Objective To construct a comprehensive evaluation index system for public health in hospitals,providing a basis for evaluating the implementation of public health work in hospitals.Methods An initial draft of the evaluation index system was formulated through a review of relevant literature and policy documents and multiple rounds of thematic discussions by the research team.A two-round Delphi expert consultation method was used to screen the evaluation indicators and construct a comprehensive evaluation index system for public health in hospitals.The analytic hierarchy process was used to calculate the weight of each indicator,and SPSS 20.0 statistical software was used to analyze expert engagement,authority,and the degree of consensus.Results The recovery rate of the expert consultation questionnaires in both rounds was 100％.The expert authority coefficients were 0.869 and 0.902,respectively,indicating a high level of expert authority.The Kendall's W coefficients of expert opinion coordination were 0.245 and 0.281,respectively(P＜0.05),indicating good consistency among expert opinions.The constructed comprehensive evaluation index system for public health in hospitals includes three first-level indicators,eight second-level indicators,and 25 third-level indicators.The first-level indicators are organizational resources,business processes,and disciplinary development,with weights of 0.257,0.451,and 0.292,respectively.The weight distribution of each indicator is reasonable.Conclusions The comprehensive evaluation index system for public health in hospitals constructed in this study has good scientific validity and reliability and can provide a reference for the scientific evaluation of public health work in hospitals.

This study analyzes the application of policy instruments in Chinas elderly health management policies to provide a reference for optimizing those policies. Using content analysis on 42 national-level policy documents concerning elderly health management, we construct a policy-analysis framework along three dimensions policy instruments, policy objectives, and policy strength and perform coding and quantitative analysis. Results show that supply-side, demand-side, and environment-oriented policy instruments account for 39.81%, 14.38%, and 45.81% of the sample, respectively; the distribution across the four dimensions of policy objectives is uneven; and the average score for policy strength is 3.03. The findings indicate an imbalance in the application of policy instruments for elderly health management in China, with insufficient use of demand-side instruments, a policy objective orientation toward basic foundations, and room for improvement in policy stability. Accordingly, we recommend increasing the use of demand-side policy instruments, expanding policy deployment for services such as health interventions, and improving the coordination and stability of elderly health management policies.

Public hospitals are an outpost for public health emergencies, and a key force to improve medical treatment capacity of community joint prevention and control.The important role of public hospitals in medical treatment of public health emergencies of community joint prevention and control system was analyzed.By sorting out the management system and operation mechanism of community joint prevention and control of public health emergencies, the weaknesses exposed by public hospitals were found, and the construction idea on public hospital community joint prevention and control of medical treatment coordination mechanism was put forward, so as to provide a reference for improving the medical treatment capacity of communities to deal with public health emergencies.

2023年1月,国家卫生健康委等6部门联合推动科学合理网格化布局紧密型城市医疗集团试点.通过区域性临床重点专科建设,提高紧密型城市医疗集团整体的医疗水平和服务质量,提升核心竞争力;紧密型城市医疗集团建设,又为区域性临床重点专科建设提供系统支持和综合保障.作者对区域性临床重点专科建设与紧密型城市医疗集团建设做出理论阐释,并以问题为导向,探讨二者协调发展的动态路径,对推动医疗服务供给侧结构性改革、促进科学有序就医格局和系统连续诊疗格局的形成,巩固分级诊疗制度建设成效具有较好的理论意义和实践价值.

With the changing spectrum of human diseases and people′s pursuit of high-quality life, the scope of medical services required of nurses keep expanding. However, the current legislation in China has not yet granted nurses the right to prescribe, and there was no specific law to regulate related issues, which will inevitably limit the development of nursing work in the extended field. Therefore, the authors explored the concept definition and legal attributes of nurses′ prescription rights from a legal perspective, and proposed to regulate them from the legislative, law enforcement, and relevant supporting institutional levels to ensure the standardized exercise of nurses′ prescription rights.

基于社区联防联控机制的突发公共卫生事件应对是社区治理的有效制度设计和运行体系的新尝试.目前社区联防联控机制在突发公共卫生事件应对中在法律保障和法治体系、多主体协调配合机制、社区组织应对能力、社区信息化建设,以及居民参与主动性等方面存在挑战.因此,本文建议应从法制建设、合作模式探索、队伍专业化、整合型信息系统、社区卫生机构等五个方面进行改进,以建立一个"立足基层,纵横协作,多元共建"的社区联防联控机制,妥善维护社会秩序.

The report of 20th National Congress of the Communist Party of China put forward five major principles that must be firmly grasped on the way forward to comprehensively build a modern socialist country. The 20th National Congress of the Chinese Communist Party put “upholding and strengthening the comprehensive leadership of the Party”to the Party Constitution,which more fully demonstrates the importance of upholding and strengthening the comprehensive leadership of the Party. Based on the new situation of high-quality development of public hospitals,it discusses the theoretical significance and value of adhering to and strengthening the overall leadership of the Party for high-quality development of public hospitals and explores the construction path.

医共体建设是优化医疗资源结构布局、提升基层医疗服务能力的重要举措,是公立医院高质量发展重点建设行动之一.国内医共体建设进入快速发展阶段,但依然存在缺乏可持续利益分配机制等问题.医共体的利益均衡是实现高质量、可持续发展的必要条件,其前提是需要明确县域医共体利益相关者的利益诉求.作者从内部、外部和潜在利益相关者3个维度,分析核心医院、成员单位、医务人员、政府、卫健部门、医保部门、药品供应保障系统、居民、患者及其家属、医务社会工作者、媒体、商业保险公司等利益相关者的利益诉求.从系统机制、组织基础和个人积极性3个角度提出建议,通过强化政府主导作用、推动三医联动、建立有效的激励机制以及搭建统一的信息管理平台达到利益相关者利益均衡.

It is already an inevitable choice for the innovative development of the global healthcare system to grant nurse practitioners the prescription rights, in an effort to improve the access to primary care services and clinical outcome of patients. The contradiction between supply and demand of health service in China is becoming increasingly prominent, making it urgent for nurses with prescription rights to join the primary healthcare team. On the basis of clarifying the connotation and characteristics of nurses′ prescription rights, the authors demonstrated and analyzed the demands, realistic basis and challenges of nurses′ prescription right granting, and put forward their thoughts on the feasible paths from the aspects of national system construction and local pilot exploration, aiming to provide reference for promoting the reform of nurses′ prescription right granting in China.

To analyze the connotation of applying a people-centered development philosophy to achieve highquality development of public hospitals. Described the current situation of beds,resource allocation ratio,regional layout of health resources and medical services of public hospitals in the past ten years in China. It showed the foundation and existing problems of high-quality development of Chinese public hospitals. Suggestions on how to realize high-quality development of public hospitals included the core of meeting people’s need,the driving force of respecting people’s achievements,the source of pooling people’s wisdom,and the goal of obtaining people’s satisfaction.

Community health workers play an important role in public health emergencies.They are not only the health managers of community residents, but also the main force of community joint prevention and control.Based on analyzing the role of community health workers in the joint prevention and control mechanism of public health emergencies, the responsibilities and existing problems of community health workers were clarified, and suggestions for actively responding to public health emergencies were put forward.Community health workers should be improved from emergency team building, emergency management skills training, human resources allocation and other aspects to improve the efficiency of the joint prevention and control mechanism of public health emergencies.

社区联防联控机制作为我国基层社区应对突发公共卫生事件的重要治理模式,在突发公共卫生事件应急管理中发挥了重要的作用.但是,我国现行立法中关于社区联防联控机制的相关规定却付之阙如,社区联防联控机制尚处于实践先行、理论与制度滞后的阶段,导致该机制停留于话语层次缺乏制度化的建构,基层社区在突发公共卫生事件应急管理中出现诸多问题.虽然党和政府具有强大的纠偏能力,但从长远看,在全面推进依法治国的背景下,建立和完善突发公共卫生事件社区联防联控机制,走向法治化道路是必然选择.探索突发公共卫生事件社区联防联控机制法治化路径需要以立法形式确立该机制的法律地位、功能与体系架构、明确各参与主体在突发公共卫生事件社区联防联控中的职责权限,同时建立与完善相关法律保障机制,以更好回应基层社区在突发公共卫生事件中法治化参与的需求.

Community joint prevention and control system is an effective way to deal with public health emergencies.Community medical and health service institutions are the "first responders" of public health emergencies, and have a special status in community joint prevention and control.The roles and functions of community health service institutions in community joint prevention and control were analyzed.And it was suggested that community health service institutions should play four important roles in joint prevention and control as frontier "sentinel",professional technical support, community health managers and health education.Based on sorting out the current challenges faced by community health service institutions in performing joint prevention and control functions, three main problems of unclear responsibilities, imperfect emergency material reserve and distribution mechanism and insufficient capacity construction were summarized, and suggestions for giving full play to the important role of community health service institutions in community joint prevention and control were put forward.

The report of 20th National Congress of the Communist Party of China took“upholding to the path of socialism with Chinese characteristics”as one of five major principles that must be firmly grasped in the way forward in building a modern socialist country in all respect. The modern hospital management system is a key institutional arrangement of the basic medical and health system with Chinese characteristics,and is an inherent requirement for the modernization of medical services. Based on the development status of China’s hospital management system and era’s demand,it implements and applies the theory of socialism with Chinese characteristics,sorts out the world view and methodology of the construction of modern hospital management system,and puts forward path suggestions.

ObjectivesIn China, it is up to the patients to choose between hospitals and primary care facilities to initiate their medical care. This study aimed to determine the association between patient experience with community health centres (CHCs, a predominant provider of community-based primary care) and patient preference of taking community-based primary care facilities as a first choice for medical attention. MethodsA questionnaire survey was conducted on 1919 patients who sought medical care in 55 CHCs in Wuhan, China. Respondents were asked to identify their preferred first choice for medical attention and rate their satisfaction with eight aspects of CHCs (basic facility, medical equipment, medical services, nursing services, treatment process, courtesy and responsiveness, time spent with medical doctor, pharmacy services). Multivariate logistic regression models were established to determine the association between the CHC experience and the first choice of providers after adjustment for variations in sociodemographic characteristics. ResultsOver 90% of respondents were satisfied or very satisfied with the eight aspects of CHCs; but only 75% preferred to take community-based primary care facilities as their first choice for medical attention. Those who were older and had a lower income were more likely to choose community-based primary care facilities. Geographic proximity and higher levels of satisfaction with the basic facility, courtesy and responsiveness, and pharmacy services in the CHCs were associated with a higher likelihood of taking community-based primary care facilities as a first choice for medical attention. ConclusionThe consumers of CHCs are generally satisfied with the services they received. However, one quarter of the CHC patients are yet to be convinced to accept community-based primary care facilities as a preferred first provider for medical care. Geographic proximity and patient experience with CHCs are associated with the patient choice.

At the report of 20th National Congress of the Chinese Communist Party,deepening reform and opening up was regarded as one of five major principles that must be firmly grasped in the way forward in of building a modern socialist country in an all-round way. The modernization of public hospital governance is the critical link to promote the high-quality development of hospitals. It made a theoretical interpretation of the deepening of reform and opening up and the modernization of the governance system and capacity of public hospitals. It took the research problem-oriented method of“structure-process-result”to analyze the problems in three aspects of the governance system mechanism,governance process,and governance efficiency. And then,it explored the path of governance modernization of public hospitals. It has vital theoretical significance and practical value for realizing the modernization of the national governance system and governance capacity.

Deep integration of healthcare and prevention in public hospitals is not only a basic function played by hospitals in their public health services, but also an inevitable choice to meet the health needs of the people in their life span. The authors analyzed the current situation in healthcare and prevention integration in Wuhan in recent years, focusing on such problems existing in the construction of healthcare and prevention integration in public hospitals, as unclear functional positioning of medical prevention integration in public hospitals, insufficient refinement of healthcare and prevention integration policies, delay in the construction of public health informatization, and poor public health awareness of medical personnel. In view of the above problems, the authors put forward the following improvement suggestions: optimizing the policy environment of healthcare and prevention integration, strengthening the leading role of the hospital management, building a hospital public health big data platform, mobilizing the initiative of clinical technicians, and improving the work identity of hospital public health workers.

IntroductionWith more than 120 million rural-to-urban migrants, urbanization of the rural population requires deeply exploration in China. ObjectiveThis study focused on settled citizens who obtained urban Hukou (household registration) during urbanization and investigated their perceptions of health services in China. MethodA cross-sectional comparison study with an original, closed questionnaire was conducted in two major cities of Hubei, central China, covering health status and both the satisfaction with and utilization of health services. In total, 863 residents with urban Hukou participated in this study; migrants formed the study group and original city residents formed the control group. Propensity score matching (PSM) was used to reduce choice bias in the analysis steps. Besides basic description of the data, ordinary least squares regression (OLS regression) was used to discover the relationship between basic demographic indicators and health expenditure. ResultsPSM yielded 290 effective pairs for analysis. The results indicated an improvement in health status for migrant residents (study group) with a higher average score of self-reported health status and lower prevalence of chronic diseases than the control group. These scores were also better than the standard urban level in central China. The study group showed a higher clinic visit utility (69.63%), lower hospitalization utility (8.28%), less convenience of health service utility, and lower health expenditure than the control group. For the study group, the biggest difference was observed in satisfaction with health service costs, which was the least improved aspect after they obtained urban Hukou. The regression results demonstrated that age, family size, living expenditures, and marital status impacted health costs in the overall model and the influences of these factors differed between the study and control groups. ConclusionsObtaining urban Hukou helps migrant residents to meet their health service needs and receive equal access to health services. However, after obtaining urban Hukou, migrants also face great pressure in terms of health consumption. This study therefore offers guidance on the next steps for progressing China's urbanization.

加强医联体建设是整合区域内医疗卫生资源、促进优质资源下沉、提升基层医疗服务能力、健全医疗服务体系的重要措施.本研究选取南京市中医院牵头组织医联体成员中的2所区级中医院和2所社区卫生服务中心,对其在加入医联体前后中医药资源配置、中医药服务提供、运营效率、中医药诊疗项目等中医药服务能力建设情况进行对比分析,把握中医医联体对于基层中医药服务能力的促进作用,并对医联体建设中存在的问题进行分析讨论,为优化中医医联体建设提供参考.

在全面推进公立医院改革新形势下,中医医院如何改革与发展从而在竞争激烈的医疗市场中谋得一席之地并促进中医药事业健康发展成为亟待解决的问题.本文通过梳理中医医院改革与发展存在的关键问题,分析相关问题的原因,提出针对性对策建议并对未来形势进行展望,为中医医院改革与发展提供参考.