The construction of compact urban medical groups has been carried out in 81 pilot cities,and whether the pilot work can form useful experiences that can be replicated depends on the grasp of key elements and develop-ment trends.It proposes that the key elements in the construction of a compact urban medical group include the le-gal status of the compact urban medical group,the distribution of rights and responsibilities between the compact medical group and local health administrative departments,the structure and integrated operation mechanism of the compact urban medical group,the demarcation between the city medical group and one hospital and multiple dis-tricts,and the evaluation of health benefits.Under the background of the superposition of healthy China and digital China construction,China's urban medical group has five significant development trends including new development models led by the digital revolution,diversifying development models oriented to demand,emphasizing the coopera-tion mechanism based on value inclusion and benefit sharing,and promoting the further strengthening of medical and prevention integration and the effectiveness evaluation shifts to results-oriented indicators.

The construction of urban medical groups is an important supply-side reform and exploration of Chinese urban health service system.It analyzes and discusses the interest generation mechanism,the dialectical relationship between public interests and economic interests and the balancing strategy of urban medical group construction,and proposes that the construction of urban medical groups mainly generates new value through comprehensive medical care,large-scale development,homogeneous services,digital construction and technology innovation,which can bring about optimizing the allocation of medical treatment resources,improving the homogeneity level and innovation ability of regional medical services,and strengthening regional primary medical services and other public interests.It can also bring about improvements in service efficiency,capacity and volume,which in turn generate economic benefits.The pursuit of public and economic interests in the construction of urban medical groups has potential value conflicts in terms of service positioning,cost and accessibility,effectiveness and rationality,and at the same time,there is a synergy mechanism in fulfilling social responsibilities,optimizing the utilization of medical resources,and promoting medical innovation and high-quality development.In the pilot construction of urban medical groups,public interests and economic interests should be viewed dialectically,the role of local governments in policy guidance,supervision and incentives should be explored,a focus on resource optimization,innovation-driven or high-quality development to promote the synergy of public interests and economic interests should be emphasized,and public participation should be strengthened and a performance evaluation mechanism should be established.

To analyze the interest distribution relationship and symbiotic mode in the construction of urban medi-cal groups,based on the symbiotic theory,a framework for analyzing the interest distribution relationship of urban medical groups is constructed.Based on actual cases,urban medical groups are summarized and divided into four types:one-way supply type,partial benefit symbiosis type,asymmetric reciprocity symbiosis type,and symmetric reciprocity symbiosis type.The focus of a one-way supply oriented urban medical group is on reshaping the profit distribution mechanism,a partial benefit symbiotic urban medical group is on establishing a profit compensation mechanism for benefit medical institutions,and an asymmetric and mutually beneficial symbiotic urban medical group is on building a long-term benefit balance mechanism.

At present,there is a series of difficulties in the development of TCM medical cluster.By sorting out the connotation and characters of TCM medical cluster and clarifying the development status and problems of TCM medical cluster,from the perspective of interest appeal of internal stakeholders of TCM medical cluster,it analyzes the interests of stakeholders such as core hospitals,member units,medical staff,government,patients and their families.It presupposes the interests appeal of stakeholders of TCM medical cluster,suggests to build up a balanced and sustainable medical consumption linkage,in order to provide a reference for guarantee the long range sustainable development of TCM medical cluster.

It is already an inevitable choice for the innovative development of the global healthcare system to grant nurse practitioners the prescription rights, in an effort to improve the access to primary care services and clinical outcome of patients. The contradiction between supply and demand of health service in China is becoming increasingly prominent, making it urgent for nurses with prescription rights to join the primary healthcare team. On the basis of clarifying the connotation and characteristics of nurses′ prescription rights, the authors demonstrated and analyzed the demands, realistic basis and challenges of nurses′ prescription right granting, and put forward their thoughts on the feasible paths from the aspects of national system construction and local pilot exploration, aiming to provide reference for promoting the reform of nurses′ prescription right granting in China.

With the changing spectrum of human diseases and people′s pursuit of high-quality life, the scope of medical services required of nurses keep expanding. However, the current legislation in China has not yet granted nurses the right to prescribe, and there was no specific law to regulate related issues, which will inevitably limit the development of nursing work in the extended field. Therefore, the authors explored the concept definition and legal attributes of nurses′ prescription rights from a legal perspective, and proposed to regulate them from the legislative, law enforcement, and relevant supporting institutional levels to ensure the standardized exercise of nurses′ prescription rights.

Objective:To analyze the online patient experiences in a public hospital′s internet hospital, and explore the influencing factors, for references for improving the online patient experiences and promoting the high-quality development of internet hospitals.Methods:Gender, age, visiting department, patient experience score, and evaluation text of patients in a public hospital′s internet hospital in 2022 were obtained. The patient experience scores were adopted the Likert 5-level scoring method. Intergroup comparisons were conducted by chi-square test and F-test. Word segmentation processing and word frequency statistics were used to extract high-frequency words in the evaluation text of dissatisfied patient experiences, and semantic network analysis on these high-frequency words was performed. Results:A total of 4 273 patients were included in this study, with a patient experience score of (4.1±1.6) points. Among them, 74.9% (3 199 cases) rated 5 points (very satisfied), and 19.5% (835 cases) rated 1 point (very dissatisfied). There was no significant difference in online patient experience scores among patients of different genders ( P>0.05), while patients of different ages or departments had different patient experience scores ( P<0.05); The top 10 high-frequently words of dissatisfied evaluation were doctor, answer, examination, limited help, ignoring, waste, refunding, registration fee, perfunctory, and closing.In the high-frequency semantic network of dissatisfied evaluations, high-frequency words such as doctor, answer, waste, examination, limited help, and ignoring were strongly correlated with each other. Conclusions:Most patients in an internet hospital were very satisfied with the online patient experience, but nearly 1/5 of the patients were very dissatisfied. The age and department affected the online patient experiences. The dissatisfied evaluations were mainly related to the attitude and professional competence of physicians, as well as the convenience of internet hospital platform and its diagnosis and treatment services.

Deep integration of healthcare and prevention in public hospitals is not only a basic function played by hospitals in their public health services, but also an inevitable choice to meet the health needs of the people in their life span. The authors analyzed the current situation in healthcare and prevention integration in Wuhan in recent years, focusing on such problems existing in the construction of healthcare and prevention integration in public hospitals, as unclear functional positioning of medical prevention integration in public hospitals, insufficient refinement of healthcare and prevention integration policies, delay in the construction of public health informatization, and poor public health awareness of medical personnel. In view of the above problems, the authors put forward the following improvement suggestions: optimizing the policy environment of healthcare and prevention integration, strengthening the leading role of the hospital management, building a hospital public health big data platform, mobilizing the initiative of clinical technicians, and improving the work identity of hospital public health workers.

In order to adapt to the development of market economy, the original medical institutions run by state-owned enterprises have undergone restructuring reform, but these medical institutions have not fully played their role. Through the sampling survey and research interviews of several medical institutions run by state-owned enterprises, it was found that many problems such as unclear functional positioning, imperfect regional health planning, unclear responsible subjects and inadequate financial support hindered the development of medical institutions run by state-owned enterprises. In order to develop healthily, medical institutions run by state-owned enterprises need to cooperate with various parties to improve supporting policies, optimize their business environment, and build and improve the health service system.

With the deepening reform of state-owned enterprise-run medical institutions, a large number of medical institutions have entered the state-owned enterprises dominated by the health industry through resource integration. The research team conducted in-depth research on six medical institutions run by state-owned enterprises and analyzed the effect of resource integration. The research found that the investment of the holding enterprises in hospitals was significantly increased, the talent team tended to be stable, and the scope and volume of medical services were improved, but there were still problems such as insufficient participation in market competition and large differences in hospital operation, which needed to be further explored in practice.