With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery s...With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery system,a medical consortium plays an important role in integrating public hospitals and primary care facilities.The first medical consortium policy issued after the COVID-19 pandemic apparently placed hope on accelerating the implementation of a medical consortium and tiered health-care delivery system.This paper illustrates the possible future pathway of China’s medical consortium through retrospection of the 10-year process,changes of the series of policies,and characteristics of the policy issued in 2020.We considered that a fully integrated medical consortium would be a major phenomenon in China's medical industry,which would lead to the formation of a dualistic care pattern in China.展开更多
In order to secure the massive heterogeneous medical data for the complex scenarios and improve the information sharing efficiency in healthcare system,a distributed medical data ledger model(DMDL)is proposed in this ...In order to secure the massive heterogeneous medical data for the complex scenarios and improve the information sharing efficiency in healthcare system,a distributed medical data ledger model(DMDL)is proposed in this paper.This DMDL model has adopted the blockchain technology including the function decoupling,the distributed consensus,smart contract as well as multi-channel communication structure of consortium blockchain.The DMDL model not only has high adaptability,but also meets the requirements of the medical treatment processes which generally involve multientities,highly private information and secure transaction.The steps for processing the medical data are also introduced.Additionally,the methods for the definition and application of the DMDL model are presented for three specific medical scenarios,i.e.,the management of the heterogeneous data,copyright protection for medical data and the secure utilization of sensitive data.The advantage of the proposed DMDL model is demonstrated by comparing with the models which are being currently adopted in healthcare system.展开更多
医联体作为推进分级诊疗制度的实践载体,对于平衡医疗资源、提升医疗服务效率具有重大意义。本文基于以北京协和医院为核心的“1+5+1”医联体合作模式,借助疾病诊断相关分组(diagnosis related group,DRG)指标,分析了医联体建设历程中...医联体作为推进分级诊疗制度的实践载体,对于平衡医疗资源、提升医疗服务效率具有重大意义。本文基于以北京协和医院为核心的“1+5+1”医联体合作模式,借助疾病诊断相关分组(diagnosis related group,DRG)指标,分析了医联体建设历程中患者、成员医院、牵头医院的获益情况,以期为构建医联体评价体系提供参考。医联体建设不仅提高了患者对优质医疗资源的可及性,同时提升了成员医院的诊疗水平,并为牵头医院调整病种结构、提升学科建设水平提供了空间。DRG作为医保支付方式改革的核心,通过病例组合指数和DRG组数等指标,为病例管理和病种结构优化提供了客观、可量化的数据支撑,有效引导医疗资源合理分配和医联体内病种/术种调整。综合利用DRG评价指标,可构建一套多维度的医联体建设评价体系,为医联体深度合作提供明确的指导方向,从而整体推动医联体良性可持续发展,实现多方共赢。展开更多
基金supported by the National Natural Sciences Foundation of China(No.71874058 and No.72174068).
文摘With the deepening of China’s health-care reform,an integrated delivery system has gradually emerged with the function of improving the efficiency of the health-care delivery system.For China’s integrated delivery system,a medical consortium plays an important role in integrating public hospitals and primary care facilities.The first medical consortium policy issued after the COVID-19 pandemic apparently placed hope on accelerating the implementation of a medical consortium and tiered health-care delivery system.This paper illustrates the possible future pathway of China’s medical consortium through retrospection of the 10-year process,changes of the series of policies,and characteristics of the policy issued in 2020.We considered that a fully integrated medical consortium would be a major phenomenon in China's medical industry,which would lead to the formation of a dualistic care pattern in China.
文摘In order to secure the massive heterogeneous medical data for the complex scenarios and improve the information sharing efficiency in healthcare system,a distributed medical data ledger model(DMDL)is proposed in this paper.This DMDL model has adopted the blockchain technology including the function decoupling,the distributed consensus,smart contract as well as multi-channel communication structure of consortium blockchain.The DMDL model not only has high adaptability,but also meets the requirements of the medical treatment processes which generally involve multientities,highly private information and secure transaction.The steps for processing the medical data are also introduced.Additionally,the methods for the definition and application of the DMDL model are presented for three specific medical scenarios,i.e.,the management of the heterogeneous data,copyright protection for medical data and the secure utilization of sensitive data.The advantage of the proposed DMDL model is demonstrated by comparing with the models which are being currently adopted in healthcare system.
文摘医联体作为推进分级诊疗制度的实践载体,对于平衡医疗资源、提升医疗服务效率具有重大意义。本文基于以北京协和医院为核心的“1+5+1”医联体合作模式,借助疾病诊断相关分组(diagnosis related group,DRG)指标,分析了医联体建设历程中患者、成员医院、牵头医院的获益情况,以期为构建医联体评价体系提供参考。医联体建设不仅提高了患者对优质医疗资源的可及性,同时提升了成员医院的诊疗水平,并为牵头医院调整病种结构、提升学科建设水平提供了空间。DRG作为医保支付方式改革的核心,通过病例组合指数和DRG组数等指标,为病例管理和病种结构优化提供了客观、可量化的数据支撑,有效引导医疗资源合理分配和医联体内病种/术种调整。综合利用DRG评价指标,可构建一套多维度的医联体建设评价体系,为医联体深度合作提供明确的指导方向,从而整体推动医联体良性可持续发展,实现多方共赢。
