The public welfare of public hospitals is determined by the social attributes of its public sector,which is a manifestation of public welfare in health management.The public welfare of public hospitals is conceptual,which is existed by the specific form,thus affects people's awareness about the public welfare in public hospitals.The paper introduced the concept of public welfare of public hospitals,analyzed the characteristics of public welfare in public hospitals,and summarized the manifestations of public welfare and the intervention policies on public welfare in public hospitals since the reform of public hospitals in China.Then the paper put forward the suggestions on the development path of public welfare in public hospitals.

Objective To explore the optimal timing of operation for experimental obstructive jaundice in a dog model. Method A dog model of bile duct stricture (BDS) was established. Dogs were divided into (n = 12 in each group) 6 groups, ie control, BDS days 5, 10, 15, 20, and 30. In each dog,the morphology and local histopathology of the bile duct, and the liver function in different periods were observed. At the time of surgery biopsy was taken and Roux-en-Y hepaticojejunostomy performed. Surgical complications and survival were evaluated. Result After bile duct obstruction, the proximal bile duct dilated continuously. The diameter of bile duct was 15.6 ± 1.7 mm at the 10th day. The injury bile ductshowed the acute inflammation change. In the early time (in 10 days), inflammatory cells increased in the tissues, mucous edema aggravated, the wall was edematous thickening, it was most severe ( WBC counting 54 ±6) in the 5th day. In the later period (10 -30 days), inflammatory cells reduced, bile duct wall became fibrosis, which was most obvious in the 15th day (42 ± 7 vs 54 ± 6, P ＜ 0.05 ). During the development of jaundice, serum bilirubin reached the highest level in the early period ( BDS days 5 group),then presented a platform time, and then rised extremely at the last stage of the experiment ( BDS day 30 group) . Changes of ALT and AST paralleled that of bilirubin before the 20th day of obstruction and then plummeted. BDS was repaired successfully in 57 dogs. Ten dogs died postoperatively due to bile leakage within 10 days, 3 dogs in BDS days 5 group (3/11), 4 in BDS days 10 group (4/12), one each in other groups. Postoperatively 13 BDS dogs died of malnutrition and organ failure within 3 months, including one each in days 5 and days 10 group, two each in days 15 and days 20 group, and 7 in days 30 group (P＜0. 05). Conclusion Considering the changes of morphology, physical function and result of follow up.The period between 10 and 20 days after acute bile duct injury is optimal for surgical repair.

ObjectiveTo explore the histopathological changes of bile duct,liver and local tissue for injurious biliary stricture(IBS). MethodTo observe the morphological and pathological changes of bile duct, local tissue and liver in different periods with dogs as the established animal model for IBS. ResultBile duct obstruction due to injury can expand the proximal bile duct up to 18.91 ±1.85 mm as the pressure goes up. Damage to local tissue triggers acute inflammation. In early injury phase (within 10 d), inflammatory cell infiltration and proliferation appears on the wall of the duct with increased mucosal edema as well as thickening of the biliary ductile wall. In the late injury phase (15 d), the degree of infiltration of inflammatory cells, edema and mucosal thickness were reduced whereas fibroblast and collagen tissue were proliferated extensively. The wall of biliary duct also becomes fibrotic and thickens. Quantitative analysis of the inflammatory edema shows the most severe outcome on the 5th day (HE staining WBC count of 54.2±5.8 unit) and its severity progressively subsides on the 15th day. (HE staining WBC count of 41.7±7.2 vs 54.2±5.8 a, P＜0.0,5). In the early obstruction (5 d and 10 d), the liver cells showed mild to moderate swelling and its degeneration is often associated with steatosis and sinusoidal expansion and congestion. As the obstruction time increases in the 20 d and 30 d group, liver cells starts to show extensive vacuolation and sinusoidal occlusion. ConclusionsEarly phase (5 days) of acute bile duct obstruction due to injury shows rapid expansion of the bile duct, edema in the bile duct itself as well as its surrounding tissue and liver damage. After 15 days, the local inflammatory edema is greatly reduced and is replaced by hyperplasia of fibers and collagen. Liver damage appears to be irreversible after 20 days. Considering local environmental and systemic conditions, the optimal time frame to repair obstruction of bile duct surgically is between 10-20 days.

Objective To analyze the effects of the " Clinic-pharmacy separation" reform in Beijing. Methods Following the chronological order, 60-month operational data of a pilot hospital from 2012 to 2016 were analyzed. These data included medical statistics reports, financial information, HIS information,authority information,and patients′satisfaction on site. Results Pilot hospital showed that its medical work efficiency continued to grow. During 2013 -2016, its outpatients volume growth rate ranged 3.53% ~15.20%, and its number of discharged patients growth rate ranged 3. 12% -8. 48%. The hospital harvested 12.21 million yuan of converted income from September 2012 (when the reform was in place to cancel the drug markup and collect medical service fees) to August 2013,scoring a smooth shift of revenue sources. Medical insurance fund expenditure did not increase as a result. The percentage of drug expense was significantly decreased,dropping over 15% in 5 years. Outpatient drug fees and inpatient drug fees continued to decline year by year. Patients expressed higher satisfaction over medical services due to longer time of consultation with physicians. Conclusions " Clinic-pharmacy separation" reform has achieved the following objectives. The revenue is maintained stable; Patients flow is diverted under guidance, with less financial burden; and medical insurance expenditure is under control. We propose to improve the performance incentive and constraint mechanism for drug prescriptions by physicians.

Objective:To explore new methods of Diagnosis Related Growp(DRG)cost accounting and improve the internal cost control system of hospitals in the context of DRG payment policy.Methods:In terms of exploring accounting methods,expert interviews and on-site research in case hospitals were carried out,and experts were organized to validate the accounting methods;in terms of method validation,accounting was carried out based on the operational data of the case hospitals,and the accounting meth-ods were validated.In terms of the method,the interviews,observation,and the expert brain storm were used to study DRG cost ac-counting method;in terms of method application,the DRG data of the case hospital was used to verify the accounting method.Re-sults:Based on the policy of"Issuing the Notice on Public Hospitals Cost Accounting Standards",it put forward the DRG cost ac-counting"marginal contribution method"and its hierarchical accounting framework.It presented the accounting path through cases,calculated the case cost and its composition,DRG cost,and analyzed the application of operation management.Conclusion:Based on the"marginal contribution method",hospitals can easily carry out"first-level accounting"for DRG costs on the basis of depart-mental cost accounting,which meets the main demand of hospitals"operation and management in the context of DRG payments;it can also match the basis of hospital costing with the degree of informatization."Level-by-level refinement"to further improve the ac-curacy of accounting.

Objective:To explore new methods of Diagnosis Related Growp(DRG)cost accounting and improve the internal cost control system of hospitals in the context of DRG payment policy.Methods:In terms of exploring accounting methods,expert interviews and on-site research in case hospitals were carried out,and experts were organized to validate the accounting methods;in terms of method validation,accounting was carried out based on the operational data of the case hospitals,and the accounting meth-ods were validated.In terms of the method,the interviews,observation,and the expert brain storm were used to study DRG cost ac-counting method;in terms of method application,the DRG data of the case hospital was used to verify the accounting method.Re-sults:Based on the policy of"Issuing the Notice on Public Hospitals Cost Accounting Standards",it put forward the DRG cost ac-counting"marginal contribution method"and its hierarchical accounting framework.It presented the accounting path through cases,calculated the case cost and its composition,DRG cost,and analyzed the application of operation management.Conclusion:Based on the"marginal contribution method",hospitals can easily carry out"first-level accounting"for DRG costs on the basis of depart-mental cost accounting,which meets the main demand of hospitals"operation and management in the context of DRG payments;it can also match the basis of hospital costing with the degree of informatization."Level-by-level refinement"to further improve the ac-curacy of accounting.

Objective:To explore new methods of Diagnosis Related Growp(DRG)cost accounting and improve the internal cost control system of hospitals in the context of DRG payment policy.Methods:In terms of exploring accounting methods,expert interviews and on-site research in case hospitals were carried out,and experts were organized to validate the accounting methods;in terms of method validation,accounting was carried out based on the operational data of the case hospitals,and the accounting meth-ods were validated.In terms of the method,the interviews,observation,and the expert brain storm were used to study DRG cost ac-counting method;in terms of method application,the DRG data of the case hospital was used to verify the accounting method.Re-sults:Based on the policy of"Issuing the Notice on Public Hospitals Cost Accounting Standards",it put forward the DRG cost ac-counting"marginal contribution method"and its hierarchical accounting framework.It presented the accounting path through cases,calculated the case cost and its composition,DRG cost,and analyzed the application of operation management.Conclusion:Based on the"marginal contribution method",hospitals can easily carry out"first-level accounting"for DRG costs on the basis of depart-mental cost accounting,which meets the main demand of hospitals"operation and management in the context of DRG payments;it can also match the basis of hospital costing with the degree of informatization."Level-by-level refinement"to further improve the ac-curacy of accounting.

Objective:To explore new methods of Diagnosis Related Growp(DRG)cost accounting and improve the internal cost control system of hospitals in the context of DRG payment policy.Methods:In terms of exploring accounting methods,expert interviews and on-site research in case hospitals were carried out,and experts were organized to validate the accounting methods;in terms of method validation,accounting was carried out based on the operational data of the case hospitals,and the accounting meth-ods were validated.In terms of the method,the interviews,observation,and the expert brain storm were used to study DRG cost ac-counting method;in terms of method application,the DRG data of the case hospital was used to verify the accounting method.Re-sults:Based on the policy of"Issuing the Notice on Public Hospitals Cost Accounting Standards",it put forward the DRG cost ac-counting"marginal contribution method"and its hierarchical accounting framework.It presented the accounting path through cases,calculated the case cost and its composition,DRG cost,and analyzed the application of operation management.Conclusion:Based on the"marginal contribution method",hospitals can easily carry out"first-level accounting"for DRG costs on the basis of depart-mental cost accounting,which meets the main demand of hospitals"operation and management in the context of DRG payments;it can also match the basis of hospital costing with the degree of informatization."Level-by-level refinement"to further improve the ac-curacy of accounting.

Objective:To explore new methods of Diagnosis Related Growp(DRG)cost accounting and improve the internal cost control system of hospitals in the context of DRG payment policy.Methods:In terms of exploring accounting methods,expert interviews and on-site research in case hospitals were carried out,and experts were organized to validate the accounting methods;in terms of method validation,accounting was carried out based on the operational data of the case hospitals,and the accounting meth-ods were validated.In terms of the method,the interviews,observation,and the expert brain storm were used to study DRG cost ac-counting method;in terms of method application,the DRG data of the case hospital was used to verify the accounting method.Re-sults:Based on the policy of"Issuing the Notice on Public Hospitals Cost Accounting Standards",it put forward the DRG cost ac-counting"marginal contribution method"and its hierarchical accounting framework.It presented the accounting path through cases,calculated the case cost and its composition,DRG cost,and analyzed the application of operation management.Conclusion:Based on the"marginal contribution method",hospitals can easily carry out"first-level accounting"for DRG costs on the basis of depart-mental cost accounting,which meets the main demand of hospitals"operation and management in the context of DRG payments;it can also match the basis of hospital costing with the degree of informatization."Level-by-level refinement"to further improve the ac-curacy of accounting.

Objective:To explore new methods of Diagnosis Related Growp(DRG)cost accounting and improve the internal cost control system of hospitals in the context of DRG payment policy.Methods:In terms of exploring accounting methods,expert interviews and on-site research in case hospitals were carried out,and experts were organized to validate the accounting methods;in terms of method validation,accounting was carried out based on the operational data of the case hospitals,and the accounting meth-ods were validated.In terms of the method,the interviews,observation,and the expert brain storm were used to study DRG cost ac-counting method;in terms of method application,the DRG data of the case hospital was used to verify the accounting method.Re-sults:Based on the policy of"Issuing the Notice on Public Hospitals Cost Accounting Standards",it put forward the DRG cost ac-counting"marginal contribution method"and its hierarchical accounting framework.It presented the accounting path through cases,calculated the case cost and its composition,DRG cost,and analyzed the application of operation management.Conclusion:Based on the"marginal contribution method",hospitals can easily carry out"first-level accounting"for DRG costs on the basis of depart-mental cost accounting,which meets the main demand of hospitals"operation and management in the context of DRG payments;it can also match the basis of hospital costing with the degree of informatization."Level-by-level refinement"to further improve the ac-curacy of accounting.