Hospitals in China are evolving from the development pattern of resource-driven to connotation-driven, which propels the rapid growth of ambulatory care in the country.In consideration of the 76 typical ambulatory care cases presented at the Fourth Championship under China Healthcare Improvement Initiative(the Initiative), the authors studied and summed up innovations of China′s hospitals in their case management, organizational management and institutional management.Their efforts aim to understand the success of ambulatory care provision and analyze problems in this regard, for contributing to this model with China-unique experiences.

To investigate the security of semen biologically, 15 bull semen samples were collected (of which 5 exhibited clinical signs of Foot-and-mouth disease) and identified by RT-PCR and virus isolation. The results indicated that the semen of the infected bulls were contaminated by Foot-and-mouth disease virus (FMDV), but FMDV was not detected in semen samples from those bulls not showing clinical signs of Foot-and-mouth disease (FMD). This is the first report of the presence of FMDV in bull semen due to natural infection in China. The analysis of the partial sequence of the VP1 gene showed that the virus strain isolated from semen has 97.9% identity with the virus isolated from vesicular liquid of infected bulls showing typical signs of FMD and belonged to the same gene sub-group.

Objective:To analyze the impact of the payment reform of diagnosis related groups(DRG)on the flow direction and cost of delivery patients in a city.Methods:Using the data of new cooperative medical system from all 13 pilot hospitals carrying out DRG payment reform in a city from October 2016 to December 2019, the changes of delivery place, delivery mode and delivery cost before and after the reform were analyzed, and the change trend of the three was analyzed by interrupted time series.Results:The proportion of maternal delivery in secondary hospitals increased from 52.79%(8 246/15 620)before the reform(October 2016 to September 2017)to 59.83%(21 229/35 485)after the reform(April 2018 to December 2019). The cesarean section rate of women in secondary hospitals decreased from 38.25% before the reform to 37.91% after the reform, and the average cost of cesarean section increased from 4226.61 yuan to 4432.67 yuan. The cesarean section rate of women in tertiary hospitals increased from 36.03% before the reform to 39.18% after the reform, and the average cost of cesarean section increased from 6363.81 yuan to 7543.29 yuan.Conclusions:After the implementation of the DRG payment reform in a city, delivery services flowed to secondary hospitals, the growth of cesarean section rate slowed down, and delivery costs continued to increase, but the growth trend slowed down.