Objective:To propose ideas for designing an incentive system that aligns with the unique characteristics of the medi-cal industry while maintaining altruism.Methods:The concepts of reciprocal altruism theory and gift exchange game experiments are introduced from the field of economics to incentivize physicians'altruistic behavior.Results:It proposes the indirect reciprocal altru-ism theory,which focuses on the three-party principal-agent relationship between physicians,patients,and management in the medical field.The compensation incentive concept that measures health value is also introduced.Additionally,it constructs a model for the incentive mechanism of physicians'altruistic behavior based on the three-party gift exchange game.Conclusion:Based on the concept of value-based incentives for physicians'altruistic behavior,it develops an incentive system that caters to the unique characteristics of the medical industry and promotes its high-quality development.

OBJECTIVE To explore the effects of multi-disciplinary comprehensive management team of tertiary hospital collaborated with the pharmacists from community health service center （hereinafter referred to as “community pharmacists”） on elderly patients with hypertension in the community. METHODS Elderly patients with hypertension from May 2020 to May 2021 in Yuhua Community Health Service Center of Nanjing were divided into control group （76 cases） and observation group （76 cases） according to the management style. The control group was treated with regular community medical services and the observation group received regular community medical services plus pharmaceutical care provided by the comprehensive management team collaborated with community pharmacists. The compliance， blood pressure control status and hypertension-related complications were compared between 2 groups before management and after 24 months of management. RESULTS After 24 months of management， the compliance and blood pressure compliance rates in both groups were higher than before management； meanwhile， the observation group was significantly higher than control group at the corresponding period （P＜0.05 or P＜ 0.01）. The blood pressure levels of both groups were significantly lower than before management， and the systolic blood pressure as well as the incidences of the whole complications and cerebrovascular injury in the observation group were significantly lower than control group at the 583867635@qq.com corresponding period （P＜0.05）. There was statistical significance in the effects of the rate of reaching the standard of blood pressure on the complications （P＜0.01）. CONCLUSIONS The hypertension management mode of comprehensive management team collaborated with community pharmacists can significantly improve the compliance and blood pressure compliance rate of elderly patients with hypertension， and reduce the incidence of hypertension-related complications.

Objective:To design a set of evaluation index system for the medical service price reform mechanism, so as to provide reference for the evaluation of deepening the medical service price reform mechanism.Methods:On the basis of searching literature of medical service prices reformfrom August 2021 to March 2023, policy logic analysis and expert consultation were used to construct evaluation indexes for the medical service price reform mechanism, set evaluation index thresholds, and assign scores to index thresholds in different grades.Results:The evaluationindex system of medical service price reform mechanism included 5 level-1 indexes, 12 level-2 indexes and 35 level-3 indexes. After scoring, the scores of 5 level-1 indexes were 12, 24, 35, 21, and 8, respectively.Based on the percentile scoring method, the evaluation criteria were categorized into five grades: premium, excellent, good, average and failure.Conclusions:This study constructed a set of evaluation index system for the mechanism of medical service price reform, which had strong scientific and operability. However, due to the fact that medical service price reform in the new era is still in its initial stage, the index system need to be further optimized drawing on the practical experience of reforms in pilot cities.

Objective To analyze the data of percutaneous coronary stent implantation related groups in certain hospi-tal of Beijing,so as to provide data support for promoting CHS-DRG payment reform and provide guidance and reference for its refined management.Methods The case data of local medical insurance patients in Beijing who received percutaneous coronary stent implantation from January 2020 to December 2021 in certain hospital were statistically analyzed,collect the medical insurance settlement information of the selected patients,and analyze the factors that affect their entry into FM19 group settlement.Results There are differences in the factors affecting FM19 inclusion in different reform stages,overtransfer personnel is a new independent factor that interferes with the group settlement in the actual operation stage.Some special operation codes may interfere with cases entering FM19 group due to pri-ority effect among disease groups.Conclusion The grouping settlement conditions of CHS-DRG are more complex,patients with different expense types need to be specifically analyzed according to the current grouping scheme and reimbursement policy.At present,there are relatively few disease groups settled by package for urban residents,and they continue to be affected by the rule of grouping priority.However,it is necessary to fully implement and strengthen the cost control of disease groups for urban employees,and rationally optimize the diagnosis and treat-ment plan to finely control medical costs.

Objective:To study the influence of the choice of main diagnosis on diagnosis-related groups(DRG) grouping and weight change, by taking cerebral infarction as the entry point.Methods:From January 1, 2019 to March 31, 2019, 331 patients in three DRG groups(BR25, BR23, BR21) with cerebral infarction were selected. The original group was used as the control group; the main diagnosis was exchanged with the first other diagnosis, then DRG group was used as the experimental group. The difference of the number of cases and weight between the two groups was analyzed.Results:41.4%(137/331) of the patients in the experimental group were enrolled in BZ11 with other neurological disorders associated with important comorbidities and comorbidities, and 82.5%(273/331) patients′ weight increased after diagnostic conversion.Conclusions:Choosing other diagnosis as the main diagnosis may change the weight of the disease and affect the corresponding disease benefit. In order to prevent downcoding, DRG grouping should be detailed, and DRG payment should consider how to reflect the value of difficult cases; for upcoding behavior, medical insurance center and relevant medical institutions should check the correctness of coding, and monitor in place.

Objective:Based on the framework of reference point contract theory,the experimental economics methodwas used to explore the medical institution managers' motivation and reflection of the profit allocation in vertical integrated?medical service system.Methods:Z-tree software was applied to design the experimental program.40 undergraduate students majoring in health management were recruited as the subjects.Sharing rates and effort levels were collected and calculated by Excel 2007 and SPSS 17.0.Results:The median of sharing rate hospital managers allocated to community health centers?was 35.00％.The median of effort level that community health center directors chose was 8.00.The proportion of sharing rates equal to or less than 50.00％ accounted for 98％.The proportion of the highest effort level was 23.50％.The correlation between sharing rate and effort level was significant(P＜0.05).Conclusion:In the process of establishing vertical integration of medical service system,sharing rates and effort levels were closely related while the community health centers' effort was shading.

Objective: The main objective of this research paper is to analyze the research focus and trend in the health policy and services between 2010 and 2016, with a view to providing a reference for the research on health policy and service in China to tackle a number of challenges and opportunities for future studies.Methods: This article retrieved English literature about the Health Policy & Services from the Web of Science (2010-2016), and analyzed the records with Citespace by general analysis, word frequency and centrality.Results: A total of 22,716 articles were obtained.The three keywords with the highest frequency of word frequency were: care, quality of life and healthcare, and Quality of life had the highest centrality.Keywords could be divided into five clusters: health measurement;health factor;health intervention;medical insurance;health intervention evaluation.Conclusions: Foreign health policy research focused on health and health care;focusing on measuring the impact of health outcomes;and committed to improving the health and quality of life of the population.

Objective To analyze the effects of the " Clinic-pharmacy separation" reform in Beijing. Methods Following the chronological order, 60-month operational data of a pilot hospital from 2012 to 2016 were analyzed. These data included medical statistics reports, financial information, HIS information,authority information,and patients′satisfaction on site. Results Pilot hospital showed that its medical work efficiency continued to grow. During 2013 -2016, its outpatients volume growth rate ranged 3.53% ~15.20%, and its number of discharged patients growth rate ranged 3. 12% -8. 48%. The hospital harvested 12.21 million yuan of converted income from September 2012 (when the reform was in place to cancel the drug markup and collect medical service fees) to August 2013,scoring a smooth shift of revenue sources. Medical insurance fund expenditure did not increase as a result. The percentage of drug expense was significantly decreased,dropping over 15% in 5 years. Outpatient drug fees and inpatient drug fees continued to decline year by year. Patients expressed higher satisfaction over medical services due to longer time of consultation with physicians. Conclusions " Clinic-pharmacy separation" reform has achieved the following objectives. The revenue is maintained stable; Patients flow is diverted under guidance, with less financial burden; and medical insurance expenditure is under control. We propose to improve the performance incentive and constraint mechanism for drug prescriptions by physicians.

We conducted complete competition market experiment in the classroom,meanwhile simulated market transactions,and at the end of the experiment taught the experiment theory and economics theory.After the class we carried out a survey to investigate the necessity of teaching methods and the help of theoretical understanding.It was found that the experimental results of the classroom experiment were quite robust compared with the theoretical predictions of the fully competitive market,and the market operating efficiency was also higher.Students affirmed the necessity of experiment teaching and thought that experiment was helpful to understanding the learning theory.

Objective To probe the association between possible single nucleotide polymorphism (SNP) in the FGB promoter region and idiopathic deep venous thrombosis.Methods A prospective analysis was performed in both IDVT group and control group (120 cases each) followed by a duplex examination using gene sequencing technique and restriction fragment length polymorphism (RFLP) in the promoter region of fibrinogen gene β.Possible SNPs in this region were detected arranged before HardyWeinberg equilibrium test and Linkage disequilibrium (LD) analyses.Ultimately,we compared the genotype frequencies between the two groups and undertook a multiple Logistic regression.Results Six kinds of SNPs were determined in the promoter region of β-fibrinogen gene:-148C/T,-249C/T,-455G/A,-854G/A,-993C/T and-1420G/A.A stronger linkage disequilibrium was confirmed between-993C/T and -455G/A (r2 =0.699) ;-993C/T and-148C/T (r2 =0.509) ;-455G/A and-148C/T (r2 =0.556).Statistical differences of genotype frequencies between two groups were observed in-148C/T,-249C/T,-455G/A and-1420G/A polymorphisms (all P ＜ 0.05).Conclusions The risk of IDVT was 4.579 times higher with every 1 g/L increase of fibrinogen concentration.Allele-148T,-455G and-1420A are IDVT risk factors.-993C/T may indirectly affect IDVT through linkage disequilibrium with-455G/A and-148C/T.