Objective To define the conceptual connotation and characteristics of medical surges,and to construct a theoretical analysis framework for responding to medical surges based on complex networks.Methods By systematically reviewing relevant domestic and international research and practices,and from the perspective of complex networks and interdisciplinary integration,it analyzed the concept connotation,characteristics and comprehensive analytical framework of medical surges.Results The concept and connotation of medical surges were defined,and six major characteristics were summarized:sudden and surging congestion,overload spillover,stage recurrence,complex network and multi-dimensional collaboration,dynamic nonlinear multi-path evolution,and cascading amplification.A theoretical analysis framework was developed,encompassing four dimensions("risk and vulnerability coupling-complex surge scenario characterization-complex risk network chain drive-network dynamic collaboration capacity assessment and construction"),multiple hierarchical levels("macro-level healthcare system-meso-level hospital department functional systems-micro-level resource elements system"),and multiple scales("Wuli-Shili-Renli").Conclusion The proposed conceptual connotation,characteristics,and multi-dimensional,multi-level,and multi-scale theoretical analysis framework provide new perspectives and theoretical support for advancing the theoretical system of medical surges,guiding healthcare institutions to respond scientifically to surge impacts,and enhancing system resilience and network dynamic collaboration capacity.

Objective To systematically identify the scenario elements of unconventional hospital infection outbreaks and provide a theoretical framework for preventing and resolving unconventional hospital infection outbreaks.Methods The literature related to unconventional hospital infection outbreaks was searched,and the text was preprocessed by Chinese word segmentation technology,and the element categories were condensed layer by layer based on the three-level coding of grounded theory.Results A total of 122 initial concepts,52 initial categories,13 sub-categories and 4 main categories were extracted disaster causing factors,disaster bearers,disaster environment,and emergency activities,and the action types:disaster factors driving the causal chain,disaster bearers bearing the mediating conduction,disaster environment exerting moderating effects,and emergency activities had two-way feedback.Conclusion The four-dimensional scenario factor action type model constructed breaks through the traditional one-way causal framework and provides a qualitative theoretical framework for factor association for the prevention and control of hospital infection outbreaks.

Objective To identify the key factors affecting the risk of medical surges and their coupling relation5 ships,providing strategic support for medical institutions to optimize risk management and emergency governance.Methods 17 influencing factors were determined based on WSR theory,and an expert scoring method was employed to assess the impact strength among the factors.The DEMATEL method was applied to calculate the centrality,cau5 sality,influence,and being influenced degrees of the influencing factors.The ISM method was used to construct a hierarchical structure of the influencing factors related to medical surge risks,thereby revealing the connections and interaction mechanisms among these factors.Results Seven critical influencing factors were identified,including the crisis decision-making capacity and leadership effectiveness of emergency managers,the completeness of the emer5 gency system and dynamic execution capabilities,and the cross-departmental coordination mechanism and com5 mand collaboration efficiency.Deep driving factors and coupling pathways were also revealed.Conclusion The risk of medical surges exhibits multi-factorial coupling cascade effects;attention should be directed towards the construc5 tion of mid-to-deep level mechanisms such as information systems,institutional frameworks,and organizational management,to enhance targeted capabilities and systemic resilience in risk governance.

Objective Exploring the components of complex scenarios of healthcare surges triggered by major epidemics to provide a theorical basis for building resilience in healthcare organizations.Methods A hybrid analysis method is used to summarize macro-meso-micro multi-level and multi-source heterogeneous information,extract the elements of complex scenarios of medical surge and evaluate the rationality.Fault Tree Analysis method is used to clarify the logical relationship between various scenario elements and construct scenario reasoning paths.Results 10 scenario states,11 disaster-bearing,24 emergency management and 23 scenario results are summarized and extracted to form the key elements of complex surge scenarios.Among them,M4 expansion and coordinated scheduling of key positions,B2 conventional drug inventory emergency/insufficient core treatment drugs,B emergency medical material transportation breakage,S3 disease symptom spectrum shift to severe disease,R13 prevention and control awareness laxity,and M5 media information dissemination management are the key driving factors that promote a major turning point in the scenario.The most positive scenario result is the orderly operation of the medical service system,and the most negative scenario result is the paralysis of the medical service system.Conclusion Medical institutions need to improve emergency plans based on the complex evolution scenarios of medical surges and agile governance capabilities targeting key turning points,focus on dynamically expanding and scheduling personnel in key positions,strengthen material rotation and reserve mechanisms,maintain smooth emergency logistics channels,and improve efficient management of media and public opinion,so as to comprehensively improve overall resilience.

Objective To explore the coupling mechanism between medical surge response resources and the spread of secondary risks during public health emergencies,as well as the effectiveness of relevant interventions.Methods Based on complex network theory,a dual-layer network model of medical resources and secondary events was constructed.The interactive feedback between medical resource status and secondary event risk,as well as the effects of network structure,were analyzed through MATLAB simulations,REPAST agent-based modeling,and mean-field analysis.Results Simulation and prediction results show that an increase in first-layer resource-deficient nodes significantly raises the activation rate and transmission speed of secondary events,while the clustering and spread of secondary events in the second layer,in turn,intensify resource depletion,creating a negative feedback loop.Mean-field analysis indicates a nonlinear positive correlation between the adequacy of medical resources and the likelihood of secondary events.Network structure analysis reveals that when the average node degree exceeds 8,resource allocation efficiency improves markedly.Conclusion There exists a dynamic coupling and bidirectional feedback relationship between medical resource status and secondary event risks.Enhancing the flexible allocation and responsiveness of medical resources,improving multi-sectoral collaborative monitoring and coordinated regulation,optimizing network connectivity and coordination mechanisms for resource distribution,and establishing dynamic monitoring and tiered early warning systems are key strategies for strengthening the resilience of healthcare systems and effectively containing the spread of secondary events.

Objective To identify the thematic dimensions and analyze the strengths and weaknesses of inpatient experiences based on reviews of inpatient experience comments,and to propose improvement suggestions.Methods Open comments provided by inpatients at a tertiary hospital in Beijing between January 2023 and June 2024 were analyzed using sentiment analysis,LDA topic model and I PA analysis.Results The average sentiment score for all comments was 3.50,indicating overall positivity.LDA identified 1 1 themes.The dominant factors influencing inpatient experience were nurse service,doctor service,and diet,while sanitation and discharge settlement were identified as weak factors.Privacy protection,facilities,and bed resources were noted as areas for improvement,with accompaniment,access control,care worker services highlighted as maintenance factors.Conclusions The overall inpatient experience is positive.However,there is a need to maintain core competitive advantages of medical services while further enhancing tangible experiences related to sanitation and facilities.Additionally,efforts should be made to strengthen the accessible experience of discharge settlement and bed resources.

Objective To analyze the impact of medical insurance payment method reform on the efficiency of health services in China and provide empirical evidence for optimizing payment policies.Methods Using panel data from 31 Chinese provinces from 2012 to 2022,it measured health service efficiency with super-efficiency SBM model,assessed the effects of payment reforms using a staggered DID model,and analyzed the heterogeneous impacts of health informatization levels and health resources.Results DRG payment method reform increased health service efficiency,while no evidence was found that DIP payment method reform improved efficiency.Heterogeneity analysis showed that DRG payment method reform effects were not significantly influenced by health informatization levels or bed resource distribution,where as DIP payment method reform's negative effects were positively moderated in regions with higher informatization or abundant bed resources.Conclusion DRG payment method reform can improve the efficiency of healthcare services.It is recommended to accelerate the promotion of the DRG payment method system.Regarding the reform of the DIP payment system,it is recommended to improve the DIP scoring settlement mechanism,strengthen refined disease management,optimize hospital information system construction,enhance the medical insurance information platform and medical record quality control system,in order to improve hospital management levels and service efficiency.

Objective To systematically evaluate the service efficiency and its differences among different types of medical institutions in Guangdong under the background of DRG payment reform,and to provide reference for optimizing regional medical insurance payment policies.Methods Using data from the Comprehensive Evaluation and Analysis Report on DRG Inpatient Medical Services in Guangdong Province in 2023,it compared the service efficiency differences among different types of medical institutions in Guangdong under the background of DRG payment reform,employing the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index as research indicators.The Kruskal-Wallis H test was used to compare the service efficiency differences among different types of medical institutions in Guangdong,and linear regression analysis was applied to explore the relationship between the cost consumption index and the drug and consumable cost consumption index.Results There were statistically significant differences in the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index among different types of medical institutions in Guangdong(P＜0.05).For the same disease group,the average length of hospital stay in Traditional Chinese Medicine hospitals is longer;the average hospitalization costs and drug expenditure per visit in tertiary public general hospitals are higher;while the average length of hospital stay and average hospitalization costs per visit in secondary public general hospitals,maternal and child health care hospitals,and county people's hospitals are relatively lower.Conclusion It needs to establish a quantitative management mechanism based on the DRG indicator system,improve dynamic adjustment and incentive policies for medical insurance payments,and optimize TCM-specific DRG grouping and payment standards,in order to systematically promote the reform of medical insurance payment methods.

Scientific and reasonable post establishment is a prerequisite for maximizing the value of human resources.Establishing a hospital personnel quota and post management model to dynamically adjust the post structure within the authorized staffing quota,thereby maintaining the balanced development of the department and the scale of talent,which provides a reliable talent guarantee for the hospital's sustainable development.It focuses on the practices of specialized infectious disease hospitals in constructing the personnel quota and post management model and administering talent staffing allocation.It proposes a dynamic adjustment framework for position-based staffing protocols and talent establishment quotas adaptable to both major outbreak emergencies and routine operations.This approach has successfully stabilized the professional workforce,optimized human resource costs,enhanced operational efficiency,and strengthened core institutional competitiveness within infectious disease hospital systems.

Objective To explore the construction of a scientific and reasonable performance appraisal and evaluation system for clinical department heads in public hospitals,so as to provide reference for improving the operational efficiency and medical service quality of hospitals.Methods Preliminary construction of the indicator system through the literature research method,using the Delphi method to conduct two rounds of correspondence with 13 experts in related fields,screening and revising the performance appraisal evaluation indicators,and establishing the final indicator system.Results Formation of a performance appraisal and evaluation system for heads of clinical departments that includes 7 one-vote veto indicators,4 first-level indicators,19 medical and 24 surgical second-level indicators and 3 plus indicators,with the authority coefficients of the two rounds of expert consultation at 0.89 and 0.90,and the harmonization coefficients at 0.504 and 0.630,respectively,and with good results in consistency tests for indicators at all levels.Conclusion The performance appraisal and evaluation system for clinical department chiefs has good science and feasibility.It has played a positive role in promoting the connotative construction of the hospital and improving the management efficiency of the hospital,and can provide a reference for hospital management practice.