Objective To understand urban residents' satisfaction with primary healthcare services and its influencing factors, and to provide a reference for improving residents' satisfaction with primary healthcare services, promoting initial visits at primary medical institutions and tiered diagnosis and treatment. Methods Based on the Anderson model, this study employed convenience sampling to conduct questionnaire surveys among residents in Yunyan District, Guiyang City. Chi-square tests and binary logistic regression models were used to analyze urban residents' satisfaction with primary healthcare services and its influencing factors. Results The overall satisfaction rate of primary healthcare services among the respondents was 81.76%. Demand-side factors of residents: age, household registration, the level of awareness for primary healthcare institutions, annual household income, income source, the type of medical insurance, subjective evaluation for primary health services, and previous medical behaviors all had an impact on satisfaction (P<0.05). Supply-side factors of institutions: various dimensions of healthcare services, such as the medical environment, availability of drugs and equipment, the accessibility and timeliness of services, healthcare providers' attitudes during communication, and the quality of technical services, all had an impact on residents' satisfaction (P<0.05). The results of the multivariate binary logistic regression analysis revealed that those aged 60 and above, who had a high level of understanding of primary healthcare institutions, a household annual income of more than 30,000 yuan, a relatively good subjective evaluation on the utilization of primary health services, receiving medical services 1 to 3 times per month, excellent medical environment, good communication attitudes of medical staff, and receiving high-quality technical services reported higher satisfaction with primary healthcare services. Conclusions Urban residents' satisfaction with primary healthcare services in the study area is influenced by factors such as the respondents' age, household income, cognition, subjective evaluation on service utilization, and the process of healthcare services.

Objective To analyze the historical evolution and policy structure of centralized drug procurement, and to propose suggestions for optimizing the related policies. Methods From the perspective of policy tools, a three-dimensional analytical framework was constructed by integrating the dimensions of stakeholders and policy evolution. The content analysis method was employed to conduct a three-dimensional quantitative analysis of policy texts. Results Cross-analysis of policy tools and stakeholder dimensions revealed that the content related to the government level in the policy text accounted for the highest proportion (38.68%); the content related to medical institutions ranked second (26.13%); and the content related to patients was the least (4.53%). The cross-analysis of the policy tools and policy evolution dimensions revealed that in the three stages of policy evolution, the environmental-oriented policies accounted for the highest proportion, while the demand-oriented policies accounted for the lowest proportion. The cross-analysis of stakeholders and the dimension of policy evolution revealed that medical institutions were most involved, with proportions of 29.35%, 39.13% and 31.52% at different stages, respectively. The cross-analysis of the three dimensions found that the use of policy tools for each stakeholder increased in the in-depth development stage and the comprehensive promotion stage, but the centralized drug procurement policies issued in the comprehensive promotion stage still focused on environmental-oriented tools, and the coverage of drug distribution enterprises and patients was still relatively limited. Conclusions The structure of the use of policy tools is unbalanced, and there is a gap in the degree of participation of different subjects. Therefore, it is necessary to establish and improve the dynamic adjustment mechanism of the centralized drug procurement.

Objective To thoroughly analyze the the operational efficiency and influencing factors of close-knit county-level medical consortia in Shandong Province, and to provide policy suggestions for improving the operational efficiency and achieving high-quality development of close-knit county-level medical consortia. Methods Based on the monitoring data of close-knit county-level medical consortia in Shandong Province from 2018 to 2022, the DEA-BCC and Malmquist index models were used to analyze the relevant indicators of the medical consortia. The Tobit regression model was employed to analyze the main factors influencing the operational efficiency of county-level medical consortia. Results The comprehensive technical efficiency of close-knit county-level medical consortia in Shandong Province in 2022 exhibited significant regional disparities, indicating considerable room for improvement. The total factor productivity increased initially and then declined from 2018 to 2022, mainly affected by technical change indicators. The Tobit regression results showed that the number of level 3 and level 4 surgeries performed by the leading hospital, the medical insurance fund income of the members in medical consortia, and the proportion of medical services income of primary hospitals and the leading hospital in the total medical income were significantly positively correlated with the comprehensive technical efficiency of the close-knit county-level medical consortia. The average cost of discharged patients in medical consortia and the land area of the county were significantly negatively correlated with the comprehensive technical efficiency. Conclusions The development of the close-knit county-level medical consortia in Shandong Province is uneven. Pure technical efficiency is the main factor restricting the efficient operation of the close-knit county-level medical consortia. Technical changes are the key to promoting the operational efficiency, and internal factors are the long-term driving force for the sustainable development of the close-knit county-level medical consortia in Shandong Province. It is suggested that measures be taken based on local conditions to promote the synergistic development of close-knit county-level medical consortia in various regions. The management-enhanced efficiency and scale synergy drive the development of close-knit county-level medical consortia with double effects. Technological progress promotes the efficiency of close-knit county-level medical consortia. Internal vitality should be stimulated to promote the high-quality development of close-knit county-level medical consortia.

Objective This paper hierarchically studies the allocation level and spatial differences of medical and health resources in China from the perspective of hospitals and primary medical and health institutions, so as to provide references for further optimizing the allocation of medical and health resources. Methods Health Resource Density Index and Dagum Gini coefficient were used to calculate the health resource allocation level index, so as to empirically analyze the allocation level and spatial differences of medical and health resources in China. Results From 2013 to 2021, the resource allocation levels of hospitals and primary medical and health institutions in China have increased. Among them, the mean value of health resource allocation level index of hospitals increased from 0.1915 to 0.2936, and that of primary medical and health institutions increased from 0.2810 to 0.3554. In terms of spatial differences, the equity of health resource allocation level in hospitals was west < east < central region, and that in primary medical and health institutions was west < central region < east. Conclusions The overall level of medical and health resource allocation in China has been improved, but the structural rationality is insufficient and there is a significant regional gap. The development strategies should be adjusted according to local conditions to promote the coordinated development of hospitals and primary medical and health institutions in various regions.

Taking Guangxi as an example, this paper introduces the general situation and effect of the construction of three national regional medical centers, and summarizes the experiences from top-level design, resource coordination, implementation of responsibilities and guarantee, a system of innovation, strengthening supervision and efficiency. The practice of Guangxi reminds us that the construction of national regional medical centers should take the actual demand as the guide to plan the layout, deepen the reform of the management system, promote homogeneous management, innovate the talent management model, coordinate the development of medical education and research, and enhance the regional influence.

Objective To analyze and discuss the influencing factors of overspending cases in FM19 disease group in public tertiary hospitals in Chongqing, and to provide ideas for medical institutions and relevant departments to strengthen the control of overspending cases. Methods The relevant data of 6,747 patients in FM19 disease group with DRG settlement in public tertiary hospitals in Chongqing were collected from January 1, 2022 to March 31, 2023. Descriptive statistical analysis, single factor analysis, multiple logistic regression analysis and association rules analysis were used to analyze the factors affecting the overspending of DRG cases. Results Disease factors (types of diseases, previous medical history of percutaneous coronary intervention) and socioeconomic factors (types of medical insurance, hospital length of stay, the number of stents, the number of treated vessels, and whether other procedures were combined) were significant influencing factors of overspending cases with DRG settlement (P<0.05). Further association rules analysis showed that overspending cases with DRG settlement were most likely to occur when patients had multiple socioeconomic factors. Conclusions Medical institutions should focus on patients who meet the conditions of strong association rules, strengthen the management of interventional surgery path planning by standardizing the diagnosis and treatment process, establish an internal review mechanism to adjust and improve clinical pathways in time, and strengthen the communication with the healthcare security department to give timely feedback on settlement problems. It is necessary to effectively control medical costs and promote the high-quality development of medical institutions and the sound operation of the healthcare security system.

Objective To systematically evaluate the prevalence trends and influencing factors of overweight and obesity among older adults in China from 2008 to 2018, providing a basis for optimizing the prevention and control policies and intervention strategies for obesity among older adults. Methods Based on the data from Chinese Longitudinal Healthy Longevity Survey (CLHLS), 27,363 older adults aged ≥60 years in 2008, 2011, 2014 and 2018 were included, and overweight and obesity were classified by the BMI index. The chi-square test, T-test, ANOVA, and rank sum test were performed by using SPSS 23.0. The binary logistic regression model was applied to identify factors influencing overweight or obesity and its changes. Results The overall overweight prevalence of the subjects increased from 11.84% in 2008 to 25.46% in 2018, and the obesity prevalence rose from 2.82% to 8.49%. The overweight prevalence and obesity prevalence significantly decreased with advancing age, which were higher in urban areas than in rural areas. The overweight Prevalence of women was higher than that of men, and the obesity prevalence of men was higher than that of women. Risk factors influencing overweight or obesity of the subjects included higher living standards (OR=1.178), being married (OR=1.147), chronic diseases (OR=1.740), and a high intake of staple foods (OR=1.236), etc. Protective factors included a light diet (OR=0.838), smoking (OR=0.759), and a high frequency of raising livestock or pets (OR=0.913). Older adults who were married, rarely experienced hunger in childhood, had chronic diseases, consumed vegetables less frequently, drank alcohol and did not smoke were more likely to be overweight or obese. Conclusions The prevalence of overweight and obesity among Chinese older adults showed a year-by-year increase, with notable urban-rural disparities. Factors such as health status, diet and lifestyle behaviors significantly influenced their occurrence.

Building robust and resilient health systems is crucial for advancing universal health coverage and global health security. On the basis of summarizing the evolution of the concept of resilience, this paper systematically overviews theories related to resilience, and focuses on the connotation and application status of resilience in the current health field of individual psychology, hospitals and medical and healthcare systems. It is pointed out that the research on resilience in the field of health still has some shortcomings, such as isolated research content, single research method, and relatively lagging research on interventions for resilience enhancement. In the future, it is necessary to strengthen the research on“health resilience” from the perspective of multidisciplinary integration.

Objective To explore the main influencing factors of fluctuations in medical service prices and to provide references for the government to formulate and dynamically adjust medical service prices. Methods Based on the China Statistical Yearbook from 1998 to 2022, LASSO Regression was applied to select the main influencing factors of medical service prices, and the random forest model was used to rank the relative importance of these factors. Results The LASSO Regression identified eight key variables. The ranking Results of the random forest model showed that the Consumer Price Index(CPI)(0.194), the proportion of personal health expenditure(0.125), the proportion of government health expenditure (0.082), the total dependency ratio(0.079), per capita health expenditure (0.069), the number of participants in basic medical insurance for urban employees (0.062), per capita disposable income of residents(0.056), and the bed occupancy rate(0.052) accounted for 72.63% of the total importance. Conclusions CPI plays a leading role in the fluctuations of medical service prices. The proportion of personal health expenditure, the proportion of government health expenditure, changes in population structure and the utilization efficiency of medical resources have significant impacts on medical service prices.

Objective By analyzing the current status, deficiencies and development trends of the unified planning policies of basic medical insurance at the provincial level in typical provinces, this paper proposes policy suggestions for promoting the unified planning of basic medical insurance at the provincial level. Methods Policy texts on the unified planning of basic medical insurance at the provincial level from various provinces were collected. Policy analysis and case study were employed to conduct a content analysis of the specific implementation of each province. In-depth interviews with some managers from medical insurance departments were carried out to gain insights into the current practices, progress and existing shortcomings in the unified planning at the provincial level. Results As of May 2025, 17 regions in China have implemented unified planning at the provincial level. Each area implementing unified planning has adopted unified planning models that suited their local conditions and has formed three typical models: unified revenue and expenditure + vertical management, unified revenue and expenditure + hierarchical management, and risk-adjusted funds + hierarchical management. Moreover, a risk shared responsibility mechanism, performance assessment mechanism, operation management system, and related supporting measures have been established. However, it still faced challenges such as inconsistent policy standards, unified planning models that required further optimization, relatively lagging supporting measures, and increased moral hazard. Conclusions Unified planning policies of basic medical insurance at the provincial level have achieved significant progress, but there are still some structural problems such as policy fragmentation and regional imbalance of funds. It is recommended to further improve the institutional framework, optimize the unified planning models, strengthen information construction, prevent moral hazard, and promote balanced allocation of funds.

Objective Based on the Healthy China strategy, this paper systematically reviews the evolution and current configuration of traditional Chinese medicine (TCM) policies to provide an optimized direction and reference path.Methods 52 TCM policies closely related to Healthy China from 2016 to 2024 were collected, whose evolution process was analyzed. Meanwhile, NVivo12 software was used to code and analyze the text content, and a quantitative model was built from three dimensions of policy tools, stakeholders and policy intensity.Results Policy changes were divided into three periods. In the initial stage, a macro strategic plan was established as the foundation. In the middle stage, innovative practices were explored. In the later stage, reforms were driven by social demands, gradually promoting the high-quality development of Healthy China. In the dimension of policy tools, environment-oriented policy tools were the most(41.34%), followed by supply-oriented policy tools (40.08%), and demand-oriented policy instruments had the smallest proportion (18.58%), and there was a shift in focus of the secondary policy instruments. In the dimension of stakeholders, social forces and the pharmaceutical industry have always been in a marginal position. In terms of policy intensity, it was found that policy formulation lacked high-level planning and the overall intensity was relatively weak. In the three-dimensional analysis, there were structural contradictions among policy tools, stakeholders and policy intensity.Conclusions The policy tool system of TCM policies is out of balance; there is imbalance within the policy tools; some stakeholders are marginalized, and the matching of the policy structure is insufficient.

Objective To reveal the differences of research hotspots and development trends in the field of artificial intelligence (AI) in healthcare at home and abroad through bibliometric analysis, providing a reference for future in-depth studies. Methods 2, 580 relevant documents in the field of AI in healthcare at home and abroad from 2015 to 2024 were retrieved and screened by taking Web of Science and CNKI as data sources. The characteristic information of the documents was extracted by using CiteSpace, and the distribution of research hotspots and the evolution trends of the frontiers were visualized and analyzed. Results Foreign research was driven by clinical issues and gradually focused on the application and performance evaluation of technologies such as deep learning and large language models in clinical diagnosis and treatment as well as medical education. Domestic research was policy-oriented, concentrating on the construction of smart healthcare systems, the application of auxiliary diagnostic systems, and the governance of medical ethics. Conclusions Future efforts should reinforce the research and development of AI in healthcare and the construction of ethical governance frameworks, draw on the foreign experiences in optimization algorithms, deepen international cooperation, explore scientific regulatory systems and medical insurance payment systems, accelerate the clinical transformation of technologies, cultivate interdisciplinary talents, to promote the efficient and safe development of China's smart medical systems.

Objective To understand the structural variation of hospitalization costs of patients with coronary artery disease (CAD) under the background of DRG payment reform, analyze the factors and categories affecting the changes in costs, and discuss the internal connection between policies and fee changes, so as to provide a reference for promoting the reform of the medical insurance payment system. Methods The data of 41679 inpatients with CAD in The First Affiliated Hospital of Guangxi Medical University from 2019 to 2023 were analyzed by structural variation degree and new grey relational analysis. The structural variation degree was used to describe the overall situation and the trend of dynamic changes of the composition of hospitalization costs, and new grey relational analysis was used to evaluate the degree of correlation between hospitalization costs and costs of each item. Results From 2019 to 2023, the average hospitalization costs per visit of patients with CAD overall showed a decreasing trend, with an average annual decrease of 5.6%.From 2019 to 2023, the structural variation degree of the average hospitalization costs per visit was 8.59%. The top three contribution rates of structural variation of types of costs were treatment costs (32.9%), drug costs (27.0%) and diagnostic fees (17.1%), and the cumulative contribution rates of the three items were 77%. Among them, the proportion of drug costs decreased year by year, and there was a reverse change between costs of comprehensive medical services and diagnostic fees. Drug costs, costs of comprehensive medical services and other costs (mainly consumables) had the greatest correlation with hospitalization costs. Conclusions The structure of hospitalization costs of patients with CAD has been optimized, with short-term fluctuations due to the epidemic. Drug costs remain the main item in hospitalization costs. Incentives for the value of medical workers are insufficient. The DRG/DIP payment reform and clinical pathways management have shown initial Results, but more efforts are needed.

Objective This paper analyzes the current situation and development trends of burden of disease of malignant tumors in China in 2021, and compares with the global data, in order to provide a reference for the prevention and treatment of malignant tumors in China. Methods Based on the data from the Global Burden of Disease in 2021 (GBD 2021), the Joinpoint log-linear model was applied to calculate the average annual percentage change in the incidence, mortality, and disability-adjusted life years (DALYs) of malignant tumors in different genders and age groups in China from 1990 to 2021. A Bayesian age-period-cohort model was built to predict the burden of disease from 2022 to 2035. Results From 1990 to 2021, the standardized incidence rates of malignant tumors in China showed a significant increase and surpassed the global level. Meanwhile, the standardized mortality rates and standardized DALYs in China remained consistently higher than the global benchmark. At the gender level, burden of disease for men had always been significantly higher than that of women in China, and the gender disparity was greater than that in the global context. At the age level, the relevant indicators in China have been continuously increasing with age. The older adults bore the most significant burden of disease. The incidence of malignant tumors showed a trend of becoming more common among young people. From 2022 to 2035, China's standardized incidence rates were projected to keep rising, while the standardized mortality rates and the standardized DALYs declined. The global trend remained downward. Conclusions China has achieved phased results in the prevention and treatment of malignant tumors, but the overall prevention and control situation still faces major challenges. The standardized incidence rate, standardized mortality rate and standardized DALYs of malignant tumors in China are all higher than the global average. Moreover, the standardized incidence rate is expected to continue to increase, and the burden of disease on the older adults and men is heavy.

Objective To explore configurational paths associated with high incidence of cross-provincial health-seeking behavior, and to provide a reference for the rational control of cross-provincial seeking healthcare. Methods Relevant publicly released data from 31 provinces (autonomous regions and municipalities) in China were collected. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was applied to conduct configurational analysis. Results A total of seven configurations were identified, which can be classified into four typical models: low-cost service-driven type, high-quality and low-cost service-driven type, transportation-driven type, and resource-constrained type. Conclusions Cross-provincial health-seeking behavior in our country has shown a generally rapid growth trend. The high incidence of cross-provincial health-seeking behavior is the result of the complex combination of multiple factors.

Objective In response to the collaborative challenges faced by multiple actors in the healthcare industry in the digital era, this study analyzes the construction logic of actor networks in healthcare driven by artificial intelligence (AI) based on Actor-Network Theory (ANT) to provide theoretical support and practical paths for the digital transformation of the industry. Methods Based on ANT, an analytical framework that included human actors such as governments, medical and healthcare institutions, and patients, as well as non-human actors such as AI technology, medical data, and policy regulations was built. Through the translation process of “problem presentation-benefit assignment-recruitment mobilization-objection elimination”, the case of digital transformation of healthcare in Guiyang was combined to examine the key links in the construction of the actor networks. Results The study found that the construction of AI-driven actor networks needed to break through the traditional perspective of technical tools and regard AI as a “non-human actor” with motivation. The case showed that Guiyang has realized the optimization of medical resource allocation through the translation strategy. The error rate of vaccine inventory management has decreased, and there were 310,000 visits in the Internet health platform, which verified the interpretation of ANT for complex social and technical systems. Conclusions The effective construction of the actor networks in healthcare should not only transform the advantages of AI technology into specific solutions to address pain points in the industry, but also establish a mechanism for sharing benefits to ensure the continuous participation of multiple stakeholders. It has expanded the application of ANT in the field of digital health, facilitating the construction of a collaborative and efficient digital ecosystem for healthcare.

This paper reasonably delineates the scope of privacy protection in psychological counseling, clarifies the basic norms for exceptions to privacy protection, and establishes a set of complete and practical procedural privacy protection norms to protect the privacy of clients in psychological counseling throughout the whole process. This paper collects and analyzes Chinese and foreign literature, relevant judicial cases, and authoritative and official information, as well as conducts key informant interviews with counselors to understand the current jurisprudential base and rule of law environment. The existing problems are sorted out as follows: At present, the scope of privacy protection in psychological counseling in China is not clear, and methods of protection are inadequate; the rules of protection are too general, and there is a lack of consensus on exceptions to confidentiality; there is a lack of specific norms to protect the privacy of special clients such as high-risk clients, minors and those involved in judicial investigations; and the protection mechanism is imperfect, and there is a lack of protection throughout the whole process. At the same time, the following suggestions are put forward. The boundaries of clients' privacy should be established by law. Basic norms for exceptions to privacy protection should be established, especially for higher-risk clients, minors and criminal suspects in judicial investigations. Procedural privacy protection norms should be established that apply to the whole process.

Objective To analyze the current status and equity of healthcare resource allocation in Tianjin, and to provide a reference for optimizing the layout during the “15th Five-Year Plan” period. Methods Relevant data from 2019 to 2023 were collected. Statistical methods were used to describe the total volume and growth of healthcare resources in Tianjin. The Lorenz curve, Gini coefficient, Theil index, and health resource agglomeration degree and Global Moran's I of spatial autocorrelation were employed to conduct a comprehensive evaluation from the economic, demographic, and spatial dimensions. Results The total volume of healthcare resources in Tianjin continued to increase from 2019 to 2023, but there were significant differences among different districts and regions. The Lorenz curve showed a relatively small degree of curvature in terms of population distribution, but a significantly greater curvature in terms of geographical and economic distribution. The allocation of various resources exhibited better equity based on economic distribution (with a Gini coefficient ranging from 0.211 to 0.267), relative rationality based on population distribution (0.258~0.331), and the poorest equity based on geographical allocation (0.209~0.410). The analysis of the Theil index indicated that regional disparities were the main cause of inequity (the contribution rate between groups ranging from 42.271% to 88.865%). The analysis of Global Moran's I revealed that there was a significant positive spatial clustering effect in the spatial distribution of various core healthcare resources (Moran's I = 0.181~0.238), further confirming the “center-periphery” pattern of resource allocation. The analysis of agglomeration degree further revealed that although resources in the central urban area were geographically highly concentrated, there was a phenomenon of insufficient “per capita occupancy rate”. The five peripheral zones exhibited the opposite structural characteristics. Conclusions The total volume of healthcare resources in Tianjin has increased, but the scientific rigor and equity of allocation still face challenges and need to be further optimized.

Objective To understand the cancer patients' current demand for digital health services in China. Methods A total of 4,375 cancer patients in Shanghai were selected to conduct a survey on the demand for digital health by using multi-stage stratified cluster random sampling. The questionnaire included socio-demographic characteristics, the demand for digital health (SCNS-SF34 and self-reported need for digital health services), ECOG Performance Status, Healthy Sleep Score Scale, a nutrition-screening tool named age, intake, weight and walking (AIWW), and mental status (GAD-2 and PHQ-2). Logistic regression analysis was used to explore the factors influencing the demand for digital health. Results The demand rate of cancer patients for digital health was 55.93% (54.46%-57.40%). The most urgent need was health information. The most widely known and used digital health was intelligent healthcare. The results of multiple factor analysis showed that cancer patients with high number of comorbidities, poor sleep, poor health status rated by ECOG, risk of malnutrition, anxiety and depression symptoms were more likely to have the demand for digital health. Conclusions The government and other multi-parties should provide appropriate digital health services such as developing health literacy skills and platforms for psychological counseling based on the current needs.

Objective To explore the relationship between the quality of life (QOL) of patients with cervical cancer and social support, and to provide a reference for improving the QOL of patients. Methods A cross-sectional design was adopted, and the QLICP-CE (V2.0) scale and the SSRS-10 scale were used for the survey. Analysis of variance was used to compare the differences between the total score of QOL of patients with cervical cancer and various dimensions under different factor levels. Multiple linear regression and canonical correlation analysis were employed to explore the correlations between different factors and the QOL of patients with cervical cancer, as well as the specific impacts. Results The total score of the QOL for 179 patients was (63.27±11.60) points. The total score of social support was (41.44±7.86) points, with the scores for subjective support, Objective support and support utilization being (24.45±4.58), (9.57±2.63), and (7.42±2.13), respectively. Multiple linear regression showed that age, education level, medical insurance type, and social support were related to QOL, among which social support level and age positively predicted the QOL. Canonical correlation analysis revealed that there was a correlation between social support (three dimensions) and QOL (five dimensions). The correlation coefficients of the first pair and the second pair of canonical variables were 0.680 and 0.308 respectively. The first pair of canonical variables contributed the most to support utilization and Objective support (respectively explaining 63.3% and 29.2% of the variance in social support and QOL). Conclusions Social support is a key protective factor for the QOL of patients with cervical cancer. Objective support and support utilization rate play a crucial role in enhancing the QOL of patients.

Objective To analyze the resource allocation, service efficiency and influencing factors of home-based and community-based integration of medical and elderly care services in seven prefectures (cities) of Xinjiang from 2021 to 2023, and to provide a reference for rationally allocating resources and improving service efficiency. Methods The resource density index was used to measure the level of resource allocation. The data envelopment analysis with BCC and Malmquist models were employed to calculate the dynamic and static efficiency of services respectively, and build a Tobit regression model to explore the factors influencing the efficiency. Results In 2023, the ranges of resource density index for healthcare professionals, senior care professionals, hospital beds, and beds for senior citizens in seven prefectures (cities) of Xinjiang were 0.465, 0.191, 0.149 and 0.890 respectively. There were five prefectures (cities) with unbalanced resource allocation, two prefectures (cities) with an overall efficiency < 1, and three prefectures (cities) with a decrease in the total factor productivity index. Conclusions The resource allocation for home-based and community-based integration of medical and elderly care demonstrates structural imbalances in Xinjiang. There are significant disparities in the efficiency of resource allocation among different prefectures (cities). The factors influencing service efficiency include the proportion of elderly population, population density, GDP, the level of healthcare services, the ratio of medical and elderly care resources, and the ratio of personnel to beds.

Objective To explore the spatial and temporal variation trends of health resource allocation in China from 2017 to 2022, and to provide a reference for optimizing the efficiency of health resource allocation. Methods The super-efficiency SBM-DEA, Malmquist index model and Moran's I were used to analyze the spatial and temporal changes of health resource allocation in China from 2017 to 2022. Results The efficiency in the southern region was significantly better than that in the northern region, and the number of provinces in the south where the static and dynamic efficiencies were greater than 1 was greater than that in the north. From 2017 to 2022, the average value of total factor productivity in China was 0.963; the average value of comprehensive efficiency was 0.983; the average value of technical efficiency was 0.98; the average value of pure technical efficiency was 0.989, and the average value of scale efficiency was 0.994. The Global Moran's I showed that there was a positive spatial correlation in 2017, 2018 and 2020 ( Moran's I > 0 ). The local spatial clustering characteristics were significant. H-H type (high-high type) was concentrated in the Yangtze River Delta, Pearl River Delta and Chengdu-Chongqing region. L-L type (low-low type) was mainly in the northeast, central and western provinces, and H-L type (high-low type) was mostly municipalities. Conclusions There are significant differences in the efficiency of health resource allocation between the north and the south as well as between the east and the west in China, and the equity is insufficient. The spatial dependence of the efficiency of health resource allocation is enhanced, and the proximity effect is significant. The dynamic efficiency of health resource allocation has declined. The scale expansion does not match the management capabilities. It is necessary to strengthen support for underdeveloped areas and scientifically control the scale.

Objective This study aims to provide robust technical support for improving the governance system of cyberbullying and creating a harmonious online environment to facilitate the healthy development of cyberspace. Methods Ten hot events on Sina Weibo from July 2022 to January 2023 were selected. A web crawler of Python was used to obtain the comment texts and related data of Weibo posts related to these events. Based on the characteristics of texts, emotion and users, the Adaboost algorithm was used for experiments to test the effectiveness of cyberbullying detection. Results The duration of cyberbullying varied significantly for different events, but it mainly appeared in the early stage of the events. The accuracy, precision, recall, and F1 Score of the optimal results were 0.769, 0.758, 0.769 and 0.729 respectively. The results obtained without considering the users' characteristics were approximately 0.01 lower than the aforementioned optimal results. Conclusions Good results can be achieved in cyberbullying detection by combining three types of characteristics. Taking into account users' characteristics can improve the effectiveness of cyberbullying detection to some extent. Paying attention to the evolution of abusive language online or incorporating multi-dimensional information can further improve the effectiveness of detection, thereby strengthening the governance of cyberbullying information and creating a favorable online environment.

Objective To study the impact of DRG payment reform on the operation management of a children's specialized hospital and provide a reference for improving the quality of hospital management.Methods This paper takes a tertiary first-class children's specialized hospital in Shandong Province as the sample, and the first page of medical records, financial data and DRG grouping data of 42 months before and after the implementation of DRG were selected. An interrupted time series model was used to analyze the changes in medical service capacity, quality and efficiency before and after the implementation of DRG payment reform.Results After the implementation of DRG payment reform, CMI increased significantly (β₁+β₃=0.004, P<0.05), while time consumption index (β₁+β₃=-0.001, P<0.05), cost consumption index (β₁+β₃=-0.004, P<0.05) and average cost per visit (β₁+β₃=-32.62, P<0.05) decreased significantly. There was no significant changes in the indicators of medical service quality (15-day readmission rate, mortality rate in the low-risk group, the incidence of hospital infection) (P>0.05).Conclusions The DRG payment reform has effectively improved the medical service capacity and efficiency of children's specialized hospitals.

Objective This study provides the basis for optimizing the disease grouping scheme and payment standards of acute myocardial infarction (AMI) by studying the case-mix and the composition of inpatient hospital costs of patients with AMI at a tertiary hospital. Methods Univariate analysis and multiple linear regression were used to analyze the influencing factors of hospitalization costs of 4,288 patients with AMI from a tertiary hospital from January 2019 to December 2023. Variables of classification thresholds were screened out. A case-mix model for Diagnosis Related Groups (DRG) was developed and the cost standards were established by using the decision tree. The effectiveness of the case-mix model was evaluated by coefficient of variation, variance reduction, and Kruskal-Wallis H-Test. Results Length of hospital stay, age, types of hospital admissions, number of surgeries/procedures, number of other diagnoses and number of emergencies were the main factors influencing inpatient costs. The above factors were incorporated into the decision tree model, forming 11 case-mix groups and charging standards, which could explain 83.72% of the actual costs. The patients who exceeded the cost limitations accounted for 6.90%, consuming 8.47% of medical resources. Conclusions DRG of patients with AMI established by decision tree model were reasonable in this study, and the corresponding hospitalization cost standards and disease weights were obtained. Analysis of exceeded costs was carried out for the disease groups to clarify cost components for both within and outside the cost thresholds, which provides a reference for the decision-making of the local healthcare security department and controls the unreasonable growth of medical expenses.

Objective This study aims to identify and analyze the key factors and behavioral mechanisms that determine the provision of integrating medical and preventive care services by family doctors, offering references for the formulation of intervention measures and the enhancement of integration of medical and preventive care policies. Methods Guided by the theory of planned behavior, a questionnaire survey was conducted among 180 family doctors from ten community health centers in Nanjing. Structural equation modeling was employed for empirical analysis. Results Perceived benefits (β=0.315, P<0.001), behavioral attitudes (β=0.191, P<0.001), subjective norms (β=0.166, P<0.01), and perceived behavioral control (β=0.188, P<0.001) had a positive impact on the willingness to integrate medical and preventive care. The willingness to integrate medical and preventive care (β=0.507, P<0.001) and perceived behavioral control (β=0.257, P<0.001) had a significant positive impact on the behavior of integrating medical and preventive care. Conclusions Family doctors' behaviors of integrating medical and preventive care are directly influenced by the positive effects of behavioral intentions and perceived behavioral control. Perceived benefits, behavioral attitudes, subjective norms, and perceived behavioral control all have a positive impact on behavioral intentions and indirectly influence the behaviors of integrating medical and preventive care through behavioral intentions.

Objective This paper explores policy effects of medical insurance for urban and rural residents on quality of life of older adults from the aspects of economy, medical care and health indicators, and provides the reference for the follow-up policy adjustment. Methods Based on the five panel data of 2011-2020 China Health and Retirement Longitudinal Study (CHARLS), people over 60 years were selected as the subjects, and a PSM-DID model was built to assess the policy effects of medical insurance for urban and rural residents from three indicators: economy, medical care and health. Results Both regression results and robustness testing indicated that the medical insurance for urban and rural residents increased the expectation of future income, and total income and total consumption increased to varying degrees (0.085, 0.246,P<0.01); the health expenditure of older adults was increased (0.879,P<0.01) to promote the utilization of medical services; self-assessed health of older adults was improved (0.499, P<0.01), and quality of life of older adults was improved to varying degrees. In terms of heterogeneity, medical insurance for urban and rural residents had a positive expected effect on expenditures of low-income seniors (P<0.01), and had a more pronounced effect on the medical indicators of high-income seniors (P<0.01). In terms of health, the policy had a greater impact on the low-income seniors (P<0.01), and women benefited more in terms of medical care and economic income (P<0.01). Conclusions Medical insurance for urban and rural residents can effectively improve quality of life of older adults, including economic, medical and health conditions. At the same time, the policy should be precision targeting to support low-income and other vulnerable groups.

Objective To understand the research status of evaluation index system for primary traditional Chinese medicine (TCM) service capacity, and to provide a reference for optimizing the allocation of primary TCM service resources and improving service efficiency. Methods The literature in PubMed, Web of Science, CNKI, Wanfang and VIP databases were searched from the establishment of the databases to March 2025 to summarize the theoretical framework, construction methods and core indicators of the evaluation index system. Results A total of 19 related literatures were included for evaluation. The existing studies mostly used methods such as Delphi method, analytic hierarchy process, and rank sum ratio method to construct the index system. A total of six first-level indicators, 21 second-level indicators and 140 third-level indicators were extracted. Conclusions The current evaluation system has problems such as redundant indicators, insufficient operability, and weak theoretical support, and most of them lack empirical applications. The evaluation of primary TCM service capacity needs to enrich the theoretical framework, select key indicators with digital and intelligent tools, standardize the definition of indicators, and optimize weights by integrating subjective and Objective weighting methods to establish a hierarchical dynamic evaluation mechanism, and improve regional adaptability.

Objective To evaluate the impact of Diagnosis-Intervention Packet (DIP) on resource allocation and medical quality. Methods The interrupted time series analysis (ITS) was employed to assess changes of disease types-related indicators in the performance assessments before and after the implementation of DIP in a tertiary hospital. Results In terms of resource allocation, in the initial phase of the implementation of DIP, the average expenditure per admission and average length of stay for each disease decreased. The average expenditure per admission for acute myocardial infarction and chronic obstructive pulmonary disease decreased by 6053.91 yuan and 4496.22 yuan respectively. The average length of stay for certain disease categories showed a significant upward trend over time (P<0.05). In terms of medical quality, in the initial phase of the implementation of DIP, in-hospital mortality rates of each disease did not increase significantly. The in-hospital mortality rates of some diseases showed a significant upward trend over time (P<0.05). Conclusions DIP initially optimizes resource allocation without compromising medical quality. However, the long-term effect of DIP is not good and it may have certain negative impacts on the control of medical expenses and medical quality, which requires further research.

Objective To assess the characteristics and implementation effectiveness of the China-Serbia health cooperation model, and to explore the demonstrative significance of this model for the building of the Silk Road of Health and regional health governance. Methods By employing content analysis, case study and expert interviews, a thorough analysis of health cooperation between China and Serbia was conducted. Results From 2012 to 2024, 11 health cooperation agreements were signed between China and Serbia, with the country/government being the main cooperation entity (54.5%), focusing on areas such as disease prevention and control (36.4%) and scientific and technological innovation (27.3%). Typical projects such as the Huada “Huo-Yan” laboratory and the China-Serbia “Belt and Road” Joint Laboratory on natural products and drug discovery had achieved remarkable results. From 2015 to 2024, the medical trade between China and Serbia witnessed a stepwise growth, indicating an upgrade in cooperation from one-way output to synergy and mutual benefits. The expert interviews focused on mechanism establishment, technological exchange, policy planning, industrial collaboration, and the construction of public health systems. Conclusions China-Serbia health cooperation has achieved remarkable results, featuring a government-led approach, crisis-driven strategy, and bilateral focus. A new type of health diplomacy model has been established based on the principles of equality and mutual benefit, and regional influence has been formed, providing theoretical support and practical foundation for the construction of the “Silk Road of Health” and the improvement of the global health governance system.

Objective To evaluate the effectiveness of fine management of medical insurance in hospitals under the reform of Diagnosis Related Groups (DRG) payment system, and to provide feasible suggestions for the further development of fine management. Methods 4, 666 cases from a Grade-A tertiary hospital in Wuhan from June 2022 to December 2024 were used as the subjects. A two-group interrupted time series model was adopted to analyze the differences in the changes of average total medical expenses per case, average drug expenses per case, average consumables cost per case, and average hospital length of stay between the experimental group and the control group before and after the implementation of fine management. Results The fine management of medical insurance in hospitals demonstrated significant improvements in the average total medical expenses per case and average drug expenses per case for disease group A (β₆=-2435.660, P<0.1; β₆=-780.333, P<0.05), which was consistent with the results of two-group interrupted time series model of the experimental group of disease group C (β₆=-326.148, P<0.1; β₆=-803.055, P<0.01). However, its effect on average consumables cost per case and average hospital length of stay was not significant (P>0.1). The degree of dispersion of various cost indicators significantly decreased after the intervention, and changes slowed down. Conclusions Under the DRG system, fine management of medical insurance in hospitals has demonstrated a positive effect on reducing patients' expenses and contributes to achieving the “identical treatment for the same disease with the same price”.

Objective To understand the preferences of postgraduates majoring in public health in Northeast China for taking jobs at the grassroots level, and to provide a scientific basis for formulating relevant policies. Methods Based on the discrete choice experiment, a questionnaire was designed to conduct a survey among 950 postgraduates majoring in public health from six universities in Northeast China. The mixed logit model was employed to analyze the preferences for grassroots jobs, and the latent class logit model was used to analyze the heterogeneity of preferences. Results Seven attributes including monthly income, working environment and budgeted posts all had a significant impact on the subjects' preferences for grassroots jobs, and there was heterogeneity in the preferences. Some of the subjects placed greater emphasis on welfare housing or housing benefits and budgeted posts when taking a job (46.6%), and were more likely to be attracted to work in grassroots medical and healthcare institutions through incentive measures. Another group of subjects considered various job attributes comprehensively (53.4%), and had a stronger tendency to work in cities or county-level areas. Conclusions Offering jobs with budgeted posts and welfare housing or housing benefits can effectively guide postgraduates majoring in public health in Northeast China to take jobs in grassroots medical and healthcare institutions. At the same time, all levels of medical and healthcare institutions should combine economic and non-economic incentives based on local conditions to formulate targeted recruitment policies for different categories.

Objective This study understands the current status of inpatient services and medical costs in a stomatological specialty hospital,and analyzes all inpatient DRG groups in a stomatological specialty hospital from two dimensions: healthcare service capabilities and medical cost management capabilities. Superior and inferior groups of the stomatological specialty hospital are identified from the overall operation level, and management recommendations are proposed. Methods Data of the front page of medical records and cost structure of inpatients with medical insurance from January 1, 2023 to December 31, 2023 were collected. Indicators reflecting healthcare service capabilities and cost management capabilities were selected. The Entropy-weighted TOPSIS method and Boston Matrix were applied to calculate scores and distribution patterns of DRG groups. Results The results of entropy-weighted TOPSIS analysis revealed that from the evaluation of medical service capabilities, DG29 (C_i=0.80), DA19 (C_i=0.46), and DG19 (C_i=0.35) demonstrated superior healthcare service capacities. From the evaluation of cost management capabilities, DZ13 (C_i=0.84), JV1A (C_i=0.83), BY19 (C_i=0.82), DR11 (C_i=0.82), and QR13 (C_i=0.82) had better medical cost management capabilities. The results of Boston Matrix indicated that the main problems of the inpatient services and operation of the stomatological specialty hospital were concentrated in the prevalence of “dog” and “question mark” categories. Conclusions Compared with general hospitals, the inpatient departments in the stomatological specialty hospital are more finely divided. However, the DRG grouping fails to adequately reflect these distinctions, resulting in weaker cost control in groups with better medical service capabilities. Furthermore, the limited capacity to treat diseases from other specialties leads to a higher proportion of patients discharged without undergoing surgery due to contraindications, which explains the prevalence of “dog” and “question mark” categories identified in the Boston Matrix analysis.

Objective To sort out and quantitatively evaluate the digital health policies at provincial level during the “14th Five-Year Plan” period, and to provide countermeasures and suggestions for policy formulation and improvement. Methods The ROST CM 6.0 software was used to conduct text mining on 11 digital health policies, and a Policy Modeling Consistency (PMC) index model was constructed, which included nine first-level variables and 39 second-level variables. Quantitative analysis was carried out on the policy texts. Results The average PMC index of 11 policies was 6.41, among which three were excellent policies and eight were acceptable policies. Among the first-level variables, X₁ policy nature (0.89), X₈ policy function (0.87) and X₉ policy evaluation (0.86) had relatively high scores, while X₂ policy timeliness (0.33), X₃ issuing institution (0.34), X₅ policy target (0.73) and X₇ policy content (0.76) had relatively low scores. Conclusions There is room for improvement in digital health policies at the provincial level in China. It is suggested to strengthen organic connection among short-term breakthroughs, medium-term layout, and long-term leadership of policies; establish a governance system led by the government, with diversified collaboration, joint construction and shared benefits; and focus on improving the balance and integrity of the policy system to stimulate the vitality of regional innovation and development.

Objective To explore the impact and mechanisms of artificial intelligence-based mobile healthcare services on self-management behaviors of patients with diabetes, so as to provide a basis for optimizing paths of mobile health services and improving self-management model of patients with diabetes. Methods A research model was developed based on the source credibility theory and the health belief model. The questionnaire survey was conducted among 408 patients with diabetes who had experiences in using artificial intelligence-based mobile healthcare services, and structural equation modeling was employed for empirical analysis. Results The accuracy, anthropomorphism, perceived expertise and timeliness of mobile healthcare services had significant positive effects on patients' perceived harm and severity caused by the disease, and benefits of changes in behaviors, while a significant negative effect on patients' perceived barriers. Patients' perceived harm and severity caused by the disease and benefits of changes in behaviors had a significant positive influence on self-management behaviors, whereas perceived barriers had a significant negative impact on self-management behaviors. Conclusions Artificial intelligence-based mobile healthcare services can effectively improve self-management behaviors of patients with diabetes. Characteristics of services and patients' health concepts play a key role in it, suggesting that services should be optimized and patients' health concepts should be enhanced to promote patients' health.

People's health is a fundamental goal and the key to achieve high-quality development for China. Based on a comprehensive understanding of the historical dimension and multidimensional complexity of the connotation of health in the modernization process, it accurately analyzes the demand logic of health such as the superposition of natural and social attributes, the unity of irreplaceability and intrinsic value, the interweaving of dynamic and diversity, and the coexistence of adaptability and plasticity under the guidance of high-quality population development goal. In order to achieve high-quality population development, it is necessary to accelerate the construction of the supply system for high-quality health products and services, cultivate self-reliant health consciousness, deepen the reform of the collaborative governance system of multiple subjects, accelerate the formation of an efficient and connected health governance system of multiple subjects, to enhance the capacity and level of health governance.

Objective To analyze the changes of the revenue and expenditure structure of public hospitals in X City, and put forward optimization strategies for revenue and expenditure structure. Methods Descriptive analysis was conducted on the data of medical income (medical income and fiscal revenue) and expenditure (personnel expenditure, costs of materials for health and drug costs) of public hospitals in X City. The structural variation degree analysis method was used to quantitatively analyze the degree and trend of changes of the revenue and expenditure structure of public hospitals. Results The fiscal revenue showed a positive change, while medical income showed a negative change. Among medical income, drug and nursing income showed negative changes, while medical services income showed overall positive changes except for nursing income. Among outpatient revenue, the revenue of materials for health had the highest correlation, followed by treatment income. Among inpatient revenue, nursing income had the highest correlation, and treatment income ranked second. Conclusions The proportion of drug income in public hospitals has decreased significantly, while the income from physical examination and materials for health have replacing growth, indicating the need to regulate the physical examination and the use and management of materials for health in hospitals.

Objective To understand the current status of the utilization of outpatient and inpatient services for older adults in urban and rural areas of China, and to explore urban-rural differences in the influence of intergenerational support from children on behaviors of seeking medical care. Methods Based on the data from the baseline survey of 2018 and 2020 China Longitudinal Aging Social Survey (CLASS), 6 201 older adults aged 60 and above with children were selected as the subjects. Logistic regression was used to analyze the effect of children's intergenerational support on urban and rural older adults' behaviors of seeking medical care. An interaction model was used to analyze the interactive effects between different intergenerational supports and healthcare-seeking behaviors. Results Children's financial support had a positive impact on outpatient services for urban and rural older adults (OR urban areas=1.025, OR rural areas=1.019, P<0.05), and had a positive impact on hospitalization services for rural older adults (OR rural areas=1.022,P<0.05), but had no impact on urban older adults (OR urban areas=1.012, P>0.05). The care and support from children had a positive impact on outpatient services for urban older adults (OR urban areas=1.054,P<0.05), but had a negative impact on rural older adults (OR rural areas=0.969,P<0.05), and had no significant impact on hospitalization services for urban and rural older adults (OR urban areas=1.017, OR rural areas=0.989,P>0.05). The emotional support from children had no impact on outpatient services for urban older adults (OR urban areas=0.997,P>0.05), but had a positive impact on hospitalization services (OR urban areas=1.035,P<0.05); and it had a positive impact on outpatient services for rural older adults (OR rural areas=1.025,P<0.05), but had no impact on hospitalization services (OR rural areas=1.001,P>0.05). In interactive effects, there was a positive interaction between intergenerational care and financial support in outpatient services for urban older adults (OR urban areas=1.590,P<0.05), while there was a negative interaction between intergenerational care and emotional support in outpatient services for urban and rural older adults (OR urban areas=0.621, OR rural areas=0.684,P<0.05). Other interactions were not significant (P>0.05). Conclusions There are differences in the impact of intergenerational support from children on behaviors of seeking medical care for urban and rural older adults.

Objective To analyze the policy documents regarding the inclusion of assisted reproductive services in basic medical insurance at the provincial level, and to provide a basis for subsequent policy optimization. Methods Policy documents related to the inclusion of assisted reproductive services in basic medical insurance that have been released from 2022 to June 1, 2025 were collected from the PKULaw database and official websites of provincial medical insurance bureaus and health commissions. From the perspective of policy comparison research, the content analysis method was used to extract policy elements and conduct comparative analysis. Results At present, among the medical insurance policies for assisted reproductive services that have been issued across the country, the main issuers were mainly provincial medical insurance bureaus. The number of assisted reproductive services included in medical insurance varied from 8 to 15 in each province(autonomous regions and municipalities), covering basic projects, additional charges projects, and extended projects. Among these, most provinces covered basic projects, and the average price was relatively low. In terms of medical insurance benefits, most provinces have included assisted reproductive services in the category B directory, without setting a deductible threshold. The reimbursement rate ranged from 50% to 90%, and the reimbursement amount was included in the annual maximum payment limit. Overall, medical insurance benefits showed significant regional differences, and economically developed areas had a relatively higher level of coverage. Conclusions Incorporating assisted reproductive services into basic medical insurance is a crucial institutional guarantee for reducing the cost of childbirth and safeguarding reproductive rights. It is recommended to moderately expand the coverage of medical insurance, relax the restrictions on the number of reimbursements, limit the eligible population for services, explore diverse payment methods, and promote fair and accessible services.

Objective To assess the impact of care bundles on the incidence of healthcare-associated infections (HAIs). Methods Inpatients of a Grade-A tertiary hospital were selected as research subjects. Conventional methods for infection prevention and control were adopted for inpatients from the first quarter of 2022 to the second quarter of 2023. From the third quarter of 2023 to the third quarter of 2024, care bundles centered on active screening and cleaning and disinfecting were implemented for inpatients. The interrupted time series was used to analyze the intervention effects in the entire hospital and the ICU. Results The incidence of HAIs decreased from 0.80% before the intervention to 0.70% after the intervention (P<0.05). The interrupted time series analysis showed that the entire hospital's β₁=0.137, β₂=-0.445, β₃=-0.150. All the differences were statistically significant (P<0.05). The differences in β₁ and β₂ of the ICU were statistically significant (P<0.05), while the differences in β₃ were not statistically significant. Conclusions The care bundles have a significant short-term effect in reducing the incidence of HAIs.