To address the pain points of healthcare reform such as the imbalanced allocation of urban medical resources, prominent homogeneous competition, insufficient downward flow of high-quality resources, and the significant siphon effect of provincial capital cities, Xiangtan City has systematically advanced the construction of compact urban medical groups by leveraging the national demonstration project for public hospital reform and high-quality development. Through establishing an integrated governance mechanism, restructuring the hierarchical diagnosis and treatment system, building a city-wide resource sharing platform, and deepening the reform of medical insurance payment methods, the city has realized the transformation of medical institutions within its jurisdiction from "physical integration" to "deep integration", effectively optimizing the allocation of municipal medical resources, improving the quality and efficiency of medical services, enhancing the efficiency of medical insurance funds, and enhancing the health and welfare of residents. This article systematically reviews the background and pain points, overall approach, core measures, and practical outcomes of the construction of the Xiangtan medical group, distills replicable reform experience, and proposes promotion recommendations suited to similar cities nationwide, providing practical reference for small and medium-sized cities to deepen the construction of compact urban medical groups and build an integrated healthcare service system.
Objective To analyze the practice and outcomes of medical quality homogenization in a compact urban medical group led by a tertiary grade A hospital in Nanyang, and to provide evidence for quality improvement. Methods A combined theoretical and case-study approach was used to compare group indicators before and after the pathway implementation (2023—2025). Results After implementation, main hospital outpatient visits, inpatient admissions, and referrals rose by 10.2 %, 14.2%, and 36.2 %, respectively; branch hospitals saw increases of 13.8 %, 11.4 %, and 51.3 %. Clinical pathway compliance and adverse event reporting improved in both. Infection, complication, irrational drug use, and dispute rates declined across the group. Patient satisfaction increased from 94.5% to 98.7 %, and staff satisfaction from 92.3 % to 98.4 %. Public health services and chronic disease management improved, data sharing deepened, and the group's influence expanded. Conclusion The homogenization pathway helps optimize resource allocation, enhance healthcare efficiency, and promote high-quality development of the medical group.
Objective To systematically analyse the practical dilemmas in the construction of compact urban medical groups and explore corresponding optimization paths, so as to provide references for the effective implementation of relevant policies. Methods Based on Smith's Policy Implementation Process Model, this study collected national and local official policy documents as well as publicly reported pilot practical materials. From four dimensions including idealized policy, implementing agencies, target groups and policy environmental factors, this study conducts element decomposition and logical deduction for the policy implementation system of compact urban medical groups. Results Although the construction of compact urban medical groups has achieved phased progress across provinces and municipalities in China, multiple dilemmas still exist, including insufficient top-level policy details and provisions, the absence of multi-department coordination mechanisms, unfully accommodated interest demands of both medical staff and patients, and imperfect supporting environmental conditions. Conclusion Systematic countermeasures should be formulated from four aspects: improving top-level policy design, clarifying the power-responsibility boundaries of multiple implementing agencies, stimulating the participation motivation of target groups, and optimizing external supporting environments for policies. These measures can resolve conflicts among policy-implementation elements, promote the downward flow of high-quality medical resources, and build a regional hierarchical diagnosis and treatment system featuring functional collaboration and continuous medical services.
Objective To evaluate the effectiveness of compact urban medical group construction on improving primary healthcare service capacity and to provide empirical reference for medical group reform in similar regions. Methods Taking the compact urban medical group in Xifeng South District of Qingyang City as the research subject, the monthly outpatient visits, medical resource allocation and patient characteristics data of 8 member institutions and 2 non-member control institutions from January 2019 to July 2025 were collected. Taking September 2023, when the medical group was established, as the time point, the data were divided into the pre-establishment period (January 2019 to August 2023) and the post-establishment period (September 2023 to July 2025), and pre-post comparison and institutional control methods were adopted for descriptive statistical analysis. Results After the establishment of the medical group, the monthly average outpatient visits of 4 community health centers increased from 894.6 to 1 192.8 person- times, with a growth rate of 33.3 %, while those of the 2 control hospitals decreased by 15.6 % over the same period. The number of community physicians increased from 12 to 25, and registered nurses from 70 to 112. The family doctor signing coverage rate rose from 50.2 % to 81.7 %, the medical insurance reimbursement ratio from 48.0 % to 85.0 %, and the return visit rate from 40.0 % to 84.0 %. The numbers of patients under standardized management of hypertension and diabetes has increased significantly, respectively. Conclusion The compact urban medical group obviously improved the primary healthcare service capacity and the accessibility of medical services for residents through resource deployment to primary care, digital support, and integrated management. Its construction experience could provide a reference for medical group reform in similar regions of central and western China.
In the context of high-quality development, compact urban medical groups, as an important vehicle for optimizing the allocation of urban medical resources and enhancing the continuity of healthcare services, impose new requirements on performance evaluation systems. Focusing on the basic operational framework of compact urban medical groups, this paper elaborates on the "four synergies" for assessing the construction of such groups. By analyzing the applicability of the Balanced Scorecard theory to the performance evaluation of urban medical groups, this paper explores the dilemmas in performance evaluation from the four dimensions of finance, patients, internal processes, and learning and growth, and proposes strategic pathways for performance evaluation. The paper indicates that the performance evaluation of urban medical groups needs to strengthen the rights, responsibilities, and accountabilities of participating entities through "integrated" construction, and to quantify the indicator system via the Balanced Scorecard, so as to align indicators across various institutions within the group, promote collaborative synergy, and achieve co-creation of value, thereby providing theoretical support for driving the high-quality development of compact urban medical groups.
Objective Taking Peking University Third Hospital Haidian North Branch as an example, this study explores a feasible pathway for newly established public hospital campuses to achieve differentiated development and ensure effective strategic implementation. Methods A single-case exploratory design was adopted to systematically review and analyze the tripartite synergy pathway of discipline, performance, and resources at Peking University Third Hospital Haidian North Branch. Results The campus established a discipline system featuring "strong specialties complemented by comprehensive general services", a strategy-oriented performance management system, as well as a dynamic and flexible resource allocation mechanism, thereby achieving steady growth in core clinical services and sustained breakthroughs in the diagnosis and treatment of complex and severe diseases. Conclusion Grounded in Dynamic Capability Theory, the "discipline-performance-resource" synergy pathway drives hospitals from scale expansion to quality and efficiency improvement through the synergy of precise discipline positioning, strategic performance integration, and flexible resource support, offering a reference for the multi-campus development of public hospitals.
Objective To explore the implementation pathways for optimizing patient experience in newly established branch campuse of large public hospital, address key challenges in the early operational phase such as insufficient quality homogenization and poor service workflow, and provide practical references for the development of similar branch campuses. Methods Taking the Peking University Third Hospital Haidian Northern Branch as a case study, a case study and mixed-methods research design were adopted. Comprehensive measures throughout the entire process from planning to operation were systematically reviewed across five dimensions: party building leadership, discipline layout, homogenized management, digital and smart empowerment, and humanistic services, with further analysis supported by multidimensional data. Results Relying on the dual-wheel driving development model of smart empowerment and process innovation, the campus has achieved substantial improvements in diagnosis and treatment efficiency, service quality, and resource allocation efficiency, which effectively optimized patients' medical experience. Conclusion The integrated optimization model established by this hospital—grounded in Party building, enabled by technology, enhanced by process innovation, and safeguarded by humanistic care—is feasible and readily generalizable. It provides a robust theoretical basis and practical reference for the high-quality development of newly established branch campuses in public hospitals and the continuous improvement of patient experience.
Objective To investigate an efficient operational pathway for newly established branch campuses of large public hospitals, and to provide practical references for expanding high-quality medical resources and achieving balanced regional distribution. Methods Taking Peking University Third Hospital Haidian Northern Branch as the study subject, medical and operational data from June to December 2025 were statistically analyzed to quantitatively evaluate operational efficiency. Results The Haidian Northern Branch implemented a "four-dimensional integrated" efficient operational model encompassing "top-level design–collaborative management–resource allocation–process reengineering," which achieved synergistic improvements in both operational efficiency and medical quality. Conclusion The efficient operational model of the new branch campus of Peking University Third Hospital Haidian Northern Branch can serve as a reference for promoting high-quality development of multi-campus public hospitals.
Objective To explore the changes in operational performance and human resource management challenges encountered by an enterprise hospital during its restructuring and integration as a branch campus of a university-affiliated hospital, and to provide a theoretical reference and practical pathway for the "one hospital with multiple campuses" management model. Methods Taking Enterprise Hospital A as a case study, longitudinal data analysis was conducted to perform descriptive statistics on outpatient visits, inpatient admissions, surgical volume, and financial indicators from 2015 to 2024. Employee satisfaction was assessed via questionnaire surveys. Results Before the restructuring, Hospital A experienced a continuous decline in various operational indicators, accompanied by human resource attrition during the restructuring period. After integration into the university-affiliated hospital, operations stabilized; however, employees remained relatively dissatisfied with compensation and career development. The rehabilitation department, established as a differentiated specialty, subsequently became a major source of revenue. Conclusion In the new landscape of coordinated development under the "one hospital with multiple campuses" model following an orderly restructuring, it is essential to strengthen the operational closeness between campuses, with the main campus providing support for the development of distinctive rehabilitation specialties at the branch campus.
Objective Based on the Traditional Chinese Medicine (TCM)-characteristic indicators in the National Performance Monitoring of Tertiary Public TCM Hospitals, and accounting for inter-departmental differences in resources and efficiency, this study aimed to construct a contribution degree evaluation model for the functional positioning of clinical departments, so as to provide a quantitative tool for refined management of TCM hospitals. Methods Using 2024 clinical data from a tertiary public TCM hospital in Shandong Province, we integrated three dimensions—resources, efficiency, and outcomes—and introduced the number of staffed beds and average length of stay as adjustment factors to construct a contribution degree evaluation model focused on five TCM-characteristic indicators for clinical departments. Results In this hospital, the Department of Medical Oncology ranked first in its contribution to the outpatient TCM decoction pieces utilization rate (15.71 %), the inpatient TCM decoction pieces utilization rate (12.92 %), and the proportion of non-pharmaceutical TCM therapies for inpatients (11.14 %); the Tuina Department ranked first in its contribution to the proportion of non-pharmaceutical TCM therapies for outpatients (22.84 %); and the Department of Rheumatology and Immunology ranked first in its contribution to the proportion of TCM advantaged diseases among discharged patients (14.67 %). Conclusion The model can quantify the actual contribution of each clinical department to the hospital's TCM functional positioning, providing a basis for resource allocation and the development of clinical disciplines.
Objective To construct a scientific and systematic evaluation index system for high-level talents, providing a quantitative tool for talent selection, cultivation, and motivation in the context of high-quality development of public hospitals. Methods Through literature research, policy analysis, and the Delphi expert consultation method, the evaluation index framework was initially constructed and optimized. Subsequently, the Analytic Hierarchy Process was used to determine the weight of each index. Results A high-level talent evaluation system was established, comprising 5 first-level indicators, 14 second-level indicators, and 35 third-level indicators. The weight coefficients for each level of indicators were determined. Among the first-level indicators, the weights were as follows: medical ethics and professionalism (0.367 2), clinical practice and technological innovation capability (0.244 6), scientific research innovation and achievement transformation capability (0.168 3), teaching and team cultivation capability (0.110 2), and public service and social responsibility (0.109 7). Conclusion The evaluation index system aligns closely with the policy orientation of "breaking the 'five-only' criteria" and the requirements for high-quality development in public hospitals. The indicators are reasonably designed, and the weight allocation is scientifically sound, demonstrating strong policy relevance and practical application value. It can provide a quantitative reference for the evaluation and management of high-level talents in this hospital and similar public hospitals, with high operability.
Objective To establish an evaluation framework for professional conduct tailored to public rehabilitation hospitals and to conduct a survey of the current situation, thereby providing a scientific basis and practical guidance for the high-quality development of public rehabilitation hospitals. Methods The index system was established through key informant interviews and two rounds of Delphi expert consultation. Using a self-designed questionnaire, a cross-sectional survey was conducted among 223 on- duty staff members of a public rehabilitation hospital in Shanghai to assess the current level of professional conduct development. Results The evaluation index system constructed in this study comprised 6 primary indicators, 21 secondary indicators, and 49 tertiary indicators. The empirical survey revealed that the overall mean score of professional conduct development in the sample hospital was4.80±0.31. Dimension scores in descending order were: guarantee system, evaluation system, publicity and education, management system, organizational leadership, and supervision and management. Conclusion The established indicator system is scientific and reasonable, reflecting the characteristics of rehabilitation; the hospital's integrity development is generally sound, providing quantitative tools and improvement directions for integrity building in public rehabilitation hospitals.
Objective To investigate the current status of cardiopulmonary rehabilitation (CR) implementation in Sichuan Province and to explore improvement strategies, so as to provide a scientific basis for regional system development and policy optimization. Methods A cross-sectional questionnaire survey was conducted in February 2025 across 128 medical institutions in 21 prefectures (cities/autonomous prefectures) of Sichuan Province. The questionnaire covered dimensions including program implementation, operational models, technology adoption, and perceived development barriers. A total of 181 valid questionnaires were returned and analyzed using Minitab and Excel. Results It showed that CR programs were insufficiently implemented overall. Among the 128 institutions surveyed, 48 (37.50 %) had not yet initiated such programs, and only 29.69 % had operated programs for more than three years. Among the 80 institutions that had launched CR programs, common constraints included narrow medical insurance reimbursement coverage (71/80, 88.75 %), low patient acceptance (59/80, 73.75 %), and shortages of specialized professionals (60/80, 75.00 %). Furthermore, CR service delivery remained heavily reliant on in-hospital settings, with weak out-of-hospital capacity and a lack of an integrated inpatient–outpatient–community/home-based service continuum. Conclusion Despite substantial demand potential, CR faces multiple constraints. Advancing standardized and sustainable CR services requires multidimensional interventions: expanding the scope of reimbursement to cover core CR items, establishing structured patient/provider cognitive intervention and education frameworks, training specialized CR professionals, strengthening quality control/quality assurance systems, and reforming delivery models to build an integrated care continuum.
The construction of close-knit county medical communities is a key measure for deepening the reform of the medical and health system and promoting the development of healthy counties. This paper takes the Gaokang Medical Group in Gaomi City, Shandong Province, one of the first batch of national pilot units, as an empirical case to systematically analyze the current situation and deep-seated difficulties of the "integration" practice of county, township and village medical services. The research finds that the current "integration" process has achieved initial results in aspects such as the informatization foundation, the coordination of emergency and critical care, the homogenization management of drugs, and the integration of medical treatment and prevention for chronic diseases. However, it still faces many core challenges. Based on the theory of collaborative governance and resource integration, this paper constructs a systematic optimization path for the "integration" of county medical services from five dimensions: organizational management collaboration, leverage of medical insurance payment, integration of element flow, platformization of intelligent diagnosis and treatment, and systematization of medical and preventive integration. Combined with the integration of the Gaokang Medical Group, it puts forward replicable policy suggestions, providing theoretical references and practical guidelines for deepening medical reform and improving the accessibility and continuity of high-quality medical resources.
Objective To systematically analyze the internal and external environmental factors of a tertiary public psychiatric hospital based on the PEST-SWOT model, and to propose optimized practical pathways for high-quality development. Methods The management status of a tertiary public psychiatric hospital was analyzed via a literature review, and the PEST-SWOT model was applied to examine its internal strengths and weaknesses and external opportunities and threats. Results The internal and external environment of the hospital was comprehensively reviewed, resulting in a development strategy matrix comprising four types of strategies: SO, ST, WO, and WT. Conclusion As a provincial regional mental health center, the hospital should consolidate its core strengths, address internal weaknesses, leverage policy incentives and market opportunities, and actively respond to various challenges. The systematic development pathways proposed in this study can provide decision-making references for the high-quality development of similar hospitals.
Objective To evaluate the impact of the "medical insurance collaborative quality-control task force" collaborative management model on key inpatient operational indicators. Methods An interrupted time series analysis was conducted using 33 months of monthly hospital operational data from January 2023 to September 2025 at a single hospital, to assess immediate and long- term effects of the intervention. Results After implementation, the proportion of medical service revenue increased significantly by 1.5 percentage points, while the proportion of drug and consumable costs decreased significantly by 2.3 percentage points, with both effects remaining stable. The mean DIP assigned-to-standard score ratio showed no immediate change but a significant sustained upward trend. Average hospitalization cost decreased initially but rebounded significantly in the long term, indicating the complexity of cost control. Conclusion The "medical insurance collaborative quality-control task force" can effectively optimize revenue structure and improve data quality, serving as an effective management model for hospitals adapting to DIP reform. Future efforts should shift from cost containment to value-based care for sustainable development.
Objective To explore the practical effectiveness of enhancing the hospital's Case-Mix Index (CMI) through refined case- category (disease-category) management strategies under the Diagnosis-Intervention Packet (DIP) payment model. Methods Inpatient medical record front-page data and DIP-related information were extracted for all discharged patients in 2023 and 2024. Measures implemented—including establishment of a dual-level case-category management directory, improvement of medical record front-page coding accuracy and completeness, optimization of clinical pathway management, advancement of the tiered diagnosis and treatment (tiered referral) system, strengthening of clinical discipline development, and implementation of performance-based incentives—were analyzed for their impact on CMI. Results These interventions produced substantial improvements in case-mix management. The hospital's CMI increased. The proportion of low-RW cases (RW<1) declined while that of moderate-to-high-RW groups (RW≥1) increased, indicating a structural shift toward more resource- intensive and clinically complex admissions. The CMI-adjusted mean cost per discharge decreased. Conclusion While the above measures have yielded substantial improvements in raising CMI and optimizing the hospital's case mix, clinical quality must remain the prerequisite for any reform driven by payment incentives. Sustainable progress will require stronger interdepartmental coordination, closer communication with local health insurance authorities, and continued advancement of health information system infrastructure.
Objective To explore the construction and effectiveness of a performance appraisal system based on medical quality and safety improvement goals, and to provide empirical evidence for medical quality management in the context of high-quality development of public hospitals. Methods This study took the practice of target-based performance appraisal for clinical departments in a grade A tertiary hospital from 2024 to 2025 as the research object, constructed a three-level performance appraisal indicator system based on the Structure–Process– Outcome three-dimensional quality evaluation model, and compared core indicators of medical quality and safety before and after revision of the indicator system. Results After the revision of the indicator system, process indicators improved significantly compared with those before revision: the spot-check pass rate of concurrent medical records, the critical value response pass rate, and the VTE assessment rate were all higher than those before revision (all P<0.001). Outcome indicators were continuously optimized: the unplanned return to operating room rate was lower than before revision (P=0.016), and the Case-Mix Index (CMI) value was higher than that before revision (P<0.001). The capacity for managing adverse events of medical quality and safety was enhanced, with the active reporting rate higher than that before revision (P<0.001). All the above differences were statistically significant. Conclusion The performance appraisal system based on medical quality and safety improvement goals can effectively guide departments to focus on the implementation of core medical systems and the improvement of intrinsic quality, promoting continuous improvement of medical quality indicators.
Objective Based on the value-based healthcare concept, implement continuous improvement measures for performance monitoring indicators in tertiary public hospitals to support their high-quality development. Methods Guided by health value, classify the three-level performance monitoring indicators into three categories: health output improvement, reasonable cost control, and necessary support and guarantee. Priority and expected values are determined based on the hospital's development stage, vision, etc. and benchmarking is used KPI, Organize and implement differentiated improvements using methods such as root cause analysis, matrix analysis, institutional entrepreneurship, and leverage resolution. Results Three types of indicators improved, after four years, the performance monitoring results have climbed from B+level to A level. Conclusion The continuous improvement mechanism of performance monitoring based on the concept of value-based healthcare has clear guidance and strong operability,which has practical significance for the development and transformation of public hospitals and the improvement of performance monitoring results.
Against the backdrop of deepening the anti-corruption campaign and the concentrated rectification of corruption in the medical field, the source prevention and systematic governance of integrity risks in the allocation of scarce medical resources and their service delivery have become a key focus of disciplinary inspection and supervision agencies. Taking the allocation and supply of scarce proton and heavy ion medical resources as an example, this study integrated the concept of collaborative integrity risk prevention and control into the design and full-process daily operation of an intelligent inpatient admission scheduling system, and constructed an integrity risk prevention and control mechanism centered on a "full-factor scoring system (FFSS)" and featuring "rules–technology–personnel" and "supervision–investigation–accountability (S-I-A)" full-chain collaboration. The mechanism ensured that the scheduling of proton and heavy ion patients was scientific, transparent, and fair, effectively mitigating potential integrity risks during the waiting period for hospitalization, optimizing the allocation of scarce medical resources, and improving patient satisfaction and sense of gain. This study provides a model and empirical reference for Chinese medical institutions, particularly those engaged in intelligent allocation of scarce medical resources, for collaborative prevention and control of integrity risks.
Objective Based on DeepSeek-assisted requirement analysis, this study developed a WeChat Mini Program for surgical progress inquiry, aiming to optimize the experience of family members waiting for surgical progress updates during the perioperative period and improve surgical efficiency. Methods Using convenience sampling, totally 388 family caregivers of surgical patients from a Grade A tertiary hospital in Xuzhou between February and March 2025 were enrolled and randomly assigned to a control group (n=193) and an intervention group (n=195). The control group received traditional communication mode, while the intervention group used the surgical progress inquiry Mini Program to obtain real-time surgical information. Satisfaction with surgical progress acquisition and surgical efficiency indicators were compared between the two groups. Results The satisfaction score of family members in the intervention group was 95.38±1.25, vs. 70.25±2.46 in the control group (P<0.001). Turnover time and patient pickup time in the intervention group were significantly shortened (P<0.001). Conclusion The WeChat Mini Program for surgical progress inquiry developed with DeepSeek-assisted requirement analysis can significantly improve family member satisfaction and shorten surgical turnover time, and has value for clinical promotion.
