Value-based healthcare (VBHC) is an important guideline for current and future healthcare services. In practice, VBHC should be the best goal of public welfare of healthcare service. Meanwhile, VBHC and cost-effectiveness analysis together provide scientific evidence for healthcare decision-making. Pay by value is inevitable in the next stage of the reform of the payment system of medical insurance, and the health service system should be reconstructed based on VBHC. Finally, the challenges of VBHC implementation are discussed.
With the rapid development of artificial intelligence (AI) technology, its application in hospital management is gradually becoming an important means to improve operational efficiency and the quality of patient health care. This article systematically explores the multidimensional applications of AI in hospital management, including medical services, administration, patient engagement and experience. Through in-depth analysis, the paper evaluates the potential of AI in these areas, especially the significant effect in improving operational efficiency and optimising patient healthcare services. However, the application of AI also faces many challenges, such as data privacy issues, algorithmic bias, operational management, and economic factors. This article not only identifies these challenges, but also provides specific inspiration and recommendations for hospital management in China, emphasises the importance of adaptability and continuous learning, and calls on hospital administrators to actively embrace change in order to achieve both improved patient health outcomes and operational efficiency.
ObjectiveTo investigate the distribution, service volume, and medical efficiency of private general hospitals in Sichuan Province to provide references for optimizing the allocation of health resources in Sichuan Province. MethodsUsing the 2020 data from private general hospitals above the second level in 18 cities and states in Sichuan Province, this study calculated the market concentration and competitiveness with the Herfindahl-Hirschman index (HHI). A three-stage data envelopment analysis (DEA) model was employed to eliminate environmental variables and random errors for hospital efficiency analysis. Influencing factors were conducted using a Tobit regression model. ResultsThe HHI indices for the number of licensed (assistant) physicians, beds, and total consultations in each city and state were below 1 000, indicating a low concentration market. The comprehensive technical efficiency, pure technical efficiency, and scale efficiency of private general hospitals above the second level in Sichuan Province were 0.534, 0.661, and 0.806, respectively, after the three-stage DEA analysis. The number of practicing (assistant) physicians was negatively correlated with scale efficiency. the number of beds was negatively correlated with pure technical efficiency. The total number of consultations showed a positive correlation with overall technical efficiency, pure technical efficiency, and scale efficiency. ConclusionThe provincial private hospital market exhibits low concentration competition. Differences in efficiency exist among various regions, grades, and hospital types. Market competition in resource allocation promotes the improvement of pure technological efficiency and scale efficiency. Market share competition hinders the improvement of comprehensive technical efficiency, pure technical efficiency, and scale efficiency.
ObjectiveTo construct a health in all policies (HiAP) evaluation index system for earthquake-stricken areas based on national health policies.MethodsFrom April to December 2020, this study combined the methods of comprehensive review of relevant literature, on the foundation of the evaluation indicators pool was preliminarily constructed. The Delphi method and analytic hierarchy process were adopted to construct the evaluation indicators system in earthquake-stricken areas and analyzed the weights of indicators.ResultsA total of 5 first-level indicators (investment, action, short-term effect, medium-term effect, long-term effect), 15 second-level indicators, and 44 third-level indicators with satisfactory logical consistency of HiAP evaluation indicators system in earthquake-stricken areas had been constructed.ConclusionsThe HiAP evaluation indicators system constructed in this study can be used to comprehensively evaluate the implementation of HiAP earthquake-stricken areas.
Participating in patients for patient safety program will help place patients at the center of efforts to improve patient safety. This paper presented a brief introduction to patients for patient safety program and its significance and functions.
The purpose of evidence-based healthcare management is to prevent the overuse, underuse or misuse of some management measures, and to eliminate the gap between research and practice or the difference between best practices and conventional practices. Evidence-based healthcare management is still in an early stage of development. It also faces many challenges, which have aroused some criticism and even suspicion. This is closely related to the complexity of the management field itself and the lack of empirical research in the field. Considering the scarcity of high-quality health and medical resources in China, in order to improve the scientificalness of healthcare decision-making, we strongly appeal that promoting evidence-based healthcare management requires government-led, universal education, intensified research, scientific evaluation, technological innovation and integration.
The selection of summary statistics to use in a meta-analysis is very important for the interpretation and application of its results. This paper introduces some basic concepts of summary statistics in meta-analysis. The selection of a summary statistic for a meta-analysis depends on the following factors: design of the studies being combined, type of data, consistency among the included studies, mathematical properties and ease of interpretation. For continuous data, the weighted mean difference (WMD) is recommended when all trials use the same scale to report their outcomes, while standardized mean difference (SMD) is more appropriate when trials use different scales to report their outcomes, or the means of their outcomes differ greatly. For dichotomous data, rate ratio or relative risk (RR) is bly recommended to be the summary statistics for meta-analyses of randomized trials. The use of odds ratio (OR) as the summary statistic is similar to that of RR, if the event being studied in both the intervention (exposure) and the control group is rare. There is no single measurement that is uniformly best for all meta-analyses.
Counterproductive work behavior (CWB) is an employee’s spontaneous behavior that is potentially threatening to the interests of the organization itself or members of the organization. It is very common in organizations and is extremely harmful. The CWB of medical staff is extremely risky and can cause many adverse effects on the economy, society and patient health. Through reading and analyzing literature, the review discusses the concept, measurement, influencing factors and behavioral consequences of the medical staff CWB, and proposes coping strategies for improvement from the social, hospital, and individual levels. The aim is to provide a reference for reducing the CWB of medical staff and to improve medical quality and safety.
Objective To analyze the research hotspots and development trend of medical advice at home and abroad, and provide the basis for the research related to medical advice in China. Methods The China National Knowledge Infrastructure and Web of Science were searched from January 1991 to November 2023 to collect domestic and international studies on medical prescriptions. Bibliometrics and CiteSpace software were used for analysis. Results A total of 3 155 articles were included. The number of publications on medical advice reached its peak in 2013, and the trend of domestic and foreign publications was consistent; the institution with the largest number of publications in China was Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology; the top three hotspots of attention in China were rational medication use, intravenous medication dispensing center and nursing care; the top three hotspots of attention in foreign countries were care, impact, and system; the top three hotspots of attention in China were intravenous medication (centralized) dispensing center and medical prescription audit 2 emergent words emergent rate had been continued to date; foreign polst, palliative care and advance care planning 3 emergent words emergent rate had been continued to date; domestic in the past five years, the key words were quality improvement, lean management, transitional care, rationality evaluation, prescription front audit system and medication adherence; the keywords for the last five years in foreign countries were assessmen, risk factor, clincial pathway. ConclusionsDomestic research on medical prescriptions needs to pay more attention to the decision-making of doctors when they give medical prescriptions and the timely monitoring of medication errors, and based on the more mature research on medical prescriptions in foreign countries, domestic research needs to combine the concepts of computer-assisted decision-making and value-based medicine to explore in-depth the correlation between medical prescriptions and the quality of medical care and patient value. It is also needed to combine computer-assisted decision-making and the concept of value-based medicine to explore the intrinsic connection between medical advice and medical quality and patient value.
Objective To construct an evaluation index system of the competitiveness of private hospitals, and to provide references for guiding, supervising, and managing the high-quality development of private hospitals. Methods An index pool was constructed by the literature analysis method. Index screening was completed using the modified Delphi method. The analytic hierarchy process, entropy weight method, and combination weight method were used to determine the index weight. Results The competitiveness evaluation index system of private hospitals was constructed, which included 5 primary indexes and 36 secondary indexes. The combination weight methods were resource allocation (0.366 8), service capacity (0.470 8), service efficiency (0.033 7), quality and safety (0.121 3), and financial management (0.007 3). Conclusion The constructed evaluation index system of competitiveness of private hospitals is scientific, targeted, and operable.