Against the backdrop of deepening the reform of medical service prices in China, since 2021, the National Healthcare Security Administration has issued a series of medical service price project approval guidelines to guide the unified and standardized medical service price project in various regions, enhance comparability and fairness of medical service, further improve the quality of medical services, and promote the high-quality and sustainable development of China’s healthcare system. This study adopts a combined approach of policy document analysis and case studies to examine the guidelines’ impacts on the operation and management of public hospitals, focusing on project integration, standardized pricing, emphasis on service outputs, recognition of technical complexity, and support for innovation. Based on these findings, the paper proposes countermeasures such as refined cost accounting, strengthened staff training, improved information management, and promotion of technological innovation. The study’s novelty lies in analyzing the guidelines from the perspective of hospital operations and offering actionable strategies. However, the lack of large-scale quantitative data and reliance on limited cases may affect the generalizability of its conclusions.

Objective: The paper analyzes the impact of the implementation of approval guidelines for traditional Chinese medicine (TCM) medical service price on inpatient diagnosis and treatment behavior in TCM hospitals, providing a reference for better adapting to these guidelines and optimizing hospital resource allocation. Methods: Based on medical insurance settlement data from March to June, 2025 at a tertiary TCM hospital in Guangzhou City, with the guideline implementation in April 2025 as the intervention point, Stata was used to draw box plots for comparative analysis of the number of cases, actual settlement scores, length of hospital stay, number of surgical procedures, and total expenses. Results: After implementing the guidelines, repetitive procedures for mild cases decreased, inpatient diagnosis and treatment services became more standardized, and resource input for severe and chronic consumptive cases increased significantly. The structure of medical expenses showed a differentiated pattern of "fewer mild cases, more severe cases". Conclusion: The implementation of approval guidelines for TCM medical service price effectively curbed over-treatment of mild cases, guided hospitals to allocate more resources to severe and complex cases, and promoted the standardization of inpatient diagnosis and treatment services in TCM hospitals. It had a positive effect on optimizing the cost structure and improving the efficiency of medical insurance fund utilization. Future studies should incorporate long-term observational data to compare clinical outcome indicators and further assess the systemic impact after guideline implementation.

Objective: This article explores the price supervision and management mechanism of psychiatric hospitals, focusing on the development and application of intelligent price supervision systems, and uses information technology to solve traditional price management problems, in order to promote high-quality development of hospitals. Method: We develop a price intelligent supervision system and build an audit rule database that meets the requirements of clinical diagnosis and treatment, medication standards, and real-time updates of medical insurance policies. Relying on the HIS, we use an integrated platform to extract billing data, and conduct real-time online review of each medical expense. A full process management approach of "prior reminder, in-process supervision, and post audit" was adopted to cover supervision and statistical methods were used to analyze practical effectiveness. Result: Information technology has optimized the price management process, solved the problems of traditional price supervision and management, and provided scientific and efficient regulatory solutions. Conclusion: This model enables real-time online review of medical expenses, early detection and correction of suspected violations, and prevention of irregular medical behaviors, implement pricing policies to ensure compliance, improve work efficiency, reduce operating costs, and lay the foundation for the high-quality development of psychiatric hospitals.

Objective: The establishment of medical insurance admission rules for innovative high-value medical consumables and supporting medical service pricing projects is the key to promoting the clinical application of innovative technologies and realizing value purchases. This study proposes suggestions for improving the medical insurance admission management of innovative high-value medical consumables and supporting medical service price projects in China from the aspects of classification management, admission process, and evaluation indicators, providing a reference for relevant projects to be included in medical insurance reimbursement. Method: This study reviewed the management experience of medical insurance admission for innovative high-value medical consumables and supporting medical service price projects at home and abroad, formed preliminary suggestions, and further verified their applicability and operability through expert interviews. Results: The study found that Australia, Taiwan Province of China and other places effectively improved the evaluation efficiency of medical service price items and promoted the application of latest innovative medical technology through classified access, standardized window period and evaluation cycle, and set up differentiated evaluation processes and indicators. In terms of medical consumables medical insurance access, Australia, Japan, the Republic of Korea and other countries have formed mature experience and adopted classified management. The difference in evaluation content mainly lies in whether economic evaluation or complete health technology evaluation is needed. The interviewed experts further proposed applicable and feasible suggestions based on classification, admission process, and evaluation criteria. Conclusion: This study proposes management methods and path suggestions for optimizing the medical insurance admission of innovative high-value medical consumables and supporting medical services in China, providing policy references for regulating the medical insurance admission of related projects and promoting the timely and rational use of innovative technologies.

Objective: The paper analyzes the impact of dynamic adjustments in medical service prices on multiple parties and the implementation risks, and proposes preventive strategies. Method: Based on the practice in Ganzhou City of Jiangxi Province, the paper evaluates the impact of price adjustments on patients, medical institutions, and medical insurance funds, identifies risks in triggering mechanisms and total quantity regulation. Result: Price adjustment needs to balance the affordability of all parties and focus on enhancing the value of technology and labor services. There are risks such as increased patient burden and fund pressure. Conclusion: It is recommended to strengthen the awareness of fund security, take into account the affordability of special groups, guide medical institutions to participate in the process, and achieve a win-win situation for all parties.

The medical service price item initiation guideline (hereinafter referred to as the item initiation guideline) is not only a standardized integration of the current medical service price items oriented towards service output, but also a comprehensive update of the medical service pricing rules. Based on a review of the national policy requirements for medical charging rules, this study analyzed the pricing rule settings and their changes in the pricing explanations and usage instructions of the item initiation guidelines. The study found that the item initiation guidelines clearly defined the charging boundaries through positive and negative lists, and put forward new requirements for the top-level design and application scenarios of medical charging rules. Policy suggestions for making full and effective use of charging rules in item initiation guidelines include updating the national and provincial versions of medical charge regulation and supervision rule databases according to significant changes in the elements of item initiation guidelines, establishing a matching relationship between medical orders and price items, embedding charging rules into information systems, and strengthening the supervision line of defense.

Objective: The paper analyzes the current status of price governance for typical laboratory test items and provides references for the standardization of medical service price governance. Methods: Taking the four laboratory test items in the first batch of national price governance as the research objects, this paper analyzes the problems of current laboratory test items, uses descriptive statistical analysis methods to compare the dynamic evolution of price levels before and after price governance, and the price relations among regions and items. Results: There is heterogeneity in laboratory test price items in various regions. Before standardized governance, the regional difference of price levels was obvious. After the implementation of the policy, the price system of laboratory test items showed a trend of overall downward price levels and narrowing of inter-provincial price differences. The price comparison of detection methodologies shows overall optimization but regional imbalance. Conclusion: The standardization and governance of price have basically achieved the goal of relatively balanced prices among regions, but there is still room for improvement in the optimization of price relations of methodologies for similar items. It is suggested to establish a unified national standard system and project initiation guidelines for price of laboratory test items, a price optimization mechanism guided by the value of technology and labor services, and a comparison and calibration mechanism for similar items based on clinical value.

This paper systematically reviews the institutional construction and practice of real-world data in charging item initiation and medical insurance admission of innovative medical technologies in China, providing inspiration for the item initiation, pricing, and payment of new price items in other regions. This article reviews the national-level policies on the item initiation, pricing and medical insurance access of innovative medical technology charges, summarizes the practice of typical regions in applying real-world data to the management of new price items, analyzes the logic of applying real-world data to the item initiation, pricing, medical insurance access and payment of innovative medical technology charges, and gains insights for optimizing the application, item initiation, pricing and medical insurance access management of new price items in other regions: promoting the conditional application model for new price items and conducting trials first for those who achieve clinical and economic effects as promised. The formation of real-world data during the regular implementation period can be used to provide a basis for the inclusion of innovative medical technologies in the medical insurance catalogue.

The release of the guide for project approval of medical service pricing is an important measure to promote the deepening of medical service pricing reform. It is also a major measure to standardize medical service price items at the national level for the first time since the establishment of the National Healthcare Security Administration in2018. This article briefly describes the background, significance of the release of guide for project approval of medical service pricing, takes the actual medical service pricing items as a case, compares, analyzes the content differences before, after the implementation of guide for project approval of medical service pricing, discusses the difficulties, countermeasures of the implementation, to provide patients, hospitals, pharmaceutical companies, medical industry authorities with a multi-angle understanding, thinking

Objective: The construction of a medical service price system involves multiple stakeholders such as healthcare security administrations, medical institutions, and patients. The orderly promotion of medical service price reform is of great significance for deepening the reform of the medical system and promoting the high-quality development of China's healthcare security industry. Method: Based on the PDCA cycle theory, this article systematically analyzes the reform practice path of Yuxi City in Yunnan Province as a provincial-level pilot city. Result: Research has shown that Yuxi City has initially formed a closed-loop management mechanism through institutional design and construction in the Plan stage, policy implementation and resource investment in the Do stage, effectiveness monitoring and problem identification in the Check stage, and feedback optimization and continuous improvement in the Act stage. The reform has optimized the hospital's income structure, ensured stable benefits for insured persons, and ensured the sustainability of medical insurance fund expenditures. However, in the process of medical service price reform in Yuxi City, there are also problems such as relatively outdated information management of medical service prices, incomplete design of medical service price adjustment system, gap between medical service price adjustment and medical institution demand, and shortage of professional personnel. Conclusion: It is recommended to take corresponding measures in four aspects: accelerating the construction of a comprehensive management information platform for medical service prices, effectively organizing dynamic adjustments tracking and monitoring of medical service prices, attaching importance to cost accounting of medical service items, and accelerating the construction of professional teams, in order to systematically promote the high-quality development of healthcare security.

Based on the theory of government regulation, this paper analyzes the internal relationship between medical service theoretical value, the influencing factors and price dynamic adjustment. According to the three stages of the medical services price adjustment (value measurement, pricing project definiteness, and price adjustment), the paper respectively puts forward standardized value measurement model, pricing project definiteness model and price adjustment model, which presents a reference method and path for dynamic adjustment of medical service price.

S City, as one of the five national pilot cities for medical service price reform, has promoted two rounds of dynamic adjustment reforms based on mechanisms such as total amount control, classification management, dynamic adjustment, and performance evaluation. By prioritizing general service items and disciplines with insufficient medical supply, S City has optimized its price adjustment direction and structure , promoting the rational flow of medical resources. The study finds that price reforms have significantly improved hospital income structures, enhanced the value of technical labor, and stimulated the supply of high-quality medical services, achieving a win-win outcome for patients, payers, and providers. However, challenges remain, including weak incentives for autonomous price reduction and an underdeveloped price generation mechanism. Based on S City’s pilot practice, this paper summarizes key approaches and reform outcomes, and proposes policy recommendations to improve the dynamic price adjustment mechanism, strengthen the construction of information technology support, and prioritize medical insurance fund sustainability, to inform ongoing medical service price reforms in other regions.

Objective: The paper attempts to provide a reference for pharmaceutical price reform and optimization of the payment standard of medical insurance in China. Methods: We studied the pharmaceutical price governance tools in Germany, Japan, Australia, the United Kingdom, Denmark, Canada and Singapore by searching official policy documents issued by governments and journal articles, and analyzed the different price formation mechanisms during the drug life cycle. Results and Conclusions: All the countries have comprehensively utilized price governance methods such as free pricing, value-based pricing, reference pricing, cost-based pricing, total expenditure control, price freezing, mandatory rebates, ceiling price and parallel import at different stages of the drug life cycle. It is recommended to adopt differentiated governance strategies around the drug life cycle, improve the reference pricing mechanism and the application of health technology assessment in China's drug pricing and medical insurance access, dynamically adjust drug prices, and strengthen the synergy and cooperation between related organizations.

Deepening the reform of medical service prices and the reform of medical insurance payment methods are both important parts of deepening the reform of the healthcare security system. Promoting high-quality development of the medical and health service industry through a series of measures is an important goal of China's healthcare security system. This article takes Leshan City, Sichuan Province as an example, starting from the pilot mechanism of medical service price reform and the DRG payment method reform mechanism, analyzes the countermeasures and focus of medical institutions in the two reforms, dynamically adjusts the DRG weight through the correlation between medical service price items and specific DRG cases, and explores the specific application path, problems, and promotion suggestions of the coordinated promotion of medical service price adjustment mechanism and DRG payment method reform.

Objective: The paper summarizes policies for dynamic adjustment of medical service price at the national level, compares the implementation plans of dynamic price adjustment in different regions, and analyzes the common indexes of triggering evaluation and the rules of public hospitals participating in the price adjustment. Methods: By literature research and comparative analysis, the paper reviews the policy documents on dynamic adjustment of medical service prices at the national and local levels, and compares the trigger evaluation indicators and rules. Results: The trigger mechanism of the implementation plan of dynamic adjustment of medical service price in various provinces has gone through three stages of development, i.e. qualitative trigger, half-qualitative and half-quantitative trigger, and quantitative trigger. Most provinces have not yet set up quotation rules for public hospitals. Conclusions: For those provinces where the mechanism of medical service price dynamic adjustment is not yet complete and the dynamic adjustment of medical service price has not been substantially executed, quantitative trigger evaluation indexes can be set up according to the characteristics of medical service projects. Meanwhile, we should set complex medical service quotation requirements and produce government’s guiding price rules, calculate item cost reasonably and take the cost as the basis of public hospital quotation, consider the economic development situation and balance the local price level with the price level in surrounding areas.

The price comparison relationship is a key consideration factor in the formation and adjustment of medical service prices. Based on a review of the policy requirements for the current price comparison relationship in medical services, this study examined the practical experience of typical regions in conducting the pricing of items in line with the item initiation guidelines, the formulation of price for new items, and the dynamic adjustment of price according to comparison rules. The study draws the following insights for promoting the rational formation and dynamic adjustment of medical service prices through comparative pricing rules: when pricing new items during the trial period, the price comparison relationship with local similar items and items approved in other provinces should be taken into consideration, when implementing the item initiation guidelines, the integrated item price will be determined by referring to the charging levels of the same price zone and neighboring provinces, and when initiating dynamic price adjustment, communication and coordination should be promoted to facilitate regional price collaboration and reasonable price differences among institutions.

Objective: To meet the people's demand for excellent medicine, the paper provides reference for the optimization of medical insurance access and pricing procedures for innovative drugs in China. Methods: This paper systematically summarizes the access and pricing policies of innovative drugs in Switzerland from three dimensions: decision-making institutions, processes and standards, and analyzes the problems and shortcomings of the current policy in China. Results: Switzerland strictly examines the drugs applying for access through the health technology assessment procedure with “WWZ” as the core, and integrates the internal and external reference prices to ensure the rationality of the price. In order to encourage innovation, innovative drugs can also get an "innovation premium" higher than the reference drugs. Conclusion: We should improve the drug health technology assessment system, and give different prices or reimbursement rates to drugs with different degrees of innovation according to the evaluation results. At the same time, we should pay attention to the communication with multiple stakeholders, promote their participation in decision-making, and ensure the openness and transparency of the evaluation.

The management of medical service price items in China has entered a new stage, and higher requirements have been put forward for innovative access to medical service price items. This article is based on the practice of various provinces in China, clarifying the relationship between medical service items, medical service price items, and medical technology, which are easily confused concepts. It outlines the methods and paths for innovative access to medical service price items in China, and proposes that in the future, we can build a management mapping table between medical service price items and technical specification items, focus on real-world data of innovative technology. We will continue to carry out work in improving national innovation and economic guidance standards, as well as cost estimation guidelines, to provide references for establishing an innovative access system for medical service pricing projects that is in line with China's national conditions.

Objective: By comparing the cost calculation methods, main practice and problems of medical service items in different regions, this paper puts forward some policy suggestions to optimize the management of newly-added medical service price items. Methods: By means of literature research and comparative analysis, this paper reviews the national cost calculation policies of medical service items, and presents the implementation progress and difficulties in various regions. Results: The cost composition and calculation criteria of medical service item varies in different regions, which affects the comparison of data between regions. Local governments have not motivated the public hospitals to participate in price adjustments based on cost calculation results. Conclusions: We should improve the top-level design of cost calculation for medical service items, and encourage public hospitals to participate in price formation and adjustment. Public hospitals should participate the cost calculation of medical service items and support the price formation and adjustment suggestions with reliable data.

Establishing a dynamic adjustment mechanism for medical service prices and substantially coordinating and operating the mechanism is a key task of deepening the medical reform. As a matter of people's livelihood, it is closely related to policies, with high social attention and various stakeholders, which is difficult to coordinate. This paper systematically summarizes the content and implementation progress of dynamic adjustment plans of medical service prices in typical areas, and analyzes the effect of reform and its impact on hospitals, medical insurance and patients. On the whole, after the dynamic adjustment of medical service prices in typical areas, the operation of public hospitals is generally stable, and the income structure of hospitals, the medical burden of patients, and the expenditure of medical insurance funds are balanced, reaching the expected goal. In order to further improve the dynamic adjustment mechanism of medical service prices, it is suggested to set quantitative evaluation indicators of trigger mechanism according to the classification of general and complex items, improve the quotation rules, rationally allocate adjustment space to selected items, and monitor the reform operation, track and evaluate the effect of price adjustment with the help of cost price information platform.

In the context of the national medical insurance negotiations for the new innovative drugs, what may affect the price formation and medical insurance access of innovative drugs has become a widely concerned issue for decision-makers and various sector. This study analyzes from aspects of the economic principles in the formation of innovative drug prices, the practice of medical insurance negotiations in China, different models of medical insurance access, and the main findings of studies. Research has found that at the micro level, value and cost are the upper and lower limits of innovative drug prices, and clinical value is the most important value dimension that requires continuous evaluation. From a macro perspective, the level of national economic development will have complex and far-reaching impacts on both the payer and the supply side. Based on the "strategic purchasing" approach, medical insurance needs to select drugs with higher cost-effectiveness. Pharmacoeconomic evaluation is one of the necessary tools, which helps to reduce decision-making risks and promote the better performance of "effective markets" and "promising governments".

Objective: The paper is to understand the research status of medical service price in China, grasp the research hotspots and trends, and provide reference for related research, so as to promote the fine management and high-quality development of public hospitals. Methods: CNKI literature database was used as the data source and bibliometric method was used to analyze the literature related to medical service price with visualization software (CiteSpace). Results: A total of 840 articles were included, and the number of articles in the field of medical service price showed an increasing trend. There were 7 authors who published 10 or more articles. The research institution with the largest number of publications was Nanfang Hospital of Southern Medical University. There were 6 key words whose between centrality was 0.1 or more. Recently medical service price, medical service price adjustment and medical service cost has been the research hotspots. Conclusion: The number of medical service price research papers in China has gradually increased in recent years, and the core research teams and institutions are mainly located in Guangdong, Shanghai and other places. The research focus gradually adapts to the overall reform of public hospitals, focusing on the embodiment of the core value of public hospital prices.

Since the founding of the country, China has undergone several price reforms for medical services, but its still cannot reflect the actual value of medical services. The National Policy Pilot Program for Deepening the Price Reform of Medical Services in 2021 marked that China's medical service price reform has entered a new phase to encourage localities to explore medical service price formation mechanisms. In policy formulation, policy pre-evaluation helps to improve the rationality, scientificity and feasibility of that. This paper summarizes the historical process and realistic needs of medical service price reform and the important elements of the construction of pre-evaluation index system, also provides a universal medical service price reform pre-evaluation index system, in order to provide reference for local construction of pre-evaluation index system.

Based on the characteristics of complex medical services and simulated market mechanism design, this study explores the new mechanism of price formation for complex medical services from the logic of hospital competitive price formation. In terms of goal orientation and formation methods, it analyzes the four crucial price formation processes of organizing hospital quotations, government review of quotations, generation of proposed price adjustments, and selection of price adjustment items, which provides a referable basis for each pilot region to explore price formation for complex medical services.

Objective: The paper attempts to provide guidance and reference for dynamically adjusting the prices of general medical services in various regions, and taking the most concerned examination fee as an example, to analyze the price comparison relationship between regions and items. Methods: In terms of price comparison between regions, descriptive statistical analysis methods are used. In terms of the price comparison relationship between items, the median or median value of the price comparison coefficient between other examination fees and the outpatient examination fees of attending physician is used to determine a reasonable price comparison coefficient. Results: The price comparison relationship between regions is not reasonable enough, and more than half of the provincial item prices do not match the price range. Some examination fee items have a large coefficient of price difference between provinces. The price comparison relationship between items is not reasonable enough, and the range of price comparison coefficient between other examination fees and outpatient examination fees of attending physicians is relatively large. Conclusion: For examination fee items with unreasonable price comparisons between regions and items, it is recommended that each region reasonably set the price benchmark for outpatient examination fees of attending physicians based on the suggested price zone, and use the reasonable price comparison coefficient between items to synchronously adjust the prices of other examination fee items.

Objective: The paper discusses the economic theoretical underpinnings of how newly launched drugs form their launch price, the challenges, and problems. Methods: Based on the general rules of drug pricing, the study explores the mechanisms of forming a launch price from the perspectives of endogenous and exogenous pricing, asymmetric information game, competition in the innovative drug market, and new institutional economics. Conclusionand Suggestion: Establishing appropriate pricing mechanism for the launching of newly-launched drugs is a measure to play the decisive role of the market in the resource allocation while better playing the role of the government. The mechanism encouraging high-quality innovation should focus on reducing institutional transaction costs. Based on the information disclosure of innovation value and competition, we propose to classify newly-launched drugs to reduce the degree of information asymmetry and address the problem of adverse selection in the current new drug market, maximize the pricing power for high-quality innovative drugs and restrict the pricing power of monopoly for homogeneous innovations, balancing efficiency and equity.

Objective: The paper analyzes the relationship between medical service price reform and DRG payment reform, explore the synergistic mechanism between the two, and provide a reference for government decision-making and high-quality development of hospitals. Methods: Based on the data of 610624 patients from the sample hospitals from 2018 to 2022, the paper applied the degree of structural variation and grey relation analysis method to quantitatively analyze the degree of structural variation, the contribution rate of the degree of structural variation, and the correlation degree of hospitalization expenses. Results: Since 2018, average hospitalization expenses of the sample hospitals have shown a fluctuating downward trend, with an average annual decrease of 1.81%. Among them, the proportion of drug fees has been decreasing year by year, with the highest contribution rate to structural changes. The cost of treatment and surgery has relatively increased, and the contribution rate is inferior to drug fees. However, the proportion of laboratory fees and inspection fees has relatively increased, while the proportion of sanitary material fees remains basically unchanged. Conclusion: The medical service price reform and DRG payment reform promoted the optimization of the medical expense structure of hospitals. It is necessary to strengthen the synergy of the two, strengthen the complementary relationship, further optimize the revenue structure of hospitals, and promote high-quality development of hospitals.

Objective: The paper reviewed the progress in the establishment and implementation of the mechanism for dynamic adjustment of medical service prices in 15 demonstration cities with central financial support for public hospital reform and high-quality development, and provided references for the dynamic adjustment of medical service prices in other provinces and cities. Methods: By literature research method and comparative analysis method, the paper reviewed the policy documents of dynamic adjustment of medical service prices in demonstration cities and compared the progress of price adjustment. Results: Sanming, Yichang, Xiangtan, Wuhu, Lishui and Zhongwei have made relatively rapid progress in price adjustment, and other regions still need to further improve the dynamic adjustment mechanism of medical service prices. Conclusions: Medical insurance departments should formulate implementation rules for dynamic adjustment of medical service prices based on local conditions, support public hospitals to participate in the dynamic adjustment of medical service prices on a cost-based basis, and ensure that the price level of medical services is commensurate with the level of regional economic development and per capita disposable income.

Objective: The paper is to grasp the coordination between China's economic development and medical service prices since China's new medical reform, and to provide a rationale for deepening and promoting China's medical service price reform for decision-making. Methods: Taking the period 2009-2021 as the observation period, disposable income per capita and average outpatient and inpatient medical service charges per capita were selected as evaluation indicators, and a coupled coordination model was used. Results: China's economic development and medical service price coordination since the new health care reform is generally in a mildly dysfunctional state, while Beijing and Shanghai have the highest coordinated type as primary coordinated development. Most coupled coordination coefficients are in the range of 0.3-0.4 and 0.2-0.3. Conclusion: There is an urgent need to strengthen the synergy between the economic level and the price of medical services in China, and attention should be paid to regional price convergence and the optimization of the price level of medical services.

Unreasonable drug use and high drug prices will not only increase the burden on patients, but also increase the pressure on the expenditure of medical insurance funds. In the context of China's liberalization of government pricing of medicines, clarifying the role of the market and the government on the formation of drug prices is conducive to playing the joint role of the market and the government, and the establishment of a drug price formation mechanism adapted to the development of the pharmaceutical market. Through an in-depth study of drug price formation mechanisms and price control measures in Denmark, this paper explores the synergism of the market mechanism and the government intervention in drug price formation, and puts forward some suggestions for realizing dynamic management of drug prices, improving laws and regulations for the pharmaceutical industry, implementing classified price management for drugs, and applying diversified policies.

How to pay for hospitals and physicians is one of the key questions in the design of healthcare security system in all countries. For China, it is reflected in two long-term tasks of medical service price management and medical staff salary management. This paper attempts to discuss the decision mechanism of medical service price and medical staff salary from two aspects of theory and practice, so as to provide decision-making reference for national healthcare security payment reform and public hospital salary reform.

This paper investigates the independent pricing work carried out by public hospitals in Jining City, and finds that policy implementation has played a positive role in meeting the diverse medical needs of the patients. At the same time, in view of the problems in price management of public hospitals, relevant suggestions are put forward to provide a reference for the improvement of the independent pricing work of public hospitals.

Objective: The purpose of this study is to sum up the experience of the national pilot cities of medical service price reform, and to provide suggestions for the following pilot areas to determine the total measurement method and explore the scientific allocation scheme. Methods: This paper clarifies the logic of the calculation method of the total amount of price adjustment, systematically summarizes the innovation highlights of the determination and distribution of the total amount of pilot cities, and analyzes the problems in the application. Results: Following the policy framework of medical service price reform, the pilot cities have explored the operation mode of gross regulation and control to adapt to the local actual situation. Conclusion: It is suggested that the following pilot areas should learn from the experience of the pilot cities that can be replicated and extended, with the goal of deepening the reform of medical service prices, make full use of the results of the baseline survey, and exercise the discretion in a scientific and reasonable mannerto establish a sustainable total amount control mechanism.

Accelerating the establishment of innovative medical technology items, and standardizing charging, pricing and medical insurance admission is to support technological innovation. On the basis of reviewing the new medical service price items and medical insurance access documents at the national level, this paper compares the practice of supporting innovative technology across different regions, and proposes relevant suggestions for standardizing the approval, pricing, and medical insurance access management for innovative medical technology charging items. We should further clarify the relationship between technical specifications, approval guidelines, and the application for new medical service pricing items, and ensure proper coordination of workflow; establish new item application channels that combine green and conventional channels based on the level of medical technology innovation; comprehensively utilize cost pricing, value pricing, and reference pricing methods to promote the reasonable formation of new item prices; clarify the application, evaluation, and selection rules for admission to the medical insurance catalogue for medical service price items with approved transfer.

Objective: The paper analyzed the spatial distribution characteristics and possible influencing factors of general medical service price in order to provide a theoretical basis for medical service price reform in China. Methods: Taking the outpatient diagnosis fee, the bed fee and the nursing fee of general medical service items in tertiary hospitals as samples, spatial autocorrelation analysis and spatial regression model was used to analyze their spatial distribution characteristics and influencing factors. Results: There was a global spatial autocorrelation between the outpatient diagnosis fee (Moran's I=0.168, P=0.006), the bed fee (Moran's I=0.154, P=0.022) and the nursing fee (Moran's I=0.205, P=0.004) in tertiary hospitals. The analysis of local hot spots showed that the hot spots were concentrated in Beijing City, Shanghai City, Jiangsu Province, Shandong Province and other places, while the cold spots were distributed in Chongqing City, Guizhou Province and other areas. Policy factors had statistical significance for the bed fee and the nursing fee, the proportion of personal health expenditure in the total health cost had statistical significance for the nursing fee, per capita GDP had statistical significance for the bed fee and the outpatient diagnosis fee (P<0.05), and other variables revealed no statistical significance. Conclusion: There was a global autocorrelation in the spatial distribution of outpatient diagnosis fees, bed fees and nursing fees in tertiary hospitals, suggesting that the dynamic adjustment mechanism of medical service price reform should pay attention to the spatial distribution of price, which is conducive to the formation of a gradient and reasonable medical service price system nationwide.

Objective: This study intends to construct a set of trigger index system for dynamic adjustment of service price suitable for traditional Chinese medicine (TCM) medical treatment, so that the diagnosis and treatment programs with TCM characteristics and significant therapeutic effects can be applied to the clinical practice in a more scientific way. Methods: Literature research, expert interviews and Delphi expert consultation method were used to validate and determine the indicator system, and the analytic hierarchy process method was used to determine the weighting coefficients for each indicator. Results: An indicator system for dynamic adjustment of TCM medical service price was constructed, which included 4 primary indicators, 6 secondary indicators and 18 tertiary indicators, and the weight coefficients were assigned to each tertiary indicator. Conclusion: The constructed indicator system of dynamic adjustment of TCM medical service price shows high scientificity and rigor, and fully considers the characteristics of TCM diagnosis and treatment, which is conducive to strengthening the construction of a dynamic adjustment evaluation index system for TCM medical service prices..

In December 2024, the National Healthcare Security Administration released the Guideline for Establishing Gynecological Medical Service Price Items (Trial). This marks a significant step in deepening the reform of the healthcare system and represents a pivotal shift from a focus on the specific operational procedures of medical services to an emphasis on service output and value demonstration in medical service price management. Guided by service output, the guideline integrates the original gynecological service price items into three categories comprising 84 items. The guideline significantly streamlined the number of projects and clarified their definitions, thereby promoting standardization and normalization of pricing. The implementation of this guideline is of great significance for restoring the true value of gynecological medical services and safeguarding women's health rights across their entire life cycle. This article analyzes the prominent issues in China's current pricing system, interprets the design philosophy and key features of the gynecological guideline, takes practice in Sichuan Province as an example to provide a detailed introduction to the specific path and challenges of local adaptation of national guidelines, thus offering reference for further advancing medical service price reform.

Objective: The paper analyzed the impact of the medical service price reform in public hospitals above the county level in Shaoxing City on the average expenses of outpatient and emergency department under the background of medical insurance management at municipal level. Methods: The degree of structural variation and gray correlation method were used to analyze the structural change and the correlation degree of the outpatient and emergency expenses in public hospitals before and after the implementation of the reform. Results: Before and after the reform, the expenses of vaccine, Chinese patent medicine, examination, surgery, diagnosis, and treatment showed a positive trend, while the expenses of laboratory testing, Chinese herb pieces, western medicine, medical materials and the other expenses showed a negative trend. Western medicine expenses were the main factor influencing the average cost, followed by the diagnosis, the treatment and so on. Conclusions: The reform had generally realized the unification of medical service prices at municipal level, and didn't significantly increase the burden of patients. The labor of medical personnel was valued, therefore the preliminary progress had been achieved. However, structural adjustment of the examination expenses needs to be further strengthened in the future.

The pediatric operation is difficult, occupational risk is high, historical price of medical services is relatively low, and fees and costs are deviated. On the basis of reviewing the policies related to the formation and dynamic adjustment of pediatric medical service prices at the national level, this paper compared the setting, pricing and price adjustment of pediatric medical service in some provinces, and put forward proposals for improving the price of pediatric medical services. According to the characteristics of pediatric medical service, the appropriate price items can be set up, and the scope and proportion of additional fees should be explained by full pricing. General and complex projects should be distinguished, and dynamic price adjustment should be initiated in time to reflect the characteristics of technical labor and support the development of pediatrics after evaluation.

With typical cases, this paper analyzes the problems and causes of unreasonable operation charging items in medical institutions, and proposes to revise the connotation of charging items such as adding instruction of restrictions and perfecting their contents.