UNASSIGNED: This study aimed to evaluate the fairness and efficiency of health resource allocation (HRAE) in Chengdu-Chongqing Economic Circle after the new healthcare reform. This study also aimed to identify existing problems, providing empirical evidence for the government to formulate regional health plans scientifically and reasonably.
UNASSIGNED: The fairness of health resource allocation was analyzed using the Gini coefficient, Theil index, and agglomeration degree from population and geographical area perspectives. The three-stage data envelopment analysis and the Malmquist productivity index were used to analyze HRAE from static and dynamic perspectives.
UNASSIGNED: The Gini coefficient for population allocation in Chengdu-Chongqing Economic Circle was 0.066-0.283, and the Gini coefficient for geographical area allocation was 0.297-0.469. The contribution rate within a region was greater than that between regions, and health resources were mainly concentrated in economically developed core areas. The overall fairness of Chengdu Economic Circle was relatively better than that of Chongqing Economic Circle. Moreover, the adjusted mean technical efficiency was 0.806, indicating room for HRAE improvement in Chengdu-Chongqing Economic Circle. Stochastic Frontier Analysis found that different environmental variables have varying degrees of impact on HRAE. The adjusted mean total factor productivity change (Tfpch) was 1.027, indicating an overall upward trend in HRAE since the new healthcare reform. However, scale efficiency change (Sech) (0.997) limited the improvement of Tfpch.
UNASSIGNED: The fairness of health resources allocated by population was better than that allocated by geographical area. The unfairness of health resources mainly stemmed from intra-regional differences, with considerable health resources concentrated in core areas. Over the past 13 years, HRAE has improved but exhibited spatial heterogeneity and Sech-hindered productivity improvement. The study recommends strengthening regional cooperation and sharing to promote the integrated and high-quality development of the health and well-being in Chengdu-Chongqing Economic Circle.

BACKGROUND: Patient perception of quality of care is an essential component in evaluating healthcare delivery. This article reports data from primary health care (PHC) centers before Greece\'s most recent PHC reform. The study was undertaken to offer some baseline information about patient experience, support the decision-making processes taking place, and provide valuable input for future policy-making comparisons in Greece.
METHODS: The research was conducted across the 16 PHC centers of Epirus, a region of north-western Greece, from June to September 2017, with 532 patients rating the importance of different aspects of three main healthcare domains (clinical behavior, support and services, and organization of care) of PHC provision. The Greek version of the European Task Force on Patient Evaluations of General Practice (EUROPEP) questionnaire was implemented for research purposes. Univariate comparisons were performed for patients with and without chronic disease, using Pearson\'s χ2 test for categorical data.
RESULTS: Study findings support that the organization of care domain is of highest importance and priority, with clinical behavior and support and services following closely. Among recruited patients, on average, only 2.1% of patients with a chronic disease were satisfied (rated 4 or 5 on the Likert scale) with the organization of care aspects under consideration, compared to 18.4% of patients without a chronic disease. Furthermore, only 4% of patients with a chronic disease were satisfied with the aspects examined in the clinical behavior domain, compared to 27% of patients without a chronic disease. Finally, 18% of sampled patients with a chronic disease reported being satisfied with the quality of support and services provided, compared to 38% of patients without a chronic disease.
CONCLUSIONS: It is necessary to back up available past information to afterwards estimate reform imprinting on expectations and perceptions. The items and aspects of EUROPEP, in line with the new tasks of the personal doctor within the PHC system that patients perceive as most essential, can be used to prioritize quality improvement activities to strengthen PHC delivery in Greece. Communication skills, practices, and behavioral change skills seem to need more attention for an efficient PHC model.

This Viewpoint discusses Dual Eligible Special Needs Plans supplemental benefits, identifies challenges of benefit coordination and accessibility, and highlights policy reforms to remedy these problems.

UNASSIGNED: The second phase of the health sector reform, called the Health Sector Evolution Plan (HSEP), has been implemented in Iran since 2014, aims to improve the equity and quality of health services. In the present study, we aimed to measure the trend of hospitalization and the crude intrahospital mortality rate from 1 year before the HSEP implementation (2013) to 5 years after the HSEP implementation (2018) in public hospitals compared with profit, nonprofit, and charity hospitals, which are affiliated with the Isfahan University of Medical Sciences (MUI).
UNASSIGNED: In a prospective, cross-sectional study, the data related to the frequency of hospitalized patients and intrahospital mortality during the time of hospitalization were collected through census sampling from 39 public hospitals as the exposed hospitals and 20 profit, nonprofit, and charity hospitals as the control hospitals.
UNASSIGNED: After HSEP implementation, the frequency of hospitalization increased in public hospitals by 50.45% compared with the previous period. Although the crude intrahospital mortality rate increased from 12.61 to 12.93 per 1000 hospitalized patients (an increase of 2.54%) in public hospitals, the raise was not significant (P value = 0.348). The frequency of hospitalization increased in Social Security Organization\'s (SSO) hospitals as well as charity hospitals. However, the percent of decrease in the intrahospital mortality rates were -42.96%, -34.76%, and -18.47% in the private, charity, and SSO hospitals, respectively, but was not significant (P value > 0.05).
UNASSIGNED: The crude intrahospital mortality rates in public hospitals affiliated with MUI did not change significantly after the implementation of the HSEP.

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OBJECTIVE: The aim of the article is to analyze the current state of functioning of the medical information space of Ukraine in order to formulate scientifically sound proposals aimed at improving the implementation of medical reform.
METHODS: The study is based on the analysis of literary sources of Ukrainian and international scientists, Ukrainian and foreign legislation and judicial practice. The article uses general theoretical and special methods of scientific cognition: theoretical analysis, systemic and structural, analysis and synthesis, sociological and statistical, logical and semantic, comparative and legal, method of ascent from the abstract to the concrete, forecasting and generalization.
RESULTS: One of the key categories of the reform of the Ukrainian national medical sphere - the unified medical information space and its constituent elements - is studied. The electronic health care system, which stores medical data about patients in a single place and ensures their exchange between medical institutions, is analyzed. Emphasis is placed on the possibilities of using telemedicine and artificial intelligence, which play a key role in the development of the unified medical information space in accordance with global trends. The importance of legislative provision of efficiency and safety of the unified medical space is emphasized. It is about regulating the protection of personal data, establishing technical standards and requirements for medical information systems, ensuring confidentiality, integrity and data availability of the unified medical information space.
CONCLUSIONS: Conclusions are drawn about the importance of proper functioning of each of the elements of the unified medical information space, both individually and in conjunction with each other. The authors\' vision of improving the existing system of the unified medical information space is presented.

Health-care technology is central to boosting the productivity and quality of health-care systems. In many sub-Saharan African countries, however, medical device management systems are weak or absent. The aim of this article is to illustrate, using a case study, how policy reforms can help ensure policy on health-care technology is translated into everyday practice and how an integrated systems approach can enhance the operation of medical device management. Between 2011 and 2023, a plan to improve medical device management systems in the United Republic of Tanzania was developed and implemented through Swiss-Tanzanian cooperation within the Health Promotion and System Strengthening Project. The availability of biomedical engineers was increased through new training courses and the creation of permanent positions in government. Moreover, additional district and regional maintenance and repair workshops were built, and a National Centre for Calibration and Training was established to ensure the correct functioning of medical devices. The introduction of an electronic medical device management system provided health facilities and the health ministry with data on the operational status of medical devices and the need for repairs and spare parts. Every level of government was encouraged to allocate more human and financial resources to medical device management. Following this decade-long effort, the percentage of functioning equipment increased substantially, and costs were reduced by repairing rather than replacing equipment. The project also demonstrated the value of an integrated, system-strengthening approach that considered personnel, maintenance and repair facilities, documentation and management, and government policy and budgeting.
Les technologies jouent un rôle crucial dans le renforcement de la productivité et de la qualité des systèmes de santé. Pourtant, dans de nombreux pays d\'Afrique subsaharienne, les systèmes de gestion des dispositifs médicaux sont limités, voire inexistants. Cet article a pour but d\'illustrer, au moyen d\'une étude de cas, comment les réformes peuvent contribuer à faire en sorte que les politiques en matière de technologies sanitaires soient appliquées au quotidien, et comment une approche intégrée peut améliorer la gestion des dispositifs médicaux. Entre 2011 et 2023, un plan visant à développer les systèmes de gestion des dispositifs médicaux en République-Unie de Tanzanie a été défini et mis en œuvre en collaboration avec la Suisse, dans le cadre du Projet de Promotion et de Renforcement du Système de Santé. De nouvelles formations et la création de postes permanents au sein du gouvernement ont permis d\'accroître la disponibilité des ingénieurs biomédicaux. En outre, des ateliers supplémentaires d\'entretien et de réparation ont été construits dans différentes régions et districts, tandis qu\'un Centre National d\'Étalonnage et de Formation a ouvert ses portes pour assurer le bon fonctionnement des dispositifs médicaux. L\'introduction d\'un système électronique de gestion des dispositifs médicaux a fourni aux établissements de soins de santé et au Ministère de la Santé des données concernant le statut opérationnel de ces dispositifs, ainsi que les réparations et pièces détachées requises. Chaque niveau de pouvoir a été encouragé à attribuer davantage de ressources humaines et financières à la gestion des dispositifs médicaux. Au terme de dix ans d\'efforts, le pourcentage d\'équipements en état de marche a considérablement augmenté et les coûts ont diminué grâce au recours à la réparation plutôt qu\'au remplacement. Le projet a également démontré l\'importance d\'une approche intégrée, qui consiste à renforcer le système en tenant compte du personnel, de l\'entretien et des installations de réparation, de la documentation et de la gestion, mais aussi de la politique gouvernementale et du budget.
La tecnología aplicada a la atención sanitaria es fundamental para impulsar la productividad y la calidad de los sistemas sanitarios. Sin embargo, en muchos países del África subsahariana los sistemas de gestión de los productos sanitarios son deficientes o inexistentes. El objetivo de este artículo es ilustrar, mediante un estudio de caso, cómo las reformas políticas pueden ayudar a garantizar que la política sobre tecnología de la atención sanitaria se convierta en una práctica cotidiana y cómo un enfoque de sistemas integrados puede mejorar el funcionamiento de la gestión de los productos sanitarios. Entre 2011 y 2023, se elaboró un plan para mejorar los sistemas de gestión de los productos sanitarios en la República Unida de Tanzania, que se implementó a través de la cooperación suizo-tanzana en el marco del Proyecto de Promoción de la Salud y Fortalecimiento del Sistema. Se aumentó la disponibilidad de ingenieros biomédicos mediante nuevos cursos de formación y la creación de puestos permanentes en el gobierno. Además, se construyeron talleres de mantenimiento y reparación adicionales de distrito y regionales, y se estableció un Centro Nacional de Calibración y Formación para garantizar el correcto funcionamiento de los productos sanitarios. La introducción de un sistema electrónico de gestión de productos sanitarios proporcionó a los centros sanitarios y al Ministerio de Sanidad datos sobre el estado operativo de los productos sanitarios y la necesidad de reparaciones y piezas de repuesto. Se animó a todos los niveles de gobierno a asignar más recursos humanos y financieros a la gestión de los productos sanitarios. Tras este esfuerzo de una década, el porcentaje de equipos en funcionamiento aumentó notablemente y los costes se redujeron al reparar los equipos en lugar de sustituirlos. El proyecto también demostró el valor de un enfoque integrado de refuerzo del sistema que tenía en cuenta el personal, las instalaciones de mantenimiento y reparación, la documentación y la gestión, y la política y los presupuestos gubernamentales.
تعد تكنولوجيا الرعاية الصحية محورًا رئيسيًا للارتقاء بإنتاجية نظم الرعاية الصحية وجودتها. ومع ذلك، فإن نظم إدارة الأجهزة الطبية في العديد من الدول الأفريقية جنوب الصحراء الكبرى، تعد ضعيفة أو منعدمة. الهدف من هذه المقالة هو استخدام دراسة حالة لتوضيح كيف يمكن لإصلاحات السياسة أن تساعد في التحقق من ترجمة سياسة تكنولوجيا الرعاية الصحية إلى ممارسة يومية، وكيف يمكن لأسلوب النظم المتكاملة أن يدعم تشغيل إدارة الأجهزة الطبية. في الفترة بين عامي 2011 و2023، تم وضع خطة لتحسين نظم إدارة الأجهزة الطبية وتنفيذها في جمهورية تنزانيا المتحدة، وذلك من خلال التعاون السويسري التنزاني في إطار مشروع للارتقاء بالصحة ودعم النظام. زاد توافر مهندسي الطب الحيوي من خلال الدورات التدريبية الجديدة، وكذلك استحداث مناصب دائمة في الحكومة. وفضلاً عن ذلك، تم إنشاء ورش صيانة وإصلاح إضافية على مستوى المناطق والأقاليم، وتأسيس مركز وطني للمعايرة والتدريب، وذلك للتحقق من الأداء الصحيح للأجهزة الطبية. إن طرح نظام إلكتروني لإدارة الأجهزة الطبية أدى إلى إمداد المرافق الصحية ووزارة الصحة ببيانات عن حالة تشغيل الأجهزة الطبية، والحاجة إلى الإصلاحات وقطع الغيار. تم تشجيع كل قطاع حكومي على تخصيص المزيد من الموارد البشرية والمالية لإدارة الأجهزة الطبية. وبعد هذا الجهد الذي استمر لمدة عقد من الزمان، زادت النسبة المئوية للمعدات قيد التشغيل بشكل كبير، وانخفضت التكاليف عن طريق إصلاح المعدات بدلاً من استبدالها. وأظهر المشروع أيضًا قيمة الأسلوب المتكامل لدعم النظام، والذي وضع في اعتباره الموظفين، ومرافق الصيانة والإصلاح، والتوثيق والإدارة، والسياسة الحكومية والميزانية.
卫生保健技术对于提高卫生保健系统的生产率和质量至关重要。然而，在撒哈拉沙漠以南的许多非洲国家，医疗器械管理系统仍比较薄弱或根本不存在。本文旨在通过案例研究说明政策改革可如何帮助确保将医疗保健技术相关政策落实到日常实践中，以及综合系统方法可如何改进医疗器械管理系统的运行。2011 年至 2023 年期间，基于瑞士与坦桑尼亚就健康促进和系统强化项目开展的合作，该国制定并实施了一项改善坦桑尼亚联合共和国医疗器械管理系统的计划。通过开设新的培训课程和在政府中设立永久职位，涌现了越来越多的生物医学工程师。此外，还建造了更多的地区和区域维护和维修车间，并建立了一个国家校准和培训中心，以确保医疗器械的正常运行。电子医疗器械管理系统的引入为医疗机构和卫生部提供了与医疗器械运行状况以及维修和备件需求相关的数据。鼓励各级政府加大在医疗器械管理方面的人力和财力投入。经过长达十年的努力，正常运行设备的比例大幅增加，且设备成本也因进行维修而不是直接更换而有所降低。该项目还证明了将人员培养、维护和维修机构、文件编制和管理以及政府政策和预算情况纳入考虑范畴的综合系统强化方法的重要性。.
Медицинские технологии играют центральную роль в повышении производительности и качества систем здравоохранения. Однако во многих странах Африки к югу от Сахары системы управления медицинскими изделиями слабы или вовсе отсутствуют. Цель данной статьи заключается в том, чтобы на конкретном примере показать, как политические реформы могут помочь обеспечить воплощение политики в области медицинских технологий в повседневную практику и как интегрированный системный подход может усовершенствовать процесс управления медицинскими изделиями. В период с 2011 по 2023 год в рамках швейцарско-танзанийского сотрудничества в ходе проекта по развитию здравоохранения и укреплению систем был разработан и реализован план по совершенствованию систем управления медицинским оборудованием в Объединенной Республике Танзания. Благодаря новым учебным курсам и созданию постоянных должностей в правительстве повысился уровень подготовки инженеров по медицинскому оборудованию. Кроме того, были построены дополнительные окружные и региональные мастерские по техническому обслуживанию и ремонту, а также создан Национальный центр калибровки и обучения для обеспечения правильного функционирования медицинских изделий. Внедрение электронной системы управления медицинскими изделиями позволило медицинским учреждениям и Министерству здравоохранения получать данные об эксплуатационном состоянии медицинских изделий и потребности в ремонте и запасных частях. Правительствам всех уровней было рекомендовано выделять больше человеческих и финансовых ресурсов на управление медицинскими изделиями. После проведения работ на протяжении десяти лет процент исправного оборудования значительно увеличился, а расходы сократились за счет ремонта, а не замены оборудования. В рамках проекта также была продемонстрирована ценность комплексного подхода к укреплению системы, который охватывал персонал, техническое обслуживание и ремонт, документацию и управление, а также государственную политику и бюджетное планирование.

BACKGROUND: Many existing healthcare ranking systems are notably intricate. The standards for peer review and evaluation often differ across specialties, leading to contradictory results among various ranking systems. There is a significant need for a comprehensible and consistent mode of specialty assessment.
METHODS: This quantitative study aimed to assess the influence of clinical specialties on the regional distribution of patient origins based on 10,097,795 outpatient records of a large comprehensive hospital in South China. We proposed the patient regional index (PRI), a novel metric to quantify the regional influence of hospital specialties, using the principle of representative points of a statistical distribution. Additionally, a two-dimensional measure was constructed to gauge the significance of hospital specialties by integrating the PRI and outpatient volume.
RESULTS: We calculated the PRI for each of the 16 specialties of interest over eight consecutive years. The longitudinal changes in the PRI accurately captured the impact of the 2017 Chinese healthcare reforms and the 2020 COVID-19 pandemic on hospital specialties. At last, the two-dimensional assessment model we devised effectively illustrates the distinct characteristics across hospital specialties.
CONCLUSIONS: We propose a novel, straightforward, and interpretable index for quantifying the influence of hospital specialties. This index, built on outpatient data, requires only the patients\' origin, thereby facilitating its widespread adoption and comparison across specialties of varying backgrounds. This data-driven method offers a patient-centric view of specialty influence, diverging from the traditional reliance on expert opinions. As such, it serves as a valuable augmentation to existing ranking systems.

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