Historically,with the decentralisation of county-level medical service price management,inconsistencies in large urban county medical service prices have arisen,facing a serious challenge to the allocation of regional medical resources and the fairness of patients' access to healthcare.There is therefore an urgent need to integrate and standardise county medical service prices.It provides a comprehensive overview of the integration process of county medical service prices in Zhengzhou,focusing on the establishment of integration principles,the determination of programme parameters,the initial integration phase,and the refinement of measurement mechanisms.It also puts forward a series of recommendations and strategies for enhancement,including the further rationalisation of the ratio-price relationship among items,the gradual promotion of price adjustment,and the establishment of a continuous dynamic monitoring mechanism.It also puts forward suggestions and strategies for improvement in terms of further rationalising the price relationship between items and gradually promoting price adjustment,and establishing a continuous dynamic monitoring mechanism.

Objective To compare the differences in the average transaction costs per-referral patients under different models of Integrated Delivery Systems(IDS).Methods Using a typical case sampling method,it selected referred patients from three IDS models:the county medical alliance in D City(Qinghai Province),the urban medical consortium in J District(Zhengzhou City,Henan Province),and the health management coalition in N County(Shandong Province).Structured questionnaires collected demographics,average transaction costs per-referral and cost perceptions.t-tests and ANOVA assessed cost differences;generalized linear regression identified influencing factors.Results Among 915 patients,the average transaction costs per-referral were 1 035.05 yuan(county alliance),195.31 yuan(urban consortium),and 700.97 yuan(health management coalition),with statistically significant differences(P＜0.05).The urban consortium exhibited lower time costs and specialized input costs.Key influencing factors included older age(county alliance),education level,employment status,and referral travel time(urban consortium),as well as urban-rural disparities(health management coalition).Patients'cost perceptions significantly differed across models(P＜0.05).Conclusion The urban medical consortium demonstrated the lowest patient the average transaction costs,highlighting its institutional advantage in minimizing financial burdens.

Objective To investigate the safety and efficacy of transabdominal preperitoneal(TAPP)laparoscopic inguinal hernia repair and its effectiveness of detecting occult hernia.Methods A retrospective analysis was conducted on the clinical data of 682 patients who underwent inguinal hernia repair at Beijing Friendship Hospital from June 2019 to November 2021.The patients were assigned to TAPP group(n=316),totally extraperitoneal(TEP)group(n=257),and traditional open surgery group(n=109)according to surgical methods.The operation time,blood loss,postoperative recovery,complications,and recurrence were compared among the three groups.The detection of occult hernias was recorded.Results The operation time in the TAPP group was significantly shorter than that in the other two groups(P<0.05).The blood loss in the three groups was as follows:TEP group

"Technology-consumption separation"in pricing of medical testing programs,refers to the medical testing programs in the pricing process will be the cost of technology and consumables cost accounting separately,this is the basis for large-scale centralized procurement of test reagents,for the standardization of medical testing programs to carry out,reduce the cost of medical testing programs is critical.The medical testing programs pricing"technology and consumption separation"of the connotation is deeply analyzed.It is considered that the main difficulties in the implementation of the"technology-consumption separation"in the pricing of medical testing programs are the difficulty of costing,the difficulty of calculating the use of special reagents,and the difficulty of policy implementation.The implementation of the"technology-consumption separation"in the pricing of medical testing programs are proposed from"pricing according to the current price minus the cost of specialized reagents","based on big data to measure the loss of specialized reagents"and"appropriate increase in the pricing level".

Historically,with the decentralisation of county-level medical service price management,inconsistencies in large urban county medical service prices have arisen,facing a serious challenge to the allocation of regional medical resources and the fairness of patients' access to healthcare.There is therefore an urgent need to integrate and standardise county medical service prices.It provides a comprehensive overview of the integration process of county medical service prices in Zhengzhou,focusing on the establishment of integration principles,the determination of programme parameters,the initial integration phase,and the refinement of measurement mechanisms.It also puts forward a series of recommendations and strategies for enhancement,including the further rationalisation of the ratio-price relationship among items,the gradual promotion of price adjustment,and the establishment of a continuous dynamic monitoring mechanism.It also puts forward suggestions and strategies for improvement in terms of further rationalising the price relationship between items and gradually promoting price adjustment,and establishing a continuous dynamic monitoring mechanism.

"Technology-consumption separation"in pricing of medical testing programs,refers to the medical testing programs in the pricing process will be the cost of technology and consumables cost accounting separately,this is the basis for large-scale centralized procurement of test reagents,for the standardization of medical testing programs to carry out,reduce the cost of medical testing programs is critical.The medical testing programs pricing"technology and consumption separation"of the connotation is deeply analyzed.It is considered that the main difficulties in the implementation of the"technology-consumption separation"in the pricing of medical testing programs are the difficulty of costing,the difficulty of calculating the use of special reagents,and the difficulty of policy implementation.The implementation of the"technology-consumption separation"in the pricing of medical testing programs are proposed from"pricing according to the current price minus the cost of specialized reagents","based on big data to measure the loss of specialized reagents"and"appropriate increase in the pricing level".

Objective To compare the differences in the average transaction costs per-referral patients under different models of Integrated Delivery Systems(IDS).Methods Using a typical case sampling method,it selected referred patients from three IDS models:the county medical alliance in D City(Qinghai Province),the urban medical consortium in J District(Zhengzhou City,Henan Province),and the health management coalition in N County(Shandong Province).Structured questionnaires collected demographics,average transaction costs per-referral and cost perceptions.t-tests and ANOVA assessed cost differences;generalized linear regression identified influencing factors.Results Among 915 patients,the average transaction costs per-referral were 1 035.05 yuan(county alliance),195.31 yuan(urban consortium),and 700.97 yuan(health management coalition),with statistically significant differences(P＜0.05).The urban consortium exhibited lower time costs and specialized input costs.Key influencing factors included older age(county alliance),education level,employment status,and referral travel time(urban consortium),as well as urban-rural disparities(health management coalition).Patients'cost perceptions significantly differed across models(P＜0.05).Conclusion The urban medical consortium demonstrated the lowest patient the average transaction costs,highlighting its institutional advantage in minimizing financial burdens.

Objective To measure the transaction costs of compact urban medical groups and analyze the evaluation of transaction costs by various stakeholders.Methods Using the typical sampling method,it took the Compact Urban Medical Group of J District General Hospital in Zhengzhou City,Henan Province as an example.A questionnaire sur-vey was conducted on the construction party(health administration department,leading hospital and member units)and related staff from January 19 to 24,2024.The contents of the survey included institutional statements,basic information of the respondents,relevant fees or costs of each participant,and the evaluation of transaction costs by the staff of each institutional participant.Results In 2023,the total transaction cost of District J Medical Group in Zhengzhou City was 75 811 014.49 yuan;the majority of transaction costs were borne by the leading hospi-tal(98.1％);all stakeholders confirmed the existence of transaction costs in the medical group,but there were dif-ferences in the perception of the manifestations and distribution of transaction costs(P＜0.05).Conclusion The transaction costs of compact urban medical group are high,most of which are borne by the leading hospital;The stakeholders have not yet clearly understood the form and distribution of transaction costs.The measures to deal with transaction costs include"facing up to the widespread existence of transaction costs","improving the compensation incentive mechanism"and"establishing a saving system supply path".

Objective To measure the transaction costs of compact county medical alliance and propose counter-measures.Methods Based on Williamson-Zhang Wuchang analysis paradigm,it established the measure matrix of transaction cost of compact county medical alliance.Through the typical sampling method,the medical community of D city in Haixi Prefecture,Qinghai Province was selected as a research example to carry out an empirical study.Results The total transaction cost of the compact county medical community was 6 292 500.00 yuan,the transac-tion cost of the leading hospital was 6 234 300.00 yuan,accounting for 99.07％,and the special investment of the leading hospital reached to 5 887 100.00 yuan,accounting for 94.43％.The total transaction cost of the 298 referred patients was 308 400.00 yuan,and the average transaction cost per patient was 1 035.05 yuan.Conclusion The transaction costs of compact county medical alliance was generally high,most of which was borne by the leading hospital,and the patients also had to bear the corresponding transaction costs.In the next stage,the transaction costs should be dealt with from three aspects,including recognizing the secrecy and universality of the transaction costs,establishing economical system supply and establishing a sound compensation mechanism.

Objective To measure the transaction costs of the health management alliance with the clue of the re-ferral treatment of patients with hypertension and diabetes.Methods Based on the Williamson-Zhang Wuchang analy-sis paradigm,a transaction cost measurement matrix of health management alliance was established.Through the typical sampling method,the health management alliance of County N in Shandong Province was selected as a re-search example to carry out empirical research.Results In 2023,the total transaction costs of the sampled health management alliance reached to 6 726 700.00 yuan,and the average transaction cost per referral patient was 3 846 yuan.The leading hospital accounted for 79.45％of the transaction cost,followed by the CDC.Meanwhile,busi-ness coordination cost accounted for 47.18％of the total transaction cost,and the average transaction cost per refer patient with hypertension or diabetes was 700.90 yuan.Conclusion The total transaction costs of the health manage-ment alliance was large,and it was mainly borne by the leading hospital.Patients also need to bear considerable transaction costs.The countermeasures included improving the service integration mechanism,establishing economi-cal system supply path,and coordinating actions between social health insurance system and health care system.