Objective To analyse the content and structure of the health management policy text for chronic obstructive pulmonary disease (COPD) in China, and to provide a reference for the optimization and improvement of subsequent relevant policies. Methods We searched for relevant policy documents on COPD health management at the national level from January 2017 to December 2023, constructed a two-dimensional analysis framework for policy tools and chronic disease health management processes, coded and classified policy texts, and used content analysis method to analyze policy texts. Results Twenty-four policy texts were included. There were 183 codes for policy tool dimension, with supply based, environmental based, and demand based tools accounting for 43.72%, 47.54%, and 8.74%, respectively. There were 124 codes for the dimension of health management processes, with health information collection and management accounting for 12.10%, risk prediction accounting for 14.52%, intervention and treatment accounting for 66.13%, and follow-up and effectiveness evaluation accounting for 7.26%. Conclusions At present, the proportion of policy tools related to the management of COPD in China needs to be dynamically adjusted. Environmental tools should be appropriately reduced, the internal structure of supply tools should be optimized, the driving effect of demand tools should be comprehensively enhanced, the coupling of COPD health management processes should be strengthened, and the relevant policy system and overall quality should be continuously improved.
With the continuous progress and development of the medical and health industry, drug procurement has gradually attracted more attention, and the drug bidding and procurement model in China is in a stage of gradual improvement. In this article, the historical evolution of drug centralized bidding and procurement policy in China is briefly introduced. By analyzing the current drug centralized bidding and procurement policy implemented in China, issues such as difficulty reasonably determining “quantity” in quantity procurement, lack of drug effective supervision of procurement policy, incomplete drug catalog procurement, and out-of-network procurement were found. Some possible feasible suggestions are also put forward, aiming at providing reference and ideas for further improvement of drug centralized bidding and procurement policy under the new situation, so as to ensure safety of drugs and benefit the people.
In the context of actively coping with aging, China has introduced a series of health care integration policies. Using the advocacy coalition framework theory, this paper aims to analyze the process of health care integration policy changes in China from three dimensions: policy beliefs, external events and policy learning. The policy subsystem of health care integration in China includes two coalitions: top-down cascade promotion and bottom-up absorption and radiation. External events and policy learning triggered policy change, where policy learning included endogenous learning within the coalition and exogenous learning between the coalitions. A policy impasse occurs when the two advocacy coalitions are at odds, and policy brokers and professional forums can get rid of the policy impasse. In the process of policy change in China’s health care integration, the two major advocacy coalitions have reached a certain consensus. It is recommended to alleviate the problems in the integration of health care by strengthening the external factors in the change of health care policy, enhancing the policy learning in the change of health care policy, and making full use of the information resources in the change of health care policy, so as to promote the high-quality development of the integration of health care.
In order to understand the latest progress of health decision support system (HDSS) construction, grasp the law of HDSS development and adopt the international advanced experience, this paper took Australia for example, presented a comparative analysis on the construction practices, including the contents, features and system functions of national construction guidelines for HDSS in different periods, and showed the integral development level of Australia HDSS was still in the exploratory stage, and its construction goal, function orientation and construction mechanism got improved gradually with the deep development of public health information. Additionally, to assure the accuracy and safety of HDSS function, Australia has been laying stress on the standard specification construction and system function authentication.
As the implementation of the high-quality development policy of public hospitals is faced with the problems of diversified environment and the coordination of execution of complex actors, the network structure has changed from the closed resistance type to the open competition type. At present, China’s high-quality development policy of public hospitals needs to improve the policy system and refine the top-level design; strengthen the executive power of network entities and innovate the joint governance mechanism; optimize the structure of policy tools to improve the resilience and flexibility of the network; implement the performance evaluation mechanism and strengthen supervision. This article is based on policy network theory and provides an in-depth analysis of the current high-quality development policy texts for public hospitals in China, with the aim of providing suggestions for policy development
Rare diseases are mostly genetic disorders that often manifest in childhood, characterized by severe conditions, difficulties in diagnosis and treatment, and poor homogeneity in clinical management. Clinical research on rare diseases contributes to enhancing the diagnosis and treatment capabilities for rare diseases in China and promotes the development of rare disease medicine. Clinical research on rare diseases in China started relatively late, and there is currently no mature and comprehensive system for clinical research on rare diseases. This article analyzes the current state of clinical research on rare diseases in China, identifies existing problems and research difficulties, and proposes ideas and key measures for the construction of China’s clinical research system on rare diseases, aiming to provide opinions and suggestions for the construction of China’s clinical research system on rare diseases.
ObjectivesTo explore the poor population’s cognition and satisfaction on medical assistance policies in Sichuan province, so as to provide evidence for improving health poverty alleviation policies.Methods A telephone survey was conducted between October and December 2017 among 1 280 poor individuals in Sichuan Province, with multi-stage stratified random sampling. The contents of the survey included general demographics of the poor population, and knowledge and satisfaction of health poverty alleviation policies.ResultsThe awareness rate of medical assistance policy was 91.80%, and the satisfaction rate was 91.88%. Poor individuals from non-poor counties, who had been out of poverty, and who reported that they had not signed up for family doctors, had low awareness of poverty alleviation policies. Poor individuals from non-poor counties, who usually went to the municipal hospital, who reported that they have not signed up for family doctors, and who do not know about health policies for poverty alleviation had a lower satisfaction rate.ConclusionsThe overall awareness rate and satisfaction rate of medical assistance policies in Sichuan province are relatively high, however, there are still some shortage. In the future, more attention should be paid to strengthen the promotion of health poverty alleviation policies for non-poor areas and those who had been lifted out of poverty, speeding up the contract service of family doctors and exploring ways to further alleviate the burden of medical expense of patients with serious diseases.
Evidence-informed decision making is one of the most common, objective and important health policy research methods used by policy makers. Its purpose is to promote the application and dissemination of research knowledge on health policy and systems to change traditional and subjective models of health policy making in order to improve national and regional health systems. Three elements will influence the effectiveness of health policy making:research evidence, available health resources and the value of policy formulation. This paper introduces some pragmatic evidence-based approaches, especially systematic reviews, priority setting and a combined approach matrix (CAM). Systematic reviews have a b impact on the decision process for policy makers. We hope that the application and development of evidence-informed methods will increase in China’s health policy research.
Objective To evaluate the pathways for improving the operational efficiency of medical teams, thereby providing micro-level empirical evidence for the refined management and high-quality development of public hospitals. MethodsBased on panel data from nine surgical teams in the Department of Thoracic Surgery at Sichuan Cancer Hospital from 2021 to 2024, this study employed the data envelopment analysis (DEA) with the BCC model to assess static efficiency, including technical efficiency (TE), scale efficiency (SE), and overall efficiency (OE). The Malmquist index was used to analyze the dynamic total factor productivity (TFP) and its decomposition into efficiency change (EC) and technology change (TC). Input indicators were the number of physicians and the number of open beds. Output indicators included the proportion of surgical patients, the proportion of grade Ⅳ surgeries, and the average length of stay (reciprocally transformed for positive orientation). Results The mean OE of all medical teams showed a continuous upward trend, while the mean SE exhibited a “V-shaped” pattern, initially decreasing and then increasing. The most significant growth was observed in mean TE, which was the primary driver of the OE improvement. All medical teams achieved positive TFP growth, with TC values greater than 1.000 across all teams, indicating that technological innovation was the core engine of efficiency enhancement. However, EC showed a divergent trend among the teams. Conclusion Public hospital performance appraisal policies effectively guide technological upgrading of medical teams through indicators such as “proportion of discharged patients undergoing surgery” and “proportion of grade Ⅳ surgeries”. However, issues of hospital resource mismatch and SE differentiation persist. It is necessary to establish specialized operation groups for dynamic resource monitoring and construct a “technological upgrading, scale adaptation, and management innovation” triangular balanced system to achieve a sustainable mechanism for maximizing healthcare resource input-output.
Precision poverty alleviation is the key task of China’s development, and its accuracy needs to be ensured in the implementation process. From the perspective of policy tools, this article defines the types of precision health poverty alleviation policy tools and explains the specific tools included in each type. Precision health poverty alleviation includes precision identification, precision implementation and precision assessment. This article also analyzes the selection of policy tools in different links. On this basis, combined with the choice of policy tools and the actual development of China, the problems in the application of different types of policy tools are summarized, and corresponding suggestions are put forward based on the existing problems. The purpose of this article is to providea reference for promoting the implementation of precision health poverty alleviation policies.