Objective:To propose ideas for designing an incentive system that aligns with the unique characteristics of the medi-cal industry while maintaining altruism.Methods:The concepts of reciprocal altruism theory and gift exchange game experiments are introduced from the field of economics to incentivize physicians'altruistic behavior.Results:It proposes the indirect reciprocal altru-ism theory,which focuses on the three-party principal-agent relationship between physicians,patients,and management in the medical field.The compensation incentive concept that measures health value is also introduced.Additionally,it constructs a model for the incentive mechanism of physicians'altruistic behavior based on the three-party gift exchange game.Conclusion:Based on the concept of value-based incentives for physicians'altruistic behavior,it develops an incentive system that caters to the unique characteristics of the medical industry and promotes its high-quality development.

Reducing low-value care is a key measure to optimize service model for cancer patients and improve the quality of and value of care.We summarizes the conceptual connotation of low-value medical services for cancer patients,compares the relevant measurement indicators at home and abroad,explains the logic of low-value medical services use for cancer patients at the three levels of"individual-institution-system",and proposes strategies for reducing low-value medical services for cancer patients in five aspects:construction of service value framework,dissemination of evaluation results,connection of drug access mechanisms,moni-toring of cancer care services,and empowering shared decision-making.

As an important healthcare service to cope with the aging population and slow disease characterization,the quality and development mode of the successive healthcare service has gradually attracted attention as to how to adapt to the existing hierarchical diagnosis and treatment system.It will sort out the supportive policies and development status of the successive medical services un-der China's hierarchical diagnosis and treatment system,and find out the problems in the development of the successive medical ser-vices under the hierarchical diagnosis and treatment system in the new period,in order to provide references and suggestions for the further sustainable development of the successive medical services in China.

Health technology assessment(HTA)is an important tool to inform health decision-making.Although highly related to ethical issues in the context of HTA,equity has attracted much attention from the academia,a consensus has not yet been reached on how to define and evaluate equity in China and abroad.It introduces the concept of equity,pointes out the necessity to realize health equity and the reflection of equity in healthcare sector,and further elaborates four ways to consider equity,and described the official practice of equity in HTA at home and abroad.It proposes several suggestions for China's HTA:considering equity in HTA and the discussion of equity should depend on specific decision-making scenarios;clarifying what health measurement perspective should be adopted before measuring health equity;paying attention to the value judgment of equity adopted by various stakeholders;conducting basic researches on the general population's preference for health measurement perspectives and value judgments of equity in China in a gesture to improve the evaluation system of equity in HTA.

In vitro diagnostic technology is an important aid for disease prevention,treatment,and prognostic monitoring.The de-velopment of its new technologies,methods and products is of great significance for improving medical quality and protecting public health.On the basis of exploring the mechanism of health impact of in vitro diagnostic technology,it takes dry chemical method and wet chemical method as an example,and compares the economy of the two diagnostic technologies for hyperkalemia diagnosis from the perspective of health system,with a view to draw references for the practical application and evaluation of new in vitro diagnostic techniques,methods and products in the future.

Based on China's health-related policy documents,combining the development history of health concepts and quality management theories,the evolution of China's view of healthcare service quality is sorted out.Moreover,based on the objectives of payment reform and the possible impact on healthcare service quality,the focus of healthcare service quality evaluation in the context of health insurance payment reform is elaborated.It aims to explore the focus of medical service quality evaluation at the present stage,and to provide a reference for better utilization of the evaluation results to improve the quality of medical services.

Objective:To explore the core issues in the implementation of"packaged payment"in China's compact county medi-cal community,in order to provide useful references for the innovative reform of medical insurance payment methods in compact coun-ty medical community.Methods:By constructing the problem system through the macro model of the health system,analyzing the re-lated literature using multidimensional scale analysis and social network analysis,and comprehensively evaluating the results using the entropy-weighted TOPSIS method,it summarizes the core issues of"packaged payment"in compact county medical community.Results:There are core issues in China's compact county medical community,such as inadequate distribution of benefits and incen-tive and constraint mechanisms within the medical community(Ci= 1.000),lack of effective supervision and assessment mechanism for medical communities(Ci= 0.732),suppressed quality and efficiency of medical services(Ci= 0.652),lagging medical informatiza-tion construction(Ci= 0.595),and incomplete supporting policy measures(Ci= 0.579).Conclusion:The"packaged payment"of com-pact county medical community can be optimized from the following three aspects:a multi-level collaborative incentive mechanism should be improved to ensure the service quality and efficiency;optimize the total amount calculation method and improve the de-tailed supporting measures;accelerate information construction and strengthen supervision and assessment management.

The typical regions have established a coordinated chronic disease management organization system,promoted the coordinated management of health care,medical,and medicine systems,optimized the chronic disease service process,and empowered the grassroots through information technology construction.It has achieved different degrees of results in controlling the condition of patients,reducing the hospitalization rate and the level of medical expenses of patients with chronic diseases,and saving medical insurance funds.

Objective:To analyze the basic medical insurance fund balance status in China and the risk warning since the new medical reform,in order to provide decision-making references for the sustainable development of basic medical insurance fund in China.Methods:Collecting the data on the basic medical insurance fund in China from 2009 to 2022 for descriptive statistical analysis,and conduct fund balance risk warning analysis based on the risk warning interval.Results:During 2009-2021,the percentage of retirees enrolled in UEBMI has continued to increase,and there will still be a certain accumulated balance in the integrated fund.The number of participants in the URBMI has been decreased since 2020,the growth rate of fund expenditures became higher than the growth rate of fund revenues,the fund balance showed a decreasing trend.Conclusion:There are certain risks to the long-term balance of the basic medical insurance fund,which may caused by factors such as aging population,funding mechanisms,and treatment levels.

Objective:To study the impact of the national volume-based procurement policy on inpatient medical costs.Methods:Firstly,a descriptive analysis on the completion of the procurement volume of drugs in the hospital was carried out,and furthermore,using the data on the medical costs of inpatients before and after the implementation of the policy,conducted statistics on changes in the structure of patients'medical expenses.Taking the time of the first day of using the volume-based procurement drugs as the breakpoint,a sharp regression discontinuity model was constructed to compare the changes in the different categories of costs.Re-sults:There is still room for improvement in the use of volume-based procurement drugs in the hospital.After the use of those drugs,in addition to the cost of comprehensive services and consumables rose by 1.01 and 3.07 percentage points respectively,the rest of the categories of costs were on a downward trend,the per capita total medical costs and drug costs of inpatients fell by 644.58 yuan and 300.19 yuan respectively.In addition,the average hospital stay of patients decreased significantly after the implementation of the poli-cy.Conclusion:The national volume-based procurement policy has achieved certain results,but there is a need to set more reason-able procurement volume targets and to adjust cost control measures in a comprehensive manner to further optimize the structure of medical costs.