Practical Insights from Case Studies of Community Medical and Nursing Integrated Services in Britain, the United States, and the Netherlands

The Chinese government has issued a series of policies to promote the development of community medical and nursing integrated services.Since the development of these services involves the transition of medical and health services from public spaces to private spaces,the home has become a critical factor in service provision.It is therefore essential to consider the concept of home and the sense of at-homeness in the research and practice of community medical and nursing integrated services in China to avoid prioritizing"others"over"self-being."Through an analysis of three cases from Britain,the United States,and the Netherlands,this article demonstrates that a sense of control and social connection are key components of the elderly’s sense of at-homeness.Community medical and nursing integrated services should not only enable the elderly to maintain their sense of self-control but also assist in building a supportive social network.

Research on the Construction Status of the Beijing-Tianjin-Hebei Medical Talent Community and the Countermeasures for Its Realization

In April 2015,the Political Bureau of the CPC Central Committee adopted the“Outline of the Plan for the Coordinated Development of Beijing,Tianjin,and Hebei.”In July 2017,the“Plan for the Integrated Development of Beijing,Tianjin,and Hebei Talents(2017–2030),”jointly prepared by the leading groups of the three regions,was officially released.The core of the coordinated development of these three regions is the orderly removal of non-capital functions from Beijing.Talents,especially medical talents,are integral to this transition.The construction of a medical talent community across these three regions promotes the further development of a healthier China,meets the growing needs of the people for a better life,and embodies the concept of putting people first.This paper begins by examining the current situation of the construction of the Beijing-Tianjin-Hebei medical talent community,reviewing the progress made,analyzing existing problems,and proposing targeted countermeasures and suggestions.

Health performance assessment modeling and its application to compact medical communities in China

Some regions in China have already implemented capitation payment or capitation budget management for medical insurance funds.However,there remains a shortage of adequate tools and methodologies to accurately quantify differences in population health risks.Therefore,this paper constructs a health performance assessment model that comprises four steps.The first step is to categorize all participants into health risk groups based on whether they have contracted with a family doctor,their age,sex,and the type of consultation.The second step is to categorize health risk groups based on differences in healthcare resource utilization.The third step is to analyze health performance by examining healthcare resource utilization year over year.The fourth step is to apply the assessment results to assist local finance bureaus and medical insurance bureaus in developing incentive schemes.According to cost weights,the health risk groups are split into six classes:insured residents without health care visits,healthy insured person,slightly ill insured patients,ill insured patients,more seriously disease patients,and severely ill insured patients.We evaluate one compact medical community's health performance by examining changes in the proportion of resource usage group size and expense.From 2019 to 2021,both the proportion of patients with severe and ultra‐severe diseases and the proportion of costs in the sample increased,according to changes in resource utilization levels.This result indicates that the population's overall health has not improved and that the compact medical community is still primarily focused on treating diseases,with poor implementation of health maintenance measures and minimal improvement in health performance.

我国县域医疗共同体研究的可视化分析

目的通过对县域医疗共同体(以下简称“医共体”)已有研究的可视化分析,为后续县域医共体相关理论研究和建设实践提供科学支撑。方法用CiteSpace软件对我国县域医共体研究进行可视化分析,利用知识图谱了解县域医共体研究发展状况、热点问题和趋势走向。结果对符合检索条件的505篇研究文献进行文本分析后发现,文献数量呈稳步增长趋势,学者之间以及机构之间的相互联系不够紧密,“医共体”“分级诊疗”“紧密型”“县域”“县级医院”等是县域医共体研究的高频关键词,“医防融合”可能成为今后的研究热点,文献研究随县域医共体建设的不断深入呈现出不同的阶段性特征。结论我国县域医共体研究呈现快速发展态势,县域医共体研究应加强区域化多元合作,注重与医防融合政策的衔接。

Homogeneous Management and Application of Appropriate Technology for TCM Care in County Medical Communities

Objective:Explore the homogeneous management of appropri-ate technology for Traditional Chinese Medicine(TCM)care based on the county medical community platform.Methods:The hospital has formed a county medical community since 2020,based on which the platform develops homogeneous management of appropriate technologies for TCM nursing,establishes a medical training center,a remote consultation center and a TCM nursing quality control center,strengthens the construction of TCM nursing specialties,integrates TCM with public health and consolidates information support.The“321”model was developed,with January 2021 to December 2021 as the post-implementation period and January 2020 to December 2020 as the pre-implementation period,to compare the application of TCM nursing techniques before and after the implementation.Results:After the implementation of homogeneous management of TCM nursing techniques in the medical community units,the TCM nursing competence of primary care staff,patient compliance and satisfaction were significantly improved.Conclusion:The implementation of homogeneous management of TCM nursing techniques in the medical community units can enhance the TCM service capacity of primary care staff and improve the“sense of access to care”of patients.

Identification of ChatGPT answers and physician answers in the online medical community

ChatGPT changes the way of knowledge production and information space structure of human society.In the healthcare industry,ChatGPT's powerful question-and-answer capability will drive its application in automated question answering in online healthcare communities.However,because ChatGPT answers are limited by factors such as the quality of data sets,their authority and accuracy cannot be guaranteed,and they are prone to misdiagnosis and damage to life and health.Therefore,the identification of ChatGPT answers in online medical communities with physician answers is crucial.In this paper,we collected medical question-answering data generated by the Haodafu platform and ChatGPT,respectively,constructed feature vectors from semantic features,syntactic features,and the fusion of both,and combined different feature vectors with XGBoost models to construct BERT-XGBoost,POS-XGBoost and Merge-XGBoost models for identifying ChatGPT answers and physician answers in online medical communities.The three models achieved accuracy rates of 0.960,0.968,and 0.986,respectively.The difference in performance between the three models reflects the degrees of variation in different features of ChatGPT answers versus physician answers.The results indicate that the differences between ChatGPT and physicians in syntactic features,i.e.,linguistic expression habits,are greater than their differences in semantic features,i.e.,specific content suggestions.