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.
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 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.
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.
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.
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.
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.
Objective To provide references for fast assessment after disasters in China by assessing articles on fast assessment of health needs after disasters. Methods We systematically searched CNKI, VIP, CBM, and PubMed from their establishments to Jan. 2011. The main results of the eligible articles were described. Results A total of 65 articles were included, of which introductions for methodology and cross-sectional studies accounted for 52.31% and 44.62%, respectively. Articles which focused on natural disasters made up 86.15% of the total. Post-disaster rapid assessment should include seismic death estimate and on-site public health assessment which contained the public health status in affected areas, health coping capacity, health condition of victims and health needs. Rapid assessment of seismic death mainly used methods based on GIS and ANN model. On-site public health assessment mainly used epidemiological field investigation. Questionnaires, interviews and surveillance of diseases were adopted. Conclusion Rapid post-disaster health needs assessment is one of the most important tasks after disasters, and the current rapid assessment methods need to be refined and improved.
ObjectiveTo investigate the demand of pediatric health service, the current situation of resource allocation and the equity of health service, so as to provide guidelines for optimizing the resource allocation of pediatric health service in Sichuan province.MethodsA questionnaire of all healthcare institutions with legal capability from a total of 183 prefectures in Sichuan province was performed in 2015. We described the demand of pediatric health service by two-week hospital visit rate, the proportion of no-visit rate within two-weeks, hospital admission rate, and the patient required hospitalization rate. We assessed current situation of resource allocation, equity and accessibility by analyzing Gini coefficient, Lorenz curve and thermodynamic diagram.ResultsThe demand of pediatric health service in Sichuan province was huge and the current resource allocation can be shown a " inverted triangle” form. According to population distribution, the Gini coefficients of physician, bed and equipment were 0.47, 0.40 and 0.49, respectively, which represented inequality in resource allocation. By location, the Gini coefficients of physician, bed and equipment were 0.82, 0.77 and 0.81, respectively, which indicated an absolutely unfair situation.ConclusionsThe health resources of pediatric in Sichuan province are limited, the distribution is unbalanced, and the supply of pediatric healthcare is not compatible with demand. The lack of resources and waste coexist simultaneously. Furthermore, the fairness of distribution in terms of geographical areas is far less than that in terms of population. The accessibility of superior health resources is low.
Objectives To construct patient trust evaluation index system based on the background of hierarchical medical system, and to provide reference for the evaluation of the degree of patient trust on medical institutions and offer guidence to the implementation and further improvement of the hierarchical medical policy in China. Methods Based on literature review, the modified Delphi method was used to carry out 2 rounds of expert consultations from 11 experts in different fields to determine the indicators of patient trust evaluation index system. Results Questionnaire recovery rates of 2 rounds were 100.00% and 90.91%, the expert authority coefficient was greater than 0.75, the coefficient of variation of each index was less than 0.25, and the coordination coefficient of experts in the total index were 0.236 and 0.424 (P<0.001). Patient trust evaluation index system was preliminary constructed including medical environment, service trust, technical skills, pharmaceutical and equipment, the overall trust 5 first-level indexes and 20 level two indexes. Conclusions The patient trust evaluation index system can be used to evaluate patients' trust in different levels of medical institutions under the hierarchical medical system.