Objective It analyzes the internal relationship between hierarchical diagnosis and remote medical treatment,explores the internal relationship state,and put forward collaborative suggestions.Methods Through the review of relevant policies and academic literature from 2009 to 2023,the magic policy tool platform of Peking University and CNKI are used to conduct visual analysis of policy documents and academic research trends.Results The included literature includes 1 119 hierarchical diagnosis and treatment policies,444 remote medical treatment policies and 16 dual-policy coordination.There were 10 224 articles related to hierarchical diagnosis and treatment,and 2 388 articles related to remote medical treatment.The number of paper of hierarchical diagnosis and treatment policies is higher than that of medical treatment in different places policies,and the main institutions are the National Health Commission and the National Healthcare Security Administration.The overall publication and academic discussion showed a trend of rising first and then decreasing.Conclution The implementation of hierarchical diagnosis and remote medical treatmentpolicies has caused friction due to departmental conflicts of interest.The government and academia should pay more attention to the coordinated development of the dual policies,and should consider more effective collaborative strategies in the future.

Objective To analyze the causes and compensation characteristics of medical damage disputes in Anhui Province in recent years,and provide reference suggestions for effectively controlling and reducing the incidence of medical errors and doctor-patient conflicts.Methods The 1 876 cases of medical damage disputes in Anhui Province from 2017 to 2022 were included in the judgment documents network,and their occurrence years and causes of disputes were analyzed.Results The number of medical malpractice cases did not decrease significantly,and the average amount of compensation continued to increase;the top three causes of disputes were improper treatment or surgery(54.6%),and the average first place of actual compensation was improper medication or adverse drug reactions,and in terms of hospital level,1 009 cases(53.8%)were concentrated in tertiary public hospitals,the average actual compensation amount of private hospitals ranked first;the top three departments were surgery(44.62%);the highest incidence of damage was death(40.2%),and the average compensation amount for first-class disability was the highest.Hospitals were mainly responsible for secondary responsibilities(38.7%).Conclusion The contradiction between doctors and patients is still serious,so it is necessary to promote the construction of tight medical association and medical community,guide the allocation of medical resources,pay attention to risk sharing and management optimization,and reduce the incidence of medical damage disputes.

Under the background of deepening the reform of medical and health system,the reform of public hos-pital salary system reform faces the dual challenges of realizing the value of knowledge and maintaining public wel-fare.Based on the public value theory,it constructs a synergistic analytical framework of"knowledge value and pub-lic welfare"to reveal the internal logic and realization path of public hospital pay system reform.Through the mecha-nisms of policy design reconstruction,assessment system innovation,remuneration structure optimization and multi-dimensional collaborative governance,the current systemic obstacles such as incentive alienation,misalign-ment of assessment,and insufficient financial compensation can be effectively solved.It is necessary to build a pub-lic value target,construct a synergistic system of"constraints and incentives",and activate the main motivation of medical staff to form a closed loop of"target-setting-mechanism-driven-practice-feedback"value cycle.It pro-vides a theoretical innovation path for the reform of public hospital remuneration system,and has important reference value for balancing the efficiency and fairness of medical services.

The design of the salary structure in public hospitals is an important part of the salary system reform.The salary structure is in a dynamic evolutionary process as the reform deepens,and at this stage,it is gradually shifting towards a development direction that emphasizes incentive-based salary performance.Continuous optimization of the salary structure is key to exploring the accurate measurement of doctors' value and the sustainable development of the hospital's public welfare attributes.Through literature research and comparative analysis,it presented a tabular presentation of the four incentive compensation models formed so far in the dynamic optimization of China's public hospitals after the new healthcare reform,and to conduct a comparative analysis of their respective advantages and disadvantages,in order to provide reference and information for the continuous optimization of the pay structure of public hospitals.

Based on the theoretical framework of incentive compatibility,it analyzes the experience of the annual salary system of deans in the reform of public hospitals,summarizes the systemic efficacy and limitations of the annual salary system of deans,and extracts the empirical insights for the reform of physicians' remuneration.The annual salary system of deans cuts off the link between salary and economic gain,strengthens the assessment of public welfare,and initially realizes the incentive compatibility,but there are also assessment defects and incentive imbalance risks.The annual salary system for doctors needs to build a hierarchical and dynamic assessment system,and rely on medical insurance payment and financial protection to break the system's island effect.In the future,the appraisal framework should be dynamically optimized with regional differences,so as to promote the higher-order compatibility of individual rationality and public welfare attributes.

The reform of salary system in public hospitals is a key link in deepening the reform of medical and health system,which is of great significance to improving the quality of medical services.With the help of Smith policy implementation process model,it constructs the theoretical framework of policy analysis,and analyzes the implementation dilemma of the salary system reform in public hospitals from four dimensions of idealized policy,implementing agency,target group and policy environment.There are the core problems of contradiction between policy and demand,administrative dominance and specialty deficiency,incentive imbalance and external environment restriction.Put forward the development path of public welfare oriented adjustment mechanism,establishing a collaborative supervision system,building a compound incentive model,and building a salary community.

Objective To explore and analyze the incentive changes before and after the implementation of the annual salary system in public hospitals to provide guidance for the implementation.Methods Using the principal-agent theory,construct the structure and model of government,hospitals and doctors,and analyze the salary incentive before and after the implementation of the annual salary system.Results Former doctors"seek profit"and hospital"income orientation"conflict with the government public welfare goals;after implementation,doctors transfer"public welfare"and hospital and government goals seek"public welfare coordination",but there are also new problems such as insufficient incentives.Conclusion If public hospitals successfully implement the annual salary system,they should adopt fine parameter design,supporting system and dynamic equilibrium mechanism.

Objective To explore the suitability of performance appraisal tools in the annual salary system reform of public hospitals,and to propose a differentiated configuration plan to optimize the effectiveness of the compensation system.Methods Through the formula deduction and deductive method,it systematically assesses the suitability and conflict points of the three tools of KPI,RBRVS and 360-degree appraisal under the framework of the annual salary system,and the comparative research method,and propose a differentiated configuration scheme based on multi-dimensional scenarios.Results KPI is suitable for short-term efficiency goals but needs to prevent quantitative bias,RBRVS embodies technical value in technology-driven departments but there is a risk of profit-seeking,and 360-degree assessment strengthens long-term development but the implementation cost is high.It needs to be dynamically adjusted in combination with the regional economic level,hospital scale and departmental functions,and implemented with the technical support of information technology.Conclusion Public hospitals should differentiate the selection of performance appraisal tools according to the specific context and establish a dynamic adjustment mechanism to realize the benign interaction between the appraisal tools and the annual salary system reform,and to promote the sustainable development of hospitals and the enhancement of the value of medical services.

Objective To explore the driving forces behind the changes in the salary system of public hospitals in China and provide scientific evidence and policy recommendations for further improving the salary system.Methods Using the multiple streams theoretical framework,combined with bibliometric analysis and policy texts analysis,to deeply understand the factors influencing the salary system reform of public hospitals.Results The problem stream highlights issues such as low salary levels,structural imbalances,and insufficient incentives:the average wage of health and social work employees is only 1.19 times the national average,with a disproportionately low share of ba-sic salary and allowances.The policy stream is grounded in the accumulation of long-term academic research and lo-cal pilot experiences:from 2002 to 2025,attention to hospital remuneration has steadily increased;the pilot reform in Sanming City led to an average annual salary growth rate of 11.87％for medical staff.The political stream is driven by the government's"Healthy China"strategy and public opinion orientation:the reform of the public hospital sala-ry system from 1993 till now can be divided into three stages,with reform objectives gradually shifting towards the establishment of a scientifically sound and rational salary distribution system.The synergy of these three streams has facilitated the opening of a"policy window"for salary system reform in public hospitals.Conclusion It is essential to establish a dynamic salary adjustment mechanism,encourage the participation of experts and stakeholders in the policymaking process,and better align with national reform orientations.

Objective The relationship between the coupling coordination degree of DRG capacity,medical quality and medical cost and the high-quality development level of hospitals under the background of DRG was quantitatively analyzed,and the linear correlation between the efficient collaboration of multiple factors and the high-quality development of hospitals was verified.Methods The relevant indicators of sample hospitals from January 2021 to June 2023 were selected to construct a multi-dimensional evaluation index system of DRG capacity,medical quality and medical cost,and the Delphi method and entropy weight method were used to carry out subjective and objective comprehensive weighting to evaluate the high-quality development level of hospitals.The coupling coordination degree model was used to measure the coordinated development level of DRG capacity,medical quality and medical cost,and then the correlation between the coupling coordination degree and high-quality development of the three was obtained through Pearson correlation.Results The monthly variation of high-quality development represented by the DRG capacity,medical quality and comprehensive medical cost capacity level of the sample hospitals is quite different,and the coupling coordination degree is the highest 0.916 and the lowest is 0.173,showing a preliminary coordination pattern as a whole.The Pearson correlation coefficient between the coupling coordination degree and high-quality development of the three is 0.731,and there is a significant positive correlation.Conclusion The coupling and coordination level of DRG capacity,medical quality and medical cost of the hospital can represent the high-quality development level of the hospital,and the synergy of elements should be paid attention to to help the overall development.