Objective Analysis of roadblocks found in the reform of performance-based salary mechanism in public hospitals, along with recommendations for the implementation strategies. Methods Both the historical document method and qualitative method are called into play to identify the characteristics and measures for performance-based salary mechanism in public hospitals. Results Such roadblocks are mostly found in value measurement of the hospital services of welfare nature, criteria of appraisal and establishment of the indicator system, job evaluation and the extent of incentives to use. The authors hold that such reforms should go in parallel with the reform, development, management level upgrading, and cultural building of the hospitals, and should call into play roles of intermediacies. Conclusion Reform for performance-based salary mechanism will be inevitable in public hospitals, as it has a direct bearing on the mission and functionality of public hospitals. In spite of the difficulties met, appropriate strategies may powerfully push forward reforms and development of such hospitals.

This paper analyzed the procedure and organization for developing the clinical guidance by the National Institute for Health and Clinical Excellence(NICE).Focusing on the balancer role of NICE in the UK healthcare system as a statutory criteria maker,it analyzed the implementation and assurance mechanism of the clinical guidance for policy recommendations to the making and effective implantation of such a guidance in China.

External evaluation of large medical institutions is key to performance management in the medical sector,which is both a major means for the government to manage such institutions and a key guideline for their internal performance management. Based on a study on the pathways of such institutions in the UK,the USA and Japan in their external evaluation of performance,the paper summarized practices of Shanghai,Shenzhen,Zhenjiang and Beijing,in an attempt to offer references for building the external evaluation system for such institutions in China.

Objective To explore the job tasks and qualifications of midwives in China for the next five years.Methods Anonymous surveys were sent by email to 80 professionals to learn the job tasks and qualifications of midwives in China using the Delphi method.The recipients include senior midwives, nursing administrators and nursing educators,senior obstetricians and gynecology department chiefs,as well as health administrators.Results Learnt in the survey were the qualifications and job tasks of professional midwives in China for the next five years.The system concludes 77 job tasks of midwives, among which 31 items are supposed to be completed independently.Conclusion China should develop the midwife system as soon as possible,strengthen the midwife training and education,develop the midwife access system and the corresponding laws and regulations for midwives,standardize midwife management,clear the midwife qualifications and job tasks,formulate normative midwife promotion system,and realize the midwifery scientific management.

OBJECTIVE:To provide policy selection for pharmacy service fee reform in China under New Health Reform that drug addition in public hospitals is abolished completely throughout the country. METHODS:The situation and general characteristics of pharmacy service fee reform were summarized since New Health Reform. The multi-dimension of pharmacy service fee was analyzed to define the connotation of pharmacy service fee again. The solution to pharmacy service fee and clinical pharmaceutical care fee reform were put forward. RESULTS:There were many theoretical discussions on the establishment of pharmacy service fee since New Medical Reform,but no achievements had been made in reform practice. The connotation of pharmacy service fee should be subdivided,and the"pharmacy service fee"should be used as the content of the cost compensation for the public service provided by the hospital;"clinical pharmaceutical care fee"should be set up as the cost compensation content of the professional technical service;according to the different natures of the service,the corresponding policy could be designed. CONCLUSIONS:It is suggested that"pharmacy service fee",as lump sum fee,could be solved in the dynamic adjustment of medical service price;"clinical pharmaceutical care fee"should be approved independently and included in the standard charge items according to the individual project.At the same time,local pilot is encouraged,the charge of clinical pharmaceutical care is included in the national charge catalogue,and national standards are studied and formulated. The performance management model of pharmaceutical personnel can be adjusted to promote the healthy development of pharmacy subject.

Objective Based on social cognitive theory,to explore the main factors influencing the behavioral inten-tion of medical staff in merged medical community and the differences among county-township-village three levels medical staff.Methods The stratified random sampling was used to investigate the county-township-village three levels medical staff in merged county medical community,and multiple linear regression method and seemingly unrelated model(SUEST)were used to quantitatively analyze the influencing factors and differences among coun-ty-township-village three level medical staff's behavioral intention.Results The environmental factors including or-ganizational support(0.098),team integration(0.227),incentive mechanism(0.126)and individual factors including cognitive degree(0.118)and participation ability(0.053)can impact the behavioral intention of medical staff,and team integration has the greatest impact on the behavioral intention of medical staff at all levels.The incentive mecha-nism has more influence on the behavioral intention of medical staff at township(0.190)and county(0.165)level than village(0.083)level.Participation ability had more influence on the of village(0.187)level than township(0.129)and county(0.126)level.Cognition had a moderate effect,and organizational support had a smaller effect.Conclusion There are both similarities and differences in the influencing factors of medical staff's behavioral inten-tion,and targeted reforms should be carried out according to different characteristics.