Analyze and evaluate the typical four medical alliance’s governance modes in China, and construct a set of medical alliance’s governance mode that adapt to the current status of medical resource allocation in China. We used interview-based case studies to investigate the four most representative medical alliance modes in China, and conducted in-depth analysis and discussion of key incentives affecting medical alliances under the guidance of the Preker-Harding model framework. The results show that the essence of the relationship between the government as the owner and the medical alliance is the entrustment and adjustment of power and responsibility; the government as a regulator has a normative and universal regulation of the medical alliance; the reform of the medical alliance requires the government to clarify the functional positioning of the medical alliance and determine a reasonable compensation system. China should establish the “Positive Triangle” model of medical alliance’s governance, this medical security model provides patients with various types of medical services in a horizontal dimension, covering a variety of difficult disease treatments in a vertical dimension.

[Background]: Improvement of synergies in medical and nursing services can help governments to optimize the allocation of medical resources; however, an appropriate evaluation method is critical for a suitable decision process in this regard. [Method]: To assess the medical and nursing service combination (MNSC) at a regional level, this study applied a five-dimension evaluation index composed of 28 basic response areas related to the MNSC development status in China, determining its respective weight through the Delphi and entropy methods. [Result]: This empirical exercise analyzed the MNSC supply system by interviewing nine heads of medical and nursing institutions and eleven healthcare-related government personnel during August of 2020 in Xinxiang City, Henan province, P.R China. Results showed: (1) public satisfaction with the fees charged by Medical and Nursing service Institutions (MNSI); (2) Medicare and supply services’ policy publicity; (3) the external financing situation of MNSI; (4) the medical staff’s professional quality; (5) the medical facilities and supply of MNSI; and (6) that the recognition level of the development plan of MNSI scored the highest effect on the synergy of MNSC supply among the assessed factors. [Conclusion]: These results showed that an evaluation based on the Delphi and entropy methods can effectively integrate the opinions of experts and related institutions to evaluate synergies on the medical and nursing service supply.

BackgroundImproved of synergies on medical and nursing services can help governments to optimize the allocation of medical resources, however, an appropriate evaluation method is critical for an appropriate decision process in this regard. MethodTo assess medical and nursing service combination (MNSC) at regional level, this study applied a 5-dimension evaluation index composed by 28 basic response areas related to the MNSC development status in China determining its respective weight through Delphi and entropy method.ResultThis empirical exercise analyzed the MNSC supply system by interviewing 9 head of medical and nursing institutions and 11 healthcare-related government personnel during august of 2020 in Xinxiang City, Henan province, P.R China. Results showed that (1) public satisfaction with the fees charged by Medical and Nursing service Institutions (MNSI); (2) Medicare and supply services policy publicity; (3) external financing situation of MNSI, (4) medical staff professional quality; (5) medical facilities and supply of MNSI; and (6) recognition level of the development plan of MNSI scored the highest effect on the synergy of MNSC supply among the assessed factors. ConclusionThese results showed that an evaluation based on Delphi and Entropy Method can effectively integrate the opinions of experts and related institutions to evaluate synergies on medical and nursing service supply.

One of the key measures for China’s investment in good health is to establish and improve a universal medical insurance system and a basic healthcare service system centered on public hospitals. Medical insurance payments are not allocated based on bed capacity or per capita service costs; instead, a coordinated payment mechanism for the management of medical insurance funds and healthcare institutions needs to be established. In 2020, Zhejiang Province City J implemented the “Head-based weighted budgeting and bundled payment for primary healthcare institutions” (HWBBPP) payment policy. Based on data from all districts and healthcare institutions in City J from 2019 to 2023, this study evaluates the impact of HWBBPP on the utilization of primary healthcare services. Empirical results show that after the implementation of HWBBPP, the enthusiasm for primary healthcare services increased, the number of contracted service users grew, and healthcare services expanded; the utilization rate of primary healthcare services improved, while the number of contracted service users seeking care outside their affiliated healthcare institutions decreased. In summary, the objectives and measures of medical insurance payment policies, as well as the design of incentive mechanisms, are closely related to the behavior of healthcare institutions. Scientific and rational policy design facilitates the healthy development of healthcare institutions.