As a new generation of health technology, digital health technology (DHT) has been widely recognised and applied in the whole process of disease control and prevention, diagnosis, treatment, and health management. Special attributes unique from traditional health technologies such as pharmaceuticals and medical devices have introduced new challenges in aspects including product registration and certification, listing supervision, and health insurance access, necessitating a thorough and scientific evaluation. There are no clear DHT evaluation standards and application guidelines in China. The study explores the international experience of DHTs practices in the United Kingdom, Germany, Finland and Republic of Korea. It compares the classification, evidence standards,assessment methods and health insurance payment methods of DHTs in these developed countries to offer insights for regulating and developing DHTs in China.

The core challenges for the development of integrated care and medical services for the elderly lie in how to improve the accessibility of medical services and enhance the affordability of integrated care and medical services for the elderly. Current practices demonstrate limitations in addressing aforementioned two issues, necessitating a comprehensive strategy to foster the sustainable advance of integrated care and medical services for the elderly. Firstly, it is imperative to scientifically clarify the connotations, the medical treatments, target beneficiaries, and integration mechanisms of integrated care and medical services for the elderly. Secondly, there is a pressing need to significantly enhance the supply capacity of the health care system at the primary care level to improve accessibility. Finally, proactive exploration is indispensable to establish a long-term care service system and corresponding security mechanisms to alleviate the burden on the elderly.

Singapore has long been at the forefront of global health performance. Its “Healthier Singapore” (HSG) strategy, launched in 2022, aims to transform its healthcare system from traditional “reactive healthcare” to “active health” and guide the population in reshaping their health behaviors and lifestyles. The White Paper on this strategy emphasizes the importance of primary healthcare system development and primary prevention for residents’ health in an aging society. This aligns closely with China’s efforts to promote family doctors, a tiered diagnosis and treatment system, and to build a high-quality health service system centered on people’s health. Therefore, this article reviews the background of Singapore’s healthcare service system and the major health plans implemented by the Singapore government over the years before the release of the HSG strategy. It further introduces the core content of the HSG strategy, revealing Singapore’s policy evolution and the construction of a supportive external environment to promote “active health” for all. The aim is to provide enlightments for strengthening primary healthcare in China.

Objective To analyze the bed utilization efficiency of various departments in a Grade-3A public hospital in Shanghai, and to provide methodological basis for evaluating the rationality of bed resources allocation. Method According to the medical operation data of a Grade-3A hospital in Shanghai in 2023, a bed utilization model was created to visually evaluate the bed efficiency. The utilization indexes were used to measure the available bed capacity in each department, which contributes to establish the bed adjustment protocol. A multi-layer perceptron neural network was employed to evaluate the protocol’s specificity, rationality and feasibility. Result The bed utilization model indicated that 11 (25.00%) departments shown bed efficiency, 11 (25.00%) departments exhibited bed weak transition, 16 (36.36%) departments had idle beds, and 6 (13.64%) departments had occupied beds. In addition, bed efficiency analysis showed that the number of beds in 8 departments should remain the same, be reduced in 16 departments, and be expanded in 20 departments on demands. A multi-layer perceptron neural network was used to construct a system of bed-fixation model, bed-reduction model and bed-expansion model. The area under receiver operating characteristic (ROC) curve of the bed-fixation model was 0.719 with a sensitivity of 100.00% and a specificity is 40.63%. The area under ROC curve of bed-reduction model was 0.875 with a sensitivity of 83.33% and a specificity of 85.00%. The area under ROC curve of the bed-expansion model was 0.913 with a the sensitivity of 100.00% and a specificity of 72.22%. Conclusion The overall utilization efficiency of hospital beds is poor and differences occur in the utilization efficiency of beds across different departments. The evaluation outcomes of the bed-expansion model created by a multilayer perceptron neural network align well with the bed utilization model and evaluation indexes. This offers a methodological foundation for managing bed resource allocation in hospitals and achieving fine management.

The trend of tumor chronicity has put forward new requirements for tumor rehabilitation, but currently there is still a lack of systematic and integrated construction and demonstration in the field of tumor rehabilitation. Therefore, it is imperative to establish a standardized management system for integrated tumor rehabilitation. To this end, the Rehabilitation Management Special Committee of the Shanghai Anti-Cancer Association conducted a research on the rehabilitation needs of the real world, and led several domestic experts in oncology, rehabilitation medicine, nursing, health management and other related fields to hold multiple rounds of expert discussions and opinions collection, jointly formulating the “expert consensus on tumor integrated rehabilitation management (2024)”. This consensus proposes the definition and objectives of tumor integrated rehabilitation, elaborates on the staging, system and mode, evaluation and intervention of tumor integrated rehabilitation, and clarifies the specific practices of primary health service centers in the field of tumor integrated rehabilitation, in order to provide a basis for the development of tumor rehabilitation discipline and the formulation of integrated rehabilitation management strategies for tumor patients.

Objective To sort out typical cases of public hospitals applying artificial intelligence to improve patient experience, and analyse related strategies and practices. Methods In April 2024, practice cases of public hospitals applying artificial intelligence to improve patient experience were searched and screened on various databases, hospital portals, and public platforms. Based on Patient Journey Theory, the case content was analysed by thematic coding using text analytics, and 2 rounds of expert consultation were conducted to identify typical cases, and a narrative approach was adopted to summarise and distil their innovative experiences. Results Initially, 47 relevant cases were retrieved and coded according to the textual content of the cases to construct a thematic framework for the application of AI to improve patient experience. The thematic framework covers three main stages: pre-diagnostic service, diagnostic service and post-diagnostic service, and specifically includes 10 organisational practices to improve patient experience, such as intelligent diagnostic guidance, process optimisation, assisted self-examination and disease prediction. The 15 typical cases identified by the experts were further summarised and analysed to refine the specific ways and focuses of applying AI to improve patient experience at different stages of the medical journey. It was found that public hospitals focus on improving patient engagement and optimising the consultation process in the pre-consultation stage, improving the quality and efficiency of consultation services in the mid-consultation stage, and providing continuous health management and personalised follow-up visits in the post-consultation stage. Conclusion The application of artificial intelligence in the pre-diagnosis, diagnosis and post-diagnosis phases can significantly improve the patient's experience from different perspectives, and public hospitals around the world should actively apply advanced technology to help improve the patient experience.

Integrating internet into appropriate technology of traditional Chinese medicine is a crucial step to comprehensively promote the preservation and innovation of traditional Chinese medicine and the implementation of the Healthy China Initiative. This paper employs SWOT analysis method to evaluate the "Internet plus appropriate technology of traditional Chinese medicine" service model in terms of strength, weakness, opportunities and threats. It proposes recommendation for enhancing relevant laws and regulations, popularizing the service model, strengthening the training of professionals equipped with appropriate technology of traditional Chinese medicine, and refining the medical insurance payment system for this technology.

Objective To compare the consistency between the National Standards for Disability Grade Assessment in Long-term Care and the Unified Needs Assessment Form for Elderly Care in Shanghai (hereinafter referred to as national standards and Shanghai standards), and propose suggestions for bridging the two standards. Methods Indicators and assessment grades from the two standards had been compared. A total of 179,141 pieces of data from the Shanghai standards from January to May 2023 were included, and consequently, these data were re-evaluated according to the two standards. Using InterQuartile Range, the consistency of Activities of Daily Living (ADL), cognitive ability, perceptual ability, together with communication ability were compared and presented in ratio line charts and bubble charts. Further, the disability situations obtained by calculating the same data in the two standards were analyzed. Results The results showed that the Shanghai standards covered all indicator dimensions of the national standards. The quartiles of the two sets of standards in the ADL dimension were 53.5 (35.0, 62.5) and 55.0 (35.0, 65.0), respectively. The quartiles in the perception and communication ability dimensions were 75.0 (75.0, 100.0) and 83.3 (66.7, 91.7), respectively. The data distribution of the 2 dimensions in terms of the proportion in each score range is close, and the trends of proportion are basically in line with each other. However, the quartiles of the two standards in the cognitive ability dimension were 48.0 (31.0, 63.0) and 38.8 (17.5, 61.3), and the data showed differences between the two standards. For example, the disability situations calculated by Shanghai standards were mild and moderate in majority, while the disability situations calculated by national standards were relatively moderate and severe. Conclusion The two standards are consistent in general with high consistency in terms of ADL and perceptual and communication skills dimensions, and differences in cognitive abilities dimensions still exist.

Objective The study aims to summarize the interview materials from clinical specialists on breast cancer, investigate the diagnosis and treatment status of breast cancer patients, and offer insights for future clinical research and health policy formulation. Methods The in-depth interview with experts was conducted to study the breast surgeons in the representative hospitals of Shanghai. The diagnosis and treatment status of breast cancer patients was analyzed using grounded theory. Results Following coding the interview materials from four experts by three levels, 15 initial categories were condensed and summarized into four maingroups: incidence, basic characteristics, continuous improvement of diagnosis and treatment level and challenges encountered in diagnosing and treating of breast cancer patients. Finally, two core categories were established: population characteristics and treatment profiles of breast cancer patients. Conclusion Breast cancer patients in Shanghai are becoming younger and diagnosed at an earlier age, and the level of diagnosis and treatment has been steadily improving. There still exist specific challenges in drug development and security policies. It is necessary to strengthen the coordination across various departments and components, elucidate the mechanism underlying the onset and progression of breast cancer, prioritize early detection and treatment of breast cancer, enforce standardized diagnosis and treatment protocols, and improve the medical security system to optimize the patient cure and survival rates.

The clinical comprehensive evaluation of drugs based on real-world data is a vital approach for assessing the clinical value of drugs, including effectiveness, safety, and cost-effectiveness, in real-world healthcare settings. Currently, most real-world studies in China have yet to establish standardized quality control management protocols. The drug clinical comprehensive evaluation team should develop the Quality Control Standards for Real-World Research in Clinical Comprehensive Evaluation of Drugs (hereinafter referred to as the "Standards"), emphasizing scientific rigor, compliance, and reliability. These Standards provide operational guidelines for researchers, ensuring that studies are standardized, homogeneous, and possess a high degree of external validity. They systematically cover key aspects such as research objectives, study design, data sources and preprocessing, statistical analysis, and result interpretation. The Standards serve as a benchmark for quality control management of drug clinical evaluations based on real-world research, aiming to enhance the quality of such research and provide robust scientific support for drug supply security decisions and clinical treatment decision-making.

Objective Based on the comparison of domestic and international literature, the study analyzes hotspots and development trends in the field of patient needs providing insights for future studies. Methods Literature from the CNKI database and Web of Science core database, spanning from January 1, 2003, to July 31, 2023, was searched. CiteSpace software was then used to visually compare and analyze the number of publications, authors, institutions, and keywords in both domestic and international research. Results A total of 1 480 Chinese literatures and 7 430 English ones were included. Both Chinese and English literature showed a significant increase in publication volume, but no stable core group of authors was identified. Compared to international institutions, domestic institutions have less inter-institutional collaboration. In addition to health education, research hotspots differ between a domestic and international studies: international research emphasizes machine learning, critical care, hospice care, pain management, quality of life, etc. Domestic research pays more attention to qualitative research, medical insurance, chronic disease management, and influencing factors. Conclusions Future research should focus on health education, chronic disease management, hospice care and explore innovate service models using mobile health technologies and artificial intelligence. Additionally, it should investigate demand-based medical insurance policies to improve medical services.

Objective To analyze the distribution characteristics of human resource for primary care from the spatial perspective, and to provide a scientific basis for the rational allocation of primary care human resources. Methods Data on human resources for primary care in 31 provinces of China from 2012 to 2021 were collected. The Moran Index and Spatial Durbin's model were employed to analyze the clustering of human resources for primary care in China, and to investigate the factors influencing human resources for primary care and their spatial spillover effects among neighbouring provinces. Results In terms of time trend, the number of primary care technicians in China increased year by year from 2012 to 2021, leading to a continuously improved structure. However, in terms of spatial distribution, there was a wide gap in the average annual growth rate of primary care technicians per 1,000 population between provinces. Provinces like Xinjiang, Gansu, Liaoning, and Heilongjiang had relatively small number of primary care technicians per 1,000 population and their growth rates were slow. The Moran Index of primary care technicians declined in 2012-2021, showing a negative correlation between the spatial and temporal distribution of the allocation of primary care technicians in China, with spatial spillover effects. Urbanisation rate and the medical and health care development were the important factors influencing the allocation of primary care technicians in the region. Conclusion The interprovincial gap in human resources for primary care has been narrowing from 2012 to 2021. Nonetheless, the total number of primary care personnel is insufficient, presenting an uneven spatial distribution. An in-depth approach should be taken from an interprovincial perspective to optimize the deployment of primary care personnel through the construction of primary service networks regional primary care cooperation mechanisms, and talent attraction policies.

Health technology assessment (HTA) has been widely used to support evidence-based decision-making in medical and health care. One of its most prominent application scenarios is to construct a multi-level medical security system. This paper studies the status quo and challenges of HTA in multi-level medical security system in China, and consequently, based on the experience of the international community, this paper puts forward the future prospects for the development of HTA in China. HTA could assist China's pharmaceutical industry with issuing more scientific and reasonable policies, but its further development still needs the joint support and efforts from many parties.

Objective This study aims to investigate the current levels of willingness to participate in Helicobacter pylori (H. pylori) screening among college students in China and the influencing factors, pathways, and mechanisms using the COM-B (Capability-Opportunity-Motivation Behavior) model as the theoretical framework. Suggestions to develop intervention strategies to improve infection screening levels are expected to be proposed. Methods By using a multi-stage stratified sampling method, college students from different regions in China were selected. A questionnaire survey was conducted to investigate their willingness to participate in H. pylori screening and its influencing factors. Analyze statistically the screening willingness of the surveyed individuals. Stratified regression analysis was employed to identify the factors influencing college students’ willingness to participate in H. pylori screening from three dimensions: capability, opportunity, and motivation. Additionally, a Structural Equation Modeling framework was constructed to evaluate the overall fit of the model. Mediation analysis was then performed to uncover the specific pathways and mechanisms through which the dimensions of capability, opportunity, and motivation influence the willingness, elucidating their roles in detail. Results A questionnaire survey was conducted among 2 242 college students from 6 cities in Shandong and Shaanxi provinces. The score for college students’ willingness to participate in H. pylori screening was (2.90 ± 1.29), indicating a moderate level. Capability factors (health literacy, H. pylori knowledge level), opportunity factors (social norms), and motivation factors (self-efficacy, anticipated regret) had significantly positive and predictive effects on college students’ screening willingness (P< 0.001). The structural equation model showed good overall fit. Among them, capability factors (β = 0.090) and opportunity factors (β = 0.305) indirectly influenced screening willingness through motivation factors, with the last playing a mediating role. Specifically, self-efficacy (β = 0.023) and anticipated regret (β = 0.020) under the motivation dimension mediated the relationship between capability factors and screening willingness. Self-efficacy (β = 0.180) and anticipated regret (β = 0.073) also mediated the relationship between opportunity factors and screening willingness. Relationships between these factors were statistically significant (P< 0.05). Conclusions The willingness of college students to participate in H. pylori screening needs to be improved. Capability factors, opportunity factors, and motivation factors significantly and positively predict the willingness to participate in H. pylori screening. Self-efficacy and anticipated regret under the motivation dimension serve as mediating variables between capability factors, opportunity factors, and screening willingness. College students are recommended to participate in H. pylori screening as early as possible.

At present, the high-quality development of public hospitals in China benefits from institutional and systemic advantages, such as a high degree of organization within the government-led medical and health service system, a strong capacity to attract medical professionals and technical talents, high public trust and broad accessibility of medical services, and a strong ability to guarantee and regulate basic medical policies. However, it also faces challenges regarding operating costs due to the large number of existing beds. The article proposes, empowering public hospitals through information technology and digitization to enhance their capacity to reconstruct the value of new services, products, and efficiency, while strengthening the utilization value of existing beds through high-quality development value foundations and the creation of distinctive advantages. It also suggests utilizing digital transformation to promote the construction of a new production relationship based on the synergy between medical treatment, medical insurance, and medicines supply, and continuously enriching the new landscape of high-quality development of public hospitals through efficient mechanisms of this synergy.

Objective To investigate and analyze the current situation and future perspectives of pharmacoeconomic evaluation in health care sector of China. Methods A structured questionnaire was created based on literature review and expert survey, covering the application and prospect of pharmacoeconomic evaluation in marketing research and development, listing, pricing, medical insurance, hospital, commercial insurance and other fields, as well as the needs and career development of professionals from different employers. Questionnaire survey was conducted in a WeChat group of relevant practitioners on condition of voluntary anonymity, and the results were statistically analyzed. Results The application and prospect of pharmacoeconomic evaluation in the pricing, access and adjustment of medical insurance has received the highest score (with 5 being the full score, the application level, importance and future prospect in the medical insurance pricing and access have received scores of 3.96, 4.17 and 4.45 respectively, adjustment has received scores of 3.29, 3.52 and 4.01 respectively). The scores in the stages of marketing research and development and hospital selection are average, and the scores in the rational clinical use and commercial insurance access are the lowest. Correspondingly, the demand of professionals is relatively high in professional consultation and pharmaceutical enterprises (with the scores of 3.56 and 3.39 respectively), good in professional consultation and scientific research institutes (with the score of 3.90), and not optimistic in medical institutions, commercial and insurance institutions. Conclusions The current application and development of pharmacoeconomic evaluation in China is centered on medical insurance pricing and access, and insufficient in hospitals and commercial insurance. And its development potentials need to be further explored.

Promoting the coordinated development and governance of medical services, medical insurance, and pharmaceuticals is a concrete practice in advancing the modernization of the national governance system and enhancing governance capacities. It is an inevitable requirement for implementing the strategy of prioritizing health development and an important part in deepening the healthcare system reforms. Currently, the coordinated development and governance of medical treatment, medical insurance, and pharmaceuticals still face numerous challenges. Healthy China Research Network, incorporating evidence-based scientific data, expert insights, and practical experience, has formulated the “Expert Consensus on the Coordinated Development and Governance of Medical Services, Medical Insurance, and Pharmaceuticals,” exploring the connotations, significance, and goals. The consensus proposed that, to promote the coordinated development and governance of medical treatment, medical insurance, and pharmaceuticals, it is essential to adhere to the comprehensive leadership of the Communist Party of China, and center the focus on people’s health. Upholding fundamental principles and breaking new ground, prioritizing institutional development, and following the systematic principle are critical as well. Accordingly, corresponding institutional mechanisms and supportive measures are proposed, aiming to provide references for policymakers, decision-makers, practitioners and researchers in the field of healthcare.

Pharmaceutical industry is a strategic emerging industry related to national livelihood and national security, and it is also an important foundation for the construction of a healthy China, and it is an important goal of China’s medical security system to support and promote its innovative development. This paper briefly summarizes the practices and achievements of the national and Shanghai medical insurance departments in promoting the innovative development of the pharmaceutical industry through system innovation, and proposes that the medical insurance departments need to grasp the advantages of “safeguarding people’s livelihood” and “assisting development”, and implement the national requirements and local reforms and innovations. It also proposes that the medical insurance department needs to grasp the three important relationships between “protecting people’s livelihood” and “helping development”, implementing national requirements and local reform and innovation, and taking the initiative and strengthening departmental linkage, so as to continuously support the innovative development of the pharmaceutical industry.

Objective To analyze the patent development trends of key innovative enterprises in capsule endoscopy (CE) both domestically and internationally, providing insights for the patent layout and development direction in China's CE technology sector. Methods Medtronic, Olympus, Anhan Technology and Jinshan Science and Technology were selected as representatives of major CE innovators. Based on Derwent Innovation (DI) database and IncoPat global patent database, a patent literature dataset of key innovative enterprises in CE was constructed to analyze the characteristics and differences in patent development among the four enterprises. Results From the perspective of patent application trends, Olympus had the earliest global patent application (1978), with the highest annual application number (213). In terms of target markets, Medtronic primarily focuses on the United States (271 cases), Olympus on Japan (954 cases), and Anhan Technology and Jinshan Technology both on China (380 cases and 397 cases, respectively). Regarding the distribution of subdivided technological focuses, Medtronic, Olympus, Anhan Technology, and Jinshan Technology hold 125, 392, 78, and 77 patents respectively for image acquisition, and 47, 281, 106, and 102 patents respectively for magnetically controlled capsules. From the perspective of technological hotspot distribution, Medtronic and Olympus pay attention to digestive wall structure imaging, image processing, and capsule enteroscopy, while Anhan Technology and Jinshan Technology focus on targeted drug delivery and battery technology. Conclusions International innovators in capsule endoscopy started their R&D earlier, resulting in a large number of patents and a broader global layout. Although domestic capsule endoscopy innovation companies are in the growth stage of technological accumulation, they have a fast development momentum and show a certain trend of catching up in some sub-technical fields.

The community serves as the fundamental unit for delivering healthcare services, and community healthcare is a crucial component of high-quality health development. This paper reviews the development history and current status of community health services in Shanghai. It outlines five practical pathways for enhancing community health service capacities: improving the "General Practice+Specialized Medical Service" model, expanding community pharmaceutical supplies, strengthening the family doctor contract service system, establishing the community health service brand "Three Centers and One Clinic," and effectively leveraging health insurance. The aim is to provide insights for the development of community health services in the new era.

Background To measure incentive preferences for voluntary blood donation among college students in Shandong Province and offer insights for developing more targeted retention and recruitment strategies for voluntary blood donors. Methods This study utilized a discrete choice experiment (DCE), and five attributes were identified using qualitative and quantitative methods: health check, privileged receiver, donation gratitude, travel time, and little gifts. A D-optimal design was developed using SAS software. A total of 193 questionnaires were collected in Jinan, Heze, and Yantai cities via in-person interviews. The mixed logit regression model was used to estimate incentive preferences. Results 175 respondents were included. Priority was given to privileged recipients when it came to incentive preferences among college student donors, followed by little gifts and travel time. Respondents were willing to sacrifice 45.91 yuan to designate their immediate relatives as privileged recipients. The acceptance rate declined by 18.2% when donation gratitude shifted from badge/certificate to school recognition. Conclusion Blood service organizations should formulate more specific retention and recruitment measures according to the blood donation incentives preferred by college student donors. To increase the frequency of blood donations and gradually transit college students into regular donors, some incentives including offering transferable health checkups, getting feedback from students on their favorite little gifts, and arranging blood donation vans to campus should be taken into consideration.

As digital health technologies rapidly advance, their products and services are increasingly applied worldwide. Germany, a leader in the digital health sector, has developed a robust market for these technologies. This study provides a comprehensive overview of the health insurance access processes for digital health applications (DiGA) in Germany, including assessment criteria and its existing challenges. Drawing from Germany’s experience, the paper offers tailored recommendations for China, aiming to inform and refine the health insurance access processes for domestic digital health technologies. These proposals are proposed to enhance China’s digital health industry.

Objective To understand the current situation of the construction of demonstration community rehabilitation centers in Shanghai and provide insights for the formulation of community rehabilitation policies in the city. Methods This study investigated the infrastructure, facilities, equipment, human resources, and service provision of 119 demonstration community rehabilitation centers in Shanghai, and compared relevant data before and after construction. Results The average treatment area of these in Shanghai was 587.4 m², with a total of 2671 beds. On average, each center is equipped with 10.8 rehabilitation physicians, 2.9 rehabilitation nurses, and 5.9 rehabilitation therapists. Among the 119 centers, 93.3% have outpatient rehabilitation information modules, 73.9% can automatically collect information data generated in rehabilitation services, 47.1% can link rehabilitation service data with residents’ health records, and 38.7% can connect rehabilitation service data with superior medical institutions in the integrated health care system. In 2023, these centers provided a total of 9.691 million rehabilitation visits, including outpatient rehabilitation (5.315 million), inpatient rehabilitation (2.704 million), and site-based rehabilitation (1.592 million). Conclusions Although significant progress has been made in the construction of demonstration community rehabilitation centers, traditional rehabilitation services still dominate, and there are notable regional disparities. It is recommended to further strengthen the community rehabilitation system, expand the workforce, enhance community service offerings, and advance informatization to improve the level of community rehabilitation services.

Objective To evaluate the cost-utility of ultrasound screening for fetal structural abnormalities in first-trimester compared to mid-trimester, providing evidence-based support for clinical optimization. Methods From a social perspective in China, a decision tree model was developed to simulate the clinical choices and pregnancy outcomes of two different prenatal screening programs for pregnant women who underwent ultrasound screening for fetal structural abnormalities in first-trimester (the intervention group) and those in mid-trimester (the control group), and to assess the cost-utility of the two groups with different pregnancy outcomes. The model simulation duration was 18 weeks, The clinical transition probabilities of pregnancy and cost were obtained from Shenzhen Nanshan Maternity & Child Healthcare Hospital, and the utility data from the published literature. Outcome measures included cost, quality adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). The sensitivity analysis was conducted to examine the robustness of the model findings. Results Compared to the control group, the intervention group could reduce unnecessary pregnancies, achieving more QALYs with less total cost and an ICER of −¥161 732.68/QALY, which presented an absolute cost-effectiveness advantage. Probabilistic sensitivity analysis indicated the robustness of the baseline analysis results. Again, the probability of the intervention group being cost-effective is 94.60%. Conclusion From the societal point of view, first-trimester ultrasound screening for fetal structural abnormalities possesses an unequivocal economic advantage compared to mid-trimester ultrasound screening.

In the context of global health, strengthening regulatory harmonization of pharmaceutics across countries and regions has become increasingly important and necessary. This study employs a literature review to analyze the key issues facing global health development, explores global practices in drug regulatory coordination and reliance, and examines the current status of China’s participation in international regulatory harmonization. It aims to propose recommendations for promoting international regulatory harmonization of pharmaceutics at both global and national levels. Currently, WHO has promoted the global drug regulatory coordination, and international organizations such as the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) and the Pharmaceutical Inspection Co-operation Scheme (PIC/S) have established international regulatory consensus. Mutual recognition of drug inspections has been largely established between regulatory agencies in developed countries, such as those in the United States, the European Union, the United Kingdom, Canada, and Australia. Regulatory agencies in Africa, Latin America, and the Caribbean, on the other hand, often rely unilaterally on the regulatory decisions made by the United States and Europe. China’s National Medical Products Administration (NMPA) has joined international regulatory coordination organizations, including ICH, PIC/S, and ICMRA (International Coalition of Medicines Regulatory Authorities), and has established bilateral cooperation with regulators in more than 50 countries and regions. In the future, agencies and organizations should work collaboratively to promote international regulatory coordination, facilitate the global sharing of regulatory resources from developed and high-income countries, and ensure that regulatory decisions are effectively shared worldwide. NMPA should advance the mutual recognition with counterpart agencies in countries with more well-established regulatory systems and encourage the creation of regional drug regulatory cooperation alliances. This will contribute China’s efforts toward addressing the imbalances in global health development.

Shanghai is advancing the construction of high-level talent highland. However, as a leading industry, biomedicine industry is inseparable from the construction of medical talent highland. This paper defines the connotation of building medical talents highland in Shanghai in the new era. It also examines the overall scale of medical talents, including the status quo of three types of talents, namely, outstanding, high-level and general ones, as well as the “Attracting and Nurturing” policy in Shanghai for talents. Currently, Shanghai has established a comprehensive medical talent highland policy system, which has facilitated the initial aggregation of high-level talents. However, to establish a competitive advantage in the field of life and health on the Asian and global stages, there still exists a wide gap to bridge. Deficiencies are apparent in the scale of outstanding talents represented by academicians of the two academies in China, high-level talents represented by physician scientists, and general talents represented by intensivists and registered nurses. Shanghai should further strengthen the introduction of overseas talents and cultivation of local medical talents in shortage disciplines, and continuously improve the innovation ecology and talent evaluation system.

In the current complex international scenario, the right to health is seriously comprised. The paper discusses the connotation of the right to health and its impact on the health system reform in China. Based on the World Health Organization's definition of health, the study puts forward 10 aspects of the right to health. This paper illustrates the legislative basis of the right to life and health in the Constitution, General Principles of the Civil law of the People’s Republic of China, and other related laws and regulations in China. The significance of high-quality development in preserving the rights to life and health achievements is evident in three sectors, i.e. medical insurance, health services and pharmaceutical industry. One of the goals of health reform is to achieve the right to health for all individuals. To fully leverage the government’s role, it necessitates the introduction of policy toolkit that benefits people to expand equal access to high-quality and safe health services. Improving political, economic, legislative, environmental and other conditions to relieve the economic burden of diseases throughout the whole society. Centering on people's health, efforts should be made to consistently enhance health conditions, and safeguard individuals’ rights to life and health.

Objective To analyze the impact of the family doctor contract service policy in Shanghai on relevant contract indicators, providing decision-making references for the development of family doctor contract services. Methods Through the Shanghai Informationization Data Platform (Shanghai Community Health Comprehensive Management Platform), dynamic monitoring data of contract service management from August 2022 to April 2024 in 16 districts of Shanghai were collected. The data includes the number of contractees, contract coverage rate, community contract saturation, compliance of contracted communities, community visit rates, visit rates within contract groups, and coverage rates for key populations. With June 2023 as the policy intervention point, the interrupted time series model was utilized to analyze changes in contract indicators before and after the implementation of the family doctor contract target management policy. Results After the policy implementation, the number of contractees (10.884 9 million VS. 9.296 2 million), contract coverage rate (43.7% VS. 37.4%), and key population contract coverage rate (84.2% VS. 79.1%) all increased, when compared to those before the contract with statistically significant differences (all P<0.001). Regression analysis showed that after the policy implementation, the number of contractees, contract coverage rate, and contract coverage rate of key populations all presented an upward trend (all P<0.05). However, there was no significant change in the long-term trend of contract saturation (P = 0.441). The contract community visit rate indicated a downward trend (P<0.01), while compliance of contract community revealed an increasing trend (P<0.05), and there was no remarkable change in visit rates within the contract groups (P>0.05). Conclusions The policy intervention has a significant short-term effect on contract coverage and contract flow, but there is a decreasing trend over time. It is recommended that future policies address the slowing growth trends and optimize the quality and efficiency of contract services.

Objective To explore the impact of intergenerational caregiving on the utilization level of healthcare services for the elderly, and to analyze whether the impact is heterogenous among different groups of elderly people. Method Screened from the 2018 national tracking survey data from the China Health and Retirement Tracking Survey database, a sample of 4 069 elderly people was selected to empirically investigate the relationship between intergenerational caregiving and the utilization of healthcare services in the elderly using the treatment effects model and the Instrumental Variables (IV) Probit model. Result The behavior of elderly people taking care of their grandchildren was self-selective, and intergenerational caregiving significantly reduced the utilization level of outpatient services (Z=−1.85, P<0.1) and physical examination services (Z=−3.67, P<0.01), with no statistically significant impact on the utilization of inpatient services. Intergenerational caregiving reduced the utilization level of physical examinations and outpatient services for the elderly by 35.2% and 16.5%, respectively. Again, a 1.0% increase in weekly caregiving hours would result in a corresponding 4.4% and 3.6% decrease in the utilization level of physical examinations and outpatient services for the elderly. Subgroup analysis showed a greater impact of intergenerational caregiving on the utilization of medical services for younger and rural elderly than for older and urban elderly. There are no significant gender differences in the utilization of physical examinations and outpatient services for the elderly. However, gender differences exist in the impact on the utilization of inpatient services. Conclusion Intergenerational caregiving has reduced the utilization level of healthcare services for the elderly, and there is a need to optimize the supportive policy for intergenerational caring from multiple aspects, to enhance the supply capacity of healthcare services, and to improve the health and welfare of the elderly.

Objective To analyze the technological innovation capability of public rehabilitation hospitals in China by sorting out patent application data. Method A total of 924 patent applications by 61 public rehabilitation hospitals in China from 1989 to 2022 were collected and sorted. Quantitative analysis was used to examine data on trends, legal status, and regions of these patent applications. Cluster analysis was applied to construct a patent cooperation network, together with natural language processing utilized in extracting patent text keywords and calculating their frequency. Results The number of patent applications by public rehabilitation hospitals in China increased year by year from 1989 to 2022, reaching a peak of 674 utility model patents (72.94%). In terms of patent legal status, there are 535 valid patents (57.90%), 117 patents under review (12.66%), and 272 invalid patents (29.44%). The top three regions with the highest number of patent applications are Beijing, Shanghai, and Jiangsu. Three Grade-3 hospitals, namely China Rehabilitation Research Center, Beijing Xiaotangshan Hospital, and Shanghai Yangzhi Rehabilitation Hospital, each have over 100 patent applications. Patent cooperation network analysis shows limited cross-regional technical cooperation among public rehabilitation hospitals in China. Currently, three large patent inventor cooperation networks have been formed. Various phases of patent development focus on different aspects of research and development technologies: the incubation phase emphasizes functional compensatory rehabilitation aids, the budding phase focuses on rehabilitation training equipment, and the development phase centers on intelligent rehabilitation training aids. Additionally, physical therapy rehabilitation equipment based on traditional Chinese medicine has been further developed. Conclusion The research and development of patent technology in public rehabilitation hospitals in China has entered its development phase, with intelligent assistive devices becoming a key direction. Grade-3 public rehabilitation hospitals play an important role in scientific and technological innovation, with Beijing and Shanghai as the major players. Public rehabilitation hospitals face challenges such as insufficient output capacity for high-value innovation achievements, low efficiency in technology transformation, and inadequate synergic innovation capabilities.

Health education is a critical component in disease prevention and the implementation of the Healthy China strategy. Children's health education is pivotal to the health service life cycle. Addressing the integration of the health education throughout the entire diagnostic and treatment process poses a crucial consideration for hospitals. This paper discusses the application of the PDCA management concept in a children's specialty hospital in Shanghai to explore the full process health education in outpatient clinics, and uncover the issues of the health education management. The hospital optimized the whole-process health education management mode by implementing health education throughout the entire diagnosis and treatment process, diversifying health science popularization content, adopting interactive health promotion methods, and etc. 90.12% of patients in the satisfaction survey reported hospital health education to be beneficial. It indicates that the exploration of health education management mode tailored for children's specialty hospitals improves the health literacy of children and their parents, as well as boosts hospital management efficiency.

Objective To evaluate the effects of health poverty alleviation in China and provide data support for the implementation of China’s rural revitalization strategy. Method According to the National Statistical Survey Data on Health Resources and Medical Services from 2009 to 2021, this paper analyzed the changes of health resources, income of medical healthcare institutions, healthcare utilization and medical burden of residents in 832 counties lifted out of poverty and from “three regions and three prefectures” before and after implementation of the health poverty alleviation policy using the method of interrupted time series. Results After implementation of the health poverty alleviation policy, the growth rate of health technical personnel, practicing (assistant) physicians, registered nurses, equipment over CNY 10,000, total income and fiscal appropriation income of medical institutions increased significantly. And the growth rate of medical expense per visit in the 832 counties lifted out of poverty and “three regions and three prefectures”. In parallel, the growth rate of the total number of outpatient visits and the number of discharged patients in the counties lifted out of poverty decreased. However, the number of discharged patients in “three regions and three prefectures” increased. Conclusions After implementation of the health poverty alleviation, healthcare systems in areas lifted out of poverty have been effectively strengthened, the healthcare utilization has been improved, the medical burden of residents has been relieved, and the accessibility of medical services has been remarkably improved. It is suggested to maintain the stability of the policy and bridge the rural revitalization and Healthy China Initiative, focusing on measures to tackle the insufficient health human resources in areas lifted out of poverty.

Objective This study aims to explore the influence of product design factors of Huimin insurance on people’s purchase willingness from the perspective of demand side. Method Sample data were collected through a questionnaire survey, and a multi-factor logistic regression model was used to examine the impact of various factors on purchase intention. Results Among the design factors of Huimin insurances, coinsurance (P<0.05), health management service (P<0.01), deductible (P<0.05) and insurance price (P<0.05) are significant factors affecting residents’ purchase intention. Among the factors related to insurance literacy, the depth of comprehension regarding Huimin insurance (P<0.01) and the intention to buy other commercial insurance (P<0.01) are vital factors affecting purchase intention. Conclusions The findings indicate that people’s demand for Huimin insurance encompasses more than just cost compensation. There is a notable need for both cost compensation and health promotion. Insurance literacy also plays a crucial role in purchase intention. It is recommended that the government guide insurance companies to reorient the value proposition of Huimin insurance product, make full use of Huimin insurance promotion activities as a means to enhance health insurance literacy of the public, and foster the orderly and healthy development of the health insurance market.

Objective By analyzing the care needs of community-dwelling seniors, together with the differences in service types and duration required in different ability levels, this paper aims to offer insights for personalized care for the elderly. Methods Using random sampling, and a door-to-door assessment was conducted on 5 133 elderly residents living at home in 5 cities in Anhui Province. The classification of disability levels was set on the national standard “Ability Assessment Standards for the Elderly”（GB/T 42195—2022）of the Ministry of Civil Affairs. Personalized care plans including care service items and duration for each research subject were provided by automatic generation model. Results The overall disability situation of the seniors was relatively mild. As the level of disability increases, fundamental movement skills and self-care ability declined most significantly. The service plan showed that medical and life assistance were most demanding, but psychological care also needs additional attention. Next, as the degree of disability mounted, the scope and activities of daily living for the seniors decreased, resulting in a notable increase in the proportion of basic life care services such as toileting, and a higher concentration of care services. Conclusions The care needs of the elderly show a certain pattern of change as disability progresses. The automatic generation model provides personalized service plans for the seniors, and deserves application in the future.

Objective To develop an evaluation index system of general practitioners’ integration capabilities of medical care and preventive services in primary care, and to explore pathways to enhance their service capabilities. Methods The improved Delphi method was used with the threshold method in indicator screening. The evaluation index system also incorporated the indices of expert enthusiasm, expert consultation authority, and coordination of expert opinions. The analytic hierarchy process (AHP) was then employed to calculate the weight coefficients of the indicators. Results A total of 33 expert consultation questionnaires were distributed, and the effective questionnaire recovery rates for the first and second rounds were 100.0% and 97.0%, respectively. The expert consultation authority coefficient for overall indicators was 0.80. After two rounds of expert consultation, the Kendall’s W coefficients for the importance of the tertiary and overall indicators were 0.677 and 0.683. χ² values were 88.774 and 91.663, respectively, with all P<0.001. This system comprised 3 first-level indicators, 10 second-level indicators, and 36 third-level indicators. Among them, the first-level indicator B “Integrated Capability in terms of capacity, skills, and techniques” had the highest weight of 0.500 0. The top five combined weights in the third-level indicators in descending order were: C11 awareness of actively serving residents (0.081 7), B12 proficient in pre-hospital emergency technology (0.075 7), A11 proficient in rational medication and prevention knowledge (0.067 7), A22 proficient in infectious disease prevention and control theory (0.055 6), and C12 awareness of actively providing health services (0.052 0). Conclusions This article systematically constructed an evaluation index system of general practitioners’ integration capabilities of medical care and preventive services in primary care from three dimensions: knowledge structure, capability, skills, techniques along with quality. It offers insights for evaluating general practitioners’ integration capability of medical care and preventive services in primary care as well as the systematic design and advance of continuing education and training programs.

Objective To analyze and evaluate the current status of short video communication among grade 3A general hospitals in Shanghai, identify key issues and deficiencies, and provide strategic recommendations for improvement. Methods Collect data from the official Douyin and WeChat video accounts of five grade 3A hospitals in Shanghai from July to December 2023. Conduct statistical analysis on the total number of videos, number of followers, total number of likes, release date of the first video, and video collections. Evaluate the communication capacity of the official Douyin accounts of the five hospitals using the Douyin Communication Influence Index (DCI). Utilize Micro Word Cloud software to analyze word frequency statistics in Douyin video titles and key user comments. Results Five hospitals collectively released 1 631 short videos on WeChat Video Account, with eight video collections. On Douyin, they published 1 152 short videos, garnering 176 000 followers and 1.999 million likes. They also released 14 video collections with content primarily focused on medical health education (58.33%), hospital culture (16.67%), and medical supplies (16.32%). Overall, the communication capacity on the short video platform is relatively low (DCI approximately 250). The most frequently terms in short video titles and user comments on the official Douyin accounts include hospital abbreviations, disease names, medical-related terms, and expressions of gratitude. Conclusions Grade 3A general hospitals in Shanghai have relatively late starts in short video development, resulting in lower numbers of followers and likes. It is recommended to accelerate the integration of new media resources in hospitals. The Douyin accounts have low communication capacity, so it is suggested to enhance interactions with medical personnel who are highly ranked in science popularization influence on the Douyin platform. The published video collections lack personalization and differentiation; therefore, it is advisable to create science popularization short videos that highlight the hospital's specialized strengths.

Objective To provide insights for enhancing the dissemination capabilities of public health science popularization, this study analyzed the pathways of factors influencing users’ intention to adopt information from public health WeChat official accounts. Methods Utilizing the unified theory of acceptance and use of technology (UTAUT) as the theoretical framework, and incorporating methods such as expert consultations and literature reviews, the hypothetical theoretical model of factors influencing users’ intention to adopt information adoption from public health WeChat official accounts was constructed. Distribute online questionnaires to collect data, and the software Smart PLS 4 was employed to establish a structural equation model for path analysis of the influencing factors. Results 874 valid questionnaires were collected in total. The model explained 80.5% of the variance in users’ intention. Information usefulness (β = 0.154, P<0.001), information quality (β = 0.104, P= 0.030), facilitating conditions (β = 0.354, P<0.001), and source credibility (β = 0.352, P<0.001) had direct positive impacts on users’ intention. Additionally, source credibility (β = 0.018, P= 0.043), social influence (β = 0.020, P= 0.008), effort expectancy (β = 0.077, P<0.001), and facilitating conditions (β = 0.029, P= 0.020) also indirectly influenced users’ intention through the perceived usefulness of the information. Conclusions Information usefulness, quality, facilitating conditions, and source credibility can significantly and positively predict users’ intention to adopt information from public health WeChat official accounts. Moreover, source credibility, social influence, effort expectancy, and facilitating conditions can indirectly influence users’ intention through the mediating variable of information usefulness. This highlights the importance for operators of public health WeChat official accounts to focus on enhancing users’ adoption intention to promote the healthy development of the platform.

Objective To analyze the basic characteristics of elderly individuals in need of long-term care and to identify the potential factors influencing their choices of long-term care. This study aims to provide a theoretical basis for pre-optimizing care services. Methods Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were employed, with “Social Long-term Care” or “Informal Family Care” selected as the dependent variable, to modify the Andersen’s Behavior Model of Health Services Use. Logistic regression was used to investigate the influence of predisposing factors, enabling factors, and need factors on the choice of long-term care methods. Results Among elderly individuals aged 65 and above who are in need of long-term care, 848 (16.68%) chose social long-term care, while 4,236 (83.32%) chose family care. Of the 5,084 elderly participants, 87.43% were aged 80 and above, 64.10% were female, 79.85% were unmarried/widowed/divorced, 67.54% were from rural areas, 80.76% had medical insurance, and 69.81% suffered from chronic diseases. Elderly individuals with education levels above primary school, high income or retirement benefits, without medical insurance, unmarried/widowed/divorced, living in the eastern/northeastern or southern regions, urban areas, and communities providing daily-life care services were apt to choose social long-term care (P<0.05). Conclusions Family care is the primary mode of long-term care in China. The choice of long-term care is mainly influenced by factors such as education level, marital status, family size, and medical insurance. It is recommended to set communities as foundational platforms, integrating elderly life care and medical care resources to further enhance the positive role of families in long-term care.

The objective of achieving carbon neutrality is a significant strategic goal for China. Failure to effectively control carbon emission will lead to global warming, directly impacting the ecological environment and the health of the population. It is inevitable that the pharmaceutical and healthcare industries will contribute to a certain amount of carbon emissions as a consequence of the provision of healthcare services. This phenomenon has attracted widespread attention. This paper briefly analyzes the necessity of decarbonization in the healthcare sector, along with the current status of carbon emissions of health system and pharmaceutical industry. It aims to explore the strategies for enhancing the measurement of carbon emissions and facilitating collaborative efforts for carbon reduction through joint efforts.

Continuity of health services, an important feature of high-quality primary health care and a priority in people-centered health services frameworks, is commonly measured by indices and scales. This study combs the measuring tools of primary health care continuity at home and abroad along with its application based on the dimensions and methods of existing health care continuity. From the perspectives of these tools’ suitability, effectiveness and standardization, the study expects to offer insights for developing more practical measuring tools for continuity of primary health care in China.