Objective:To systematically evaluate the service capacity of Traditional Chinese Medicine(TCM)in secondary and above general hospitals in Jiangsu Province and to uncover differences in service capacity across economic types,hospital grades,and re-gions.Methods:The entropy weight method was employed to conduct a comprehensive evaluation of the TCM service capacity of 579 sec-ondary and above general hospitals in Jiangsu Province.Additionally,T-tests were used to compare these four dimensions of human re-sources,financial resources,material resources,and resource utilization efficiency across different types of hospitals.Results:The TCM service capacities in Nanjing,Suzhou,and Wuxi ranked among the highest in Jiangsu,with comprehensive scores of 0.810,0.676,and 0.426,respectively.In contrast,Taizhou and Zhenjiang exhibited relatively weaker service capacities,with scores of only 0.067 and 0.049.The service levels in other regions were moderate.Furthermore,the results of T-tests and entropy weight method indicated significant differences(P＜0.05)in TCM service capacity across hospital grades and economic types for most dimensions,while regional differences were not statistically significant(P＞0.05).Conclusion:There is significant imbalance in the TCM ser-vice capacity across Jiangsu Province.Economically developed cities(e.g.,Nanjing,Suzhou,and Wuxi)demonstrate strong service capacities,while certain regions(e.g.,Taizhou and Zhenjiang)are relatively weak.The service capacity of public and tertiary hospi-tals is significantly higher than that of private and secondary hospitals;however,regional differences are not significant.Future efforts should focus on policy support for regions with lower resource utilization efficiency and weaker hospitals,aiming to promote a more bal-anced and efficient development of TCM services to better meet the growing demand for TCM across different areas and populations.

Objective:To explore the mechanism that leads to the formation of medical insurance fraud,in order to propose countermeasures and suggestions for preventing medical insurance fraud.Methods:Taking 30 provinces and cities in China as research objects,Fuzzy-Set Qualitative Comparative Analysis and Necessary Condition Analysis are applied to explore the configuration paths that lead to medical insurance fraud.Results:A single factor does not constitute a necessary condition for a high incidence of Medicare insurance fraud.There are four grouping paths that lead to a high incidence of Medicare insurance fraud,namely,the dominant factor of poor medical insurance operation status,the dual auxiliary factor of low informationization level and weak regulatory mechanism under the dominant status of poor medical insurance operation,the auxiliary pathway of low economic level under the dual dominance factors of poor medical insurance operation and low informationization level,and the three dominant factors of poor medical insurance operation as well as weak regulatory mechanism and low economic level.Conclusion:Medical insurance fraud is caused by multiple factors,therefore the following prevention strategies are proposed,focusing on rectifying and breaking through difficult problems,strengthening regulatory effectiveness through departmental linkage,enhancing regulatory accuracy through technological empowerment,and improving long-term mechanisms by addressing both symptoms and root causes.

Objective:To explore the mechanism that leads to the formation of medical insurance fraud,in order to propose countermeasures and suggestions for preventing medical insurance fraud.Methods:Taking 30 provinces and cities in China as research objects,Fuzzy-Set Qualitative Comparative Analysis and Necessary Condition Analysis are applied to explore the configuration paths that lead to medical insurance fraud.Results:A single factor does not constitute a necessary condition for a high incidence of Medicare insurance fraud.There are four grouping paths that lead to a high incidence of Medicare insurance fraud,namely,the dominant factor of poor medical insurance operation status,the dual auxiliary factor of low informationization level and weak regulatory mechanism under the dominant status of poor medical insurance operation,the auxiliary pathway of low economic level under the dual dominance factors of poor medical insurance operation and low informationization level,and the three dominant factors of poor medical insurance operation as well as weak regulatory mechanism and low economic level.Conclusion:Medical insurance fraud is caused by multiple factors,therefore the following prevention strategies are proposed,focusing on rectifying and breaking through difficult problems,strengthening regulatory effectiveness through departmental linkage,enhancing regulatory accuracy through technological empowerment,and improving long-term mechanisms by addressing both symptoms and root causes.

Objective:To systematically evaluate the service capacity of Traditional Chinese Medicine(TCM)in secondary and above general hospitals in Jiangsu Province and to uncover differences in service capacity across economic types,hospital grades,and re-gions.Methods:The entropy weight method was employed to conduct a comprehensive evaluation of the TCM service capacity of 579 sec-ondary and above general hospitals in Jiangsu Province.Additionally,T-tests were used to compare these four dimensions of human re-sources,financial resources,material resources,and resource utilization efficiency across different types of hospitals.Results:The TCM service capacities in Nanjing,Suzhou,and Wuxi ranked among the highest in Jiangsu,with comprehensive scores of 0.810,0.676,and 0.426,respectively.In contrast,Taizhou and Zhenjiang exhibited relatively weaker service capacities,with scores of only 0.067 and 0.049.The service levels in other regions were moderate.Furthermore,the results of T-tests and entropy weight method indicated significant differences(P＜0.05)in TCM service capacity across hospital grades and economic types for most dimensions,while regional differences were not statistically significant(P＞0.05).Conclusion:There is significant imbalance in the TCM ser-vice capacity across Jiangsu Province.Economically developed cities(e.g.,Nanjing,Suzhou,and Wuxi)demonstrate strong service capacities,while certain regions(e.g.,Taizhou and Zhenjiang)are relatively weak.The service capacity of public and tertiary hospi-tals is significantly higher than that of private and secondary hospitals;however,regional differences are not significant.Future efforts should focus on policy support for regions with lower resource utilization efficiency and weaker hospitals,aiming to promote a more bal-anced and efficient development of TCM services to better meet the growing demand for TCM across different areas and populations.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.

Aiming at the practical problems of insufficient supply efficiency and low utilization rate of primary health services,it systematically reviewed the research status of residents'participation in the value co-creation of primary health services from the perspective of residents'active utilization.It explores the theoretical framework of realizing the value of primary health service based on residents'active utilization,and deeply analyzes its internal logic.Finally,it puts forward the concrete realization path,that is,multi-subject broadening the health information communication channel,optimizing the health service supply mode according to local conditions,constructing multi-dimensional trust mechanism between doctors and patients,and building a precise digital health management platform.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.

Aiming at the practical problems of insufficient supply efficiency and low utilization rate of primary health services,it systematically reviewed the research status of residents'participation in the value co-creation of primary health services from the perspective of residents'active utilization.It explores the theoretical framework of realizing the value of primary health service based on residents'active utilization,and deeply analyzes its internal logic.Finally,it puts forward the concrete realization path,that is,multi-subject broadening the health information communication channel,optimizing the health service supply mode according to local conditions,constructing multi-dimensional trust mechanism between doctors and patients,and building a precise digital health management platform.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.

Aiming at the practical problems of insufficient supply efficiency and low utilization rate of primary health services,it systematically reviewed the research status of residents'participation in the value co-creation of primary health services from the perspective of residents'active utilization.It explores the theoretical framework of realizing the value of primary health service based on residents'active utilization,and deeply analyzes its internal logic.Finally,it puts forward the concrete realization path,that is,multi-subject broadening the health information communication channel,optimizing the health service supply mode according to local conditions,constructing multi-dimensional trust mechanism between doctors and patients,and building a precise digital health management platform.