This paper reviews the historical evolution of the Communist Party of China and the leadership system of public hospitals in different periods. During the revolutionary years, the Party was responsible for ideological and political work in military hospitals. After the founding of the People's Republic of China, with consolidating the state power and exploring socialist construction, public hospitals had management systems such as the president responsibility system and the president responsibility system under the leadership of the Party committee. Since the reform and opening up, the president responsibility system has been gradually established. After the 18th National Congress of the Communist Party of China, China has entered a new era of socialism with Chinese characteristics. Under the background of comprehensively strengthening the leadership of the Party, the president responsibility system under the leadership of the Party committee has been established in public hospitals. The leadership system of the Party and public hospitals has been continuously improved. In deepening the reform of public hospitals, what remains unchanged is the original intention of the Party to always put people's health in an important position. Only for the sake of people's health, relying on the people's power, and sharing the results by the people, can we promote the high-quality development of public hospitals.

Based on the advocacy of international organizations,this paper summarizes the practices of typical countries and regions in the promotion of mental health of children and adolescents,and summarizes international experiences such as policy support,strengthening school education and preventive interventions,developing community services of mental health,strengthening cross-departmental cooperation,developing professional teams and multidisciplinary teams,to provide suggestions for improving policies and practical development in the field of children and adolescents' mental health in China.

With the continuous in-depth application of big data and artificial intelligence technology in the medical field,the level of digital intelligence in hospitals is constantly improving. The applications of digital intelligence in medical service,clinical analysis,clinical prediction and intelligent management are widely used in the diagnosis,treatment and management of hospitals. However,digital intelligence has brought many challenges to hospital management from the aspects of concept,quality and safety. In the face of challenges,hospital managers should change their ideas,improve the quality of personnel,ensure information security and scientifically plan and comprehensively coordinate the development strategy of hospital digital intelligence. Hospital managers should turn challenges into new opportunities for hospitals to develop and leap forward,and promote the improvement of hospital management level.

This paper reviews the development and typical mode of medical insurance payment based on classification of disease in foreign countries. It also introduces the practice and progress of medical insurance payment reform based on classification of disease in China and analyzes the advanced experience and deficiency of domestic pilots,so as to put forward countermeasures on the reform of medical insurance payment based on classification of disease and provide theoretical reference for promoting the reform of medical insurance payment based on classification of disease.

Objective To explore the operation status of medical insurance fund from the perspective of provincial pooling,and to provide data and prediction reference for improving the pooling level of medical insurance fund in national pooling areas. Methods Taking Hainan Province as an example,this paper drew the flow chart of action mechanism of key variables in the operation of medical security fund,set variable equations,and constructed the system dynamics model of the operation of medical security fund by using the system dynamics method. The authenticity and sensitivity of the model were tested and the policy intervention was simulated and predicted. Results Without policy intervention,there would be no current deficit of resident medical insurance and employee medical insurance before 2028. The affordable months of resident medical insurance and employee medical insurance would be increased compared with the national safety standard months by 2031. When financing standards of resident medical insurance remained unchanged and the reimbursement rate for hospitalization was raised,there would be no current deficit of resident medical insurance fund in the next five years. When financing standards of resident medical insurance and the reimbursement rate for hospitalization were raised,there would be no current deficit in resident medical insurance fund in the next 10 years. After reducing the proportion of contributions paid by units and increasing the reimbursement rate for hospitalization,the current deficit risk of employee medical insurance fund would be one year earlier than the existing policy. After increasing the proportion of contributions paid by units and the reimbursement rate for hospitalization,the current deficit risk of employee medical insurance would be delayed by one year compared with the existing policy. Conclusions Provincial pooling enhances the security of medical insurance fund,but it still needs to improve payment mechanisms for medical insurance continuously,and accelerate pricing reform on medical services to avoid the current deficit risk of medical insurance fund under overall planning at the provincial level.

Objective To understand the importance of 3A-grade hospitals to assistant the people's hospitals in ethnic minority autonomous counties,analyze the influencing factors,and put forward improvement suggestions,so as to provide reference for improving the pairing assistance policy. Methods The sampling survey was carried out by the self-made questionnaire,Evaluation of the Status Quo and Countermeasures of Pairing Assistance for County-Level Hospitals by 3A-Grade Hospitals,to evaluate the role of pairing assistance of 3A-grade hospitals in promoting the development of county-level people's hospitals. Ordinal multinomial logistic regression was used to analyze the influencing factors in promoting the development of county-level people's hospitals. Results A total of 730 valid questionnaires were obtained. The respondents evaluated the role of pairing assistance of 3A-grade hospitals in promoting the development of county-level people's hospitals. 571(78.22%)thought it was very important. 145(19.90%)thought it was important,and 14(1.90%)thought it was general. The higher level of weekly ward round or teaching in department and punctual attendance of the accredited staff of 3A-grade hospital performed,the greater role 3A-grade hospitals played in promoting the development of people's hospitals in ethnic minority autonomous counties. Conclusions The pairing assistance of 3A-grade hospitals for the people's hospitals in ethnic minority autonomous counties has achieved remarkable results. The excellent work performance of the accredited staff and their persistence in teaching have promoted the development of people's hospitals in ethnic minority autonomous counties.

Objective The implementation effects before and after the transformation of the new service mode of tuberculosis prevention and treatment are compared in Yunnan Province to provide the basis for the rational formulation of tuberculosis prevention and treatment measures. Methods The treatment information of suspected tuberculosis patients and the medical records of tuberculosis patients registered for treatment were collected from 112 counties(cities and districts)that implemented and completed the transformation of the new service mode of tuberculosis prevention and treatment in Yunnan Province from 2015 to 2020. The data of patient sources,treatment outcome and etiological examination results before and after the transformation of the new service mode of tuberculosis prevention and treatment were compared and analyzed. Results The consultation rate of patients with suspicious symptoms of tuberculosis,the proportion of imaging and etiological examination among patients with suspicious symptoms increased after the transformation of the new service mode of tuberculosis prevention and treatment(χ²=48,909.69,P<0.0001;χ²=2765.911,P<0.0001;χ²=11,699.384,P<0.0001). There was no statistical significance in the proportion of male and female patients(χ²=1.528,P=0.21). The proportion of age group 0~ and 65~ increased,while that of age group 15~ decreased. The proportion of students increased(χ²=530.337,P<0.001). The positive rate of etiology increased year by year(χ²=5834.910,P<0.0001). The proportion of patients with successful treatment declined(χ²=548.08,P<0.0001). The median of delay of treatment decreased from 34d to 26d(Z=38.173,P<0.0001). Conclusions It has greatly improved the detection and diagnosis of tuberculosis patients after the implementation of the new service mode of tuberculosis prevention and treatment in Yunnan Province.

Foreign studies on evaluation of epidemic management of COVID-19 clusters mostly use index ranking method and model method. The evaluation dimension attaches importance to national recovery,and the evaluation content focuses more on the comparison of a measure before and after its implementation. There are a variety of relevant research methods in China,most of which are descriptive research and comparative analysis. Some scholars evaluate the effect of epidemic management by establishing epidemiological models and constructing evaluation index system. The dimension of evaluation content is relatively macro and the selection of evaluation index is relatively broad. The application of evaluation system remains to be seen.

By means of literature research,logic deduction,expert opinion and induction and summary,this paper clarifies the meanings of“public health”and“national emergency or extraordinary situation”,and draws a conclusion that the scope of the initiating subject of compulsory licensing of pharmaceuticals is appropriately broadened. So the compulsory licensing of pharmaceuticals can be implemented in response to major infectious diseases to meet the health needs of Chinese citizens,and enable Chinese drugs to quickly occupy the world market and take the lead in the international market.

Based on the performance assessment results of public hospitals from 2019 to 2021,according to the three regions(east,middle and west)of the economic zone of planning layout issued by the National Bureau of Statistics in 2021,two public hospitals(Beijing Tsinghua Changgung Hospital,the Affiliated Hospital of Tsinghua University and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine)are selected from the eastern region. One hospital in central China(Zhongnan Hospital of Wuhan University)and one hospital in western China (West China Hospital of Sichuan University)are selected as sample hospitals. The typical practices and experiences of public hospitals in promoting the construction of operation management are sorted out,and appropriate suggestions are put forward for each hospital to carry out operation management,including strengthening the top-level design,emphasizing the construction of operation talents,building professional teams with multidisciplinary background,establishing an operation index system in line with the actual situation of hospitals,and strengthening information construction,so as to provide technical support for the operation management.

Since 2019,the demonstration zone for integrated ecological and green development in the Yangtze River Delta region,as a pilot field of the integrated development of Yangtze River Delta,has actively explored and innovated in the field of health care,has gradually established the policy system,cooperation mechanism and cooperation platform for the integrated development of health care,and has continuously promoted the integration of medical treatment,public health,medical security and the governance of health industry. Results have showed gradually. At the same time,there are also problems such as imperfect top-level design,slow integration process of systems,standards and norms,insufficient overall planning of medical resources,inadequate information interconnection and coverage,inadequate sense of residents' access to integrated health services and insufficient linkage of the health industry. It is suggested that the integrated development of health care in the demonstration area should be taken as an“important window”for the development of the Yangtze River Delta. The 5 relationships between current work and long-term development,the zone and area,the increment and stock,the differentiation and integration,the health care and industrial development should be clarified. Efforts should be made to promote the health care integration in the demonstration zone from overall planning of regional medical resources,accelerating the integration of standards,expanding the scope of interconnection and mutual recognition of health information,improving the experience of integrated health services and accelerating the development of the health industry.

Objective To understand the HIV testing behavior of college students and influencing factors in Shunyi District of Beijing,and to provide a basis for detection of HIV/AIDS in colleges and universities. Methods An anonymous online questionnaire survey was conducted among students from three colleges and universities in Shunyi District of Beijing. Results Binary logistic regression analysis showed that respondents who were male(OR=3.078),married or cohabiting(OR=8.885),had positive attitude towards HIV testing(OR=1.856),received publicity of HIV testing(OR=2.656),had other sexual orientation(OR=4.408)and had sexual behaviors(OR=2.987)were more likely to take HIV testings. Conclusions The proportion of HIV testing among college students in Shunyi District of Beijing is low. Colleges and universities should increase publicity of HIV testing,and provide suitable methods of detection to meet the needs of HIV testing of college students.

Objective According to the relevant policies of family caregivers for the elderly in China,this paper analyzes the key points and shortcomings of the policy texts. Methods 56 policy texts related to family caregivers promulgated by central and provincial governments from 2013 to 2022 were selected as the research objects. From the perspective of policy tools,quantitative descriptive statistics was used for the policy text units. The system cluster analysis method was used to analyze the policy tools of each province,and key points of the cluster policy were compared by the word clouds. Results There were imbalances within the three types of policy tools. Legal obligations were most frequently used among mandatory policy tools,while rights protection of policy tools was least used. Among the hybrid policy tools,skills training and infrastructure were used more. Tax incentives and employment security were rarely used. Policy guidance was used most frequently among voluntary policy tools,while reward and recognition of policy tools were used least frequently. According to the clustering results,27 provinces that have introduced policies related to family caregivers for the elderly can be divided into mixed policy tool oriented,mandatory policy tool oriented and preliminary development type. Conclusions China has not promulgated a policy that is completely aimed at family caregivers for the elderly,and the internal imbalance of policy tools is serious. It is recommended to strengthen policy support for caregivers,enhance the synergy between policy tools and policy effectiveness,and improve policy system of family caregivers for the elderly.

Objective To analyze the job satisfaction of public health personnel and its influencing factors in Jiangsu Province,so as to provide scientific basis for the government to formulate health policies. Methods Based on the comprehensive incentive model,a job satisfaction questionnaire was designed. A total of 238 public health institutions at all levels under Jiangsu Commission of Health were selected for online surveys. 10,302 questionnaires were collected,and SPSS statistical software was used for processing data and statistical analysis. Results The overall job satisfaction of personnel in public health institutions in Jiangsu Province was(132.22±23.38),among which the lowest score was(14.08±4.73)for job efficacy satisfaction,and the highest score was(20.44±2.87)for satisfaction with own work ability. The results of Independent Samples T-Test and one factor analysis of variance showed that types of institutions,gender,age,education background and professional title were the influencing factors of job satisfaction(P<0.05). Conclusions The overall job satisfaction of personnel in public health institutions in Jiangsu Province is not high. Practical policies and incentives should be developed to improve the job satisfaction of employees from the aspects of strengthening the leading role of the government,optimizing the salary distribution structure,paying attention to the training of young and middle-aged backbone talents,and improving the appointment of personnel.

Based on the actual situation of China's supplies of medicine and medical devices for foreign aid,this paper summarizes the development status and significance of supplies of medicine and medical devices for foreign aid. Difficulties faced by the current supplies of medicine and medical devices for foreign aid are analyzed and summarized,such as insufficient supply,low supply and demand matching,difficult equipment maintenance,severe transportation damage,and lack of top-level design. Furthermore,it proposes some suggestions such as increasing supplies of medicine and medical devices for foreign aid,optimizing the allocation of medicine and medical devices for foreign aid,strengthening the training of technical personnel,improving the transportation conditions of medicine and medical devices for foreign aid,and improving the top-level design of medicine and medical devices for foreign aid,in order to provide the reference for foreign medical aid in the new era.

Objective Based on the three-stage Data Envelopment Analysis(DEA)model,this paper measures the efficiency of urban-rural medical and health services,and further explores the hindering factors and measures to improve efficiency. Methods The efficiency was measured in 28 provinces in China by using the input and output data of urban-rural medical and health services,and the three-stage Data Envelopment Analysis model was used to eliminate environment variables and statistical noise. Results Under the influence of external factors,DEA of urban medical and health services was effective in 3 provinces and ineffective in 25 provinces. DEA of rural medical and health services was effective in 7 provinces and ineffective in 21 provinces. The results of the second stage SFA analysis showed that external factors had an impact on the input redundancy of urban-rural medical and health resources,and the comprehensive technical efficiency of urban-rural health care services in all provinces decreased after eliminating external factors. Conclusions 1. At present,the allocation and efficiency of primary medical and health resources are imbalanced between regions and between urban and rural areas. 2. The development of primary medical and health services is facing new challenges brought by economic and social development and population aging. 3. Urban medical and health services are inefficient,and the function of diagnosis and treatment services is weakened.

Objective To understand the change trend of the coupling coordination degree between allocation of grass-roots medical resource and economic development in time and space in Ningxia,in order to promote the coordinated development between the two systems. Methods Firstly,the comprehensive evaluation index of the allocation of grass-roots medical resources and the level of economic development in cities(districts and counties)in Ningxia was calculated by linear weighting method. Then the coupling coordination model was used to calculate the coupling coordination degree between allocation of grass-roots medical resource and economic development in each district and county from 2016 to 2020. Finally the spatial distribution and spatial correlation characteristics of the coupling coordination degree were analyzed by Arc GIS software. Results From 2016 to 2020,the changes in the coupling coordination degree of allocation of grass-roots medical resource and economic development in various districts and counties showed slight fluctuations,and the numerical changes were not large during the study period. From 2016 to 2018,the coupling coordination degree of the two systems changed little,and the coupling coordination degree of the two systems changed greatly from 2018 to 2020. The development trend of coupling coordination was good. The local spatial autocorrelation analysis showed that some districts and counties had high-high,high-low,low-high and low-low aggregation patterns. Conclusions The coupling coordination degree between allocation of grass-roots medical resource and economic development needs to be improved in Ningxia. The coupling coordination between the allocation of grass-roots medical resources and economic development is unbalanced among regions. In some cities(districts and counties),there is a spatial correlation of the coupling coordination between the allocation of grass-roots medical resources and economic development.

Aiming at the practical problems of residents' insufficient awareness and low utilization rate of health services,this paper systematically reviews the theory and practice of residents' participation in the value co-creation of health services from the perspective of residents' participation. It is found that relatively mature standards or norms of residents' participation in the value co-creation of health services have been formed internationally,but residents' participation in the value co-creation of health services in China is still in the exploratory stage. Enlightenments can be drawn on this basis.

Objective To explore the coordination between the development of traditional Chinese medicine(TCM resource allocation,TCM service level and service efficiency level)and economic development level in western China,so as to promote the coordinated development of health and economy in western China. Methods Based on the concept of coupling coordination and the relative development degree,the coupling coordination degree between the development level of traditional Chinese medicine and economic development in western provinces from 2016 to 2020 was measured,and the spatial autocorrelation was discussed on this basis. Results From 2016 to 2020,the mean value of relative development degree of TCM development and economic development level in western China was 1.178,1.244,1.240,1.413 and 1.30 respectively. The mean value of coupling coordination degree(D value)was 0.522,0.527,0.538,0.543 and 0.533. The coupling coordination degree showed a ladder distribution from southwest to northwest. Conclusions The development of traditional Chinese medicine is higher than the level of economic development. The coupling coordination degree has an upward trend in fluctuation with obvious regional differences. Spatial distribution shows positive spatial autocorrelation. Traditional Chinese medicine should be transformed into the driving force of economic development,beactively integrated into the policy guidance,play a leading role in the radiation of the central region,and promote the coordination and integration of the two.

Since the operation of long-term care insurance pilots in 2017, Guangzhou has actively explored the scope of insured population, financing and treatment, disability identification and classification of nursing service grade, nursing services, designated service institutions and supervision and management system. The following results have been achieved: the gradually optimized long-term care insurance system, industrialized service providers, gradually matured model of community-based home elderly care, and improved services and management level. At present, there are still some problems in Guangzhou long-term care insurance, such as the trend of aging population and the imbalance of regional development of designated institutions, the poor quality of service supervision of some designated institutions, and inadequate coverage of service practice. Combined with the national policies of insurance system and information development, suggestions are put forward to optimize the spatial layout of service providers of long-term care insurance, expand the scope of security of long-term care insurance, make flexible payment system of long-term care insurance, improve closed loop of supervision system and intelligent operation system.

As the soul of promoting the high-quality development of medical consortiums,the culture of medical consortiums is currently in an imbalanced state and unable to give full play to the leading role and spiritual force. Based on the synergy theory,this paper constructs the synergy mechanism of cultural construction of medical consortiums from two dimensions of external-internal synergy and horizontal-vertical synergy,to realize the synergy and cooperation between external forces of the government,society and the public and medical institutions at all levels within medical consortiums. This paper promotes the cultural construction of medical consortiums from passive to active participation,from surface cooperation to deep integration,and promotes the continuous optimization of the cultural system of medical consortiums in the dynamic environment. This paper also puts forward the path of cultural construction of medical consortiums with the transformation of government functions as the key point,cultural guidance as the focus,the improvement of team as the growth point,the encouragement of participation as the core point and the use of digital technology as the auxiliary means.

Objective To provide a reference for improving the innovation efficiency and promoting the rapid development of innovative drug enterprises in China. Methods A three-stage Data Envelopment Analysis(DEA)model was used to measure the efficiency of 27 listed innovative drug companies in China. Research and development personnel and research and development expenditure were selected as input indicators,the number of patents and main revenue as output indicators. While environment variables were concerned at first stage. Then the SFA model was used to remove the influence of environmental factors and the innovation efficiency before and after adjustment was calculated. Results The overall efficiency of China's innovative drug enterprises was 0.443,and that was 0.422 after adjustment. Innovation efficiency was slightly overestimated and showed a decreasing trend during the observation period. The pure technical efficiency and scale efficiency were at the same level,which together led to low innovation efficiency. Conclusions China's innovative drug companies are still in the early stage of transformation,and innovation efficiency is low,showing high input and low output. Innovative drugs are facing the problems of poor ability of transformation,small scale and serious homogenization. The government and enterprises need to innovate together to break through the dilemma.

The inheritance of folk traditional Chinese medicine(TCM)plays a pivotal role in people's happiness,national self-confidence and long-term national security. This paper takes Zhangzhou city of Fujian Province as an example and is combined with the Law on Traditional Chinese Medicine to discuss and analyze the difficulties faced by the inheritance of folk traditional Chinese medicine in the declaration of folk TCM resources,the lack of protection of the intellectual property rights of folk TCM resources,the insufficiency of recognition and transmission of folk TCM resources as intangible cultural heritage,and the lack of effective play of the advantages of folk TCM. Some countermeasures are proposed,such as further strengthening the survey of folk TCM resources,exploring ways to protect the intellectual property rights of folk TCM resources,strengthening the cognition and transmission of folk TCM resources as intangible cultural heritage,and giving play to the advantages of folk TCM.

Objective This paper analyzes the structural change of medical income of tertiary public hospitals from 2015 to 2021 and provides the reference for optimizing the income structure of public hospitals. Methods The relevant data and indicators in China Health and Family Planning Statistical Yearbook and China Health Statistical Yearbook from 2016 to 2022 were selected. The value of structural variation,degree of structure variation and contribution rate of structural variation were used to study the structural change of medical income of tertiary public hospitals. Results From 2015 to 2021,the total structural change of medical income in tertiary public hospitals was 19.81%. The structural change of outpatient income was 17.64%,and the structural change of inpatient income was 23.32%. Drug income was the main items of the structural change of medical services revenue in tertiary public hospitals. Conclusions The proportion of drug income has decreased significantly,and the policy of cost-control has achieved certain results. The proportion of check-ups income and health materials income have increased,which has formed a new growth point so control should be strengthened. The proportion of medical service income reflecting the labor value of medical personnel has increased slightly,but the structure needs to be further optimized.

This paper analyzes the status and function of private hospitals in China's public health emergency management system from monitoring and early warning and emergency care. In the process of public health emergency management,private hospitals still lack policy support,risk awareness of emergency,professional personnel and cooperation mechanism. It calls on the government to treat private hospitals equally from the policy level. Private hospitals should also respond to their social responsibilities and improve internal emergency management system in hospitals from the aspects of organization and command system,expert treatment system,training system of prevention and control,comprehensive management system,personnel scheduling system,material support system and information communication system.

China's elderly care services have a new concept with the popularization of Internet information technology. The mode of “Internet +elderly care services” has become an important development path for the elderly care service industry. This paper explores the development status of smart elderly care industry in China and finds that there are problems such as deviations in the supply and demand structure,shortage of high-quality professionals and fragmented operation of management departments. In response,the supply and demand of smart elderly care should be accurately identified. The professionals of smart elderly care should be vigorously cultivated and a sound system of smart elderly care should be established.

The paper provides a reference for promoting DRG payment,optimizing clinical pathway management,improving the allocation efficiency of high-quality medical resources and realizing refined cost control. In this paper,the first pages of patients' medical records in a tertiary general hospital in Guangdong Province in 2019 are divided into DRG groups. Each group is classified according to the entry of clinical pathway. Degree of structure variation and contribution rate of increment are used to evaluate the characteristics of the structural change of hospitalization expenses,and analyze management of clinical pathway and structure of hospitalization expenses in different DRG groups. It is found that the total treatment cost(less than 20%)and comprehensive medical service cost(less than 10%)of DRG diseases used for analysis account for a relatively low proportion. Some DRG diseases(such as WB23)of clinical entry can effectively control hospitalization cost in items such as consumables,diagnosis and drugs. However,the clinical pathway management of some DRG diseases(such as FE15)still needs to be optimized,and the sample hospital can provide lower costs of consumables or diagnosis for patients with these diseases. It is suggested to attach importance to filling in the information of the first page of medical records and strengthen the information construction of medical records;further optimize the cost structure to reflect the labor and technical value of medical personnel;attach importance to the in-depth application of DRG diseases and clinical pathway to realize refined cost control;further realize the organic unity of clinical pathway and DRG to jointly improve the allocation efficiency of high-quality medical resources.

Objective To analyze rural elderly's willingness to go to elderly day care centers and its influencing factors. Methods Guided by Andersen behavior model,data of rural elderly people were collected through questionnaire survey from September to November 2022. Logistic regression model was used to analyze influencing factors of rural elderly's willingness to go to elderly care centers from tendency factors,enabling factors and demand factors. Results Among 490 elderly people,270 elderly people were willing to go to elderly day care centers. Multivariate Logistic regression analysis showed that the willingness of female elderly people to go to elderly day care centers was 2.477 times than that of male elderly people. In terms of cceptability of elderly care services,the number of uncertainty,relative approval and very approval about going to elderly day care centers were 20.883 times,86.527 times and 161.23 times than that of disapproval and very disapproval. The willingness of the elderly who were supported by family to go to elderly day care centers was 89.204 times than that of the elderly who were unsupported by family. The willingness of the elderly who had a good relationship with their children and were visited by children on holidays to go to elderly day care centers was 0.255 times than that of the elderly who were not closely related to their children. The willingness of the elderly who walked to elderly day care centers between 30 and 45 minutes,and the willingness of the elderly who walked more than 45 minutes were 0.18 times and 0.096 times than that of the elderly who walked less than 15 minutes. The willingness of the elderly with three chronic diseases to go to elderly day care centers was 0.173 times than that of the elderly without chronic diseases. Conclusions Rural elderly's willingness to go to elderly day care centers is general. Gender,the cceptability of the concept of elderly care,the attitude of the family,the relationship with children,the time to walk to elderly day care centers,and the number of chronic diseases have a significant impact on the willingness of the rural elderly to go to elderly day care centers.

This paper analyzes the current research of health system resilience at home and abroad in order to provide positive reference for the sustainable development of the research of health system resilience. At present,the research on health system resilience at home and abroad is in a period of rapid development,mainly focusing on the basic connotation,measurement and evaluation,influencing factors,enhancement strategies and COVID-19. Domestic research starts relatively late,and the research content is weak;while foreign countries have made some progress in this field,but the breadth and depth of research need to be strengthened. Directions of future research and exploration are empirical research using quantitative methods,evaluation and research of health system resilience showing temporal and spatial dynamics,assessment tools of health system resilience with multi-hazard coupling,and governance strategy of health system resilience in the context of overwhelmed health systems.

Objective The changes of medical expenses and medical expense structure of patients with I25.1 disease are compared and analyzed in 4 stages,including pre-centralized procurement(January 2019 to June 2019),provincial procurement(January 2020 to June 2020),national procurement(January 2021 to June 2021),and DRG payment reform(January 2022 to June 2022). This paper analyzes the impact of centralized procurement and policy synergy of medical insurance payment on medical expenses in order to provide the reference for optimizing related policies for medical insurance. Methods A retrospective analysis was conducted on the cases of patients with I25.1 disease in a tertiary medical institution in Nanjing. Descriptive statistical methods and nonparametric tests were used to analyze the hospitalization expenses and structural change of hospitalization expenses. Results Vascular interventional consumables such as stents,balloons,guide wires,and guide tubes have all been purchased in bulk. The effect of centralized procurement on the control of total medical expenses was limited,and the cost control effect was significant under the synergistic effect of DRG medical insurance payment reform(P<0.05). The structure of medical expenses was optimized,and the proportions of medical expenses reflecting the labor value of medical personnel in different stages were 17.42%,18.26%,21.31% and 24.21% respectively. Conclusions The synergy of centralized procurement and DRG medical insurance payment reform policies has a significant effect of cost control on patients with I25.1 disease,and promotes the rationalization of hospitalization cost structure.

Objective To evaluate the allocative efficiency of health resources in China from 2009 to 2020,and to provide the reference for relevant departments to optimize health resource allocation. Methods The time-series and cross-sectional analyses of the allocative efficiency of health resources in 31 provinces in China were conducted by using DEA method,and a comprehensive TOPSIS evaluation ranking was conducted for non-DEA valid years and provinces. Results The mean value of comprehensive efficiency of DEA time series analysis of China's health resource allocation was 0.988;the mean value of comprehensive efficiency of DEA cross-sectional analysis in 2020 was 0.852. The top five provinces of non-DEA efficient provinces in TOPSIS ranking were Shandong,Hebei,Hubei,Anhui and Shaanxi provinces. Conclusions The overall allocative efficiency of health resources in China needs to be improved,and there are significant differences in the allocative efficiency among provinces. It is recommended to increase the integration of health resources among regions,promote the optimization of resources within regions and improve the accuracy of health resource allocation.

From the perspective of urban strategy,this study marks the index system of “Healthy China” and “Healthy Life Destination”,so as to define the concept of “International Healthy City” in Kunming. The concept of “International Healthy City” in Kunming is decomposed into six aspects:health level,health service,health security,healthy life,healthy environment and health industry,so as to form a behavioral and operational structure system. This paper adopts case study,experience reference,literature data analysis and non-structured interview and other research methods,and has made a relatively comprehensive phased systematic study on the above six aspects. In view of the existing problems,countermeasures and suggestions are put forward. For example,a health governance system should be built to integrate health into all policies and solve the problems of insufficient quality medical resources and prominent structural contradictions;the integrated development of industries should be promoted to build the “Spring City of China” with the most ecological and wellness value to accelerate the agglomeration and demonstration effect of big health industries.

Rural revitalization enabled by traditional Chinese medicine(TCM)industry conforms to realistic needs of comprehensively promoting rural revitalization and accelerating agricultural and rural modernization. The inner logic of TCM enabling rural revitalization lies in providing development support and powerful help mechanism for rural revitalization to promote the formation of new forms of agriculture,new rural style and new features of farmers. However,the current practice of TCM enabling rural revitalization is still faced with a series of practical difficulties,such as the coexistence of excessive reliance on primary factors and the difference of the matching of factor supply,farmers' weak awareness of “protagonists”,insufficient rural “blood circulation”,low industrial integration and development,and the risk of returning to poverty. To give full play to the enabling role of TCM industry,it is necessary to strengthen the unified and reasonable allocation of production factors and build the input mechanism of symbiotic TCM resource;to change the overall logic from the made of “blood transfusion” to the sustainable method of “blood making” and establish a synergistic mechanism for empowering development and transformation;to continue the spirit of “treating both the symptoms and the root causes” and build a dynamic mechanism for industrial output and preventing the return to poverty.

Objective To analyze the equity of the implementation of basic medical insurance in Anhui Province,and to provide suggestions for further optimizing the implementation of medical insurance system and promoting provincial overall planning of basic medical insurance in Anhui Province. Methods The concentration index and Gini coefficient were used to measure a number of representative indicators in the implementation of basic medical insurance in Anhui province,and its equity was analyzed. Results The absolute value of the concentrated index of most measurement indicators was less than 0.2,and the Gini coefficient was less than 0.4. The absolute value of the concentration index was greater than 0.2 and the Gini coefficient was greater than 0.4 for the number of flexible employment participants and the rate of out-of-county consultations in the basic medical insurance for urban employees,and the current balance rate of pooling funds and the rate of out-of-county consultations in the basic medical insurance for urban and rural residents. Conclusions The equity of the implementation of basic medical insurance in Anhui Province is generally good,but there are still some imbalances. The implementation equity of basic medical insurance for urban and rural residents in Anhui Province is better than that for urban employees.

Scientific and technological innovation is the strategic core of national and regional development,and the enhancement of scientific and technological innovation capability is related to economic and social development. Scientific evaluation of scientific and technological innovation capabilities is conducive to improving economic efficiency and promoting innovation-driven development strategies. By reviewing the research on the evaluation of scientific and technological innovation capability,this paper combs the evaluation system and evaluation method. It finds that the evaluation systems at different levels and in different fields have their own characteristics and focuses,and different evaluation methods have their own characteristics and scope of application. By analyzing the existing studies,it is found that there are problems in the evaluation of scientific and technological innovation capability. For example,the standard of evaluation system is not unified;the application of evaluation methods is single;and the research in the evaluation field is not deep,etc. The future research direction of the evaluation of scientific and technological innovation capability is further proposed from the aspects of theoretical research,empirical research and innovative research methods.

Objective To analyze the influencing factors of urban elderly's willingness about community—based home elderly care,and to provide a basis for realizing diversified patterns of elderly care. Methods A questionnaire survey was used to investigate the willingness to have community-based home elderly care. The random forest model and Logistic regression model were used to analyze the influencing factors of the willingness to have community-based home elderly care from three aspects. Results 20.68% of the elderly were willing to have community-based home elderly care. The highest education level,the cost of elderly care,the frequency of community-based home elderly care services,daily demand for elderly care services,satisfaction of the demand for community elderly care facilities,and the demand for assistant cleaning services were the influencing factors of urban elderly people's willingness to have community-based home elderly care(P<0.05). Conclusions Urban elderly people's willingness to have community-based home elderly care is low. The willingness to have community-based home elderly care is influenced by multiple factors. The level and quality of existing elderly care services in the community are important influencing factors,so the professionalism and diversity of community-based home elderly care services should be enhanced from the community perspective.

Objective To investigate the job satisfaction and its influencing factors of contracted family doctors for elderly patients with chronic diseases in Nanjing. Methods A multi-stage cluster sampling survey was conducted to investigate the basic information,job cognition,work satisfaction and influencing factors of 720 family doctors contracted to serve elderly patients with chronic diseases in Nanjing. Results 85.86% of family doctors were satisfied with their work. In univariate analysis,the satisfaction of those who were ≤30 years old,female,had graduate degree,junior professional title,and registered budgeted posts;whose average monthly income was between 3001 and 5000 yuan,service age less than two years;who accredited the contracted family doctors system and undertaking medical services in integrated elderly care and medical services was higher(P<0.05). In binary logistic regression analysis,gender,years of working,satisfaction with the assessment system,cognition of the utilization degree of patients' health records,and approval of undertaking medical services in integrated elderly care and medical services were related to job satisfaction(P<0.05). Conclusions The job satisfaction of family doctors contracted to serve elderly patients with chronic diseases is relatively high. Factors such as low salary and workload overload affect family doctors' job satisfaction. Measures such as raising the salary of family doctors,improving the medical insurance policy,increasing the special fund should be taken to improve the job satisfaction of family doctors.

Objective To build a performance evaluation index system for third-party services of medical insurance fund supervision,to better evaluate,standardize and supervise third-party services,and to effectively promote the modernization of medical security governance. Methods Based on the performance evaluation model of “structure-input-process-output-result” of the third-party services of medical insurance fund supervision,the content and weight of indicators were determined by expert consultation and Analytic Hierarchy Process,and the evaluation index system was established and measured in Zhanjiang City. Results The performance evaluation system for third-party services of medical insurance fund supervision was constructed in four dimensions,including organizational structure and management(weight 0.20),resource input(weight 0.10),supervision process(weight 0.44),and supervision effect(weight 0.26). Conclusions The construction of the index system that is oriented by policy goals and focused on process and results is scientific and reasonable. It can evaluate the third-party services of fund supervision in a multi-dimensional manner throughout the whole process.

Through the analysis of the status quo of the national TCM service system, service ability and security from 2016 to 2021, it is found that TCM services are facing problems such as relatively insufficient total medical resources, uneven distribution of TCM services, inadequate use of TCM characteristics and advantages, and serious loss of rural TCM doctors. In this regard, countermeasures and suggestions are put forward to implement policies and financial security for the development of Chinese medicine, promote the expansion and balanced layout of high-quality Chinese medicine resources, and strengthen the service system and service capacity of Chinese medicine.

The evaluation of charitable medical assistance programs can improve the service quality of programs. On the one hand,it is conducive to achieving program objectives,improving social benefits and clarifying the future development direction of the program. On the other hand,it is of great significance to enhance the self-construction and social credibility of charitable organizations and promote the development of philanthropy. Based on this,this paper combs the current situation of the research of charitable medical assistance program evaluation in China,and analyzes three main problems encountered in the evaluation and research of charitable medical assistance programs in China. Firstly,the consciousness of program evaluation is weak,so it is difficult to guarantee the funding;secondly,the program is mostly internal evaluation with lack of third-party evaluation;thirdly,talents for program evaluation are insufficient and the evaluation lacks professionalism. Following suggestions are put forward. The construction of laws and regulations should be strengthened and the awareness of evaluation should be improved;the third-party evaluation should be introduced to ensure objective results;professional talents for program evaluation should be cultivated to promote ability of evaluation.