Objective Under the national policy framework, this study aims to explore integrated governance pathways to address fragmentation in managing restricted medical technologies—caused by disparities in provincial catalogs and procedures, varying hospital levels, and inconsistent quality control measures—to enhance management efficiency. Methods Based on policy texts including the 2018 "Regulations on the Clinical Application of Medical Technologies", we employed multi-case comparison and policy text analysis to examine differences in catalog formulation, filing procedures, and quality control mechanisms across representative provinces. Results The current management system faces three main dilemmas: Insufficient policy coordination among national, provincial, and hospital levels leads to inconsistent management standards. A disconnect between online and offline approval processes creates a "digital divide". A fractured quality control chain across pre-event, in-process, and post-event stages results in disjointed oversight. Conclusion An integrated governance framework centered on a national information platform should be constructed through enhanced policy coordination, process standardization, and data-driven supervision. This framework would enable whole-process, homogeneous, and refined management of restricted medical technologies.
Objective To scientifically evaluate the equity and regional differences in health human resources allocation in Guangdong Province, predict future personnel numbers, and provide evidence for optimizing regional resource allocation and formulating health human resources policies. Methods Based on data from 2000 to 2023, the agglomeration degree and Theil index were used to assess the equity of allocation for in-service health workers, health technicians, and licensed (assistant) physicians. The data were used to establish ARIMA and Holt's exponential smoothing models, respectively. The model with superior accuracy was selected to predict the number of health personnel from 2024 to 2026. Results The total number of health workers in Guangdong Province showed a significant growth trend. However, regional allocation disparities for the three types of health human resources were evident, with inter-city imbalance in resource allocation being the main contributor to overall inequity. Conclusion Differentiated allocation strategies should be formulated, focusing on talent supply and capacity building in underdeveloped areas and establishing a cross-regional talent flow mechanism to narrow regional resource gaps and promote balanced allocation across the province.
Taking a prefectural-level tertiary general hospital as an example, this study explores how to forge an innovation pathway for scientific and technological advancement in the context of precision medicine. By enhancing top-level design, strengthening talent support, building innovation platforms, as well as implementing precise prevention, diagnosis, treatment, and medication, a virtuous cycle of "technology application—data accumulation—research breakthrough" has been established. This practice promotes the application of precision medicine at the clinical forefront, supports the hospital's high-quality development, and provides a reference for building scientific and technological innovation systems in prefectural-level public hospitals in the new era.
Objective To explore the development pathways of public management disciplines in medical universities under the context of new liberal arts construction, utilizing the PEST-SWOT model. Methods The study examines 85 public medical universities in China, investigating undergraduate programs in public administration, master's degree offerings in public management, and the development of master's programs in public management. The internal and external environments of the discipline are analyzed through the PEST-SWOT framework. Results Internal environment analysis reveals that medical universities possess unique advantages in discipline system construction and curriculum development but face challenges such as lack of targeted and distinctive features, underdeveloped secondary disciplines, and insufficient integration of theory and practice. External environment analysis indicates that public management disciplines in medical universities encounter both opportunities and threats across political, economic, social, and technological dimensions. Conclusion It is essential to accelerate the distinctive development of public management disciplines in medical universities, harnessing crises as opportunities for innovation and promoting integrated growth of the discipline.
Objective Based on the actual situation of public health work in secondary and above mental health specialized hospitals in Shandong province, sort out the public health tasks and construct an evaluation index system to provide a basis for the scientific and homogeneous management of mental health specialty public health in Shandong province. Methods Two rounds of expert letter inquiries were conducted using the Delphi expert consultation method to establish an evaluation index system for public health management of psychiatry in Shandong province, and to clarify the connotation of the indicators and the evaluation methods. Results The authority coefficients of the two rounds of expert consultation were Cr=0.921 and Cr=0.928 respectively. Kendall's W in the first round of expert consultation was 0.700, and Kendall's W in the second round was 0.850 (P all<0.001). The coefficient of variation (CV) of each index was less than 0.25. The constructed evaluation index system for public health management of psychiatry in Shandong province includes 8 first-level indicators, 34 second-level indicators and 61 third-level indicators. Conclusion Scientifically construct an evaluation index system for public health management that conforms to reality, providing a basis for health and wellness administrative departments in optimizing the public health system of mental health specialized hospitals in Shandong province and rationally allocating health resources, thereby improving the level of public health and disease prevention and control in mental health specialized hospitals.
Recently, the National Health Commission and five other ministries jointly issued a document to launch a one-year special rectification campaign against "black ambulances". Against this backdrop, this paper first analyzes the hazards and causes of "black ambulances", and then, based on the principle of addressing both symptoms and root causes, explores the significance and construction ideas for scientifically building a non-emergency medical transfer service system covering the whole country from six aspects: institutional setup, scientific development, professional division, standardized services, professional ethics, and fee standards, aiming to provide references for eliminating the phenomenon of "black ambulances".
Objective This study aims to systematically review China's national policies concerning the construction of township health centers (THCs), clarify their quantitative construction standards and core development logic, and propose directions for future policy optimization in response to existing challenges. Methods By systematically reviewing relevant policy documents and employing quantitative analysis, this research analyzes key indicators of THC construction requirements, including bed capacity and allocation ratios. Based on this analysis, it explores the developmental pathway and practical difficulties of THCs. Results A multidimensional quantitative standard system for THCs in China has been established, which specifically regulates key parameters such as bed capacity ( ≤100 beds per facility) and bed allocation ratio (0.6~1.2 beds per thousand population). Future development should focus on digital upgrading and the integration of medical care with disease prevention (i.e., "medical-preventive integration"). However, significant challenges persist, including regional disparities, a shortage of qualified personnel, and insufficient operational feasibility of certain quantitative indicators. Conclusion To strengthen the three-tier rural healthcare network, policymaking should transition towards a "targeted" approach. This involves implementing differentiated management and dynamic adjustment mechanisms and shifting the evaluation system from a primary reliance on quantitative metrics towards an emphasis on improving service quality.
Objective To analyze the current situation of high rates leukemia DRG cases in a certain hematology hospital, and provide more optimized solutions for targeted cost control, reducing patients' medical burden, and promoting the rational use of medical insurance funds for high rates cases. Methods Leukemia cases discharged from a blood disease specialist hospital in Tianjin from April 1, 2024 to April 1, 2025 were extracted, and patient data paid according to the high-cost case payment standard were screened. Their basic information was analyzed, and the grey correlation analysis method was used to analyze the correlation between each sub item cost of high-cost cases and the total hospitalization cost. At the same time, typical cases were selected for key analysis. Results In the 2024 agreement year, the hospital settled a total of 7,256 cases according to DRG, of which 335 cases were paid according to high-cost cases, accounting for 4.62 % of the total cases. Grey correlation analysis found that the overall drug cost and total hospitalization cost of high-cost cases had the highest correlation. Among the top 12 high-cost DRG groups with the highest number of cases, 6 DRG groups had the strongest correlation between drug cost and hospitalization cost, 4 DRG groups had the strongest correlation between examination cost and hospitalization cost, and 2 DRG groups had the strongest correlation between treatment cost and hospitalization cost. Conclusion The correlation between drug costs, examination costs, treatment costs, and the total cost of high incidence cases is the highest, which is the key to controlling the cost of high incidence cases of leukemia DRG. Optimizing clinical diagnosis and treatment, improving medical insurance payment policies, and strengthening hospital management are effective strategies for addressing high rates of cases.
High-level professionals are crucial for driving the high-quality development of public hospitals. Under the requirements of developing new-quality productive forces, and faced with institutional restructuring and a new landscape of talent competition brought by the 2025 island-wide customs closure of the Hainan Free Trade Port, public hospitals urgently need to optimize their talent recruitment mechanisms, research platforms, and incentive systems. Guided by this paradigm and addressing current challenges such as talent shortages, structural imbalances, and insufficient incentives, this study proposes pathway recommendations in four key areas: talent system construction, evaluation and incentive reform, research environment enhancement, and management system optimization. It emphasizes building a quality-oriented talent recruitment system, strengthening multi-dimensional support mechanisms, and improving talent aggregation and utilization efficiency, to provide human resource support for regional medical service innovation and institutional openness.
Factors influencing the effectiveness of medical device adverse event monitoring and countermeasures
Since the implementation of the Registrant / Filer System for Medical Device Adverse Event Monitoring, the monitoring performance of the primary responsible entities—registrants and filers—remains suboptimal. This study aims to identify the key factors influencing the effectiveness of their monitoring work, pinpoint areas for improvement, and propose targeted recommendations. We conducted a questionnaire survey of registrants and filers to identify and systematically analyze the factors affecting their poor monitoring performance. The findings indicate that suboptimal monitoring performance can be attributed to both external organizational factors and internal implicit factors. Key issues include a lack of diverse adverse event collection channels and inadequate implementation of risk control measures. The root causes are closely related to insufficient reporting initiative from the enterprises themselves and operating and using institutions insufficient cooperation.
Objective To explore the application effectiveness of the FOCUS-PDCA method in the management of psychiatrichigh-alert medications. Methods Four indicators—compliance rate of partitioned storage, cognitive compliance, incidence of adverseevents, and dispensing error rate—were used to compare and analyze the changes in management effectiveness of psychiatric high-alertoptimized the management system for psychiatric high-alert medications, resulting in a significant increase in the compliance rate of compliance rate of partitioned storage, cognitive compliance, incidence of adverseevents, and dispensing error rate—were used to compare and analyze the changes in management effectiveness of psychiatric high-alertmedications before and after the implementation of the FOCUS-PDCA method. Results The application of the FOCUS-PDCA method optimized the management system for psychiatric high-alert medications, resulting in a significant increase in the compliance rate of partitioned storage and cognitive compliance, and a significant decrease in the incidence of adverse events and the dispensing error rate. Conclusion The FOCUS-PDCA method can significantly reduce errors in the dispensing, distribution and adminstration of psychiatric high-alert medications, demonstrating value for promotion and application.
Objective Based on the information technology identity theory and the Technology Acceptance Model (TAM), this study explored the factors influencing the effective use of Internet hospitals among outpatients. Methods A questionnaire survey was conducted among outpatients from Nanjing Drum Tower Hospital and Jiangsu Provincial Hospital of Traditional Chinese Medicine. A total of 224 questionnaires were distributed, with 209 valid responses collected, yielding an effective response rate of 93.3 %. The data were analyzed using structural equation modeling (SEM). Results Perceived usefulness, perceived ease of use, willingness to use, and information technology identity were all significant predictors of the effective use of Internet hospitals. However, perceived ease of use did not show a significant effect on information technology identity. The influence of perceived ease of use on effective use was mediated through multiple pathways. Among these, the mediating effects centered on perceived usefulness and willingness to use were more stable and significant. Conclusion To promote the development and application of Internet hospitals, government departments should establish and improve the relevant development systems, laws, and regulations. Medical institutions need to continuously enhance the service capacity and quality of Internet hospitals. System developers should utilize information technology to improve the functionality and development of Internet hospital platforms and always optimize the service experience with a patient-centered approach to increase users' willingness to use.
Objective To construct an intelligent prevention and control system for venous thromboembolism (VTE), improve the standardized prevention and treatment of VTE in hospitals, and achieve medical quality and safety goals. Methods An intelligent VTE prevention and control system was developed and interfaced with the Hospital Information System (HIS). The system automatically captured data from clinical wards, including information on medical staff, patients, medical orders, and surgical records. Data on VTE prevention and control for hospitalized patients from 2023 to 2024 were retrospectively analyzed to evaluate the system's effectiveness. Results The implementation of the intelligent VTE prevention and control system enabled systematic VTE screening, achieving procedural, intelligent, and standardized prevention and control, and established a comprehensive management system. Compared with 2023, the hospital's VTE prevention and control process indicators in 2024 showed a clear trend of improvement, with a significant increase in the VTE detection rate. Conclusion The intelligent VTE prevention and control system enables intelligent and homogeneous VTE assessment, diagnosis, and treatment. This contributes to enhancing medical service efficiency, improves the level of comprehensive prevention and control, and helps achieve medical quality and safety goals.
Objective This study aimed to explore the impact of head nurses' sense of power on nursing team creativity, examining the mediating role of leadership self-efficacy and the moderating role of Machiavellianism. Methods A cross-sectional survey was conducted among 152 head nurses from four public hospitals in a city in southern China. Well-validated scales were used to assess their sense of power, leadership self-efficacy, nursing team creativity, and Machiavellianism. Multiple regression analysis and bootstrap methods were employed to test the mediating and moderated mediation effects. Results Sense of power significantly and positively predicted nursing team creativity. Leadership self-efficacy partially mediated this relationship. Machiavellianism positively moderated the relationship between sense of power and leadership self-efficacy, thereby enhancing the overall indirect effect. Conclusion Enhancing head nurses' sense of power and leadership self-efficacy can promote nursing team creativity. Machiavellianism, as an individual trait, moderates this transformation process.
Objective To evaluate the effect of bundled nursing measures on preventing perioperative venous thrombosis in elderly patients with lung cancer and to assess their impact on the incidence of venous thromboembolism (VTE). Methods From January 2023 to December 2024, 3,288 elderly patients with lung cancer admitted to our thoracic surgery department for surgery were randomly assigned on admission to an experimental group or a control group. The experimental group received a bundle nursing intervention, while the control group received routine nursing care. Outcomes compared between groups included the incidence of postoperative venous thrombosis, incidence of bleeding, adherence to preventive measures, average length of hospital stay, average hospitalization cost, and patient satisfaction with nursing care. Results Bundle nursing significantly reduced the incidence of postoperative venous thrombosis and increased the implementation rate of preventive measures. It was also associated with shorter average hospital stay, lower average hospitalization costs, and higher patient nursing satisfaction (all P<0.05). There was no statistically significant difference in bleeding incidence between groups. Multivariate analysis identified bundle nursing, advanced age, and open surgery as independent factors influencing the occurrence of VTE. Conclusion Bundle nursing is effective for preventing and managing perioperative venous thrombosis in elderly lung cancer patients. It significantly reduces the incidence of venous thrombosis and warrants wider implementation.
The "Fengqiao Experience" is a grassroots approach to social governance that focuses on community involvement, conflict prevention, and local resolution. It has become a cornerstone of China's modern governance strategy. This study examines the Shanghai Eye Disease Prevention and Treatment Center as a case, delving into the nuances of hospital complaint management and exploring how the "Fengqiao Experience" can enhance it. By adopting four key strategies, the hospital has pioneered a new grassroots governance framework. Drawing on three years of complaint data, all designed to prioritize patient satisfaction in dispute prevention and resolution. Results demonstrate that applying the "Fengqiao Experience" in healthcare not only mitigates doctor-patient tensions and boosts hospital efficiency but also offers a blueprint for modernizing broader social governance practices.
Objective To analyze the current situation and underlying causes of inpatient medical insurance claim rejections at a tertiary grade A psychiatric hospital from 2019 to 2025, and explores effective strategies to standardize medical practices and reduce such rejections. Methods Data on medical insurance claim rejections from the Beijing Medical Insurance Information System from 2019 to 2025 were retrieved. Descriptive analysis was employed to statistically examine the rejected amounts, proportions, reasons, and project distributions. In combination with a literature review and hospital management practices, The underlying causes of rejections were comprehensively analyzed. Results From 2019 to 2025, the total amount of medical insurance fund rejections accounted for 0.13 % of the total fund disbursements. The rejection rate was 0 in 2019 and 2020, rose to 0.22 % in 2021, and peaked at 0.32 % in 2022. Subsequently, it decreased to 0.10 % in 2023, fluctuated slightly to 0.26 % in 2024, and dropped to a relatively low level of 0.04 % in 2025. Overall, the trend clearly presented in stages of "initial exposure, mid-term rectification, and later - stage control." The primary reasons for rejections were "unreasonable examinations, treatments, or medication usage" (43.30 %) and "exceeding the medical insurance coverage scope" (56.23 %). Among these, assessments using the Psychiatric Nursing Observation Scale and rehabilitation therapy projects were the main rejected items in their respective categories. Conclusion Medical insurance claim rejections reflect disparities between healthcare providers and insurance agencies in policy interpretation, project scope definition, and clinical necessity assessments. Medical institutions need to shift their mindset from post - rejection appeals to proactive prevention and in-process control. By strengthening internal refined management, developing intelligent audit systems, establishing incentive and restraint mechanisms, and promoting "medical-insurance" collaboration, medical practices can be fundamentally standardized. This measurement is expected to alleviate and mitigate improper payment denials, thereby safeguarding the integrity of the insurance fund and the legitimate rights of patients.
Objective To conduct a satisfaction survey of discharged patients with the aid of an intelligent voice system, and to analyze the survey results and explore strategies to enhance patient satisfaction. Methods The discharged patients from 89 departments of the hospital from October 2024 to March 2025 were selected as the survey subjects. The satisfaction survey was conducted by automatically making calls through the iFlytek intelligent voice outbound calling platform, covering multiple aspects such as the overall hospital service and the attitude of medical staff. Results The survey results for the fourth quarter of 2024 and the first quarter of 2025 showed that the overall patient satisfaction was good, but there were still some unsatisfactory situations, mainly concentrated in doctor- patient communication, medical staff attitude and environmental hygiene, etc. Among the unsatisfactory situations, the rate of invalid issues was extremely high (78.63 %). Conclusion Conducting a satisfaction survey of discharged patients through an intelligent voice system can efficiently identify the core areas where patients are dissatisfied, but it needs to address the high rate of ineffective problems. By analyzing the results of satisfaction surveys and formulating targeted improvement strategies, it is helpful to enhance the quality of hospital services and improve the medical experience of patients.
This study systematically reviews the development trends, research status, application effects, existing problems, and future directions regarding the pre-admission model in China. By allocating virtual beds to clinically stable patients and moving preoperative examinations forward, the pre-admission model aims to shorten the average length of stay (ALOS), increase bed turnover rates, reduce medical costs, and improve patient experience. The model has proven effective in enhancing hospital operational efficiency and satisfaction of both healthcare providers and patients. However, it still faces challenges such as non-standardized processes, blind spots in safety management, underdeveloped information platforms, and a limited scope of pilot implementation. Future efforts should focus on process optimization, strengthened safety management, improved information platform development, and expansion of the eligible patient population. These measures will contribute to establishing a scalable management model that facilitates the high-quality development of public hospitals.
Objective To analyze the research hotspots and development trends in the field of mechanical prophylaxis for Venous Thromboembolism (VTE) in Chinese hospitals and to provide a reference for future research and clinical practice. Methods Based on data from the China National Knowledge Infrastructure and Wanfang Data databases, a bibliometric analysis was conducted on relevant literature from 2001 to 2024 using CiteSpace software to map the knowledge structure. Results A total of 977 publications were included. Research in this field has shown phased development: the initial exploration phase (2001–2015), the rapid growth phase (2016–2021), and the in-depth development phase (2022–2024). The research focus evolved from conceptual understanding to mechanical prophylaxis devices, and further progressed to targeted prevention for high-risk populations and evidence-based practice. Keyword clustering analysis identified five major clusters: mechanical prophylaxis tools and technologies, high-risk populations and specialized applications, nursing interventions and management, pathological mechanisms and risk assessment, and interdisciplinary integration and emerging fields. However, challenges remain, including a scarcity of high-quality studies and weak academic collaboration networks. Conclusion Research on mechanical VTE prophylaxis in China has progressively deepened. Future work should focus on enhancing multicenter collaboration, promoting the integration of intelligent technology and precision prevention, continuously expanding applicable scenarios and target populations, and enhancing clinical translation efficacy.
This updated consensus building on the 2021 edition, incorporates recent policies and regulations, new evidence from domestic and international literature, and accumulated clinical experience to further refine the FSMP clinical governance framework. It recommends that healthcare institutions establish FSMP management committees and implement end-to-end systems encompassing access criteria, logistics and storage, formulation management, information management, pricing and fee management, informed consent, prescription review, and adverse reaction surveillance. Clinical application should adhere to a standardized pathway—nutritional screening, assessment, diagnosis, and treatment— while ensuring appropriate selection of oral or enteral (tube) routes, routine clinical monitoring, and complication prevention. By advancing the standardization and digitalization of FSMP management in healthcare settings, this consensus aims to improve safety and effectiveness in clinical practice, shorten rehabilitation timelines, reduce healthcare burden, and facilitate high-quality clinical translation.
