Chronic disease management is seen as a breakthrough point for establishing the hierarchical medical system, also an important task in building a healthy China. We summarized the experiences of the chronic diseases management of Beijing Chao-Yang Hospital, focusing on the establishment of a chronic diseases management team, development of the diagnosis and treatment norms and management procedures, and the interoperable information platform. And we introduced the practical effects, such as guiding patients to primary medical institutions, reducing medical costs, and improving the primary capabilities to manage chronic diseases, and existing problems of the management model.

Objective:To compare the clinical efficacies of arthroscopic acromioplasty combined with platelet-rich plasma (PRP) and acromioplasty alone in the treatment of subacromial impingement syndrome (SAIS).Methods:A retrospective cohort study was conducted to analyze the clinical data of 30 patients with SAIS. The patients, who were admitted to the General Hospital of Chinese PLA Eastern Theater Command from January 2020 to December 2021, included 9 males and 21 females, with the age range of 24-48 years [(34.3±9.8)years]. There were 19 left shoulders and 11 right shoulders. All the patients underwent arthroscopic acromioplasty. A total of 15 patients were injected with 4 ml of PRP after surgery (acromioplasty+PRP group), while the remaining 15 patients received nothing (acromioplasty group). Visual analogue score (VAS), Constant-Murley score, and active forward flexion, abduction, internal rotation, and external rotation of the shoulder joint were compared between the two groups before and at 6 weeks, 3 months after surgery and at the last follow-up. The postoperative complications were also observed.Results:All the patients were followed up for 3-12 months [(9.0±2.6)months]. There was no significant difference in VAS or Constant-Murley score between the two groups before surgery, at 3 months after surgery, and at the last follow-up (all P>0.05). At 6 weeks after surgery, the VAS and Constant-Murley score were (1.5±0.5)points and (80.3±6.2)points in the acromioplasty+PRP group, which was lower or higher than those in the acromioplasty group [(2.5±0.7)points, (58.1±7.6)points] ( P<0.05 or 0.01). The VAS showed gradual decrease and the Constant-Murley score showed gradual increase in both groups after surgery ( P<0.05 or 0.01). There were no significant differences in active forward flexion, abduction, or internal rotation of the shoulder joint between the two groups before surgery, at 3 months after surgery, and at the last follow-up (all P>0.05). At 6 weeks after surgery, the active forward flexion, abduction and internal rotation of the shoulder joint were (158.1±26.3)°, (146.2±27.4)° and (54.2±11.8)° in the acromioplasty+PRP group, respectively, which were significantly larger than those in the acromioplasty group [(128.8±29.6)°, (111.0±28.6)°, (35.7±12.3)°] ( P<0.05 or 0.01). The active forward flexion, abduction and rotation of the shoulder joint were gradually improved in both groups after surgery ( P<0.05 or 0.01). There was no significant difference in the active external rotation of the shoulder joint between the two groups at different time points (all P>0.05). No complications such as infection or acromion fracture appeared in the acromioplasty+PRP group; only one patient in the acromioplasty group had delayed wound healing, which was healed by dressing change. Conclusion:Compared with acromioplasty alone, acromioplasty combined with PRP can alleviate pain at early stage, promote shoulder function recovery, improve joint active range of motion, and reduce the incidence of acromioplasty.

This paper introduced the legislative development of community benefits system of nonprofit hospitals at federal level in the United States,as well as state legislatures in this regard. Based on America's experiences, an analysis was made on the "community benefits and health promotion model", which refers to community health needs assessment, health promotion programs, program implementation, supervision and appraisal. Thus the authors put forward inspirations for the social responsibility system development of public hospitals in China as follows. This refers to the establishment of hospitals' social responsibility system; development of community health promotion planning based on health needs;and establishment of social responsibility information disclosure system for fulfillment of their social responsibilities.

Information disclosure is important for the government and society to monitor the fulfillment of social responsibility of hospitals. This paper introduced the existing legislatures of the community benefits information disclosure system for non-profit hospitals in the United States, and analyzed the "two-level and two-way reporting system" of these hospitals, based on facts of California, Illinois and other regions. In the end, the authors put forward inspirations for the development of public hospitals' community benefits system in China as follows. This refers to the establishment of a social responsibility reporting system,stipulating the hospital and its health authority as the entities accountable for disclosure;a two-level/two-way reporting mechanism to improve the integrity of information disclosure;and standardization of information disclosure content and better timeliness and accessibility of information disclosure.

Objective:To study the willingness of the medical staff of tertiary hospitals to be dispatched to work for a long time at the district hospitals under the " municipal trusteeship of district-ownership hospitals" mode, and explore the key factors that affect their long-term willingness, for references of optimizing the incentive system of the model.Methods:A questionnaire was designed as guided by the two-factor theory. In May 2019, a typical sample survey was made to investigate 103 medical staff of two tertiary hospitals in Beijing on their willingness to be dispatched to hospitals of district ownership. The survey covered such aspects as their basic personal information, hygiene factors(family responsibility, interpersonal connections expansion, mobilization and encouragement of leaders, etc.), and incentive factors(personal career development, greater potential giving play to their own talents, self-achievement, etc.). Descriptive analysis and univariate hypothesis testing were used to compare the differences of the dispatch willingness of staff of different characteristics. Meanwhile, an ordinal multinomial logistic regression model was built to analyze the influence factors of long-term dispatch willingness of these staff along with individual in-depth interviews.Results:The medical staff when they were dispatched to work at the entrusted hospitals for a long time, were concerned mostly with top six factors. These factors refered to a reasonable incentive(rewards)mechanism, family responsibility, colleague evaluation of the entrusted hospital, interpersonal connections expansion, personal career development, and potential unlocking. Those staff with dispatch experience had higher willingness to be dispatched than those without( P <0.05). The former saw higher of their personal career development resulting from the dispatch(3.91 points), while the latter saw higher their post-dispatch salary incentive mechanism(3.95 points). Compared with common medical staff, medium and high level management staff were more willing to be dispatched for a long time( H=14.536, P<0.001). Leadership mobilization in hygiene factors and personal career development in incentives factors were the key drivers for the long-term willingness of medical staff to be dispatched( P<0.05). Conclusions:The willingness of medical staff to be dispatched for a long time needs to be strengthened in the " municipal trusteeship of district-ownership hospitals" mode. Managers of the district-ownership hospitals should take into full consideration, the needs of different categories and levels of medical staff dispatched, guarantee the remuneration and performance pay of these staff, and enable their career track planning, hence mobilizing their incentives, and increase their willingness to work at such hospitals for a long time.