With the deepening reform of China's medical security system, prepayment methods represented by Diagnosis- Related Groups (DRG) and Diagnosis-Intervention Packet (DIP) have gradually replaced the traditional Fee-for-Service (FFS) payment method, promoting the transformation of public hospitals from "revenue centers" to "cost centers". In this context, the cost management of public hospitals has exposed core problems such as extensive accounting systems, outdated control models, misplaced performance appraisals, and lagging information systems, which restrict their ability to adapt to reforms. Based on the analysis of the impact of the reform on hospital cost management, the study proposes refined management strategies such as reconstructing a disease-oriented cost accounting system, building an intelligent information platform integrating business and finance, innovating a performance evaluation mechanism oriented to value-based healthcare, and improving organizational and cultural cultivation with full staff collaboration. It provides a practical path for public hospitals to relieve cost pressure and optimize resource allocation, helps them realize the transformation from scale expansion to connotative high-quality development, and ultimately improves the efficiency of medical insurance fund use and the value of medical services.
The establishment of child-friendly hospitals represents a significant step towards enhancing children's health and well-being. Against this background, taking a children's hospital in Nantong City as an example, this study analyzes the core issues and challenges faced in the construction of child-friendly hospitals, and actively explores the dual-path driven construction of child-friendly hospitals, namely promoting "intensive spatial design" and "refined service optimization" through the integration of functions and process re-engineering. By implementing measures such as age-appropriate renovations, age-specific diagnosis and treatment, and smart services, the medical experience and resource efficiency have been enhanced. It is recommended to further promote the construction of child-friendly hospitals from the levels of government administration, hospitals, and society.
Objective To apply the core framework of the Kaiser model, optimize the indicator system based on the characteristics of dental hospitals, conduct a hazard vulnerability analysis (HVA), identify high-risk events, and enhance the hospital's emergency management capacity. Methods A tertiary grade A stomatology hospital in Guangxi was selected as the study subject. The initial risk list was constructed through a literature review. The final list was determined using the Delphi method, followed by a questionnaire survey to calculate and rank the relative risk values of events. Results The analysis identified the top 10 high-risk events as follows: healthcare worker occupational exposure; medical disputes/violence against medical staff; medical equipment failure (e.g., dental chair); information system failure; fire; patient safety incidents (e.g., falls, foreign body ingestion/aspiration); elevator malfunction; air conditioning and fresh air system failure; critical material supply shortages; and power failure. Conclusion The adjusted and optimized Kaiser model is more suited to the characteristics of dental hospitals and can provide targeted strategies for their emergency management. It is recommended that dental hospitals regularly conduct risk assessments based on their actual conditions and continuously refine the emergency management system to achieve dynamic and precise emergency management.
Amid low fertility rates and the deepening of healthcare reform, maternal and child health institutions face multiple challenges such as shrinking service demand, underutilized resources, and intensified external competition. This study takes Yangzhou Maternal and Child Health Care Hospital as a case study, retrospectively analyzing the operational dilemmas it faced from January to August 2025 due to declining fertility demand, internal resource misallocation, and policy pressures. Pathways for enhancing operational management capabilities are proposed from multiple dimensions, including optimizing the internal management structure, building external collaborative systems, strengthening discipline development, promoting technological innovation, scientific research guidance, expanding services, and extending childcare services. These measures aim to increase medical service revenue while simultaneously improving healthcare quality and efficiency. Applying synergy theory to operational management practice, this study explores pathways for healthcare resource integration from three synergistic dimensions: policy, fiscal, and resource synergy, to provide novel management insights and research perspectives for similar institutions.
Objective To construct a hospital quality management platform and system based on digital and intelligent technologies and to evaluate its practical outcomes, thereby providing a reference for the development of hospital quality management. Methods A digital medical administration management system, a clinical trial project management system, and a medical record information management system were established. Corresponding quality management and control systems were built based on each platform. Innovative quality management models and implementation pathways were developed, forming a systematic medical data quality management system for the hospital. Results Following the implementation of digital medical administration management, the compliance rates of key medical quality indicators—including surgical checklist compliance, preoperative discussion compliance, critical value response compliance, and consultation compliance—improved significantly compared to pre-implementation levels(P<0.05). After the implementation of digital clinical trial project management, the first- and second-tier quality control rates and the third-tier quality control rectification rate for clinical trial projects showed significant improvements (P<0.05). Following the implementation of digital medical record information management, the medical record quality control rate, the rate of medical record homepage completion within 24 hours, the qualified rate of medical record homepages, and the proportion of Grade A medical records all increased significantly compared to pre-implementation levels (P<0.05). Conclusion The construction of digital and intelligent- driven hospital platforms and systems optimizes key indicators of medical quality, enhances the efficiency of clinical trial quality management, and improves the standardization and efficiency of medical record management, thereby comprehensively promoting the high-quality development of hospital medical quality management.
Objective To strengthen the management of the initiation process for investigator-initiated trial (IIT), explore and establish a hospital-based IIT project initiation management system, and improve the scientific rigor and standardization of IIT projects. Methods In accordance with the Management Measures for Clinical Research Initiated by Investigators in Healthcare Institutions issued by the National Health Commission, and considering the current status of IIT management in the hospital, the IIT project initiation management process was clarified, relevant management systems and standard operating procedure (SOP) were formulated, and a flexible, efficient, and scalable hospital-based IIT project initiation management system was built based on a modular information architecture. Results The hospital-based IIT initiation management system and expert review system were successfully launched, with integration into the hospital's single sign-on system and short message service (SMS) platform. The supporting SOPs were also established. During the 26 months of system operation, the system has supported the initiation of more than 1,000 IIT projects and more than 2,000 online expert reviews, reducing the average initiation cycle to 2 weeks. Conclusion The established project initiation management scheme and system have significantly improved the efficiency of IIT project initiation, enhanced the management quality of IIT projects, and promoted the standardized development of IIT projects and the improvement of research quality.
Objective To analyze the influencing factors of hospitalization costs and medical insurance surplus costs for pneumonia patients under the Diagnosis-Intervention Packet (DIP) payment model, and to provide references for optimizing health insurance policies, rationally allocating medical resources, and improving the quality of medical services. Methods Basic information of 1,381 pneumonia patients from the sample hospital in 2023 was collected. A random forest model was used to explore the factors influencing hospitalization costs and medical insurance surplus costs. The predictive accuracy of the model was evaluated using four indicators: coefficient of determination (R2), root mean square error, mean absolute error, and mean absolute percentage error. Results The prediction model constructed in this study demonstrated good fitting capability and accuracy. Case Mix Index (CMI), length of hospital stay, and age were the key factors affecting the total hospitalization costs of pneumonia patients, while the admitting department was an important factor affecting the medical insurance surplus cost. Conclusion It is necessary to promote refined management in hospitals and departments, optimize the separate negotiation mechanism for special cases, to better leverage the role of health insurance payment methods in promoting the optimal allocation of medical resources and improving the quality of medical services.
Objective To construct a training system for infection prevention and control tailored to cleaning staff in psychiatric hospitals. Methods Through literature review and Delphi method, a total of 16 experts with experience in infection management, nursing management, and clinical practice were invited to participate in indicator screening and system optimization. Two rounds of consultation were completed. The importance of indicators at each level was assessed by experts using the Likert 5-level scoring method. Results The positive coefficients of experts in both rounds were 100%, with authority coefficients of 0.87 and 0.85, respectively. Coefficients of variation were all less than 0.3. In the second round, the mean importance scores of all indicators exceeded 4.00, with full score rates ≥30 %, indicating improved consensus compared to the first round. A final training system for infection prevention and control for cleaning staff in psychiatric specialty hospitals was established, comprising 5 first-level indicators, 23 second-level indicators, and 102 third-level indicators. Conclusion The construction process of this training system is scientific and reliable. The indicator content is comprehensive and highly targeted, closely aligned with the clinical reality of psychiatric specialty hospitals. This system provides a detailed and directly applicable training framework for systematically implementing infection prevention and control training for cleaning staff across psychiatric specialty hospitals at various levels, holding significant practical value for dissemination.
Objective To investigate the current status and influencing factors of professional values among young medical staff. Methods From October 2024 to January 2025, a stratified random sampling by job position was conducted among 274 medical workers aged 18 to 40 years at a tertiary Grade A hospital in Shanghai. A survey on professional attitude and values was administered. Univariate analysis and multiple linear regression analysis were used to identify influencing factors of professional values. Results The total mean score of professional values was 191.00±32.50. The "social interaction" dimension received the highest score (4.09±0.69), while the "leisure, health, and transportation" dimension received the lowest score (3.68±1.10). Education level was a significant negative influencing factor on the total score of professional values (β=-14.828, P<0.001). Conclusion Young medical workers demonstrate professional values characterized by a strong emphasis on collaboration and professional development, while also experiencing significant work pressure. Hospitals should improve the career development support system for young professionals, implement stratified training based on different educational levels, optimize salary incentives and performance management, and reasonably regulate workload to stabilize the workforce and ensure the quality of medical services.
Against the background of the shift in medical services from a "disease-centered" to a "patient-centered" model, the absence of humanistic care in hospital logistics services directly impacts patient experience and healthcare quality. Using Anqing Municipal Hospital as a case study, this paper theoretically and practically elucidates the hospital's innovative practices in logistics services by constructing a four-dimensional theoretical model: "Emotional Bonding–Dignity Preservation–Crisis Support–Intelligent Empowerment."
Objective This study systematically reviews practical experiences of outpatient medical insurance payment methods both domestically and internationally, aiming to provide theoretical reference and policy implications for deepening reforms in China. Methods Through literature review and typical case analysis, typical models from both China and other countries were compared. The mechanism design, operational outcomes, and challenges faced were summarized. Results Layered, categorized, and mixed payment reforms can effectively leverage the strategic purchasing function of medical insurance, promoting rational allocation of medical resources, effective cost control, and improved service quality. Conclusion It is recommended that China focus on establishing a value-based payment system in future reforms.
Objective To explore the effectiveness of implementing medical insurance Multidisciplinary Team management in public hospitals under the context of Diagnosis-Related Groups (DRG) payment, aiming to promote high-quality development of hospitals and provide a reference for hospital management methods. Methods Discharge data of insured patients from a tertiary general hospital in 2023 were selected as the baseline and compared with case data after the implementation of medical insurance Multidisciplinary Team management in 2024. Indicators were extracted from the dimensions of DRG grouping, service capacity, service efficiency, cost control, and medical insurance supervision. Growth rates and percentage changes before and after implementation were analyzed. Results Following the implementation of Multidisciplinary Team management, indicators in the dimensions of service capacity, service efficiency, and DRG grouping all improved. The number of DRG groups increased by 1.23%, case mix index (CMI) increased by 8.40 %, the volume of level-3 surgeries increased by 18.51 %, the volume of level-4 surgeries increased by 16.96 %, the volume of minimally invasive surgeries increased by 9.37 %, and total relative weight increased by 16.58 %. The average length of stay decreased by 4.91 %, the time consumption index decreased by 4.21 %, and the DRG grouping error rate decreased by 36.69 %. The drug proportion decreased by 4.39 percentage points, while the proportion of consumables and average cost per case showed slight increases of 2.47 % and 3.47 %, respectively, both within controllable ranges. Dimensions such as cost control and medical insurance supervision exhibited characteristics of structural advantages coexisting with localized fluctuations. Conclusion Under the DRG payment model, medical insurance Multidisciplinary Team management has a significant positive empowering effect on hospital refined operations. It represents a high-quality management model well-adapted to DRG payment reform and conducive to promoting high-quality development of hospitals.
Objective To explore the effect of applying the PDSA cycle management method in reducing the incidence of hospital- associated venous thromboembolism. Methods Compared and analyzed the VTE risk assessment rate, bleeding risk assessment rate for patients at moderate-to-high risk, implementation rate of preventive measures, and hospital-associated VTE incidence rate before and after the implementation of the PDSA cycle management method. Results After implementing the PDSA cycle management method, the VTE risk assessment rate and the bleeding risk assessment rate for moderate-to-high risk patients improved significantly, and the implementation ratem of preventive measures increased from 51.43 % to 58.40 %, and the incidence of hospital-associated VTE decreased from 0.26 % to 0.12 %. Conclusion Application of the PDSA cycle management method can effectively improve the standardized management level of VTE in hospitals.
Objective To analyze the characteristics and causes of medical disputes in an infectious disease hospital during its comprehensive transformation, and to explore strategies for preventing and reducing such disputes, thereby providing a reference for improving medical risk management mechanism. Methods In May 2025, a retrospective analysis was conducted on 102 compensated medical dispute cases from a tertiary grade A infectious disease specialized hospital in Jiangsu Province, spanning the period from 2020 to 2024. The cases were divided into an infectious disease patient group (35 cases) and a non-infectious disease patient group (67 cases) based on whether the patients had a legally defined notifiable infectious disease. Descriptive statistics and intergroup comparisons were performed on the department distribution, causes, timing of occurrence, and resolution approaches of the medical disputes. Results The surgery department was identified as the high-risk department for medical disputes. Medical technical error was the primary cause of medical disputes. Disputes occurred most frequently during the day shift and were primarily resolved through hospital-based negotiation. Statistically significant differences were observed between the infectious disease patient group and the non- infectious disease patient group in terms of departmental distribution, causes, and time of occurrence of medical disputes (P<0.05). Conclusion In the process of comprehensive transformation and development, infectious disease hospitals should build on the irspecialized advantages, focus on enhancing comprehensive diagnostic and treatment capabilities, rigorously enforce quality and safety management, and strengthen professional skills training and the development of doctor-patient communication mechanisms.
Objective To explore the effects of the relationship quality between head nurses and the directors of nursing departments on team performance, as well as the mediating role of head nurses' self-monitoring and the moderating role of team size. Methods In December 2024, a convenience sample of 139 head nurses from three public hospitals in Shenzhen was selected as the study subjects. A survey was conducted using a general information questionnaire, the Leader-Member Exchange Social Comparison Scale, the Team Performance Scale, and the Self-Monitoring Scale. The questionnaire was designed and distributed using the WJX platform. Data were analyzed using multiple linear hierarchical regression and simple slope analysis. Results The relationship quality between head nurses and directors of nursing departments had a positive impact on team performance ( β=0.280, P<0.001). After introducing the mediating variable of head nurses' self-monitoring, both the relationship quality and head nurses' self-monitoring significantly and positively influenced team performance ( β=0.142, P<0.01; β=0.654, P<0.001). Head nurses' self-monitoring mediated the relationship between relationship quality and team performance. Team size positively moderated the positive relationship between relationship quality and head nurses' self-monitoring ( β=0.016, P<0.05). Conclusion The relationship quality between head nurses and directors of nursing departments significantly and positively predicts team performance, with head nurses' self-monitoring serving as a mediator. Furthermore, compared to smaller teams, the positive effect of relationship quality on head nurses' self- monitoring is more significant in larger teams.
Objective This study examined the effects of safety climate and service climate on nursing assistants' proactive caring behavior in nursing homes, and tested the mediating role of job satisfaction as well as the moderating effect of safety climate. Methods A questionnaire survey was conducted among 447 nursing assistants. Multiple regression analyses, bootstrap tests (5,000 resamples), and moderation analyses were performed to verify the hypothesized relationships. Results Both safety climate ( β=0.322, P<0.001) and service climate ( β=0.673, P<0.001) significantly improved job satisfaction. Job satisfaction positively predicted proactive caring behavior ( β=0.331, P<0.001) and partially mediated the effects of the two climates. Safety climate significantly moderated the effect of service climate on job satisfaction (interaction β=0.221, P<0.001), with a stronger positive effect observed under high safety climate. Conclusion Enhancing safety and service climates can effectively increase job satisfaction and promote proactive caring behavior among nursing assistants. Safety climate serves as a key contextual factor that amplifies the positive influence of service climate.
Objective To understand the cognition, current practice, and restrictive factors of managers from 4 public hospitals in Weihai City regarding the integrated development of traditional Chinese and Western medicine, so as to provide a reference for improving management measures and formulating relevant policies. Methods A cross-sectional survey was conducted among managers of 4 public hospitals in Weihai City from June to July 2025. The questionnaire was designed via Questionnaire Star and distributed through WeChat, with 54 valid questionnaires recovered. Frequency and percentage analyses were performed using SPSSAU. Results All 4 hospitals had formulated plans for the integrated development of traditional Chinese and Western medicine. 90.7% of the managers recognized its importance in enhancing the core competitiveness of hospitals. The integrated development achieved remarkable effects in improving clinical efficacy, but the development was unbalanced. Internally, the shortage of interdisciplinary talents was the primary challenge, accompanied by problems such as departmental barriers and inadequate top-level design. Externally, the restriction of medical insurance payment policies was the main constraint, and there was a lack of authoritative standards and specifications. Conclusion The integrated development of traditional Chinese and Western medicine in public hospitals of Weihai City needs to construct a linkage system of "hospital-led promotion and government policy support". Hospitals should optimize top-level design, cultivate interdisciplinary talents, and improve incentive mechanisms. The government should promote the reform of medical insurance payment and accelerate the construction of a standardization system. The joint efforts of both sides will boost the quality, efficiency, and in-depth development of the integrated model.
Bibliometric analysis of the talent cultivation path empowered by party building in public hospitals
Objective To explore the strategy of talent cultivation in public hospitals empowered by party building, and to provide theoretical and practical basis for enhancing hospital talent competitiveness. Methods Relevant literature on party building- empowered talent cultivation indexed in CNKI from January 1, 2005, to August 31, 2025, was retrieved. CiteSpace software was used for bibliometric analysis, generating knowledge maps of keyword co-occurrence, clustering, burst detection, and timeline analysis. Results Keyword co-occurrence, clustering, and burst analysis revealed that core research themes in this field focused on the integration of party building and professional practice, hospital culture construction, and party building-led talent cultivation models. These findings indicate that research in this field has gradually formed a four-dimensional thematic framework encompassing political guidance, organizational empowerment, practice integration, and mechanism assurance. Conclusion Research on party building- empowered talent cultivation in public hospitals has gradually shifted from early exploration of party building work toward party- business integration, collaborative education, and mechanism assurance. Future efforts should further strengthen the coordination mechanism between party building and talent cultivation, improve practice transformation and evaluation feedback systems, and enhan ce the specificity and effectiveness of talent team development in public hospitals.
Objective To grasp the current research status and evolutionary trends of public welfare reform in public hospitals in China, and to provide references for future research directions. Methods Taking 1,044 valid literatures included in CNKI from 2004 to 2025 as the research objects, CiteSpace software was used to conduct visual analysis from the dimensions of publication time, journals, authors, institutional distribution of the included literatures, as well as keyword co-occurrence, clustering and bursting. Results The research evolution process shows a distinct policy-driven feature, the distribution of research forces is concentrated but the cooperation network is still not mature, and the research hotspots and evolution paths progress layer by layer. Conclusion The research on public welfare reform of public hospitals in China has formed a clear context, However, there are limitations such as a single source of literature and insufficient synergy, practicality and forward-looking of existing achievements. In the future, it is necessary to build a multi-disciplinary collaborative research network to strengthen cross-disciplinary research and interdepartmental collaboration; deepen empirical research and mechanism analysis to enhance practical guidance value; focus on the two-way interaction between doctors and patients and explore micro-level implementation mechanisms.
The Healthy China Initiative constitutes a core component of China's modernization agenda, and its advancement increasingly relies on digital intelligence – driven approaches. As key institutional platforms for translating the Healthy China strategy into evidence generation and scientific innovation, universities and research institutes play a pivotal role in conducting academic research that supports the digital-intelligence – enabled development of Healthy China. The Expert Consensus on Digital Intelligence – Driven Academic Research for Healthy China (2025) was led by the Health Reform and Development Center / Health and Reform Policy Laboratory, at Renmin University of China, jointly developed with member institutions of the Healthy China Scientific Research Alliance, and technically supported by the Committee of Proactive Health for Standardization. The consensus was formulated through a rigorous, scientific process involving multiple experts from relevant fields in China. It presents nine consensus statements across three domains – significance, principles, and priority areas of digital intelligence – driven research for Healthy China – and proposes four action strategies to facilitate implementation.
