Health Care Science最新文献

Remarkable progress has been made in infection prevention and control (IPC) in many countries, but some gaps emerged in the context of the coronavirus disease 2019 (COVID-19) pandemic. Core capabilities such as standard clinical precautions and tracing the source of infection were the focus of IPC in medical institutions during the pandemic. Therefore, the core competences of IPC professionals during the pandemic, and how these contributed to successful prevention and control of the epidemic, should be studied. To investigate, using a systematic review and cluster analysis, fundamental improvements in the competences of infection control and prevention professionals that may be emphasized in light of the COVID-19 pandemic. We searched the PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, and CBM databases for original articles exploring core competencies of IPC professionals during the COVID-19 pandemic (from January 1, 2020 to February 7, 2023). Weiciyun software was used for data extraction and the Donohue formula was followed to distinguish high-frequency technical terms. Cluster analysis was performed using the within-group linkage method and squared Euclidean distance as the metric to determine the priority competencies for development. We identified 46 studies with 29 high-frequency technical terms. The most common term was “infection prevention and control training” (184 times, 17.3%), followed by “hand hygiene” (172 times, 16.2%). “Infection prevention and control in clinical practice” was the most-reported core competency (367 times, 34.5%), followed by “microbiology and surveillance” (292 times, 27.5%). Cluster analysis showed two key areas of competence: Category 1 (program management and leadership, patient safety and occupational health, education and microbiology and surveillance) and Category 2 (IPC in clinical practice). During the COVID-19 pandemic, IPC program management and leadership, microbiology and surveillance, education, patient safety, and occupational health were the most important focus of development and should be given due consideration by IPC professionals.

The events of the coronavirus disease 2019 pandemic have emphasized the indispensable role of doctors in promoting public health and well-being [1]. Although medicine and health care are being transformed by technological advances, such as artificial intelligence, big data, genomics, precision medicine, and telemedicine, doctors continue to play a critical role in providing health care. However, a key challenge today is the lack of recognition of doctors by society at large. Hospitals, patients, and public opinion all play a role in evaluating doctors. However, this study will focus on hospitals’ doctor evaluations.

At the macro level, doctor evaluations influence their value orientation, research directions, and resource allocation. Assessing doctors also impacts their research and behavior at the micro level, as it is a crucial element in their development. It is challenging to build a suitable doctor evaluation system; therefore, doctor evaluations are a common research subject among the global academic community. Various stakeholders have paid attention to this issue, which is still being debated in the literature.

The global academic community considers an evaluation system based purely on merit and performance to be the most suitable for doctor evaluations [2, 3] with a primary focus on clinical care and scientific research. In addition, doctors are expected to also teach when working at large academic medical centers. Among these three sections, the index for scientific research evaluation accounts for the highest proportion [4]. A survey of 170 universities randomly selected from the CWTS Leiden Ranking revealed that among the 92 universities offering a School of Biomedical Sciences and promoting the accessibility of evaluation criteria, the mentioned policies included peer-reviewed publications, funding, national or international reputations, author order, and journal impact factors in 95%, 67%, 48%, 37%, and 28% of cases, respectively. Furthermore, most institutions clearly indicate their expectations for the minimum number of papers to be published annually [5]. Alawi et al. have shown that in many countries, the evaluation of medical professionals is primarily based on their ability to publish papers and secure research funding [6]. The recognition of these achievements under the existing evaluation system has a significant impact on key evaluation factors, such as performance, publications, work roles, and research awards.

Doctors in Chinese hospitals are assessed primarily on the inclusion of their scientific publications in the Science Citation Index (SCI). The number of published papers indexed in SCI significantly influences their professional ranking and likelihood of promotion. Hence, many young Chinese doctors feel under pressure to publish academic papers in addition to performing their clinical duties [7]. According to the Nati

The China Basic Medical Insurance Program was created in 1999 with three objectives: equal accessibility, affordability, and quality. Today, it has become the biggest medical insurance program in the world, covering 95% of China's population. Since 2015, China's healthcare ecosystem has been reshaped by increasing innovation, which has in turn been driven by regulatory reform, enhancement of research and development capability, and capital market development. There has also been improved regulatory efficiency to reduce lags in launching drugs. In 2022, nearly 20% of novel active substances launched globally were from China. China has also risen to become the second biggest contributor to innovation in terms of pipelines. Using a “fast-follow” strategy, many locally developed innovative drugs can compete with products from multinational companies in their quality and pricing. However, China's pharmaceutical and biotechnology industry will continue to face challenges in pricing and reimbursement, as well as a shortened product lifecycle with rapid price erosion. The government has already accelerated the timeline for updating the drug reimbursement list and is willing to create a high-quality medical insurance program. However, some obstacles are hard to overcome, including reimbursement for advanced therapies, limited funding and an increasing burden of disease due to an aging population. This article reviews the trajectory of medical innovation in China, including the challenges. Looking forward, balancing affordability and innovation will be critical for China to continue the trajectory of growth. The article also offers some suggestions for future policy reform, including optimizing reimbursement efficiency with a focus on high-quality solutions, enhancing the value assessment framework, payer repositioning from “value buyer” to “strategic buyer”, and developing alternative market access pathways for innovative drugs.