doc-tors, gradually ease the current situation of the rural doctor shortage .

Simple Analysis of New Health Care Reform of the United States and the Reference for Our Country' / 中华医学科研管理杂志

Firstly,this article introduces the background and detailed content about the New health care reform of the United States.Then it describes the basic principles of these reforms and the problems to be solved,putting forward author's own speculative viewpoints to these health care reforms.Finally,it list the reference to New health care reform of our country.