Since the new medical reform,the macro personnel salary policy has experienced three stages of soft policy requirements,overall exploration,key breakthrough and comprehensive reform,showing the characteristics of public oriented,equal weight,equal to the efficiency of the pull hack,to focus on efficiency and the breakthrough.The evolution of policies(such as salary,evaluation of professional titles and formation) were processed with their own characteristics.In the course of policy evolution,the evolution mechanism of policy exploration path was different,and the problem should be solved first.It suggested to deal with the relationship between equality and efficiency,scientifically apply policy experiments to promote policy making,and improve the overall planning ability of reform.

The paper categories the modern hospital management and finds that there is an important and in-ner-relationship between the paper documents on public hospital reform and the policies on modern hospital manage-ment system construction. Secondly, it seems to be appropriate to coordinate the relation between deepening health reform and social governance in the pathway of modern hospital management system. Hence,this paper puts forward a series of countermeasures to address the difficulties.(1) Scientifically balancing the issues on unification and legaliza-tion with the reform and the system are raised;(2) The introduction of rules and implementation measures are men-tioned;(3) Guideline should be specialized to different hospital properties; (4) Non-public medical sector need more exploration;(5) The adaption and capacity of governance and government transformation are required.

With the rapid development of Internet, the number of online medical service review websites has gradually increased, whereby more and more patients use those engines to share their experience in health treatment, discuss the quality of medical services or rate physicians, and make more researches on medical institutions and doc-tors just to detailed information on the remedies of their health cases. This paper selected the UK and US as typical cases of countries that have rapidly developed in this field, and focused on UK’s NHS Choices and the United States’ RateMDs, Healthgrades and Yelp websites. Their current status, organization structure, content, characteristics, ex-perience and problems were analyzed and summarized. At present, China’s medical service online review is still in the ascendant, but the relevant policies and academic research are facing scarcity. Based on the situation in China and the experience from the UK and US, this paper proposed policy suggestions as follows: (1) Establishing a na-tional comprehensive medical service platform led by the government or professional and competent association which integrates health information query, retrieval and medical service review functions. (2) Set up a scientific and pro-fessional organization structure for standardized and orderly governance. (3) Combining the subjective reviews with objective quality indicators. (4) Adopting performance evaluation, and so on. All of these concerns are proposed in order to improve the medical service transparency and responsiveness, and to promote the medical service quality im-provement.

Objective:To comparatively analyze the development of hospitals and primary healthcare institutions during the healthcare reform since 2009.Methods:Based on statistical data from 2009 to 2018 and qualitative data, the development of primary healthcare institutions and hospitals was compared from 2009 to 2018 by computing the compound annual growth rate of health manpower, facilities, income, expenditure and service.Results:The growing speed of health professionals in hospitals(7.49%)was much faster than primary healthcare institutions(4.32%). The difference of healthcare professionals in hospitals and primary healthcare institutions grew larger and larger. The infrastructure in hospitals had developed much faster compared to that of primary healthcare institutions. The growing speed of fiscal subsidy in primary health care institutions was much faster. However the absolute number of fiscal subsidy for primary health care institutions was smaller than hospitals. The average growing speed of total income and medical income in hospitals was much faster. The average growing speed of health service in primary healthcare institutions was much slower, especially the inpatient service. The rates of hospital beds use in hospitals and primary health institutions were about 84% and 60% respectively.Conclusions:The quick expansion of hospitals was siphoning resources and curbing the development of primary healthcare institutions. Healthcare resources mismatch could hardly be overturned by measures taken in medical insurance. Rational health resources distribution was essential for hierarchical medical system to develop.

Objective:To understand the real feelings of new medical employees in public hospitals and analyze the influencing factors of their job satisfaction.Methods:From September to December 2019, we adopted the phenomenological research method to conduct semi-structured interviews with 27 new clinical medical staff from three tertiary general hospitals in Beijing for the purpose of understanding their working experience. The 7-step analysis method of Colaizzi phenomenology was used to collate and analyze the data.Results:The five main factors that affect the job satisfaction of new medical staff include job background, job content, expectation and support, interpersonal interaction and hospital culture. Nineteen respondents said they worked long hours and felt overwhelmed. Twenty-five respondents reported that good interpersonal interaction helped improve their work experience.Conclusions:Their satisfaction can be improved by bettering the working environment, implementing person-post value matching, providing emotional support, improving the compensation incentive mechanism, focusing on career development and strengthening humanized management.

Medical security is a prominent problem in China,and the medical safety supervision system needs to be improved.Through the analysis of the existing literature,medical supervision process,current situation and problems are analyzed,and the medical supervision system in England is comparatively analyzed,and the relationship model of British regulators is built,the internal mechanism of British medical supervision is analyzed,and finally through combining with the actual situation of China,new ideas for perfecting the medical safety supervision are put forward.

The nursing care assistance system in Germany is an integral part of the overall payment of long-term care insurance,and as the last line of defense of"multiple subjects sharing",its payment mechanism accurately identifies individual overflow nursing care needs and provides differentiated guarantee.This study proposes the"risk-embedded need spillover theory"based on the need spillover theory and applies this theory to analyze how the payment mechanism of care assistance system in Germany provides differentiated guarantee,and found that the payment mechanism classified families'ability and resources from the perspective of risk.In the context of building a care protection system,learning Germany's experience is an effective way to cope with the problem of inadequate care protection in China.

The unclear connotation and fragmented governance of the multi-tiered medical security system pose challenges to its high-quality development.This article redefines the concept and connotation of the multi-tiered medical security system using holistic governance theory.It distinguishes the bottom layer,basic layer,and supplementary layer from the perspective of the essential attributes and direct functions of each system.Furthermore,from the perspective of holistic governance,the article analyzes the current reform practice and finds that fragmented management thinking,unclear positioning of sub-system functions,insufficient policy coordination,single participation subject,and lack of equal negotiation mechanisms are constraints on the overall effectiveness of the multi-tiered medical security system.Therefore,it is necessary to adopt systematic and targeted reform measures from the perspective of holistic governance to improve the system.

General Secretray Xi Jinping clearly proposed that modern hospital management system should be perfected in The Parly's Nineteenth Report.Through reviewing the research of modern hospital management system by domestic scholars,the research progress is summarized from external governance system,corporate governance mechanism and internal management system aspects.The virgin lands and shortcomings of existing research are analyzed to make readers have a better understanding of the research of modern hospital management system in China,to provide suggestions for further study,and to provide reference for policy makers at all levels to perfect modern hospital management system.

Objective:To analyze the impact of Beijing Medical Reform on inpatient costs of medical and surgical patients in a hospital, and to provide reference for the hospital to explore the path of patient cost control.Methods:Based on the data of medical and surgical inpatients′ expenses from June 2016 to December 2019 in a hospital in Beijing, breakpoint regression method was used to analyze the impact of the two reforms(namely the comprehensive reform of separation of medicine and pharmacy and the comprehensive reform of medical consumption linkage)on the level of medical and surgical inpatients′ expenses and the cost structure of drugs and consumables.Results:The two reforms controlled the rapid rise of hospitalization expenses and reduced the proportion of drugs and medical consumption. The effect of the reforms on the total cost control of internal medical patients was better than that of surgical patients.For internal medical patients, the reform of separation of medicine and pharmacy played a greater role in the proportion of medicine; For surgical patients, the two reforms had effectively reduced the proportion of consumables, and the proportion of drugs had gradually decreased.Conclusions:The two reforms have effectively controlled the growth trend of hospitalization expenses, and changed the cost structure of drugs and consumables.