Objective:It aimed to improve pilot programs and explore medical insurance payment methods tailored to the characteristics of Traditional Chinese Medicine(TCM)services by summarizing practical experiences,analyzing common issues,and proposing strategic suggestions.Methods:It conducted a comprehensive review of literature and policy documents to analyze the progress of TCM advantageous condition and payment modality reforms,prevalent conditions,and service types.Results:It revealed various payment modalities for TCM,including remuneration for advantageous conditions,establishment of TCM Diagnosis Related Groups(DRG),and formulation of differential adjustment coefficients for TCM-focused healthcare institutions.Reforms predominantly involve expanding condition-based remuneration scopes,individual-condition remunerations,and remuneration based on therapeutic efficacy.The effect of the reform is mainly reflected in the recognition of the value of TCM,the support of hospitals,and the benefit of patients.Predominant conditions include bone injuries,rheumatic ailments,and anorectal disorders,with hospitalization being the primary service modality.Conclusion:Current payment modalities for TCM advantageous conditions face challenges such as limited reform scope and service coverage,coding system standardization issues,performance incentive deficiencies,and irrational cost estimation.Recommendations include exploring integrated TCM advantageous condition service models,establishing a management paradigm for TCM conditions,addressing transient policy-related deficits,leveraging data analytics and AI algorithms,and formulating clinical pathway standards.

Objective:In the background of the national promotion of DIP insurance payment reform,using empirical data to evaluate the initial effects of payment reforms in typical traditional Chinese medicine hospitals.Methods:It collected inpatient case data from a Chinese medicine hospital in S city,encompassing a total of 207 500 cases from 2016 to 2022,and the differences between before and after the reform were analyzed using key indicators such as medical costs.Interrupted time series was applied to analyze the initial effects of the reform based on three intervention time points:reform implementation,epidemic development and static management.Logistic regression was applied to explore the main influencing factors,and recommendations for refinement were made based on the results of the key informant interviews.Results:It was found that the percentage of the high hospitalization cost group,high self-pay cost group and high bed-day cost group increased after the reform.There was an overall increasing trend in bed-day costs after the reform.Age,being married,operation times and average grade of operations,and death were the common influences.Conclusion:The initial stage of the DIP insurance payment reform was not effective in regulating medical costs.Demographic changes,strong intervention in epidemics,and the tendency of Chinese medicine hospitals to perform surgeries all tend to lead to an increase in hospitalization costs.At the same time,factors such as the shortage of policy interpretation and the lack of incentives for medical staff have affected the effectiveness of the reform.It was suggested that the DIP insurance payment reform of the Chinese medicine hospitals should be further promoted by strengthening the interpretation of policies and changing the solidification model,establishing positive incentives for medical staff,and adding indicators of traditional Chinese medicine characteristics.This will further fully leverage the advantages of Chinese medicine characteristics and enhance the substance and quality of Chinese medicine services.

Objective It constructs a new culture index system for high-quality development of public hospitals to provide scientific tool for evaluating the level of new culture construction of public hospitals and promoting high-quali-ty development.Methods A pool of indicators was established based on policy combing and literature research.Then,an indicator system was formed through Delphi expert consultation and demonstration,and weighting coefficients were assigned using the hierarchical analysis method.Results The indicator system of the new culture in public hospi-tals contains four primary indicators,eight secondary indicators and 23 specific entries.The four primary indicators are hospital culture system construction,strengthening the orientation of patients'needs,caring for medical staff and distinctive hospital culture.The effectiveness of implementation as an additional dimension contains two secondary indicators and eight specific entries.The weights of the primary indicators are balanced.Among the sec-ondary indicators,institutional planning(0.250),staff care(0.170),medical services(0.130),discipline branding(0.125)and professionalism(0.125)have higher weights.Conclusion The new culture index system for high-quality development of public hospitals is in line with Xi Jinping's cultural thought and the requirements of the new culture for high-quality development of public hospitals.It needs to pay attention to the planning of the cultural system,em-phasises the care of employees and the cultivation of professionalism,and focuses on the construction of medical services and disciplinary brands,so as to promote the construction of the new culture in public hospitals in line with the requirements of the national strategies.

Objective It developed and tested the reliability and validity of the Hospital Culture Perception and Experi-ence Scale for medical staff to provide a scientific tool for assessing medical staff's perceptions and experiences of hospital culture.Methods The scale was constructed with reference to the Dennison model of organisational culture and refined based on policy documents,literature and expert consultation.A hospital was selected to conduct the questionnaire survey.It used item analysis,factor analysis,and Cronbach's α to test scale reliability and validity.Results The total scale contains 43 entries in 4 subscales:institutional initiatives,practitioner perception,manage-ment training and mission commitment.Item analysis results showed that the scale had good differentiation;the Cronbach's αof the total scale was 0.992,and the Spearman-Brown was 0.979,with good reliability.Exploratory factor analysis results suggested that the institutional initiative,practitioner perception,and management training sub-scales had only 1 dimension,with a variance contribution rate of 77.12％,76.33％,and 85.75％,respectively.For the mission subscale,2 male factors were extracted,with a cumulative variance contribution rate of 91.34％.The factor loadings were all greater than 0.4.The validation factor analysis results shows that the model fit is good.The AVE of each subscale and dimension is greater than 0.5,and the CR is greater than 0.7,which indicates that the convergent validity is good.Conclusion The scale has good reliability and validity,and can be used to quantitatively as-sess the medical staff's perception and sense of experience of hospital culture.

Objective It developed a hospital culture awareness and experience scale for patients and their families and its reliability and validity were verified.The scale provides a tool for investigating patients'and families'experiences of hospital culture and promoting hospital culture building.Methods A scale that meets policy requirements and practice needs was designed with reference to a theoretical framework of hospital customers satisfaction index and it was refined through expert consultation.Patients and family members of a sample hospital were selected for the survey,and the reliability and validity of the scale were tested by item analysis,factor analysis and Cronbach's α.Results The scale contains 29 items in 3 dimensions of service perception,value recognition and cultural knowledge.Item analysis results showed that the scale had good differentiation.The Cronbach's αof the total scale was 0.975,and the Spearman-Brown was 0.934,with good reliability.Exploratory factor analysis extracted three male factors,with a cumulative variance contribution rate of 76.61%,and the factor loadings of each factor were all greater than 0.4.Validation factor analysis results suggests a better model fit.The CR is greater than 0.7 and the AVE of each dimension is greater than 0.5,which proves that convergent validity is good.Conclusion The scale has good reliability and validity,and can be used to quantitatively assess patients'and their families'sense of knowing and experiencing the hospital culture.It can provide scientific tool for evaluating the status of cultural leadership in helping public hospitals to develop high quality from the patient's perspective.

Objective It investigates patients'and families'awareness and experience of hospital culture and analyses its influencing factors.It provides empirical evidence for optimising hospital brand culture from a demand-side perspective.Methods The Patients'and Families'Awareness and Experience of Hospital Culture scale developed by the research team was used to investigate the awareness and experience status of hospital culture among patients and their families in a sample hospital.Multiple linear regression was used to analyse the influencing factors.Structural equation modelling was constructed to explore the relationship between cultural awareness,service perception and value recognition.Results A total of 4 783 valid questionnaires were collected for the study.The overall score of patients and family members on cultural awareness and sense of experience of the hospital was 80.0%,but the cultural awareness score was only 65.0%.Age,usual place of residence,and the duration of the most recent stay in hospital were the influencing factors for the sense of experience.Structural equation modeling results showed that cultural awareness positively influenced service perception but slightly negatively influenced value recognition,and service perception positively influenced value recognition.Conclusion Patients and their families have a good sense of awareness and experience of hospital culture,but the degree of cultural awareness is poor.It suggest strengthening patient demand-oriented hospital culture publicity.The hospital's characteristic culture is integrated into the whole process of patients'outpatient medical treatment,strengthening the service perception of patients and their families,promoting the recognition of the hospital's cultural value,and enhancing their sense of hospital cultural experience.

Objective:To investigate the intelligence status of children aged 10 - 12 in rural areas of Linxia Hui Autonomous Prefecture (referred to as Linxia) in Gansu Province.Methods:From September to November 2019, a cross-sectional study was carried out to investigate the intelligence status of children aged 10 to 12 in 8 counties (cities) of Linxia. Chinese Raven's Progressive Matrices (rural version) was used for intelligence test and children's intelligence quotient (IQ) was calculated by regular mold to evaluate children's intelligence level.Results:A total of 1 721 children in Linxia were tested for intelligence, with an average IQ of 103.2. Among them, low intelligence (≤69) accounted for 1.0% (18/1 721), borderline (70 - 79) accounted for 3.0% (52/1 721), middle and lower (80 - 89) accounted for 8.4% (144/1 721), moderate (90 - 109) accounted for 56.6% (974/1 721), middle and upper (110 - 119) accounted for 21.9% (377/1 721), excellent (120 - 129) accounted for 7.8% (135/1 721), extremely excellent (≥130) accounted for 1.2% (21/1 721). There were 635, 598 and 488 children aged 10, 11 and 12, respectively, with an average IQ of 106.1, 103.3 and 99.2. There were 919 males and 802 females, with an average IQ of 102.9 and 103.4, respectively.Conclusion:In 2019, the intelligence of children aged 10 to 12 in rural areas of Linxia has reached the moderate level.

ObjectiveLife education and hospice & palliative care (HPC) involve many aspects of medicine, humanities and education, which is not only an important public health issue, but also an important livelihood issue and education issue widely concerned at home and abroad. This study aims to explore the design and implementation of integrated life education and HPC small-class teaching curriculum for medical students, and to guide students to build correct attitudes towards life education and HPC in terms of knowledge, ability and emotion. MethodsA general course of Life Education and HPC for College Students was set up in a medical college in Shanghai using online and offline teaching models. The practical evaluation system and semi-structured outline were studied and constructed. The teaching effect data were collected by questionnaire survey and semi-structured qualitative interview. The Wilcoxon rank sum test was used to quantitatively analyze the objective teaching effect while the thematic analysis method was used to evaluate the subjective learning effect of students. ResultsThrough the integrated teaching practice, the quantitative analysis found that students’ overall evaluation of the course was higher. Learning effectiveness and course satisfaction ratings were both higher online than offline (both P<0.01). The qualitative analysis obtained three major themes: the understanding of life and HPC, the development prospect of HPC and its impact on the future life and career, and eight corresponding sub-themes: the value of life, the significance of HPC, human kindness, the promotion of HPC concept, the improvement of HPC services, the acceptance of HPC, the sense of responsibility as medical students, and the enrichment of life experience. ConclusionThe integrated course of life education and HPC for medical students in a medical college in Shanghai has achieved the teaching goals in terms of knowledge, ability and emotion. The study suggests that the integrated teaching model should be further improved by combining the advantages of online and offline teaching, and the construction of a professional curriculum system should be accelerated, so as to include life education and HPC into the required general courses for undergraduates in medical colleges to help students establish a correct outlook on life and values, establish the concept and will of HPC service, and guide the professional quality improvement and career development of future medical career.

Objective:It aimed to improve pilot programs and explore medical insurance payment methods tailored to the characteristics of Traditional Chinese Medicine(TCM)services by summarizing practical experiences,analyzing common issues,and proposing strategic suggestions.Methods:It conducted a comprehensive review of literature and policy documents to analyze the progress of TCM advantageous condition and payment modality reforms,prevalent conditions,and service types.Results:It revealed various payment modalities for TCM,including remuneration for advantageous conditions,establishment of TCM Diagnosis Related Groups(DRG),and formulation of differential adjustment coefficients for TCM-focused healthcare institutions.Reforms predominantly involve expanding condition-based remuneration scopes,individual-condition remunerations,and remuneration based on therapeutic efficacy.The effect of the reform is mainly reflected in the recognition of the value of TCM,the support of hospitals,and the benefit of patients.Predominant conditions include bone injuries,rheumatic ailments,and anorectal disorders,with hospitalization being the primary service modality.Conclusion:Current payment modalities for TCM advantageous conditions face challenges such as limited reform scope and service coverage,coding system standardization issues,performance incentive deficiencies,and irrational cost estimation.Recommendations include exploring integrated TCM advantageous condition service models,establishing a management paradigm for TCM conditions,addressing transient policy-related deficits,leveraging data analytics and AI algorithms,and formulating clinical pathway standards.

Objective:In the background of the national promotion of DIP insurance payment reform,using empirical data to evaluate the initial effects of payment reforms in typical traditional Chinese medicine hospitals.Methods:It collected inpatient case data from a Chinese medicine hospital in S city,encompassing a total of 207 500 cases from 2016 to 2022,and the differences between before and after the reform were analyzed using key indicators such as medical costs.Interrupted time series was applied to analyze the initial effects of the reform based on three intervention time points:reform implementation,epidemic development and static management.Logistic regression was applied to explore the main influencing factors,and recommendations for refinement were made based on the results of the key informant interviews.Results:It was found that the percentage of the high hospitalization cost group,high self-pay cost group and high bed-day cost group increased after the reform.There was an overall increasing trend in bed-day costs after the reform.Age,being married,operation times and average grade of operations,and death were the common influences.Conclusion:The initial stage of the DIP insurance payment reform was not effective in regulating medical costs.Demographic changes,strong intervention in epidemics,and the tendency of Chinese medicine hospitals to perform surgeries all tend to lead to an increase in hospitalization costs.At the same time,factors such as the shortage of policy interpretation and the lack of incentives for medical staff have affected the effectiveness of the reform.It was suggested that the DIP insurance payment reform of the Chinese medicine hospitals should be further promoted by strengthening the interpretation of policies and changing the solidification model,establishing positive incentives for medical staff,and adding indicators of traditional Chinese medicine characteristics.This will further fully leverage the advantages of Chinese medicine characteristics and enhance the substance and quality of Chinese medicine services.