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.

Objective To explore the influence of the coupling and coordination of DRG and clinical pathways on Antibiotics Use Density.Methods The data of 7 clinical departments in a sample hospital from 2021 to 2022 were selected,the data were collated through descriptive statistics,and the coupling coordination degree model was used to measure the coordinated development level of DRG and clinical pathways.Taking the per-average drug cost and the average hospital stay of patients as the threshold variables,the threshold regression model was used to calculate the threshold value of Antibiotics Use Density at the level of coordinated development.Results There was a single threshold(F=21.98,P<0.05)of 6334.69 and a double threshold(F=160.53,15.99,P<0.1)of 6.74 and 8.20 for the average length of stay of patients.The statistical values between the level of coordinated development and Antibiotics Use Density in the two threshold variables were positive.Conclusion There is a nonlinear relationship between the level of coordinated development of DRG and clinical pathway with Antibiotics Use Density,and there is a positive promotion effect,and there are differences in the impact size in different threshold variable intervals.Medical institutions should pay attention to the nonlinear relationship,make good use of hospital informatization,do a good job in reasonable monitoring,and reasonably promote the management of antimicrobial drugs.

With the implementation of DRG payment method reform in China,how to apply the DRG payment method to Traditional Chinese Medicine (TCM) has become a key issue that needs to be solved urgently.Although at present,TCM medical institutions in China may not implement the DRG payment method for the time being,but combined with the policy orientation and the process of work at the present stage of China,the combination of the DRG method payment reform and TCM has become a general trend.In order to explore the feasibility of the combination of DRG method payment and TCM diseases,it firstly combs through the status quo and dilemma of the implementation of DRG payment method reform in TCM diseases,and then discusses the feasibility of the combination of DRG payment method and TCM diseases and joint promotion of the policy based on the idea of the same price for the same disease and combining with the concept of TCM culture,in order to provide theoretical support for the further exploration of the health insurance payment method in accordance with the characteristics of TCM at the next stage.The purpose is to provide theoretical support for the next stage of further exploration of health insurance payment methods in line with the characteristics of TCM.

With the widespread implementation of the DRG point method in China,how to deal with the potential risks brought by the punching behavior of medical institutions under the point method is a real problem that needs to be solved.It explains the special characteristics of uncertainty in the distribution of health insurance fund under the DRG point method,and explores the possibility,feasibility and proliferation of the point flushing behavior of medical institutions under the DRG point method at the theoretical level based on the rational economic man perspective,the principal generation theory and the cohort effect.In response to the theoretical model,game theory is used to further construct a model of point-shuffling behavior of medical institutions under the DRG point method,and analyze the reasons for point-shuffling behavior and its potential risks.It is suggested that the potential risks of point-shaving can be prevented by strengthening the communication and cooperation between medical institutions under the medical association and hierarchical diagnosis and treatment system,and by implementing the monitoring mechanism of medical insurance government departments on medical institutions.

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.