Health Care Science最新文献

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.

Breaking bad news is a critical communication competency for healthcare professionals. Any disclosure of a life-threatening event, such as a malignancy diagnosis, often causes significant stress to patients. While some patients may respond with acceptance and a determination to fight their illness, research has consistently shown that cancer patients often respond to the disclosure of their diagnosis with a range of negative emotions, such as anxiety, distress, and depression [1, 2]. These reactions are often accompanied by feelings of fear, uncertainty, and a sense of loss of control over their lives. Patients may also experience denial, manifesting as reluctance to accept or discuss the diagnosis [3]. Avoidance is another common reaction, where patients may choose to avoid certain situations or people that remind them of their illness [4]. These reactions are not uncommon and are a natural response to the stress and uncertainty of cancer diagnosis.

A common ethical dilemma in breaking a cancer diagnosis is that patients have different preferences and coping mechanisms when dealing with difficult news, and it is important to explore their wish to know about their health condition. Some patients may want to be fully informed about their diagnosis, prognosis, and treatment options, as they believe it empowers them to make decisions and take control of their healthcare. They may also value the opportunity to prepare emotionally and practically for the challenges that lie ahead. However, other patients may prefer to shield themselves from the potentially distressing information [5]. They may prioritize maintaining hope, protecting their mental well-being, or focusing on the present moment rather than dwelling on the future. Previous students showed that different cultures or religions influence how patients perceive the disease, their desire to know about the health condition, or their willingness to accept a diagnosis. For example, in some cultures, cancer is seen as a death sentence, leading to denial or avoidance of diagnosis and treatment [6]. There is a social stigma and gender label attached to cancer, which can lead to shame and embarrassment about the diagnosis [7-9]. Patients may be reluctant to seek medical attention, disclose their diagnosis, or follow through with treatment due to fear of being ostracized or discriminated against.

Remote communication methods like video and phone calls are being used more frequently to prevent the spread of the virus during disease outbreaks, such as the COVID-19 pandemic. It has become more difficult for healthcare professionals to inform patients about their cancer diagnosis. However, giving a cancer diagnosis over the phone can be a challenge since it does not allow for in-person support, and can come across as impersonal and insensitive. Unfortunately, in some cases, delivering bad news can have tragic conseq