Objective:To explore the scientificity of the public hospital liability policy governance from the perspective of policy tools,and to provide evidence for the optimization and adjustment of subsequent policies.Methods:Policy texts at the national and regional levels from 2009-2022 were selected,and the coding results were statistically analyzed using Excel 2019 based on Rothwell and Zegveld's classification of policy tools.Results:A total of 128 policy texts were included in the analysis,with 29.96%,34.16%,and 35.88%of the policy tools in the policy instrument dimension being demand-based,supply-based,and environment-based,respectively.The system mechanism dimension focused primarily on compensation mechanisms.Conclusion:The use of the three policy instruments is mainly dominated by environmental policies,with a relative lack of policies from demand side.It is recommended that the use of policies from demand side could be strengthened and the internal structure of policy tools be optimized,to improve the consistency and coupling of policies.

Objective:To analyze the changes in the income structure of public hospitals at all levels in Hebei Province,evaluate the effectiveness of the compensation mechanism reform in public hospitals of Hebei Province,and provide policy recommendations for optimizing the compensation mechanism.Methods:Select some public hospitals at all levels in Hebei Province as samples,and use structural change analysis to analyze the income structure of the sample hospitals.Result:From 2016 to 2021,the proportion of medical income in tertiary and primary hospitals increased by 2.6 and 9.8 percentage points respectively,while the proportion of medical income in secondary hospitals decreased by 0.6 percentage points.The proportion of consumables revenue in hospitals at all levels has increased,and drug revenue remains the main driving factor for the growth of medical revenue in hospitals at all levels.The contribution rate of drug revenue to the growth of medical revenue in tertiary hospitals is 50％.Conclusion:The optimization of medical income structure in public hospitals in Hebei Province is significant,but the compensation mechanism still needs to be further improved,and the income structure still needs further adjustment.On the basis of consolidating and improving the policy of canceling consumable markup,it is needed to further standardize medical service behavior,improve precise and sustainable financial compensation mechanisms,adjust medical service prices,and broaden financing channels.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Objective:To explore the scientificity of the public hospital liability policy governance from the perspective of policy tools,and to provide evidence for the optimization and adjustment of subsequent policies.Methods:Policy texts at the national and regional levels from 2009-2022 were selected,and the coding results were statistically analyzed using Excel 2019 based on Rothwell and Zegveld's classification of policy tools.Results:A total of 128 policy texts were included in the analysis,with 29.96%,34.16%,and 35.88%of the policy tools in the policy instrument dimension being demand-based,supply-based,and environment-based,respectively.The system mechanism dimension focused primarily on compensation mechanisms.Conclusion:The use of the three policy instruments is mainly dominated by environmental policies,with a relative lack of policies from demand side.It is recommended that the use of policies from demand side could be strengthened and the internal structure of policy tools be optimized,to improve the consistency and coupling of policies.

Objective:To analyze the changes in the income structure of public hospitals at all levels in Hebei Province,evaluate the effectiveness of the compensation mechanism reform in public hospitals of Hebei Province,and provide policy recommendations for optimizing the compensation mechanism.Methods:Select some public hospitals at all levels in Hebei Province as samples,and use structural change analysis to analyze the income structure of the sample hospitals.Result:From 2016 to 2021,the proportion of medical income in tertiary and primary hospitals increased by 2.6 and 9.8 percentage points respectively,while the proportion of medical income in secondary hospitals decreased by 0.6 percentage points.The proportion of consumables revenue in hospitals at all levels has increased,and drug revenue remains the main driving factor for the growth of medical revenue in hospitals at all levels.The contribution rate of drug revenue to the growth of medical revenue in tertiary hospitals is 50％.Conclusion:The optimization of medical income structure in public hospitals in Hebei Province is significant,but the compensation mechanism still needs to be further improved,and the income structure still needs further adjustment.On the basis of consolidating and improving the policy of canceling consumable markup,it is needed to further standardize medical service behavior,improve precise and sustainable financial compensation mechanisms,adjust medical service prices,and broaden financing channels.

Objective:To explore the scientificity of the public hospital liability policy governance from the perspective of policy tools,and to provide evidence for the optimization and adjustment of subsequent policies.Methods:Policy texts at the national and regional levels from 2009-2022 were selected,and the coding results were statistically analyzed using Excel 2019 based on Rothwell and Zegveld's classification of policy tools.Results:A total of 128 policy texts were included in the analysis,with 29.96%,34.16%,and 35.88%of the policy tools in the policy instrument dimension being demand-based,supply-based,and environment-based,respectively.The system mechanism dimension focused primarily on compensation mechanisms.Conclusion:The use of the three policy instruments is mainly dominated by environmental policies,with a relative lack of policies from demand side.It is recommended that the use of policies from demand side could be strengthened and the internal structure of policy tools be optimized,to improve the consistency and coupling of policies.

Objective:To analyze the changes in the income structure of public hospitals at all levels in Hebei Province,evaluate the effectiveness of the compensation mechanism reform in public hospitals of Hebei Province,and provide policy recommendations for optimizing the compensation mechanism.Methods:Select some public hospitals at all levels in Hebei Province as samples,and use structural change analysis to analyze the income structure of the sample hospitals.Result:From 2016 to 2021,the proportion of medical income in tertiary and primary hospitals increased by 2.6 and 9.8 percentage points respectively,while the proportion of medical income in secondary hospitals decreased by 0.6 percentage points.The proportion of consumables revenue in hospitals at all levels has increased,and drug revenue remains the main driving factor for the growth of medical revenue in hospitals at all levels.The contribution rate of drug revenue to the growth of medical revenue in tertiary hospitals is 50％.Conclusion:The optimization of medical income structure in public hospitals in Hebei Province is significant,but the compensation mechanism still needs to be further improved,and the income structure still needs further adjustment.On the basis of consolidating and improving the policy of canceling consumable markup,it is needed to further standardize medical service behavior,improve precise and sustainable financial compensation mechanisms,adjust medical service prices,and broaden financing channels.

Objective:To explore the scientificity of the public hospital liability policy governance from the perspective of policy tools,and to provide evidence for the optimization and adjustment of subsequent policies.Methods:Policy texts at the national and regional levels from 2009-2022 were selected,and the coding results were statistically analyzed using Excel 2019 based on Rothwell and Zegveld's classification of policy tools.Results:A total of 128 policy texts were included in the analysis,with 29.96%,34.16%,and 35.88%of the policy tools in the policy instrument dimension being demand-based,supply-based,and environment-based,respectively.The system mechanism dimension focused primarily on compensation mechanisms.Conclusion:The use of the three policy instruments is mainly dominated by environmental policies,with a relative lack of policies from demand side.It is recommended that the use of policies from demand side could be strengthened and the internal structure of policy tools be optimized,to improve the consistency and coupling of policies.

Objective:To analyze the changes in the income structure of public hospitals at all levels in Hebei Province,evaluate the effectiveness of the compensation mechanism reform in public hospitals of Hebei Province,and provide policy recommendations for optimizing the compensation mechanism.Methods:Select some public hospitals at all levels in Hebei Province as samples,and use structural change analysis to analyze the income structure of the sample hospitals.Result:From 2016 to 2021,the proportion of medical income in tertiary and primary hospitals increased by 2.6 and 9.8 percentage points respectively,while the proportion of medical income in secondary hospitals decreased by 0.6 percentage points.The proportion of consumables revenue in hospitals at all levels has increased,and drug revenue remains the main driving factor for the growth of medical revenue in hospitals at all levels.The contribution rate of drug revenue to the growth of medical revenue in tertiary hospitals is 50％.Conclusion:The optimization of medical income structure in public hospitals in Hebei Province is significant,but the compensation mechanism still needs to be further improved,and the income structure still needs further adjustment.On the basis of consolidating and improving the policy of canceling consumable markup,it is needed to further standardize medical service behavior,improve precise and sustainable financial compensation mechanisms,adjust medical service prices,and broaden financing channels.

Objective:To explore the scientificity of the public hospital liability policy governance from the perspective of policy tools,and to provide evidence for the optimization and adjustment of subsequent policies.Methods:Policy texts at the national and regional levels from 2009-2022 were selected,and the coding results were statistically analyzed using Excel 2019 based on Rothwell and Zegveld's classification of policy tools.Results:A total of 128 policy texts were included in the analysis,with 29.96%,34.16%,and 35.88%of the policy tools in the policy instrument dimension being demand-based,supply-based,and environment-based,respectively.The system mechanism dimension focused primarily on compensation mechanisms.Conclusion:The use of the three policy instruments is mainly dominated by environmental policies,with a relative lack of policies from demand side.It is recommended that the use of policies from demand side could be strengthened and the internal structure of policy tools be optimized,to improve the consistency and coupling of policies.