Preamble

Practice and Optimization Strategies for the Construction of Joint Wards in the Pudong New Area under the Medical Consortium Model

Abstract

As the deepening of healthcare reform progresses, the construction of "Joint Wards" within Medical Consortia (MCs) has emerged as a critical strategy for optimizing the allocation of medical resources and enhancing the service capacity of primary healthcare institutions. This study examines the practical experience of establishing joint wards in the Pudong New Area of Shanghai. By analyzing the current operational status, resource integration mechanisms, and patient outcomes, this paper identifies existing challenges and proposes targeted optimization strategies. The findings suggest that strengthening policy support, improving bidirectional referral mechanisms, and enhancing talent cultivation are essential for the sustainable development of joint wards, ultimately providing a reference for the integrated development of regional medical services.

1. Introduction

The "Healthy China 2030" planning outline emphasizes the importance of establishing a hierarchical medical system characterized by "primary-level diagnosis, bidirectional referral, separate treatment of acute and chronic diseases, and upper-lower linkage." In this context, the Medical Consortium (MC) model serves as a vital organizational framework to bridge the gap between tertiary hospitals and Community Health Service Centers (CHSCs).

The Pudong New Area, as a pioneer in medical reform in Shanghai, has actively explored the construction of "Joint Wards." These wards are collaborative inpatient units established between secondary or tertiary hospitals (the lead institutions) and CHSCs. By sharing expertise, management protocols, and technical resources, joint wards aim to improve the quality of care at the grassroots level and alleviate the pressure on large hospitals. This paper analyzes the practical implementation of this model in Pudong and explores strategies for its further optimization.

2. Current Status of Joint Ward Construction in Pudong New Area

2.1 Organizational Structure and Management

The construction of joint wards in Pudong follows a "1+X" model, where one high-level hospital partners with multiple CHSCs. Management is typically governed by a joint committee that oversees clinical protocols, nursing standards, and administrative policies. This structure ensures that the quality of care in community-based joint wards remains consistent with that of the lead hospital.

2.2 Resource Integration and Sharing

Resource sharing is the cornerstone of the joint ward model. This includes:
- Personnel Exchange: Senior physicians and nursing experts from lead hospitals conduct regular rounds, provide technical guidance, and participate in complex case discussions at the CHSCs.
- Technical Support:

1.261000 山东省潍坊市，山东第二医科大学管理学院

Author Affiliations

Liu Shanshan, Associate Researcher;
Xuanqiao Community Health Service Center, Pudong New Area, Shanghai;
Pudong Institute for Health Development, Pudong New Area, Shanghai;
Pudong New Area Health Commission, Shanghai.

背景

Implementation of the Hierarchical Medical System

In the process of promoting the hierarchical medical system, the rational allocation of medical resources and the effective guidance of patient flow have become core challenges for healthcare reform. The hierarchical medical system aims to establish a medical service model characterized by "primary-level first contact, two-way referral, coordination between upper and lower levels, and separation of acute and chronic care." By optimizing the distribution of medical resources, this system seeks to alleviate the current imbalance where high-level hospitals are overcrowded while primary-level medical institutions remain underutilized.

1. Resource Allocation and Patient Guidance

The core of implementing hierarchical medical care lies in enhancing the service capacity of primary-level medical institutions. Currently, the concentration of high-quality medical resources in tertiary hospitals leads to a "siphoning effect," where patients bypass local clinics in favor of large urban centers regardless of the severity of their condition. To address this, it is essential to utilize information technology and machine learning to predict patient demand and optimize the distribution of medical personnel and equipment.

[FIGURE:1]

2. The Role of Information Technology

Modern healthcare systems increasingly rely on deep learning and big data analytics to support decision-making. In the context of hierarchical medical care, these technologies can be applied to:

• Intelligent Triage: Using natural language processing to analyze patient symptoms and recommend the appropriate level of care.
• Chronic Disease Management: Implementing remote monitoring and predictive modeling to manage patients with chronic conditions at the primary level, reducing the burden on specialist hospitals.
• Resource Optimization: Applying optimization algorithms to ensure that medical supplies and specialist support are available where they are most needed.

3. Challenges and Future Directions

Despite significant progress, several obstacles remain in the full implementation of the hierarchical medical system. These include the disparity in medical insurance reimbursement rates, the lack of standardized clinical pathways for referrals, and the public's ingrained trust in large-scale hospitals. Future research should focus on developing integrated health platforms that facilitate seamless data sharing between different tiers of medical institutions, ensuring that patient records are accessible throughout the referral chain.

[TABLE:1]

By strengthening the synergy between primary-level care and specialized medicine, the hierarchical medical system can provide more equitable, efficient, and high-quality healthcare services for the entire population. This transition requires not only policy support but also continuous technological innovation to bridge the gap between different levels of the healthcare hierarchy.

背景

The Practice and Optimization Strategy of Joint Ward Construction in Pudong New Area under the Medical Consortium Model

Abstract: To address the prominent issues of uneven medical resource distribution and the underutilization of primary healthcare resources, the "joint ward" has emerged as an innovative collaborative medical service model. The construction of joint wards is of significant importance for accelerating the allocation and sharing of high-quality medical resources. This study aims to understand the current status of joint ward construction in the Pudong New Area, deeply analyze its operational models and difficulties, and provide optimization strategies to improve medical resource utilization and residents' access to convenient, high-quality care. From November 2024 to March 2025, a literature research method was employed to systematically search domestic and international databases and official health commission websites for policy documents and literature related to joint ward construction, summarizing the main development models, advantages, and disadvantages in China. In August 2024, a key informant interview method was used to conduct semi-structured interviews with the heads of joint wards from five lead hospitals of medical consortia and seven community health service centers. These interviews focused on discipline construction, matching of dominant diseases, and developmental constraints. Currently, the primary development model for joint wards in China is "led by the medical consortium's lead hospital with cooperation across various levels of medical institutions," manifesting in five typical models. Among these, the "hospital-community" one-stop ward is the primary operational mode, providing patients with a direct transitional pathway for medical treatment. Joint ward construction in Pudong New Area currently faces challenges such as indistinct development of dominant diseases, suboptimal physician training arrangements, difficulties in coordinating downward referrals, and insufficient publicity. Based on these findings, a visualized implementation plan for optimizing joint ward development in Pudong New Area should be pursued by focusing on four aspects: institutional regulation construction, grasping core points, securing key elements, and building external conditions. The joint wards in Pudong New Area are in an exploratory stage. It is recommended to focus on enhancing community specialty capabilities, using the construction of dominant disease treatments as a core driver, increasing publicity, and stimulating the enthusiasm of joint ward teams. Furthermore, scientifically arranging community physician training and establishing flexible management mechanisms will allow residents to enjoy high-quality medical services "close to home," providing a feasible practical paradigm for joint ward construction in other regions of China.

Keywords: Medical Consortium; Joint Ward; Hierarchical Diagnosis and Treatment; Community Health Service Center

1. Introduction

Against the backdrop of deepening healthcare reform, the "joint ward" has emerged as an innovative collaborative medical service model designed to solve the prominent issues of uneven medical resource distribution and low utilization of primary health resources. The construction of joint wards is critical for accelerating the sharing of high-quality medical resources. This study investigates the current construction status in Pudong New Area, analyzes operational difficulties, and proposes optimization strategies to improve resource utilization and resident access to quality care.

2. Methodology

2.1 Literature Research

From November 2024 to March 2025, a systematic search was conducted across domestic and international databases and official Health Commission websites. This search targeted policy documents and academic literature related to joint ward construction to summarize the primary development models, advantages, and disadvantages within the Chinese context.

2.2 Key Informant Interviews

In August 2024, semi-structured interviews were conducted with key stakeholders. The participants included the primary heads of joint wards from five lead hospitals within medical consortia and seven community health service centers (CHSCs). The interviews focused on:
- Discipline construction within the joint wards.
- The degree of matching for dominant diseases.
- Constraints hindering development.

3. Results

3.1 Current Development Models

The current development of joint wards in China primarily follows a model where the lead hospital of a medical consortium takes the initiative, and medical institutions at various levels collaborate. Five typical development models were identified, with the "hospital-community" one-stop ward being the most prevalent. This model provides patients with a seamless transitional pathway from acute care to rehabilitation or chronic disease management.

3.2 Challenges in Pudong New Area

The investigation revealed several challenges currently facing joint ward construction in the Pudong New Area:
- Indistinct Dominant Diseases: The selection and development of specific diseases for joint management lack clear focus and competitive advantage.
- Training Constraints: Arrangements for community physicians to undergo advanced training at lead hospitals require further refinement to balance clinical duties and professional development.
- Referral Coordination: There are significant hurdles in coordinating the downward referral of patients from tertiary hospitals to community-based joint wards.
- Insufficient Publicity: Public awareness of joint ward services remains low, limiting the utilization of these facilities.

4. Discussion and Optimization Strategies

To further optimize the development of joint wards in Pudong New Area, a visualized implementation plan should be developed focusing on four dimensions:

1. Institutional Regulation Construction: Establishing clear protocols and standards for joint ward operations.
2. Grasping Core Points: Identifying and focusing on the most critical clinical pathways.
3. Securing Key Elements: Ensuring the availability of human resources, equipment, and information technology.
4. Building External Conditions: Improving policy support and financial incentives.

5. Conclusion

Joint ward construction in Pudong New Area is currently in an exploratory phase. To move forward, it is essential to enhance the specialty capabilities of community health centers and use the construction of dominant disease treatments as a primary driver. Increasing publicity efforts and stimulating the enthusiasm of medical teams are vital. By scientifically managing physician training and establishing flexible operational mechanisms, residents can access high-quality medical services within their communities. These practices in Pudong can serve as a practical paradigm for other regions in China seeking to implement similar collaborative healthcare models.

Shandong Second Medical University Weifang 261000 China

Pudong New Area, Shanghai 200120, China. Corresponding authors: ZHANG Yimin, Researcher; LIU Shanshan, Associate Researcher.

TANG Xinyi, GU Guiguo, HU Xinyu, et al. Research on the Practice and Optimization Strategies of Joint Ward Construction in Pudong New Area under the Medical Consortium Model [J]. Chinese General Practice, 2026. DOI:

TANG X Y，GU G G，HU X Y，et al. The practice and optimization strategy of joint ward construction in Pudong New Area under the medical consortium model［J］. Chinese General Practice，2026. ［Epub ahead of print］ Editorial Office of Chinese General Practice. This is an open access article under the CC BY-NC-ND 4.0 license.

Chinese General Practice https

Background

In the context of implementing the hierarchical diagnosis and treatment system，in order to solve the prominent problems of uneven distribution of medical resources and low utilization of primary health resources et al，the joint ward has emerged as an innovative medical service collaboration model，which is of great significance for further accelerating the allocation and sharing of high-quality medical resources.

Objective By studying the current situation of the construction of joint wards in Pudong New Area，deeply analyzing the operational mode and difficulties in the operation process of joint wards，and providing reference optimization strategies for improving the utilization rate of medical resources and residents access to convenient and high-quality medical resources.

Methods

From November 2024 to March 2025，the literature research method was adopted to systematically search domestic and foreign databases as well as the official website of the National Health Commission，aiming to obtain policy documents and literature related to the construction of joint wards，so as to summarize the main development models of joint wards in China along with their advantages and disadvantages. In August 2024，the key informant interview method was adopted to conduct semi-structured interviews with the main persons in charge of the joint wards from 5 medical alliance leading hospitals and 7 community health service centers，so as to understand issues such as disciplinary construction，matching of advantageous diseases，and development constraints in the joint wards of medical consortia.

Results

Research has found that the development model of joint wards in China is led by medical consortia，with hospitals taking the lead and cooperation with medical institutions at all levels. There are five typical development models，among which the "hospital community" one-stop ward construction is the main operating model，providing patients with a direct transition to medical care.

The research on the exploration and construction of joint wards in Pudong New Area has found that there are currently problems such as the lack of prominent advantageous disease construction，incomplete arrangements for physician training，difficulty in coordinating the transfer of patients，and insufficient coverage of publicity work. Based on this，the study proposes to optimize the visual implementation plan for the development of joint wards in Pudong New Area from four aspects：the construction of rules and regulations，the grasp of core points，the grasp of key elements，and the construction of external conditions.

Conclusion

The joint ward in Pudong New Area is in the stage of exploration and development. In practice，it is recommended to focus on improving the level of community specialties，taking the construction of advantageous diseases as the core focus，increasing the publicity of joint wards，stimulating the work enthusiasm of joint ward teams，scientifically and reasonably arranging the training time of community doctors，and establishing a flexible management mechanism for joint wards，so that residents can enjoy high- quality medical services "nearby"，and provide a feasible practical paradigm for the construction of joint wards in other regions of China.

The development of Medical Alliances (hereinafter referred to as "Medical Alliances") is a critical component of deepening medical reform and establishing a basic healthcare system with Chinese characteristics. In January 2023, six ministries, including the National Health Commission, jointly issued the Notice on Carrying Out Pilot Work for the Construction of Tight-knit Urban Medical Groups. This document proposed "building a new pattern of hierarchical diagnosis and treatment services with the core being the downward extension and sharing of resources," and established 81 pilot areas for tight-knit urban medical groups. This strategy aims to further address the scarcity and uneven distribution of high-quality medical resources in China, as well as the weak medical service capabilities of primary healthcare institutions. Furthermore, it serves as an important measure to innovate Medical Alliance construction and promote the equalization of basic medical and health services \cite{3-4}.

Under the Medical Alliance model, medical institutions must establish close cooperative relationships to jointly undertake patient treatment and nursing responsibilities, leading to the emergence of "joint wards." Against the backdrop of deep integration within Medical Alliances, joint wards are established through cooperation agreements between hospitals and primary healthcare institutions. Eligible patients are transferred to joint wards in community hospitals where, supported by the family doctor contract system, they receive full-cycle health management services covering follow-up treatment and rehabilitation. The objective of this model is to improve the overall utilization rate of medical resources and promote close cooperation and coordinated development among members of the Medical Alliance.

Currently, the nine major Medical Alliances in the Pudong New Area of Shanghai have essentially commenced the construction of joint wards. The joint ward of East Hospital–Beicai Community Health Service Center and the joint ward of the Seventh People's Hospital–Gaohang Community Health Service Center represent mature practical cases that currently handle a significant volume of patients. To better understand the current development status and challenges facing these facilities, this study focuses on the joint wards in the Pudong New Area. By exploring new opportunities and optimization strategies for their development, this research aims to provide effective reference experiences for the construction and advancement of joint wards across the country.

1 资料与方法

The research group conducted a survey of the nine major medical consortia in the Pudong New Area, collecting qualitative data to understand the practical effectiveness of joint wards in the region. The qualitative data consist of two components: policy documents and database literature, and key informant interviews. The policy documents and literature were used to analyze policy information, current development status, and construction strategies related to joint wards in China. Meanwhile, the key informant interview data were utilized to analyze the critical issues currently facing the construction of joint wards in the Pudong New Area.

Keywords: Medical consortium; Joint ward; Graded diagnosis and treatment; Community health center

From November 2024 to March 2025, a systematic search was conducted across databases including PubMed, CNKI, and the Wanfang Data Knowledge Service Platform to obtain literature related to joint wards. The search employed keywords such as "medical consortium," "tight-knit," "joint ward," and "medical group," with the search period set from March 2016 to March 2025. Furthermore, official websites of national and local Health Commissions were searched to obtain policy documents, including opinions and strategic plans related to the construction of joint wards and medical consortia; the timeframe for this policy search was set from April 2017 to November 2024. The final data included in the analysis comprise:

9 份政策文件和13 份数据库文献（具体纳入文献见附

Key Informant Interviews

In August 2024, semi-structured interviews were conducted using purposive sampling with the primary heads of five lead hospitals within medical alliances and seven community health service center joint wards. The interview content covered the operational rules and regulations of the medical alliance joint wards, the development of specialized disciplines (predominant diseases) within the respective communities, the current status of specialized discipline construction in joint wards, and the challenges encountered during this process.

The interviews were conducted face-to-face, and with the participants' consent, the entire sessions were audio-recorded. Each interview lasted between 90 and 120 minutes. Following the interviews, members of the research team organized and summarized the key points, performing a comprehensive analysis. To ensure the accuracy and integrity of the information, the resulting analysis tables were verified and reviewed by other members of the research group.

2.1 我国联合病房发展模式概况

Currently, the development model of joint wards in China is primarily characterized by "leadership by the lead hospital of the Medical Alliance and collaborative implementation by medical institutions at all levels." Regarding construction principles, these wards strictly adhere to the fundamental tenets of mechanism sharing, information integration, and the combination of management and operation.

Among these, the principle of mechanism sharing ensures that resources across different medical institutions are effectively integrated and optimized, thereby enhancing overall service efficiency. The principle of information integration utilizes advanced information technology to achieve seamless connectivity and real-time sharing of patient clinical data. The principle of combining management and operation ensures effective macro-level supervision and guidance by government departments while granting medical institutions autonomy and flexibility in micro-level operations. In terms of operational entities, development primarily involves the establishment of expert outreach teams and expert studios \cite{5,6}. Expert outreach teams consist of high-level specialists from superior hospitals who are stationed at or regularly visit primary healthcare institutions. Through outpatient consultations and ward rounds, they introduce advanced medical concepts and technologies to the grassroots level. Expert studios serve as long-term support platforms established through cooperation between specialists and primary healthcare institutions, providing continuous technical support and talent cultivation through regular consultations and teaching. Regarding rights and responsibilities, a dual-linkage management model is adopted, where government departments and medical institutions jointly participate in management. Both parties enjoy equal rights in participation and decision-making for development planning, ensuring the smooth implementation of joint ward activities. Examples of these models include the "Hospital-Community" one-stop ward construction in the nine major Medical Alliances of Pudong New Area, Shanghai; the Medical Community (MC) in Guangxin District, Jiangxi Province; and the Yongcheng Medical Community in Henan Province. These represent tight-knit county-level hospital team development models. Other variations include specialty co-construction and sharing models focused on rehabilitation beds, such as the rehabilitation joint wards between Xiangtan Central Hospital and Xiangtan Medicine & Health Vocational College, and the Nangang Hospital-Chongda Hospital rehabilitation joint ward. Additionally, some models leverage the headquarters of a Medical Community to create characteristic specialty joint wards in branch hospitals, such as the rehabilitation joint ward in the Quanan Town branch of Nanxiong Medical Community, the urology joint ward in the Gujing branch of Xinhui District People's Hospital in Guangdong, and the chronic disease joint ward in the Longshan branch of the Zhejiang Municipal Medical Community. Furthermore, cross-regional supportive joint wards have been established, such as the "Shanghai-Yunnan Anorectal Joint Ward" co-built by the Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine and the Jingdong Yi Autonomous County Traditional Chinese Medicine Hospital in Yunnan Province.

By reviewing the development models of joint wards across various regions in China, the research team identified five typical models: "Hospital-Community" one-stop ward construction, tight-knit county-level hospital team development, specialty co-construction and sharing focused on rehabilitation beds, branch characteristic specialty joint wards supported by the Medical Community headquarters, and cross-regional supportive joint wards \cite{7,8}. From an overall developmental perspective, the "Hospital-Community" one-stop ward is the primary operating model, providing patients with a direct transitional pathway for medical care. Other models incorporate regional characteristics, policy orientations, and hospital management systems as effective supplements to the mainstream model. Although joint wards have made progress in practice, they still face several challenges, particularly regarding inefficient bidirectional referrals, weak integration of management and operations, and the relatively low quality of community medical services \cite{1,9-14}. To further promote the decentralization of high-quality medical resources and enhance the service capacity of community health service centers, Pudong New Area initiated the construction of regional Medical Alliance joint wards in 2023. This work was guided by the Implementation Plan for Comprehensively Enhancing the Service Capacity of Community Health Service Centers in Pudong New Area (Pudong Government Office [2023] No. 33) and the Implementation Plan for Promoting High-Quality Development of Public Hospitals in Pudong New Area (Pudong Government Office [2023] No. 2). The initiative focuses on improving configurations, creating characteristic joint wards, enhancing medical service capabilities, and supporting family doctor contracted services. However, the bidirectional referral procedures remain incomplete, and a true linkage of medical resources has yet to form. The principle of combining management and operations has not been effectively implemented and remains fragmented. Limitations in county-level infrastructure and medical service capacity hinder the downward referral of patients. Furthermore, the limited scope of specialties (disease types) leads to poor operational efficiency in joint wards. Issues such as unsmooth information connectivity and the separation of management and operations persist, alongside relatively low levels of community medical services. Lead hospitals face challenges such as excessive management loads and increased management hierarchy, necessitating the expansion of specialized personnel for joint wards to alleviate management pressure. Technical support also faces geographical constraints; due to the cross-district nature of some alliances, many new technologies cannot effectively flow to joint wards in the supported regions. Key operational strategies include emphasizing both upward referrals and guaranteed downward reception, where superior hospitals refer patients down and community centers refer patients up. The one-stop management model in county-level hospitals involves transferring stable chronic or rehabilitating patients to joint wards, while primary health centers transfer critical cases upward. Strategic cooperation agreements between superior hospitals and community rehabilitation departments clarify co-construction goals. This supportive model establishes previously unavailable or non-independent specialties (e.g., rehabilitation, orthopedics, TCM) in branch hospitals under the integrated vertical management of the headquarters. By leveraging characteristic technical brands and responding to national resource support policies, these alliances co-build specialty joint wards with remote medical institutions to facilitate public access to care.

Chinese General Practice (https://...) reports that implementation plans have been formulated for contracted doctor services and the improvement of the hierarchical diagnosis and treatment system. The core focus is on strengthening the characteristic service brands of lead hospitals within Medical Alliances and enhancing the medical service capabilities of community health service centers. By optimizing resource allocation and innovating governance mechanisms, the goal is to provide the public with more equitable, accessible, integrated, continuous, and high-quality healthcare services. Based on the exploratory practices of the nine major Medical Alliances in Pudong New Area, research indicates that current joint ward construction faces difficulties regarding dominant disease types, training arrangements, public science popularization, and bidirectional referral processes.

2.2.1 联合病房优势病种建设不突出

Since the inception of joint wards, the primary bottleneck in their development has been the lack of distinct characteristics among dominant disease types. Currently, in the promotion of joint ward construction in the Pudong New Area, some community health service centers have failed to develop dominant disease categories based on their own disciplinary strengths or specialized personnel. This oversight limits the potential and pace of joint wards moving toward diversification and specialization. To promote the balanced development of joint wards, it is urgent to strengthen specialty construction, ensuring that joint wards can achieve diversified and refined services based on the specific needs and resource conditions of different communities.

Interviewee 3: "The joint ward we manage is currently in the renovation stage; the number of beds has increased, and the number of patients we can admit is rising. However, it is not feasible to establish a disease like diabetes as a dominant specialty for construction, because the condition is often difficult to control effectively."

Interviewee 7: "Currently, the construction of disease categories is quite disorganized. What we need to do first is clarify the dominant diseases in each community and the actual status of the patients. Patients often have long recovery cycles, which puts significant pressure on the community; therefore, defining clear construction goals is the primary issue to be resolved at present."

Interviewee 9: "What we need to clarify now is the fundamental purpose of the joint ward. Only then can we determine the compatibility between the lead hospital and the community and identify the dominant disease types for each community."

Interviewee 10: "Taking patients with Chronic Obstructive Pulmonary Disease (COPD) as an example, transferring such patients to a community joint ward presents multiple challenges: first, the condition is complex and volatile, with the potential for sudden deterioration; second, the community's infrastructure and medical equipment are currently insufficient to handle such emergencies; third, it remains uncertain whether the doctors on night duty can promptly identify clinical worsening; and fourth, the emergency skills and experience of current community medical staff are still lacking. Therefore, we should not blindly follow the referral wishes of superior hospitals; instead, we must make rational judgments based on the community's own capacity to receive and treat patients."

2.2.2 联合病房医师进修安排难以协调

Existing training pathways for joint wards are primarily divided into two categories: first, specialized rotations at higher-level hospitals focused on joint ward operations, and second, periodic in-house training sessions organized within the community itself. The current training cycle is set at 3–6 months, requiring 1–2 sessions per week. This concentrated and frequent schedule demands that community medical staff repeatedly adjust their existing work arrangements, making it difficult for them to balance joint ward training with their routine clinical duties, thereby creating a dual burden.

Interviewee 4: "Medical staff are already under considerable work pressure. Requiring them to regularly travel to higher-level hospitals for training means temporarily leaving their posts, which creates gaps in the hospital's original staffing arrangements. If this workload is shifted to other colleagues, it leads to overtime. Clinical work is already demanding, and having to juggle training on top of that—this issue requires careful consideration."

Interviewee 8: "This situation is genuinely challenging. When we arrange for medical staff to attend training, people generally feel caught in a dilemma. They complain that departmental workloads are already overwhelming, making it difficult to step away for further study, so their motivation is not particularly high."

Interviewee 11: "Although medical staff participate in the training, the learning outcomes do not appear to be satisfactory. Numerous gaps still emerge when they attempt to apply what they learned in actual practice."

2.2.3 联合病房宣传工作覆盖面不足

The primary objective of developing and constructing joint wards is to provide patients with more efficient and coordinated medical services by integrating resources from various healthcare institutions. Although joint wards have undergone a period of development, a significant gap remains between their actual effectiveness and public awareness. Potential reasons for this discrepancy include promotional content that is overly technical and obscure, as well as a lack of case studies closely related to residents' daily lives. Consequently, the vast majority of residents remain unfamiliar with, or even entirely unaware of, the operational mechanisms of joint wards. They lack clarity on how these wards facilitate multidisciplinary team collaboration and improve diagnostic and therapeutic efficiency, further indicating that current promotional and outreach efforts for joint wards remain insufficient and lacking.

Interviewee 1: "Since the establishment of joint wards within a certain medical alliance, we frequently encounter situations where patients refuse to be transferred down to a community joint ward for post-acute rehabilitation. The primary reason is a profound lack of understanding regarding joint wards; only a small minority of patients are willing to accept the transfer, either because the community center is close to home or because their condition is relatively mild." Interviewee 2: "The issue of trust is indeed critical. For instance, the awareness rate of joint wards among patients in a specific medical alliance is very low, at less than 10%. Under such circumstances, implementing joint ward policies faces significant resistance. Therefore, the focus of future efforts must be placed on public science communication and education."

2.2.4 上级医院下转患者环节存在堵点

In the two-way referral system between lead hospitals and community health service centers, a persistent challenge remains: "upward referrals are easy, while downward referrals are difficult." The referral mechanism for community joint wards necessitates close collaboration among three key stakeholders: superior hospitals, community health service centers, and patients.

First, from the perspective of superior hospitals, evaluating whether a patient is suitable for downward referral to a community joint ward requires multidisciplinary consultation. Because patient conditions are dynamically changing, the actual number of patients meeting the criteria for downward referral is limited, which in turn affects the bed occupancy rate of community joint wards. Second, from the perspective of community health service centers, receiving patients referred from superior hospitals tests both the completeness of their medical facilities and the specialized diagnostic, treatment, and emergency response capabilities of community medical staff. When faced with potential changes in a patient's condition, the community medical team must ensure they have sufficient resources and the ability to respond rapidly. Furthermore, due to the weak foundation of specialty construction and the shortage of specialized talent in community healthcare institutions, community doctors may opt for simple stabilization followed by immediate re-referral to superior hospitals. This prevents significant improvements in the service capacity of community medicine, and such uncertainty leads to a more cautious attitude when accepting downward-referred patients. Third, from the patient's perspective, some patients have very little understanding of the service model of community joint wards, which reduces their willingness to be transferred downward.

Interviewee 5: "Currently, there are relatively few medical records in the hospital's joint wards."

Upward referrals utilize a 'one-click' procedure, which is relatively convenient; however, downward referrals are currently the primary problem to be solved. First, patients do not understand the concept of joint wards and may resist downward transfer. Second, there are concerns regarding whether the community's capacity and conditions are sufficient to 'catch' and manage these patients. Third, the assessment procedures to determine if a patient can be transferred to the community for follow-up rehabilitation and nursing are very cumbersome. If there is an issue in any of these three links, the two-way referral process becomes blocked. Interviewee 6: "The difficulty of two-way referrals lies specifically in the downward transfer of patients. For instance, if a hospital's rehabilitation department is well-known, the community health service centers within the alliance will only receive rehabilitation patients; meanwhile, professional rehabilitation therapists are dispatched to the community for consultations and ward rounds. Patients have a high degree of trust in the hospital's rehabilitation department and are therefore willing to cooperate with downward transfers to the community for follow-up treatment. Additionally, the rehabilitation facilities in that community are relatively complete, and some equipment is shared, making the operation of the entire joint ward smoother and more efficient."

Therefore, the conditions for downward referral are often met only when there is mutual trust and sufficient capacity between both parties.

3.1 优化浦东新区联合病房建设的实施路径

Based on the typical development models and experiences of joint wards in China, and addressing the specific challenges faced by joint wards in the Pudong New Area, this study constructs an implementation path for Pudong's joint wards centered on four key operational pillars:

1. Regulatory and Institutional Construction

The establishment of a Medical Consortium Office is essential to implement both emergency response and routine supervision mechanisms, managing the operational status of joint wards across two distinct phases. The Medical Consortium Office bears the critical responsibility of driving the construction and development of joint wards within the medical consortium. Its core functions include managing expert teams, supporting ward operations, and coordinating two-way referrals. These expert teams comprise specialists from general practice, emergency medicine, and logistics administration. They operate through two primary pathways: an emergency track that activates "green channels" for rapid upward referral and treatment, and a normalized management track involving deep integration into the community for supervision, professional training, and health education.

2. Mastery of Core Strategic Points

The development of "advantageous disease categories" serves as the central strategic focus. Joint wards should select primary disease types that facilitate ward growth based on factors such as patient volume and the specific clinical characteristics of the community specialty. By focusing on these strengths, the wards can ensure sustainable development and better alignment with local healthcare needs.

3. Consolidation of Key Elements

It is necessary to strengthen the promotion and publicity of joint wards to further stimulate the motivation of medical staff. This involves optimizing the scheduling of advanced training for community medical personnel and achieving comprehensive information sharing within the medical consortium's joint wards. Building upon this foundation, a flexible ward management mechanism should be established to maximize the service capacity and proficiency of community specialties.

4. Construction of External Supporting Conditions

Financial and human resource support are vital for long-term success. There must be an increase in dedicated funding for joint wards in the Pudong New Area to ensure stable operations. Furthermore, recruitment efforts should be intensified to attract and integrate more high-quality specialized talent into the system, thereby strengthening the overall clinical expertise of the joint ward framework.

3.2.1 以优势病种建设为发展核心要点

In the process of high-quality development for community joint wards in the Pudong New Area, the establishment of "advantageous disease categories" (priority clinical conditions) serves as the core element for activating the efficiency of primary healthcare services. The "Notice on the Approval of New Quality Clinical Specialty (Disease) Projects for the 2025 Pudong New Area Peak and Highland Discipline Construction" (Pudong Health Science and Education [2025] No. 3) provides an in-depth blueprint for the development directions and strengths of priority disciplines within the region's large hospitals. This document offers a goal-oriented framework for community joint wards to select and develop appropriate priority disease categories. Consequently, when advancing the construction of these categories, joint wards can adopt a strategy of building standardized disease lists through two specific implementation paths. The first path involves proactive reporting by the Pudong New Area Community Health Service Centers: by conducting a comparative analysis of various diseases treated within the joint wards, the top three or five most frequent conditions are identified as the visual implementation path for the development of Pudong New Area joint wards.

Chinese General Practice https: These identified conditions are reported to the lead hospital of the Medical Consortium for joint evaluation. Based on this disease list, these high-incidence conditions are formally designated as the priority disease categories for cultivation within the specific community.

The second path allows Community Health Service Centers to select matching disease categories as development priorities based on their own medical resource layout, clinical specialty characteristics, or by directly aligning with the "new quality specialty" construction requirements of the lead hospital. This development model not only facilitates deep integration into the "Peak Discipline" construction system of the Pudong New Area but also fosters a disease cultivation ecosystem characterized by "vertical integration and specialized expertise." Furthermore, centers can deploy and develop relevant priority categories by focusing closely on the specific characteristics of the disease spectrum among their local community residents.

3.2.2 抓牢联合病房建设的五大要素

Strategies for Enhancing Community Specialist Medical Services and Team Motivation

1. Enhancing the Capacity of Community Specialist Medical Services

In the context of developing the Pudong New Area into a leading zone for socialist modernization, improving the specialist capabilities of community health service centers is a critical lever for promoting the high-quality development of hierarchical diagnosis and treatment. Regarding specialist collaboration mechanisms, community centers can adopt a collaborative model that integrates general and specialist medicine or join specialist alliances. By actively recruiting specialist physicians with deep clinical experience and professional expertise, centers can strengthen the professional depth of community medical services. Furthermore, a robust training system should be established where specialist physicians serve as mentors. Through regular training courses and a "specialist-led generalist" model, the professional skills and clinical practice capabilities of general practitioners can be systematically improved, bringing advanced diagnostic and therapeutic technologies and concepts to joint ward teams.

In terms of smart medical collaboration, the establishment of a medical consortium information platform is essential. Using comprehensive electronic health records as a link, systems for remote consultation, remote discussion of complex cases, and remote imaging diagnosis should be developed. This progress toward "visualized ward rounds" will enable the real-time sharing of medical information resources among consortium members. Additionally, green channels for referrals should be opened, supported by an information-direct-transfer mechanism. This will facilitate upward and downward referral services and coordinate the movement of patients within the medical consortium, achieving hierarchical treatment and accurately positioned collaborative development.

Regarding the development of specialist talent, great efforts should be made to build a talent echelon for joint wards. Priority should be given to internal cultivation by selecting medical personnel with rich clinical and teaching experience for specialized training. These individuals should be sent for advanced studies or trained and assessed by external experts on-site, with a focus on specialist diagnosis and emergency response capabilities. Internal staff should be encouraged to participate in academic exchanges to enhance their mastery of specialized knowledge. Alternatively, medical talent can be recruited externally to serve as reserve forces for community joint ward construction. For these new hires, detailed specialist training plans should be formulated—referencing standardized residency training schedules—with a duration of one to three years to ensure they receive sufficient clinical practice opportunities.

2. Stimulating the Motivation of Joint Ward Teams

Standardizing the handover and incentive mechanisms for expert teams descending from superior hospitals is a key link in ensuring the efficient operation of community joint wards. First, relying on the collaborative mechanism of the Pudong New Area medical consortium, a "dual-hospital linkage" pre-scheduling system should be established. By launching the "Pudong New Area Medical Consortium Collaborative Platform," work information can be synchronized in advance. This platform allows for the clear definition of tasks, including the duration of the experts' stay, personnel composition, and specific guidance requirements. The ultimate goal is to ensure that "descending experts remain connected to their original posts while being fully supported at both sites," thereby maintaining operational continuity and professional security.

Second, a long-term incentive mechanism should be established by refining the list of core responsibilities for specialists within joint wards. This includes clearly defining duties such as the frequency of weekly on-site rounds, response times for emergency consultations, and the required duration for community-based specialist training. Third, the operational indicators of joint wards should be integrated into performance appraisal systems. This involves increasing the weight of joint ward metrics within the overall performance management framework, supported by dedicated financial subsidies from district-level governments \cite{20-21}. Fourth, clinical experience gained from working in community health service centers should be categorized as a "bonus item." Specialists participating in the construction of community joint wards should receive priority recommendations for professional title evaluations and career promotions.

(3) Establishing a flexible management mechanism for joint ward beds. To enable community health service centers to serve referred patients more efficiently, a flexible bed management mechanism can be adopted, aligning with Pudong New Area's developmental characteristics of "efficient synergy, intelligence, and convenience." Patients receiving rehabilitation in joint wards can complete their routine basic diagnosis, treatment, and examinations directly at the community health service center \cite{22-23}. When referred patients require further diagnostic testing—such as MRI scans for stroke patients during the recovery phase—community medical staff can directly issue a joint ward examination request form. With this form, patients can proceed to the lead hospital of the medical consortium for testing. Leveraging Pudong New Area's smart medical platform, examination results for referred patients can be synchronized in real-time with the community medical service management system. Members of the joint ward management team can access these results online immediately, allowing them to adjust and optimize subsequent diagnosis, treatment, and rehabilitation plans based on the patient's latest condition. This ensures that patients receive precise and continuous medical services within a "15-minute community health service circle."

(4) Scientifically planning training arrangements for community physicians. Training schedules for community physician teams in joint wards should be personalized and flexible, fully aligning with regional characteristics. Regarding the duration of training, the traditional "one-size-fits-all" approach should be abandoned in favor of a model that combines long-term and short-term cycles \cite{25-26}. Community physicians can be given priority to participate in short-term theoretical training cycles, with content focusing on the operational mechanisms of joint wards and the standardized diagnosis and treatment of common and specialized diseases.

Based on the rich medical practice cases in the Pudong New Area, this approach helps community physicians quickly master the key knowledge and skills required for joint ward operations, establishing a solid foundation for subsequent in-depth study and practice. Long-term advanced training should be more profound and professional, covering diagnostic and treatment strategies for difficult and complicated diseases, as well as emergency measures within joint wards, to further enhance the professional quality and comprehensive practical abilities of physicians. This phased advancement in training is more aligned with the fast-paced and diversified development characteristics of the Pudong New Area. It assists community physician teams in learning new joint ward knowledge more efficiently, effectively avoids the intimidation caused by an excessive volume of information, and tangibly improves learning outcomes, ensuring that community physicians achieve substantive growth and progress during their training period.

(5) Strengthen the publicity and promotion of joint wards. By the end of 2024, the total family doctor contract rate for the permanent population in the Pudong New Area reached 45.4%. This core indicator can be transformed into a "Pudong-style" communication matrix for joint ward promotion. The Pudong New Area Medical Consortium can leverage the high engagement of family doctors and utilize their role as bridges within the community to organize special lectures on joint wards. These sessions should use accessible language to promote the core concepts, operational modes, and practical health benefits of joint wards to community residents.

Simultaneously, modern technological means should be fully utilized to promote joint ward services through multiple channels and in an all-around manner, ensuring both the breadth and precision of information coverage. Leading hospitals within the Medical Consortium should also actively use new media channels, such as official hospital WeChat accounts, to release video tutorials or articles. For instance, by linking with the "Health Cloud" platform, the joint ward services can be integrated into a broader digital health ecosystem.

Precise ward service guidelines are delivered directly to the personal accounts of contracted residents. Through "virtual triage" demonstrations, the operational procedures and appointment systems of the joint ward are showcased. These initiatives aim to disseminate knowledge regarding medical consortium joint wards to the general public, thereby enhancing public awareness of the two-way referral system and the priority of community medical services.

Recommendations for the Development of Joint Wards in China

To promote the high-quality development of community-based joint wards nationwide, it is essential to construct a multidimensional system characterized by "policy guidance, resource linkage, capacity enhancement, and service optimization."

First, a cultivation mechanism for "advantageous disease types" should be established. Local authorities should refer to regional health development plans and disease spectrum characteristics to identify priority conditions. This can be achieved through a dual-pathway approach involving "primary-level application and superior-level evaluation." Community health service centers should be actively encouraged to align with the specialized strengths of higher-level hospitals, fostering a division of labor where "common diseases are managed in the community and rehabilitation is transitioned downward."

Second, there must be a strengthening of generalist-specialist collaboration and human resource development. The "integrated generalist-specialist" collaboration model should be promoted, where specialists from lead hospitals are deployed to community centers to serve as mentors. This can enhance the specialized capabilities of general practitioners through regular training and joint clinical rounds. Furthermore, an "internal and external linkage" talent cultivation mechanism should be established: internally, key medical staff should be selected for advanced studies at superior hospitals; externally, professional talent should be recruited to bolster the primary-level workforce. This should be supported by preferential professional title evaluation policies and clear career development pathways.

Third, a smart medical support system must be constructed. Centered on electronic health records, a regional medical consortium information platform should be developed to achieve full coverage of functions such as remote consultation and diagnostic imaging. The implementation of "green channels for referrals" should be promoted, utilizing information technology to simplify referral processes and facilitate the mutual recognition of diagnostic results, thereby reducing the burden on patients.

Fourth, innovative models for publicity and promotion should be explored.

Relying on the family doctor contract service network, the advantages of joint wards should be popularized through channels such as specialized lectures and new media platforms. This approach aims to further enhance residents' awareness and understanding of the hierarchical medical system.

Author Contributions: Xinyi Tang was responsible for the research design and the drafting of the initial manuscript. Guiguo Gu and Xinyu Hu were responsible for literature collection and data organization. Yimin Zhang and Shanshan Liu participated in the design of the research framework and were responsible for the revision and review of the manuscript. All authors take overall responsibility for the final article.

The authors declare that there are no conflicts of interest associated with this work.

参考文献

Wang Liangsheng, Xu Qiuping, Huang Manwei, et al. Research on the Practical Effectiveness of Promoting the Construction of Rehabilitation Joint Wards in a Certain City [J]. Modern Hospital Management, 2023, 21(4): 42-45.

Abstract

Objective: To analyze the effectiveness of the construction of rehabilitation joint wards in a certain city, providing a reference for the further development of the "acute treatment, hierarchical rehabilitation" diagnosis and treatment model.

Methods: A retrospective analysis was conducted on the operational data of rehabilitation joint wards in City A from 2020 to 2021. Key indicators, including the number of discharged patients, average length of stay, and hospitalization costs, were compared and analyzed across different levels of medical institutions.

Results: The implementation of rehabilitation joint wards effectively promoted the downward transfer of patients in the recovery phase. The average length of stay in tertiary hospitals decreased, while the bed utilization rate in primary medical institutions significantly improved. Furthermore, the total hospitalization costs for patients were effectively controlled, and the continuity of rehabilitation services was enhanced.

Conclusion: The construction of rehabilitation joint wards is an effective measure to optimize the allocation of medical resources and improve the efficiency of the rehabilitation medical service system. Future efforts should focus on strengthening quality control, improving reimbursement policies, and enhancing the professional capabilities of primary healthcare workers.

1. Introduction

With the intensification of the aging population and the change in the spectrum of diseases, the demand for rehabilitation medical services among the public has grown rapidly. However, the current rehabilitation medical system faces challenges such as the concentration of high-quality resources in large hospitals, insufficient service capacity at the primary level, and a lack of smooth transition mechanisms between acute and recovery phases.

To address these issues, City A has actively explored the construction of "rehabilitation joint wards." This model establishes a collaborative mechanism between tertiary hospitals and primary healthcare centers (community health service centers), allowing patients to be transferred to joint wards in primary institutions for professional rehabilitation after their condition stabilizes in acute care. This study aims to evaluate the practical effectiveness of this model and provide empirical evidence for its optimization.

2. Materials and Methods

2.1 Data Sources

Data were collected from the health information system of City A, covering the period from January 2020 to December 2021. The dataset includes patient demographics, diagnostic information, length of stay, and

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Abstract

To address the challenges of "difficult and expensive medical treatment" for the public, this paper explores the construction of a "Cloud Medical" business system for joint wards within a Medical Alliance (Medical Consortium). By integrating high-quality medical resources from core hospitals with the infrastructure of primary healthcare institutions, the system facilitates bidirectional referrals, remote consultations, and unified management of joint wards. The practical application of this system demonstrates its effectiveness in improving the efficiency of medical resource utilization, enhancing the service capabilities of primary healthcare providers, and providing patients with continuous, high-quality medical services.

1. Introduction

In recent years, the Chinese government has vigorously promoted the construction of Medical Alliances to optimize the distribution of medical resources and establish a hierarchical diagnosis and treatment system. As a critical component of these alliances, "joint wards" serve as a bridge between tertiary hospitals and community health centers. However, traditional management models often face issues such as information silos, inefficient referral processes, and a lack of standardized clinical pathways.

With the rapid development of cloud computing and information technology, "Cloud Medical" provides a new technical framework for the collaborative operation of Medical Alliances. This paper designs and implements a cloud-based business system specifically for joint wards, aiming to achieve seamless information exchange and business synergy between different levels of medical institutions.

2. System Design

2.1 Overall Architecture

The system adopts a cloud-based architecture consisting of the infrastructure layer, data layer, platform service layer, and application layer. By utilizing a centralized cloud deployment, the system ensures that all member institutions within the Medical Alliance can access the same business logic and data standards.

[FIGURE:1]

2.2 Functional Modules

The system is designed with several core functional modules to support the full lifecycle of patient care within joint wards:

• Bidirectional Referral Management: This module automates the process of transferring patients between core hospitals and primary institutions. It tracks the patient's status in real-time and ensures that clinical data is transferred alongside the patient.
• Remote Consultation and Ward Rounds: Utilizing high-definition video conferencing and integrated Electronic Medical Record (EMR) access, specialists from core hospitals can conduct

Gu Xiaomeng, Zhang Wanwan. Application of Famous Doctor Studios and Joint Wards in the Development of Specialist Medical Quality in Traditional Chinese Medicine Hospitals [J]. Journal of Traditional Chinese Medicine Management, 2023, 31 (24).

Abstract

Objective: To explore the application effects of establishing "Famous Doctor Studios" and "Joint Wards" in promoting the development of specialist medical quality within Traditional Chinese Medicine (TCM) hospitals.

Methods: The study selected 80 medical staff members from the hospital's specialist departments as research subjects, covering the period from January 2021 to December 2022. The study was divided into two phases based on the timing of management interventions. The period from January to December 2021, during which conventional management models were employed, was designated as the pre-implementation group. The period from January to December 2022, during which the "Famous Doctor Studio + Joint Ward" management model was implemented, was designated as the post-implementation group. The study compared the quality of specialist management, the professional competence of the medical staff, and the satisfaction levels of both patients and clinicians before and after the implementation.

Results: Following the implementation of the new model, scores for specialist management quality—including TCM characteristic nursing, medical record management, ward environment management, and safety management—were significantly higher than those in the pre-implementation group ($P < 0.05$). Furthermore, the professional competence scores of the medical staff, specifically in TCM theoretical knowledge, clinical operation skills, and emergency response capabilities, showed significant improvement compared to the pre-implementation period ($P < 0.05$). Patient satisfaction and clinician satisfaction also increased significantly after implementation ($P < 0.05$).

Conclusion: The integration of Famous Doctor Studios and Joint Wards effectively enhances the quality of specialist medical services in TCM hospitals. This model improves the professional skills of medical personnel and increases satisfaction among both patients and staff, thereby providing a robust foundation for the high-quality development of TCM specialties.

1. Introduction

With the continuous deepening of healthcare reform and the increasing demand for high-quality medical services, Traditional Chinese Medicine (TCM) hospitals face the critical task of enhancing their specialist core competitiveness. The quality of specialist medical care is the lifeline of a hospital's development. However, traditional management models often struggle to balance the inheritance of expert experience with the efficient utilization of

Dong Xianglong, Pan Yunlong, Tang Jia, et al. Practical Exploration of the Construction of Integrated Medical Communities [J]. Jiangsu Health System Management, 2023, 34(12): 1623-1625, 1631.

Practical Exploration of the Construction of Integrated Medical Communities

1. Introduction

In recent years, the deepening reform of the medical and health system has placed significant emphasis on the construction of integrated medical communities (IMCs). As a critical organizational form for optimizing the allocation of medical resources and improving the efficiency of the healthcare service system, IMCs aim to establish a collaborative mechanism between tertiary hospitals and primary healthcare institutions. This paper explores the practical implementation, operational models, and preliminary outcomes of constructing a "tight-knit" IMC, providing a reference for the high-quality development of regional healthcare services.

2. Organizational Structure and Management Model

The core of a tight-knit IMC lies in the transition from loose cooperation to integrated management. In our practical exploration, we established a unified management committee to oversee the personnel, finance, and assets of the member institutions.

2.1 Integrated Management of Human Resources

To address the shortage of high-level talent in primary healthcare facilities, the IMC implemented a "dual-recruitment and shared-use" policy. Specialists from the lead hospital are regularly dispatched to community health centers to conduct outpatient clinics, surgeries, and ward rounds. Simultaneously, primary care physicians are encouraged to undergo standardized training at the lead hospital to enhance their clinical capabilities.

2.2 Unified Financial and Asset Management

By implementing a unified financial accounting system, the IMC ensures the efficient use of funds. Large-scale medical equipment is shared across the community, reducing redundant investments and lowering operational costs. This centralized management model facilitates the standardization of medical supplies and pharmaceutical procurement.

3. Key Measures for Service Integration

3.1 Construction of Shared Resource Centers

To improve diagnostic accuracy at the primary level, the IMC established several shared centers, including imaging, laboratory, and pathology centers. Under this model, examinations are performed locally at primary institutions, while diagnostic reports are issued by experts at the lead hospital through a cloud-based platform.

[FIGURE:1]

3.2 Hierarchical Diagnosis and Treatment System

The IMC has refined the "two-way referral" process. A "green channel" was established to ensure that patients in critical condition

Tu Yixin, Yu Jianxing. County-level Medical Community Reform: A Chinese Solution for Constructing an Integrated Medical and Health Service System [J]. Governance Research, 2025, 41(1): 81-90, 159.

Abstract

The construction of an integrated medical and health service system is a global challenge in health governance. Since the 18th National Congress of the Communist Party of China, the Chinese government has proposed the "County-level Medical Community" (CMC) reform as a strategic response to the fragmentation of the medical and health service system. This paper systematically analyzes the logic, mechanisms, and practical effects of the CMC reform. By integrating medical resources at the county, township, and village levels, the reform aims to shift the focus of medical services from "treatment-centered" to "health-centered." The study finds that the CMC reform achieves functional integration through administrative, financial, and personnel restructuring, effectively improving the efficiency of resource allocation and the accessibility of primary healthcare services. As a "Chinese solution" for integrated healthcare, the CMC reform provides valuable experience for other developing countries and contributes to the global discourse on health system strengthening.

Introduction

The fragmentation of medical and health service systems is a common dilemma faced by countries worldwide. With the transition of the disease spectrum and the acceleration of population aging, the traditional hospital-centric and treatment-oriented model has become increasingly unsustainable. To address these challenges, the World Health Organization (WHO) and various international academic communities have advocated for the development of Integrated Health Service Delivery (IHSD).

In China, the long-standing "dual-track" structure between urban and rural areas, coupled with the profit-seeking behavior of public hospitals under market mechanisms, has led to a serious imbalance in medical resource distribution. High-quality resources are overly concentrated in urban tertiary hospitals, while primary healthcare institutions remain weak. To bridge this gap, the Chinese government launched the County-level Medical Community (CMC) reform. This reform is not merely a technical adjustment of medical resource distribution but a profound institutional transformation aimed at building a people-centered, integrated medical and health service system.

The Theoretical Logic of Integrated Medical Services

The core of the CMC reform lies in "integration." From a theoretical perspective, integrated medical services involve the coordination of different levels and types of medical institutions to provide continuous and comprehensive health services to the population.

1. Vertical Integration

Vertical integration refers to the structural and

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Research on the Construction Path of Smart Hospitals in Multi-campus Medical Groups

Abstract

With the continuous deepening of healthcare reform and the rapid development of information technology, the construction of smart hospitals has become an inevitable trend for the high-quality development of large-scale medical groups. This paper analyzes the current status and challenges of smart hospital construction in multi-campus medical groups. By exploring the integration of information resources, the standardization of business processes, and the innovation of management models, it proposes a systematic construction path. The goal is to achieve high-quality development through "unified management, resource sharing, and business synergy" across multiple campuses, ultimately improving medical efficiency and patient satisfaction.

1. Introduction

In recent years, the scale of public hospitals in China has expanded rapidly, leading to the emergence of numerous multi-campus medical groups. While this expansion improves the accessibility of medical resources, it also presents significant challenges for hospital management and operational efficiency. The "Smart Hospital" concept, which integrates "Smart Medical Services," "Smart Nursing," and "Smart Management," provides a critical framework for addressing these challenges. For multi-campus medical groups, the core objective is to utilize information technology to bridge geographical gaps and ensure consistent, high-quality healthcare delivery across all sites.

2. Challenges in Multi-campus Smart Hospital Construction

The construction of smart hospitals in a multi-campus environment faces several unique difficulties compared to single-site institutions:

• Data Fragmentation and Silos: Different campuses often utilize disparate legacy systems, making it difficult to achieve real-time data synchronization and unified management.
• Inconsistent Business Processes: Variations in clinical workflows and administrative procedures across campuses can lead to inefficiencies and confusion for both staff and patients.
• Infrastructure Disparities: Discrepancies in network hardware and server capacities between older and newer campuses can hinder the deployment of centralized cloud-based platforms.
• Management Complexity: Coordinating human resources, financial oversight, and logistics across multiple locations requires a highly integrated and intelligent management system.

3. Construction Path and Strategies

3.1 Unified Top-level Design and Infrastructure

The foundation of a multi-campus smart hospital lies in a

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Research on the Construction of Public Health Talent Teams from the Perspective of Medical-Preventive Integration

Abstract

The integration of medical and preventive services is a critical strategy for strengthening the public health system and ensuring national health security. This study examines the current state of public health talent team construction through the lens of medical-preventive integration. By analyzing existing challenges—such as structural imbalances, insufficient professional capabilities, and inadequate incentive mechanisms—this paper proposes strategic recommendations. These include optimizing talent cultivation models, enhancing cross-disciplinary training, and improving career development pathways to build a robust, high-quality public health workforce capable of responding to complex health challenges.

1. Introduction

In recent years, the global health landscape has undergone significant shifts, highlighting the urgent need for a more resilient public health infrastructure. The concept of "medical-preventive integration" emphasizes the seamless coordination between clinical medicine and public health services. Central to this integration is the development of a skilled workforce that possesses both clinical expertise and public health acumen. However, the current talent cultivation and management systems often operate in silos, creating a gap between preventive measures and therapeutic interventions. This study aims to explore effective pathways for talent team construction to bridge this gap and enhance the overall efficiency of the healthcare system.

2. Current Status and Challenges

The construction of public health talent teams faces several systemic hurdles that impede the progress of medical-preventive integration.

2.1 Structural Imbalances in the Workforce

There is a notable disparity in the distribution of public health professionals across different regions and levels of the healthcare system. Primary healthcare institutions often suffer from a shortage of high-level talent, while specialized public health agencies may lack personnel with diverse clinical backgrounds. This imbalance limits the capacity for early disease detection and comprehensive health management at the community level.

2.2 Insufficient Professional Capabilities

The traditional education system for public health often focuses heavily on theoretical epidemiology and statistics, sometimes at the expense of practical clinical training. Conversely, clinical medical education frequently overlooks the

Su Dongran, Xu Ying, Zhou Luojing, et al. Practice and Effectiveness of Improving Medical Services at Subei People's Hospital [J]. Chinese Hospitals, 2019, 23(2): 77-78. DOI: 10.19660/j.issn.1671-0592.2019.02.25

Practice and Effectiveness of Improving Medical Services at Subei People's Hospital

1. Introduction

In recent years, Subei People's Hospital has actively responded to the national call to improve medical services by focusing on the core objective of "enhancing patient experience." By integrating information technology with optimized clinical pathways, the hospital has implemented a series of innovative measures aimed at streamlining medical processes, improving service quality, and ensuring patient safety. This paper summarizes the specific practices and preliminary outcomes of these initiatives.

2. Key Practices in Improving Medical Services

2.1 Optimization of Outpatient and Emergency Processes

To address the long-standing issue of "long waiting times and short consultation times," the hospital has implemented a comprehensive appointment-based system. Patients can now schedule appointments through multiple channels, including WeChat, the hospital website, and self-service terminals. Furthermore, the hospital has introduced a "one-stop" service center in the outpatient hall to provide integrated services such as medical insurance consultation, diagnostic certification, and guidance, significantly reducing the need for patients to move between different departments for administrative tasks.

2.2 Advancement of "Internet + Healthcare"

The hospital has leveraged big data and cloud computing to build an integrated information platform. This platform supports mobile payment, online report inquiries, and remote consultations. By digitalizing the entire service chain, the hospital has effectively reduced physical queues and improved the efficiency of information flow. Additionally, the implementation of an intelligent triage system ensures that patients are directed to the most appropriate specialists based on their symptoms, enhancing the precision of medical care.

2.3 Enhancement of Inpatient Care and Nursing Services

In the inpatient department, the hospital has promoted the "Responsibility Nursing" model, where dedicated nurses provide holistic care to assigned patients. To improve the quality of life for hospitalized patients, the hospital has also optimized the discharge process, allowing for bedside settlement and providing detailed post-discharge rehabilitation guidance through an automated follow-up system.

3. Effectiveness and Results

3

Leveraging a New Admission Model to Enhance the Patient Healthcare Experience

Zhao Yang, Jiang Yumei, Zhang Wen, et al.

Abstract

With the continuous deepening of healthcare reform, improving the patient experience and optimizing the medical service process have become core objectives for hospital high-quality development. This paper explores the implementation and effectiveness of a new admission model designed to address traditional bottlenecks in the hospitalization process. By integrating information technology, optimizing resource allocation, and streamlining administrative procedures, the new model aims to reduce waiting times and improve overall patient satisfaction. Preliminary results indicate that the implementation of this model has significantly enhanced operational efficiency and the quality of patient care.

1. Introduction

The admission process serves as the primary gateway for patients entering the inpatient system and is a critical touchpoint that shapes their overall perception of the hospital. Traditional admission models often suffer from fragmented workflows, redundant paperwork, and prolonged waiting periods, which can lead to patient dissatisfaction and inefficient resource utilization. In response to the national call for "improving medical services" and promoting "patient-centered" care, our institution has developed and implemented a new admission model. This study analyzes the impact of these reforms on the patient healthcare experience and hospital operational efficiency.

2. Current Challenges in Traditional Admission Processes

In the traditional model, patients often face a convoluted journey from the outpatient clinic to the inpatient ward. Key issues include:

• Information Silos: Lack of real-time data sharing between departments leads to repetitive data entry and verification.
• Inefficient Bed Management: Manual bed allocation processes often result in delays and suboptimal occupancy rates.
• Complex Administrative Procedures: Patients and their families frequently navigate multiple windows for registration, insurance verification, and deposit payments.
• Poor Communication: Insufficient guidance during the transition from outpatient to inpatient status increases patient anxiety.

3. Implementation of the New Admission Model

The new admission model focuses on "one-stop" services and digital transformation to create a seamless transition for patients.

3.1 Integration of Information Technology

By leveraging the Hospital Information System (HIS) and Electronic Medical Records (EMR), we established a centralized platform for admission management. This allows for:
- Pre-admission Registration: Patients can complete preliminary administrative tasks via mobile applications or self-service kiosks before arriving at the hospital.
- Real-time Bed Tracking: A dynamic visualization system provides staff with immediate updates on bed availability, cleaning status, and maintenance.

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Research on the Implementation Path of Management Homogenization in Medical Consortia under the Background of High-Quality Development of Public Hospitals

Authors: Wang Xingrui, Ren Shunyu, Li Jinhui
Journal: Chinese Hospitals, 2023, 27(7)

Abstract

In the context of promoting the high-quality development of public hospitals, achieving management homogenization within medical consortia has become a critical strategy for optimizing resource allocation and improving the overall efficiency of the healthcare system. This study explores the theoretical framework and practical implementation paths for management homogenization. By analyzing the current challenges faced by medical consortia, such as fragmented administrative structures and inconsistent service standards, the research proposes a multi-dimensional approach. Key strategies include the integration of information systems, the standardization of clinical pathways, and the establishment of unified performance evaluation metrics. The findings suggest that management homogenization not only enhances the operational synergy between lead hospitals and member institutions but also ensures the delivery of high-quality, equitable healthcare services to the public.

1. Introduction

The high-quality development of public hospitals is a core component of China's current healthcare reform. As a vital organizational form for implementing the hierarchical medical system, medical consortia (Medical Alliances) play a pivotal role in shifting the focus of healthcare from "treatment-centered" to "health-centered." However, the effectiveness of these consortia is often hindered by "nominal" cooperation, where member institutions operate in silos despite formal affiliations. To address this, management homogenization—defined as the application of consistent management philosophies, systems, and standards across all member units—is essential. This paper investigates how medical consortia can transition from loose cooperation to deep integration through standardized management practices.

2. The Necessity of Management Homogenization

2.1 Enhancing Operational Efficiency

The primary objective of management homogenization is to eliminate the "island effect" within medical consortia. By unifying financial management, procurement, and human resource policies, consortia can achieve economies of scale and reduce operational costs.

2.2 Ensuring Quality and Safety

Homogenization of clinical management ensures that patients receive the same standard of care regardless of which institution within the consortium they visit. This involves the unified implementation of clinical pathways, infection control protocols, and medical quality monitoring systems.

2.3 Promoting Resource Sinking

Effective management homogenization facilitates the flow of high-quality resources from tertiary hospitals to primary healthcare providers. When management systems

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