Objective To investigate the drivers,stakeholders,core tasks,and differentiated development models of digital transformation in Chinese hospitals,develop a hospital digital transformation model,and propose advancement pathways.Methods Leveraging ROCCIPI theory,socio-technical systems theory,and social network theory,a multiple case study approach was employed to analyze four representative Chinese hospitals,examining the driving factors,social network relationship,and core tasks of digital transformation.Results Hospital digital transformation is a complex process driven by regulations,opportunities,and capabilities,requiring efficient collaboration among stakeholders focused on patient services,clinical operations,hospital management,and security.It identified three development models-ecology-oriented,regional integration,and grassroots enhancement—based on the distinct characteristics of the hospitals.A theoretical model for digital transformation in four Chinese hospitals was developed,along with proposed pathways and strategies.Conclusion It presents a digital transformation model and advancement pathways for hospitals through multiple case analyses,addressing the limited perspectives of existing research and providing a reference for practice.

Objective:This study empirically analyzes the relationship between outpatient and inpatient services under the impact of healthcare payment reform,and evaluates the effects of the reform.Methods:Data from healthcare services and basic medical insurance payments in eight districts of Jinhua City from 2020 to 2022 were used.A fixed-effects model for outpatient and inpatient services was constructed to analyze the impact of healthcare payment reforms and outpatient services on inpatient services.Results:The DRG-based payment had a significant positive effect on inpatient visits and a significant negative effect on employee basic medical insurance inpatient costs.The"capitation+APG"outpatient payment policy had a significant negative effect on inpatient visits and a significant negative effect on residents'basic medical insurance inpatient costs.The interaction between outpatient payment and outpatient visits had a significant negative effect on employee basic medical insurance inpatient visits,while the interaction between outpatient payment and outpatient costs had a significant negative effect on both overall and employee inpatient costs.Conclusions:The DRG payment reform led to an increase in inpatient visits and a reduction in employee basic medical insurance inpatient costs.The outpatient"capitation+APG"payment reform reduced inpatient visits and lowered residents'basic medical insurance inpatient costs,thereby slowing down the complementary effect between outpatient and inpatient services.

[Purpose]To analyze the prevalence and disease burden of malignant tumors in cancer registration areas of Hubei Province in 2020.[Methods]The incidence and mortality data of ma-lignant tumors in cancer registration areas in Hubei Province in 2020 were collected,and the data were quality controlled according to the quality evaluation standards and methods formulated by the National Cancer Center.The data from 24 registries met the inclusion criteria.Using descrip-tive epidemiological methods to calculate incidence/mortality rate,age-specific incidence/mortality rate,standardized incidence/mortality rate by Chinese standard population(ASRC),standardized incidence/mortality rate by world standard population(ASRW).Disability-adjusted life years(DALY)and DALY rates were calculated using formulas provided by the World Health Organization to as-sess the disease burden of malignant tumors.[Results]In 2020,the crude incidence of malignant tumors in cancer registration areas of Hubei Province was 311.36/105,the ASRC was 184.14/105,the ASRW was 197.37/105,and the cumulative rate of 0～74 years old was 20.52％.The age-spe-cific incidence of malignant tumors in the province and rural areas reached its peak in the age group of 75～79 years old,while in urban areas it reached its peak in the age group of 80～84 years old.In 2020,the crude mortality rate of malignant tumors in cancer registration areas of Hubei Province was 184.58/105,the ASRC was 96.91/105,the ASRW was 110.92/105,and the cumulative rate of 0～74 years old was 11.01％.The age-specific mortality rate of malignant tumors in the province and urban areas reached its peak in the age group of above 85 years old,while in rural areas it reached its peak in the age group of 80～84 years old.Lung cancer ranked first in the incidence and mortality of malignant tumors in the province.In the cancer registration area of Hubei Province,the DALY of malignant tumors in 2020 was 641 497 person-years,and the DALY rate was 28.6‰.[Conclusion]Common cancers such as lung cancer,female breast cancer and upper digestive tract cancer have a great impact on the incidence,mortality and disease burden of malignant tumors in Hubei Province.Targeted cancer screening and early diagnosis and treatment are the most effective means to improve social and economic benefits.

[Purpose]To analyze the epidemiological characteristics of lung cancer in 2020 and the trend from 2012 to 2020 in Hubei Province.[Methods]Qualified lung cancer registry data reported by 24 cancer registries in Hubei Province was utilized to estimate the number of new lung cancer cases and deaths.Incidence/mortality rate,age-specific incidence/mortality rate,age-standardized incidence/mortality rate by Chinese standard population(ASIRC and ASMRC)and by world stan-dard population(ASIRW and ASMRW),cumulative rate of 0～74 years old and other indicators of lung cancer in urban and rural areas,different sex,age groups in 2020 were calculated.Annual percentage change(APC),average annual percentage change(AAPC)and 95％confidence interval(CI)were calculated to analyze the trends of incidence and mortality of lung cancer in cancer regi-stration areas of Hubei Province from 2012 to 2020.[Results]In 2020,the estimated number of new lung cancer cases in Hubei Province was 41 531,accounting for 23.17％of all new cancer cases.The incidence rate was 72.13/105,with the ASIRC of 38.19/105 and ASIRW of 42.75/105 respectively.The cumulative incidence rate of 0～74 years old was 4.82％.The estimated number of lung cancer deaths in Hubei Province in 2020 was 31 374,accounting for 29.52％of all cancer deaths.The mortality rate was 54.49/105,with the ASMRC of 27.66/105 and ASMRW of 31.95/105,respectively.The cumulative mortality(0～74 years old)was 3.36％.The incidence of lung cancer was higher in urban areas than that in rural areas,and higher in men than that in women.The in-cidence and mortality of lung cancer increased with age,and reaching the peak in the age groups of 75～79 and 80～85 years old respectively.From 2012 to 2020,the overall trend of crude inci-dence and mortality of lung cancer in Hubei Province was stable.The ASIRC and ASMRC showed a slow decline during 2012-2020,with the AAPCs of-0.51％(95％CI:-1.06％～-0.02％)and-1.84％(95％CI:-2.65％～-0.53％),respectively.The ASIRC showed a slow decline(APC=-1.76％,95％CI:-3.30％～-1.03％)during 2012-2018 and increase trend(APC=3.33％,95％CI:0.61％～5.02％)during 2018-2020,respectively,while ASMRC showed a significant decrease trend(APC=-3.00％,95％CI:-6.58％～-1.13％)during 2016-2020.[Conclusion]The incidence and mortality levels of lung cancer in Hubei Province were relatively high,resulted in a heavy disease burden and no significant downward trend.In the future,we should continue to strengthen the compre-hensive prevention and treatment of lung cancer,and promote lung cancer screening and early diagno-sis and treatment for target populations vigorously,especially in rural areas.

[Purpose]To analyze the opportunistic screening results of upper gastrointestinal can-cer in Hubei Province from 2022 to 2023.[Methods]The data of upper gastrointestinal cancer opportunistic screening program in Hubei Province from January 1,2022 to December 31,2023 were summarized.The biopsy rate,positive lesion detection rate and early diagnosis rate were ana-lyzed.The differences in rates between/among different sexes,age groups and regions were com-pared by x2 test,trend x2 test.[Results]A total of 372 507 people were included in the oppor-tunistic screening of upper gastrointestinal cancer from 2022 to 2023.Among them,100 379 in-dividuals underwent biopsy histopathological examination,with a biopsy rate of 26.95％.A total of 4 678 positive cases(high-grade intraepithelial neoplasia,early-stage cancer and advanced can-cer)were detected in the opportunistic screening,with a positive lesion detection rate of 1.26％.The detection rates of positive lesion in the esophagus,cardia and stomach were 0.61％,0.07％and 0.58％,respectively.There were 721 cases of early upper gastrointestinal cancer(high-grade intraepithelial neoplasia,early-stage cancer),representing an early diagnosis rate of 15.41％.The early diagnosis rates for the esophagus,cardia and stomach were 14.53％,11.96％and 16.89％,respectively.[Conclusions]The implementation of opportunistic screening for upper gastrointesti-nal cancer is conducive to expanding the coverage of screening.It is necessary to strengthen stan-dardized and homogeneous training and complete high-quality endoscopic examination to improve the detection rate and early diagnosis rate of opportunistic screening program for upper gastroin-testinal cancer.

Malignant tumors,as chronic diseases that seriously affect human life and health,are one of the most serious public health problems worldwide in the 21st century.Hubei Province at-taches great importance to the prevention and control of chronic diseases such as cancer,and launched the"323"campaign in 2021.This paper reviews the progress of cancer prevention and control in the"323"campaign from 2021 to 2024 from the aspects of science popularization,tu-mor registration,cancer screening,standardized diagnosis and treatment,and grassroots capacity improvement,and explores the key points of cancer prevention and control work in Hubei Province in the next step.

[Purpose]To analyze the prevalence and disease burden of malignant tumors in cancer registration areas of Hubei Province in 2020.[Methods]The incidence and mortality data of ma-lignant tumors in cancer registration areas in Hubei Province in 2020 were collected,and the data were quality controlled according to the quality evaluation standards and methods formulated by the National Cancer Center.The data from 24 registries met the inclusion criteria.Using descrip-tive epidemiological methods to calculate incidence/mortality rate,age-specific incidence/mortality rate,standardized incidence/mortality rate by Chinese standard population(ASRC),standardized incidence/mortality rate by world standard population(ASRW).Disability-adjusted life years(DALY)and DALY rates were calculated using formulas provided by the World Health Organization to as-sess the disease burden of malignant tumors.[Results]In 2020,the crude incidence of malignant tumors in cancer registration areas of Hubei Province was 311.36/105,the ASRC was 184.14/105,the ASRW was 197.37/105,and the cumulative rate of 0～74 years old was 20.52％.The age-spe-cific incidence of malignant tumors in the province and rural areas reached its peak in the age group of 75～79 years old,while in urban areas it reached its peak in the age group of 80～84 years old.In 2020,the crude mortality rate of malignant tumors in cancer registration areas of Hubei Province was 184.58/105,the ASRC was 96.91/105,the ASRW was 110.92/105,and the cumulative rate of 0～74 years old was 11.01％.The age-specific mortality rate of malignant tumors in the province and urban areas reached its peak in the age group of above 85 years old,while in rural areas it reached its peak in the age group of 80～84 years old.Lung cancer ranked first in the incidence and mortality of malignant tumors in the province.In the cancer registration area of Hubei Province,the DALY of malignant tumors in 2020 was 641 497 person-years,and the DALY rate was 28.6‰.[Conclusion]Common cancers such as lung cancer,female breast cancer and upper digestive tract cancer have a great impact on the incidence,mortality and disease burden of malignant tumors in Hubei Province.Targeted cancer screening and early diagnosis and treatment are the most effective means to improve social and economic benefits.

[Purpose]To analyze the epidemiological characteristics of lung cancer in 2020 and the trend from 2012 to 2020 in Hubei Province.[Methods]Qualified lung cancer registry data reported by 24 cancer registries in Hubei Province was utilized to estimate the number of new lung cancer cases and deaths.Incidence/mortality rate,age-specific incidence/mortality rate,age-standardized incidence/mortality rate by Chinese standard population(ASIRC and ASMRC)and by world stan-dard population(ASIRW and ASMRW),cumulative rate of 0～74 years old and other indicators of lung cancer in urban and rural areas,different sex,age groups in 2020 were calculated.Annual percentage change(APC),average annual percentage change(AAPC)and 95％confidence interval(CI)were calculated to analyze the trends of incidence and mortality of lung cancer in cancer regi-stration areas of Hubei Province from 2012 to 2020.[Results]In 2020,the estimated number of new lung cancer cases in Hubei Province was 41 531,accounting for 23.17％of all new cancer cases.The incidence rate was 72.13/105,with the ASIRC of 38.19/105 and ASIRW of 42.75/105 respectively.The cumulative incidence rate of 0～74 years old was 4.82％.The estimated number of lung cancer deaths in Hubei Province in 2020 was 31 374,accounting for 29.52％of all cancer deaths.The mortality rate was 54.49/105,with the ASMRC of 27.66/105 and ASMRW of 31.95/105,respectively.The cumulative mortality(0～74 years old)was 3.36％.The incidence of lung cancer was higher in urban areas than that in rural areas,and higher in men than that in women.The in-cidence and mortality of lung cancer increased with age,and reaching the peak in the age groups of 75～79 and 80～85 years old respectively.From 2012 to 2020,the overall trend of crude inci-dence and mortality of lung cancer in Hubei Province was stable.The ASIRC and ASMRC showed a slow decline during 2012-2020,with the AAPCs of-0.51％(95％CI:-1.06％～-0.02％)and-1.84％(95％CI:-2.65％～-0.53％),respectively.The ASIRC showed a slow decline(APC=-1.76％,95％CI:-3.30％～-1.03％)during 2012-2018 and increase trend(APC=3.33％,95％CI:0.61％～5.02％)during 2018-2020,respectively,while ASMRC showed a significant decrease trend(APC=-3.00％,95％CI:-6.58％～-1.13％)during 2016-2020.[Conclusion]The incidence and mortality levels of lung cancer in Hubei Province were relatively high,resulted in a heavy disease burden and no significant downward trend.In the future,we should continue to strengthen the compre-hensive prevention and treatment of lung cancer,and promote lung cancer screening and early diagno-sis and treatment for target populations vigorously,especially in rural areas.

[Purpose]To analyze the opportunistic screening results of upper gastrointestinal can-cer in Hubei Province from 2022 to 2023.[Methods]The data of upper gastrointestinal cancer opportunistic screening program in Hubei Province from January 1,2022 to December 31,2023 were summarized.The biopsy rate,positive lesion detection rate and early diagnosis rate were ana-lyzed.The differences in rates between/among different sexes,age groups and regions were com-pared by x2 test,trend x2 test.[Results]A total of 372 507 people were included in the oppor-tunistic screening of upper gastrointestinal cancer from 2022 to 2023.Among them,100 379 in-dividuals underwent biopsy histopathological examination,with a biopsy rate of 26.95％.A total of 4 678 positive cases(high-grade intraepithelial neoplasia,early-stage cancer and advanced can-cer)were detected in the opportunistic screening,with a positive lesion detection rate of 1.26％.The detection rates of positive lesion in the esophagus,cardia and stomach were 0.61％,0.07％and 0.58％,respectively.There were 721 cases of early upper gastrointestinal cancer(high-grade intraepithelial neoplasia,early-stage cancer),representing an early diagnosis rate of 15.41％.The early diagnosis rates for the esophagus,cardia and stomach were 14.53％,11.96％and 16.89％,respectively.[Conclusions]The implementation of opportunistic screening for upper gastrointesti-nal cancer is conducive to expanding the coverage of screening.It is necessary to strengthen stan-dardized and homogeneous training and complete high-quality endoscopic examination to improve the detection rate and early diagnosis rate of opportunistic screening program for upper gastroin-testinal cancer.

Malignant tumors,as chronic diseases that seriously affect human life and health,are one of the most serious public health problems worldwide in the 21st century.Hubei Province at-taches great importance to the prevention and control of chronic diseases such as cancer,and launched the"323"campaign in 2021.This paper reviews the progress of cancer prevention and control in the"323"campaign from 2021 to 2024 from the aspects of science popularization,tu-mor registration,cancer screening,standardized diagnosis and treatment,and grassroots capacity improvement,and explores the key points of cancer prevention and control work in Hubei Province in the next step.