ISSN 2097-4205 CN 31-2200/R
The concept of “Whole Health” originates from the definition of health articulated in the Constitution of the World Health Organization in 1948. Currently, the Whole Health framework encompasses five key dimensions: physical health, behavioral health, socioeconomic conditions, mental and spiritual health, and environmental health. Internationally, this concept has been applied across diverse areas, including vaccination programs, green prescription models, climate policy evaluation, digitalization and social interaction, and the assessment of community-based health care organizations. In future health economic evaluations, broader concepts of costs and outcomes need to be established, alongside the active adoption and integration of multiple analytical methods. Key approaches include cost-benefit analysis (CBA), extended incremental cost-effectiveness ratios (E-ICERs), wellbeing adjusted life years (WELLBY), and distributional cost-effectiveness analysis (DCEA). Greater emphasis should be placed on indicators that evaluate social value. Ultimately, comparative analyses are needed to assess the impact of different policies on the maximization of health outcomes, from the perspectives of the healthcare system, other public sectors, and society as a whole.
Upholding and strengthening Party overall leadership constitutes the fundamental guarantee for the high-quality development of public hospitals and serves as a principal requirement for comprehensively deepening healthcare reform. In the process of advancing these objectives, this consensus addresses three key components: deepening the reform of operational mechanisms, implementing the president responsibility system under the leadership of the Party committee, and integrating Party building with clinical and professional work. By providing a systematic analysis of implementation pathways, the consensus seeks to ensure the effective execution of healthcare reform at the primary level. This document provides a standardized reference for healthcare policymakers, hospital executives, and policy researchers to facilitate the transition from strategic directives to institutional practice.
Against the backdrop of escalating medical complexity and soaring patient volumes, traditional medical record management systems face significant challenges, including the intensified burden of clinical documentation, inefficiencies in quality control, and the underutilization of data value. By synthesizing global practices, this paper systematically analyzes the application value and inherent challenges of artificial intelligence (AI) across critical phases of medical record management. Core scenarios had been examined including AI-assisted documentation, intelligent quality control, the automated management of medical record face sheets, the construction of quality indicator systems, and unlocking the potential of medical record data. The integration of AI remarkably improves the quality and efficiency of medical record management, assists in establishing intelligent risk prevention systems, and advances data governance and real-world evidence (RWE) research. However, the widespread adoption of AI is still constrained by multidimensional hurdles, such as technical limitations, privacy concerns, and regulatory compliance risks. To facilitate a sustainable AI transition, this paper proposes a tiered governance framework. At the macro-level, an ecosystem integrating policies, regulations, and collaborative innovation must be established. At the meso-level, hospitals should drive institutional innovation through digital value transformation and technical integration. At the micro-level, operational workflows must be standardized, with an emphasis on physicians’ ultimate accountability as final signatories and the enhancement of competency-based training.
Data collaboration provides a key entry point for deepening the integration between basic medical insurance and commercial health insurance. However, addressing structural issues such as conflicting value objectives, overlapping responsibilities, and the absence of consultation and incentive mechanisms requires robust theoretical guidance. By analyzing driving mechanisms targeting demand gaps, product innovation, and regulatory resilience, this article proposes a policy framework focused on the dynamic balance of value objectives. This framework adopts incentive compatibility within collaborative structures as a starting point and establishes secure and efficient data circulation as a benchmark. Policy recommendations include refining rules for public value guidance and auditing, and integrating offline coordination with online data platforms. Furthermore, the article advocates for performance-linked mechanisms, clinical outcome data sharing, and comprehensive risk monitoring to facilitate the secure circulation of trusted data.
Objective The study aims to systematically analyze published invention patent applications related to medical large language models (LLMs) in China, and to explore their application status and developmental characteristics. Methods Patentometrics and patent content analysis were employed to construct a multi-level classification framework for application domains. Quantitative analysis and visualization were conducted on disclosure trends, patent assignees, geographical distribution, keyword frequency, and application domains. Results As of April 15, 2025, a total of 660 invention patent applications related to medical LLMs had been published in China. Related patents began to emerge in the second quarter of 2023 and peaked in the first quarter of 2025. Technology enterprises were the primary patent assignees, with patenting activities concentrated in Beijing, Shanghai, and Guangdong. Application scenarios were mainly clustered in two domains: medical service management and medical education and research. Key areas included clinical decision support, medical image processing, AI-aided consultation, and research assistance. Conversely, areas such as the healthcare industry, public health, and primary care remained relatively weak, indicating an imbalanced distribution of use cases. Conclusions The number of patent applications for medical LLMs in China exhibits a sharp increase, with technological innovation highly aligned with healthcare service needs. However, challenges stay in industrialization, adaptation for primary care, and system integration. It is urgent to strengthen data interoperability, expand application use cases, improve regulatory frameworks, and cultivate interdisciplinary talent to promote the sustainable development of medical LLMs.
Objective This study aims to explore the research frontiers and hotspots in the field of low-value care in oncology through bibliometrics and visualization analysis, and to provide a reference for future theoretical research and practice in this field. Methods English-language literature on low-value care in oncology from 2000 to 2025 was systematically retrieved from the PubMed database. CiteSpace was employed to conduct co-occurrence analysis, cluster analysis, timeline visualization, and burst detection. Subgroup analyses were performed for four major solid tumors: breast cancer, prostate cancer, thyroid cancer, and lung cancer. Results A total of 2 367 publications were included. Since 2012, the publication volume has surged, with the United States contributing a significantly higher volume than other countries. Co-occurrence analysis identified high-frequency keywords such as breast cancer, prostate cancer, drug interactions, thyroid cancer, geriatric assessment, lung cancer, and active surveillance. Cluster analysis identified ten major clusters, including polypharmacy, prostate cancer, breast cancer, and cancer screening. The timeline view demonstrated a shift from studies focused on individual low-value practices to those addressing comprehensive value-based governance. Burst detection highlighted potentially inappropriate medication (PIM) and drug interactions as current research frontiers. Keyword co-occurrence analyses of the four high-frequency cancer subgroups indicated that cancer screening and imaging examinations are the focal points of low-value care, while also revealing heterogeneity in practices across different tumor types. Conclusions Research on low-value care in oncology evolves rapidly, currently focusing on screening services for high-incidence solid tumors (e.g., breast and prostate cancer) and medication management for the seniors. Future research should expand value assessment across a broader range of cancer types, strengthen the translation of evidence into practice, promote the development of new technologies, and formulate value-based healthcare management strategies to advance precision and high-value oncology practices.
Objective This study aims to analyze the progress of China’s national volume-based drug procurement (NVBP), renewal, summarize the policy linkage between NVBP and renewal upon agreement expiry, and to provide suggestions for improving renewal policies. Methods Selection results and renewal procurement plans from NVBP Rounds 1-6 were compiled. Descriptive statistics were employed to examine NVBP winning prices, renewal winning prices, and the number of successful bidders. Results As of December 2024, agreements for 234 medicines had expired, of which 232 had completed the renewal process. Core renewal procurement consortia, led by Henan, Shanghai, Guangdong, and Jiangsu, emerged. Overall, renewal prices for the first 6 rounds of medicines continued to decline, with an average reduction of approximately 15%. However, 17.7% of medicines saw price rebounds during the renewal. The magnitude of price changes varied across consortia due to different methodologies. Price dispersion for the same product after renewal fluctuated: differentials widened in Round 1 but narrowed in Round 3 (P<0.05). Regionally, during the NVBP phase, winning prices in western China shifted from 1.0% higher than the national average initially to 0.4% below post-renewal. Conclusions Renewal procurement generally led to further price reductions following NVBP, although prices for some products rebounded. Different renewal mechanisms influenced price outcomes, and price disparities across products and regions remain notable. Future efforts should focus on evaluating the effects of different renewal methods, promoting transparency in renewal work, strengthening price fluctuation monitoring, improving inter-regional price coordination, and aligning renewal policies with the governance of medicines with the same generic name, dosage form, strength, and made by the same manufacturer.
Objective This study aims to investigate the factors influencing the total end-of-life (EOL) medical expenditure among older adults with disabilities. Methods This study selected older adults with disabilities who were hospitalized and died in Chengdu, Sichuan Province between January 1 and June 30, 2024. Hospitalization information within one year prior to death was collected to construct a quantile regression model. This model was utilized to analyze the impact of gender, age, care modality, and disability assessment levels on medical expenditure across various EOL cost levels. Results Institutional care significantly reduced the total EOL medical expenditure for older adults with disabilities. In contrast, seeking care at tertiary medical institutions, participation in the Urban Employee Basic Medical Insurance (UEBMI), and the number of hospitalization days significantly increased these expenditures. As quantile levels increased, the influence of care modality, tertiary institution utilization, and hospitalization days on the total EOL medical expenditure became more pronounced. Conclusions Care modality, hospital level, insurance type, and number of hospitalization days are the main influencing factors of the total medical expenditure among older adults with disabilities at the end of life. Efforts should be made to optimize the Long-term Care Insurance (LTCI) system and transform the care models for older adults with disabilities. It is essential to enhance the consolidation and integration of medical insurance schemes to promote the equitable and rational allocation of EOL medical resources. Furthermore, the hospice and palliative care service network should be improved to alleviate the economic and care burdens on this vulnerable population at the end of life.
Objective This study aims to identify the influencing factors of glycemic control among older adults aged 60 and above with diabetes in Shanghai and investigate the mediating role of nutritional status to inform personalized interventions. Methods A cross-sectional survey was conducted among permanent residents aged 60 and above in Shanghai. Data on demographics, lifestyle, care modalities, and health status were collected using the Shanghai Unified Elderly Care Needs Assessment (UECNA). Factors associated with glycemic control were analyzed via multivariate logistic regression, and the mediating effect was examined using PROCESS Model 4. Results A total of 36,101 participants were included in this study. Taking the normal glycemic group as a control, poor glycemic group was positively associated with overweight (OR = 1.21, 95%CI: 1.05 to 1.38), underweight (OR = 1.49, 95%CI: 1.20 to 1.85), adherence to a non-low-salt diet (OR = 1.09, 95%CI: 1.00 to 1.18), and poor living environment hygiene (OR = 1.53, 95%CI: 1.00 to 2.33). Other significant risk factors included malnutrition (OR = 4.37, 95%CI: 2.85 to 6.68), poor sleep quality (OR = 2.47, 95%CI: 1.95 to 3.12), impaired social function (OR = 1.68, 95%CI: 1.42 to 1.99), hearing impairment (OR = 1.20, 95%CI: 1.04 to 1.38), and severe ADL (activities of daily living) disability (OR = 1.18, 95%CI: 1.13 to 2.92). Conversely, advanced age (≥80 years) (OR = 0.77, 95%CI: 0.69 to 0.86), non-low-sugar or sugar-free diets (OR = 0.81, 95%CI: 0.75 to 0.87), and living alone (OR = 0.82, 95%CI: 0.72 to 0.94) were negatively associated with poor glycemic control. Furthermore, nutritional status mediated the relationship between two care models (informal and formal care) and glycemic control (R = 0.21, 95%CI: 0.19 to 0.23; R = 0.21, 95%CI: 0.19 to 0.23). This indicates that care models exert a significant indirect effect on glycemic control through the mediating variable of nutritional status, and the models are positively associated with the glycemic control. Conclusions Glycemic control in older adults with diabetes is closely associated with various factors, including demographic characteristics, dietary habits, care models, living conditions, and other health-related factors. Patients should prioritize personal hygiene and living environment hygiene, adhering to a low-salt diet, and maintaining functional independence and an appropriate BMI (body mass index). In parallel, strategic focus should be placed on complication prevention and the enhancement of caregivers’ nutritional nursing competencies to optimize glycemic outcomes.
Objective This study aims to examine family intergenerational support patterns by considering both their dimensions and directions, and to explore how these patterns relate to the seniors’ care preferences, with a view to promoting the allocation of elderly care resources and the development of family support policies. Methods Data from the China Longitudinal Aging Social Survey (CLASS) 2020 were used, including 7 840 samples. Latent Class Analysis (LCA) was employed to identify and classify family intergenerational support patterns. A multinomial logistic regression model was adopted to analyze the association between intergenerational support patterns and care preferences. Results The dominant family intergenerational support pattern in China was the “support type” (60.78%), followed by the “tight-knit type” (23.19%), while the “detached type” was least common (16.03%). Univariate analysis showed that intergenerational support patterns were significantly associated with care preferences (χ² = 84.51, P<0.001). Multinomial logistic regression results indicated that the “support type” was positively correlated with the preference for home-based care. The “tight-knit type” was positively associated with both community-based care (OR = 2.073, P<0.001) and institutional care (OR = 1.489, P = 0.002). The “detached type” had a positive but not statistically significant correlation with institutional care (OR=1.045, P = 0.823). Heterogeneity analysis revealed distinct patterns between urban and rural seniors, with males and the young-old participants showing stronger associations between the “tight-knit type” and care preferences compared to females and the oldest-old. Conclusions Intergenerational support patterns are correlated with the seniors’ care preferences. Insights from these patterns can further optimize the “support type” family model, imporve elderly care service supply strategies, and better meet the diverse needs of the aging population.
Objective This study attempts to analyze the current status of clinical trial registration for cell therapy of cardiovascular diseases in China and abroad, identify existing issues in China, and provide a reference for related research and policy formulation. Methods Clinical trial data on cell therapy for cardiovascular diseases were collected from six major registries: ChiCTR (China), Chinadrugtrials (China), ClinicalTrials.gov (USA), ISRCTN (UK), ANZCTR (Australia), and IRCT (Iran). The search spanned the period from the inception of these databases to December 31, 2024. Descriptive analysis was conducted on key variables including the number of registrations, registration types, trial designs, target disease/indications, trial phases, interventions, cell types, and recruitment status to compare the differences across the five countries. Results A total of 453 clinical trials on cell therapy for cardiovascular diseases were identified globally, including 42 trials conducted in China. In China, study types were predominantly interventional (92.86%); trial phases were concentrated in Phases I-II (69.04%); cell sources were relatively limited, mainly consisting of stem cells (36 trials); and the target diseases focused primarily on cardiovascular diseases such as peripheral vascular disease, heart failure, coronary atherosclerotic heart disease, and acute myocardial infarction. In contrast, clinical trials in the rest four countries exhibited a broader distribution across trial phases, ranging from Phase I to IV. Their cell sources included diverse types such as mesenchymal stem cells (MSCs) and induced pluripotent stem cells (iPSCs), with treatment targets involving a wider range of cardiovascular diseases such as myocardial infarction and heart failure. Conclusions Substantial differences exist in the registration of clinical trials for cell therapy of cardiovascular diseases between China and the other four countries. China should strengthen policy support, guidance, and supervision for clinical trial registration, establish and refine the management mechanism for registration, and align domestic practices with international standards further.
Objective The study aims to explore the differences in health technology assessment (HTA) and reimbursement policies for chimeric antigen receptor T-cell (CAR-T) therapy products across the EU5 countries (UK, France, Germany, Italy, and Spain), and to assess their implications for China. Methods Official documents from HTA agencies, reimbursement decision-making bodies, and payers in the EU5 countries were retrieved. Combined with data from the European Medicines Agency (EMA) and the UK Medicines and Healthcare Products Regulatory Agency (MHRA), HTA reports, reimbursement decisions, and pricing mechanisms for CAR-T therapy products approved in major European markets as of April 2025 were analyzed. Results As of April 2025, six CAR-T therapy products had been launched in these five countries. Differences existed in HTA timelines, conclusions, and reimbursement decisions. The UK had the shortest initial HTA cycle (average 9.2 months). Through the coverage with evidence development (CED) mechanism, the Cancer Drugs Fund (CDF) provided temporary reimbursement for products not meeting routine access criteria; however, the secondary assessment process, based on real-world evidence, had a longer cycle. France adopted an early patient access policy, resulting in a relatively short HTA cycle (average 10.7 months). Its HTA results directly determined the reimbursement rate and pricing strategy, also utilizing the CED mechanism. Secondary evaluations were more frequent in France, with shorter intervals between initial and follow-up evaluations. Italy, Spain, and Germany featured fragmented payment systems and discontinuous HTA and reimbursement decision processes. All three adopted the pay-for-performance (P4P) model but differed in reimbursement trigger points, outcome indicators, and payment mechanisms. Germany implemented a survival-based “refund-for-failure” model, while Italy and Spain adopted a staged payment model based on clinical results. Conclusions Both CED and P4P can effectively address the high value and high uncertainty of CAR-T cell therapy products. CED enables provisional reimbursement while conducting concurrent post-marketing studies, whereas P4P links routine access to efficacy milestones for risk-sharing; both rely heavily on real-world evidence. It is recommended to integrate CED and P4P into the medical insurance access framework to reduce decision-making uncertainty through dynamic evidence updates.
Objective The study attempts to explore preferences and influencing factors among caregivers of children aged 1-4 years regarding antiviral treatment for influenza. It also seeks to quantify the relative importance of treatment attributes and provide evidence to optimize pediatric influenza treatment regimens and improve medication adherence. Methods From May to June 2025, a face-to-face survey was conducted among 108 caregivers of children aged 1-4 years with influenza in seven cities, including Beijing, Shanghai, and Chongqing, using stratified convenience sampling. The questionnaire collected data on caregiver demographics, pediatric influenza treatment information, and included discrete choice experiment (DCE) choice sets. A conditional logit model was used to analyze preference weights for different antiviral regimens. Relative importance and marginal rates of substitution (MRS) were calculated to quantify trade-offs among attributes. Results A total of 108 questionnaires were collected, of which 106 were valid. Caregivers placed the highest importance on the overall incidence of drug-related adverse events, followed by dosing frequency, time to fever resolution, taste, time to viral shedding cessation, and dosage form. The conditional logit model indicated significant preferences for an adverse event rate of 6% (β = 1.49, P<0.001), single-dose regimen (β = 0.91, P<0.001), 2-day fever resolution (β = 0.55, P<0.001), and sweet taste (β = 0.49, P<0.001). Subgroup analysis showed that caregivers of children aged 1-2 years had stronger preferences for sweet taste, single-dose regimens, and lower adverse event rates than caregivers of children aged 3-4 years. Caregivers of children with a history of hospitalization favored regimens offering faster fever resolution and single-dose administration, but the difference is not statistically significant. Conclusions When selecting antiviral drugs for children aged 1-4 years with influenza, caregivers prioritize safety and convenience, particularly the incidence of adverse events and dosing frequency. These findings provide empirical evidence to inform the optimization of pediatric influenza treatment strategies, guide drug design, and support policy development. It is recommended that regulatory agencies incorporate patient preference evidence into pediatric drug evaluation and approval framework. Particular emphasis should be placed on convenience indicators, such as dosing frequency, to guide the R&D and approval of pediatric antiviral drugs that address clinical needs.
Objective This study aims to evaluate the progress and effectiveness of China’s graded diagnosis and treatment system, investigate existing problems, and explore countermeasures for system improvement. Methods Data from statistical yearbooks, government reports, and relevant literature were comprehensively collected and analyzed. The effectiveness of the system was assessed from four aspects: resource allocation, medical service provision, healthcare-seeking behavior, and vertical collaboration. Results As of 2023, regarding resource allocatation, China had 3.40 practicing (assistant) physicians and 4.00 registered nurses per 1 000 population, while the number of general practitioners reached 3.99 per 10 000 population. Despite these improvements in health workforce capacity, visits to primary healthcare institutions accounted for less than 65% of the total diagnosis and treatment volume and exhibited a declining trend. Correspondingly, fewer than 70% of patients in most regions chose primary healthcare institutions for two-week illness episodes. Nevertheless, the overall medical treatment rate within counties reached 94%, and the contract rate of family doctors exceeded 30%. In terms of vertical integration, more than 18 000 medical consortia had been established nationwide by the end of 2023, and a total of 30.321 7 million two-way referrals were recorded, including 15.559 7 million upward and 14.722 0 million downward referrals. Conclusions Since the implementation of the graded diagnosis and treatment policy, the overall availability of medical resources in China has increased, accompanied by improved downward allocation and a more balanced distribution of high-quality resources. However, challenges remain, such as the relatively low diagnosis and treatment volume and first-visit rate at primary healthcare institutions, as well as the need to enhance vertical collaboration. Future efforts should focus on strengthening the vertical integration of medical institutions and improving the supporting policy system.
Objective This research attempts to develop a Healthy Shanghai Index (HSI) evaluation system, systematically assess the implementation effectiveness of the Healthy Shanghai Action, and provide a scientific basis for urban health governance. Methods A literature review and policy analysis were conducted to establish the evaluation system framework and an initial pool of indicators. The Delphi method was then applied to design questionnaires and consult experts, with indicators screened based on their importance, feasibility, and the rationality of calculation methods. Indicator weights were determined using the Analytic Hierarchy Process (AHP) and the equal-weighting method. Indicator data from 2019 to 2024 were collected to calculate annual HSI scores. Results The HSI evaluation system comprised seven first-level indicators (health outcomes, healthy living, health services, health environment, health security, health industry and technological innovation, and health governance), 26 second-level indicators, and 65 third-level indicators. From 2019 to 2024, the composite HSI score increased from 58.93 to 83.68, representing a 42.00% growth. Scores across all dimensions exhibited an upward trend, with particularly pronounced growth in the health industry and technological innovation dimension (209.84%) and the health governance dimension (143.49%). Conclusions The HSI evaluation system is scientifically sound and applicable. It can effectively track progress and identify gaps in the development of the Healthy Shanghai Action and serves as a quantitative tool for assessing health governance performance in megacities. The index provides a reference for further advancing the Healthy Shanghai Action and for healthy city development nationwide.
Objective This study aims to construct a competency evaluation index system for personnel in mental health prevention and treatment institutions, and provide a reference for talent cultivation, supervision and assessment, and career development within the mental health workforce. Methods Expert panel discussions and the Delphi method were employed to construct the competency evaluation index system for personnel in mental health prevention and treatment institutions. The Analytic Hierarchy Process (AHP) was used to calculate the weights of the indicators. Results The questionnaire response rates for the two rounds were 100.00% and 90.63%, respectively, and the expert authority coefficient (Cr) was 0.91 in the first round and 0.90 in the second round. In the first round, the coordination coefficients for importance and feasibility were 0.12 and 0.16. In the second round, they were 0.15 and 0.21. The weights of the first-level indicators ranked as follows: professional skills (0.412), theoretical knowledge (0.293), comprehensive abilities (0.187), and personal attributes (0.108). Conclusions The experts consulted in this study demonstrated high authority and a high degree of consensus, while the degree of coordination was moderate. Overall, the constructed index system can, to some extent, provides a reference for competency evaluation of personnel in mental health prevention and treatment institutions.
Objective This study aims to identify key factors influencing energy consumption in public tertiary hospitals in Shanghai and to develop a benchmark evaluation method applicable for these hospitals. Methods Data from 30 public tertiary hospitals in Shanghai were analyzed. Pearson correlation analysis was first conducted to identify key influencing factors. A weighted hybrid model integrating Multiple Linear Regression (MLR) and Support Vector Regression (SVR) was then constructed, with the identified factors as independent variables and total energy consumption as the dependent variable. Finally, 10 general hospitals and 10 specialized hospitals were randomly selected for model validation, and the mean absolute error (MAE) was used to evaluate model accuracy. Results Hospital building area, number of employees, bed count, and outpatient and emergency visits were identified as the primary determinants of energy consumption in public tertiary hospitals in Shanghai. The MAE of the weighted hybrid model for energy consumption benchmark evaluation reached 850 tce (tons of coal equivalent), with prediction error rates ranging from -16.22% to 12.03%. Conclusions The benchmark evaluation method developed in this study demonstrates good predictive accuracy in assessing energy consumption levels in public tertiary hospitals in Shanghai. It provides a scientific basis and reference benchmark for energy-saving retrofitting and energy management.
Objective The paper aims to explore professional medical accompaniment services as a significant innovation in optimizing healthcare supply. Through topic modeling and sentiment analysis, this study attempts to reveal public demand characteristics and existing issues, hoping to provide a scientific basis and practical references for the standardized development of the industry. Method LDA (latent Dirichlet allocation) topic modeling and SnowNLP sentiment analysis were employed to conduct text mining and analysis on social media data from 2020 to 2025. Results Public primarily focused on four themes: basic service needs and medical support for the seniors (48.27%), optimization of medical treatment process and collaborative efficiency (23.14%), service professionalism and practitioner qualifications (16.71%), and technology integration and regional pilot exploration (11.88%). The sentiment tendency showed weakly positive (69.24% positive). Public demand was concentrated on enhancing healthcare efficiency for the seniors (topic proportion 48.27%). However, challenges remained in disordered service processes (24.13% negative sentiment) and a lack of practitioner qualifications. Conclusions Under the dual background of an aging society and the digital transformation of healthcare, professional medical accompaniment services should leverage pilot experiences in Shanghai and other regions. Future efforts should target establishing a professional licensing system, implementing ethical governance of technology, and constructing a hierarchical regulatory framework to protect patient rights and promote the standardized and high-quality development of the industry.
The global market for international medical services is experiencing rapid expansion. As a hub of high-quality medical resources in China, developing international medical services is essential for Shanghai to become an excellent global city and a premier medical center. Furthermore, it serves as a pivotal measure to promote high-level openness and high-quality development within its health service industry. This study reviews the policy evolution and current status of international medical services in Shanghai, analyzes its strategic advantages, and identifies critical challenges regarding marketing, branding, and management mechanisms. Systematic development strategies are proposed, including strengthening regional branding, deepening international cooperation, optimizing payment systems, and attracting global talents. These strategies aim to enhance the global competitiveness and influence of international medical services in Shanghai.
Objective This study aims to identify the factors influencing the healthcare-seeking behavior of young and middle-aged residents under the family doctor contract service (FDCS), providing a basis for guiding rational medical treatment-seeking among this population. Methods The Andersen Behavioral Model was employed to survey young and middle-aged residents across five cities and counties in Guangxi through non-probability sampling. Univariate analysis and multivariate logistic regression were utilized to analyze the determinants of their healthcare-seeking behavior. Results A total of 1,109 young and middle-aged residents were included in this study, revealing a contracting rate of 47.3%. Among the 525 residents who had signed with family doctors, 85.5% (n = 449) reported primary healthcare institutions (PHIs) as their first contact when seeking care for illness. Multivariate logistic regression indicated that residents who were farmers (OR = 1.799, P<0.05), were highly familiar with PHIs (OR = 2.587, P<0.05), understood the service offered by PHIs (OR = 2.038, P<0.05), and were aware of the FDCS (OR = 1.923, P<0.05) were significantly more likely to visit PHIs as their first contact. In contrast, individuals with a bachelor's degree or higher (OR = 0.609,P<0.05) and urban residents (OR = 0.447, P<0.05) were less likely to visit PHIs. Conclusions Rual young and middle-aged residents, those with lower educational levels, and individuals who are familiar with PHIs and their services, are more likely to prioritize primary care. Notably, the act of signing a family doctor contract emerges as a key factor influencing the healthcare-seeking behavior of this population. It is recommended to provide personalized FDCS for this demographic, alongside the efforts to enhance the clinical capabilities of PHIs, thereby advancing the hierarchical medical system.
Objective This study attempts to develop an AI-driven knowledge management method for use in pharmaceutical regulatory contexts, so as to enhance the visualization, retrieval, and applicability of regulatory knowledge. Method Based on pharmaceutical regulatory texts, a terminology extraction method leveraging a supervised fine-tuned large language model (LLM) was proposed, on the basis of which a structured knowledge graph (KG) for pharmaceutical regulation was constructed. Results Comparative evaluation identified Qwen2.5-7B-Instruct-sft as the optimal extraction model, with a precision of 0.363, recall of 0.838, and an F1-score of 0.506. Using a multi-feature fusion-based term filtering method (Domain + G-value), the precision, recall, and F1-score reached to 0.857, 0.823, and 0.840, respectively. The fine-tuned LLM initially extracted 63 672 candidate terms, which were refined to 7 359 following the filtering process. The resulting pharmaceutical regulatory KG comprises 9 719 entities and 33 216 relations. Conclusion This study constructs a pharmaceutical regulatory KG based on a domain terminology lexicon, which effectively organizes fragmented regulatory information into a structured and standardized knowledge system and enables the visualized representation of regulatory texts.
Objective This study aims to conduct a comparative analysis of research progress in maternal and child health (MCH) management in China and outside China, providing references for domestic research in this field. Methods Literature on MCH management was retrieved from CNKI and Web of Science. CiteSpace was used to analyze author collaboration networks, keyword co-occurrence and bursts, and topic clustering. Additionally, the large language model GPT-4o was utilized to identify, disambiguate, and compare research methods. Results Both Chinese and English publication volumes showed a three-stage growth pattern: entered a phase of increased activity post-2010, publication volumes surged in 2020, and subsequently fluctuation. Research methods in China primarily included literature reviews and SWOT analysis, while international studies mainly utilized logistic regression, cross-sectional studies, and qualitative interviews. Again, domestic research focused on internal management issues such as hospital management and informatization, whereas international research highlighted topics like maternal and infant safety and mental health. Chinese authors have made notable contributions in the fields of air pollution and maternal and infant health. The focus of domestic research has gradually shifted from early family planning to hospital management, medical technology application, and policy-related MCH management. International research continues to prioritize maternal and infant health and risk factors. Conclusions The evolution trends of MCH management research in China and outside China are similar, demonstrating a shift from focusing on subsistence to promoting development. However, significant differences exist in research hotspots. Future research is expected to transit from a single medical perspective to multi-disciplinary comprehensive development.
Through a comprehensive analysis of development strategies, methodological guidelines, and assessment manuals from representative global health technology assessment (HTA) agencies, this study explores the application of frontier digital technologies, represented by artificial intelligence (AI), in the HTA field to provide a reference for China’s digital HTA transition. Leading global HTA agencies have placed the digital transformation of HTA on their agendas, emphasizing the broad prospects of AI-empowered HTA in their recent strategic plans. These agencies have initiated the exploration of AI technologies, such as natural language processing, neural networks, and machine learning algorithms, to collect and analyze data in evidence synthesis and outcome evaluation. China should recognize the strategic significance of HTA digital transformation for modernizing the national health governance system and capacity, establish and improve corresponding organizational and institutional support mechanisms, and comprehensively advance the application and development of frontier digital technologies, represented by AI, in HTA.
This article examines the construction and application of “Mon Espace Santé”, the French digital health platform, alongside the Shared Medical Record (dossier médical partagé, DMP) to reveal their multifaceted impact on patient healthcare services. By reviewing the platform's developmental trajectory and technical architecture, the article evaluates its value across various healthcare stages, including primary care, referral coordination, inpatient management, and postoperative rehabilitation. This article summarizes the platform’s advantages in centralized data management, information interoperability, and patient-led health management. Additionally, the paper identifies challenges encountered during its implementation, such as technical adaptation, user adoption, and privacy protection, while providing corresponding solutions and developmental recommendations. The article indicates that the French experience provides a benchmark for global healthcare digitalization and offers significant implications for the development of medical informatics in China.
Drawing upon the practical experience of the United Kingdom and Ireland in refining their healthcare delivery systems, this paper analyzes specific interventions across four key domains: operational management, resource allocation, talent cultivation, and technological innovation. The United Kingdom and Ireland have continuously enhanced their healthcare systems by establishing professionalized hospital management teams, prioritizing budget management and resources allocation, and integrating Diagnosis-Related Group (DRG) with clinical pathways. Key drivers of efficiency include the advancement of medical information interoperability, the optimization of service workflows, and the fostering of high-caliber general practitioners, alongside the development of robust technological innovation support systems. Currently, China faces challenges such as fragmented resource distribution, suboptimal talent structures, and developmental gaps in training systems. Moreover, bottlenecks in digital infrastructure and data sharing, coupled with the low efficiency of translating medical research into clinical practice, remain significant barriers. Future strategies must prioritize professional workforce development, strengthen digital health infrastructure, and consolidate high-quality resources. By optimizing workflows and standardizing clinical training, China can build a more efficient healthcare delivery system, thereby substantively advancing the high-quality development of the national health sector.
