Establishment of tiered diagnosis and treatment system based on the stakeholder theory and its strategies: a case study on Nanjing

Purpose: This dissertation's purpose is to discuss the tiered diagnosis and treatment system and its implementation strategies in China based on the stakeholder theory. Method: The thesis will take Nanjing as an example to compare the composition, management, and operation of the three major medical partnerships, namely, Jiangsu Province Hospital Group, Nanjing Drum Tower Hospital Group, and Zhongda Hospital Southeast University Group, based on the stakeholder theory and case analysis. Key stakeholders will be derived from the literature review, and the attribute of all stakeholders will be determined by Mitchell score-based approach. The thesis will also investigate cognition, recognition, interest demands and suggestions of core stakeholders concerning tiered diagnosis and treatment, and propose relevant suggestions to facilitate the implementation of tiered diagnosis and treatment. Results: The three major medical associations in Nanjing are mainly established according to the model of "government appointment plus voluntary association". Their operation model and effects are different. Core stakeholders of tiered diagnosis and treatment include: health administrative departments, medical insurance departments, medical staff working at superior medical institutions, the public (patients, dependents of patients and residents), medical staff working at primary medical institutions, and companies; marginal stakeholders include center for disease control and prevention, new media such as WeChat official accounts and Microblog, administration for industry and commerce, medical staff working at private medical institutions, commercial insurance institutions, traditional media such as newspapers and TV channels; and general stakeholders include departments of finance, price departments, National Development and Reform Commission, Food and Drug Administration, public security organs, procuratorates and people’s courts, and industrial associations. There are differences in the cognition, recognition, and interest demands among all key stakeholders. Conclusion: The effect of the implementation of tiered diagnosis and treatment is not satisfactory. To further develop tiered diagnosis and treatment, more measures should be taken, such as publicity and guidance, proper resource allocation, introducing commercial capital, strengthening independent practices of medical personnel, and establishing sharing medical platform.Propósito: O objetivo desta dissertação é discutir o sistema de diagnóstico e tratamento em níveis e as suas estratégias de implementação na China com base na teoria dos stakeholders (partes interessadas). Método: A tese tomará Nanjing como um exemplo para comparar a composição, gestão e operação das três principais parcerias médicas, ou seja, o Grupo Hospitalar da Província de Jiangsu, o Nanjing Drum Tower Hospital Group e o Zhongda Hospital Southeast University Group, com base na teoria dos stakeholders e na análise de caso. As principais partes interessadas serão identificados com base na revisão bibliográfica e o atributo de todas as partes interessadas será determinado pela abordagem baseada no escore de Mitchell. A tese também investigará a cognição, o reconhecimento, as exigências de interesses e as sugestões dos principais interessados no diagnóstico e tratamento escalonados, e proporá sugestões relevantes para facilitar a implementação do diagnóstico e tratamento escalonados. Resultados: As três principais associações médicas em Nanjing são estabelecidas principalmente de acordo com o modelo de "nomeação governamental mais associação voluntária". O seu modelo de operação e efeitos são diferentes. As principais partes interessadas do diagnóstico e tratamento escalonado incluem: departamentos administrativos de saúde, departamentos de seguros de saúde, equipe médica trabalhando em instituições médicas superiores, o público (pacientes, dependentes de pacientes e residentes), equipe médica trabalhando em instituições médicas primárias e empresas; partes interessadas marginais incluem o centro para controle e prevenção de doenças, novos meios de comunicação como contas oficiais do WeChat e Microblog, administração para indústria e comércio, pessoal médico trabalhando em instituições médicas privadas, instituições de seguros comerciais, meios de comunicação tradicional como jornais e canais de televisão; e as partes interessadas em geral incluem departamentos de finanças, departamentos de preços, Comissão Nacional de Desenvolvimento e Reforma, Administração de Alimentos e Medicamentos, órgãos de segurança pública, procuradorias e tribunais do povo e associações industriais. Existem diferenças nas exigências de cognição, reconhecimento e interesse entre todos os principais interessados. Conclusão: O efeito da implementação do diagnóstico e tratamento escalonado não é satisfatório. Para desenvolver ainda mais o diagnóstico e o tratamento escalonados, mais medidas devem ser tomadas, como publicidade e orientação, alocação adequada de recursos, introdução de capital comercial, fortalecimento das práticas independentes de pessoal médico e estabelecimento de plataformas de partilha médica

Smart Plot Division, Research on the Morphological Evolution of Nanjing South Historic Urban Area and its Plot Redivision since 1949

Chinese historic cities have experienced drastic transformations since the socialist revolution of 1949, in which an essential change is the reconstruction of the plot pattern. The historic plot pattern in a majority of Chinese cities was heavily damaged by constant urban renewals, while the renewed plot pattern lost its historically morphological identity. The transformation of plot pattern is directly influenced by plot division which serves as not only a planning apparatus but also a key link in the land development system. The damage of historic plot pattern has shown that the current plot division mechanism is not necessarily in favor of the conservation and continuation of historic cities. Under this background, this dissertation takes the first step to understand the special role of plot division in affecting the transformation of urban form in the historic urban area. Based on the hypothesis that the plot serves as a mediator connecting urban morphology and land development system, this research establishes a plot-based morphological-institutional analytical framework, exploring the morphological evolution of Nanjing south historic urban area since 1949 and its plot redivision. The research is composed of four parts, including analysis of morphological evolution, institutional analysis of plot division, comparative research with Berlin and the strategy for the urban refurbishment. Based on the typo-morphological theory, the analysis of morphological evolution is made at three different spatial levels including the historic urban area, unit plot and plan-unit. The analysis shows that the elimination of traditional plot subdivision and the prevalence of megaplot schema is the prominent feature for the morphological evolution of Nanjing Old South area since 1949. The megaplot schema not only implies excessive plot scale but also represents excessive differences of building types and an increasingly alienated plot-building relationship. The renewed plot pattern in five typical plan-units has neither continued the historically morphological characteristics nor generated better urban space. The institutional analysis of plot division focuses on three aspects including the conservation planning, the regulatory planning, and land development mode. The result shows that the plot pattern is for a long time neglected by the conservation planning system. The regulatory planning does not establish a mature standard of plot division and shows a deficiency in the morphological control on the unit plot. The historical institutionalist(HI) analysis of land development mode in Nanjing shows that the prevalence of megaplot is the result of the land development of growth supremacism. The comparative research between Nanjing and Berlin shows that the development of Nanjing Old South area was for a long time in a fragmented way. Taking a reference on Berlin’s Critical Reconstruction since the 1990s, a set of smart plot division strategy is finally proposed to promote the refurbishment of the historic urban area

The process of hospital consolidation: a case study in Anhui Province, China

JEL: I11, I18, M1, M54Hospital consolidation is an important topic both in theoretical research and practical exploration in the healthcare sector as it allows for the improvement of the utilization efficiency of medical resources and for the optimization of cost reduction. Based on the strategic management theory, especially the resource-based theory, this thesis makes an in-depth analysis of the strategic choices of the First People‘s Hospital group of Hefei City, Anhui Province, China. Combining with the process of China‘s health system reform, the motivating factors of establishing hospital groups, the basic concept of hospital groups and modes are reviewed while the reasons and background for public hospitals consolidation in China are introduced. Under this setting, the thesis studies the motivations behind strategic choices and incentives towards consolidation as well as the environment and the strengths and weaknesses of the internal resources of the hospital. Based on the case study method, 25 semi-structured interviews to 25 experts and participants and field visits were conducted for data collection. The research shows that the consolidation strategy followed by the hospital allows for its sustainable development. However, in identical situations, for positive results to be achieved, a core member of the group should be selected to lead the consolidation process during the transition period and to balance the relationship between centralization and decentralization while respecting each specific situation The analysis of the strategic consolidation of the hospital studied allowed for the identification of difficulties and challenges, which may serve as a theoretical base for the practice of other organizations undergoing a similar processA consolidação de unidades hospitalares é um tópico de investigação importante para a teoria e para a prática, pois permite reorganizar os recursos médicos através da sua utilização eficiente e da optimização da redução de custos. Com base na teoria da gestão estratégica e em especial na teoria dos recursos, esta tese analisa em profundidade as escolhas estratégicas com que se debateu um grupo hospitalar da cidade de Hefei, província de Anhui na China: o First People‘s Hospital Group. Tendo como base o processo de reforma do sistema de saúde na China, a tese estuda as motivações inerentes à tomada de decisão, bem como os incentivos à consolidação. São analisados os pontos fortes e fracos do hospital, os seus recursos principais e a envolvente procurando-se entender as escolhas estratégicas que levaram à consolidação. A tese utiliza o método do estudo de caso tendo sido realizadas 25 entrevistas semiestruturadas a peritos e participantes no processo bem como diversas visitas que permitiram observação direta. A investigação demonstra que a estratégia de consolidação permite assegurar o desenvolvimento sustentado do hospital mas, para isso, a melhor opção é escolher um dos membros do grupo para assumir um papel de liderança durante o período de transição e cuidar do equilíbrio da relação entre centralização e descentralização sem descurar a especificidade da situação local. A análise da consolidação estratégica do hospital estudado permitiu ainda identificar as dificuldades do processo contribuindo com uma base teórica que poderá ser útil ao desenvolvimento de outras organizações em idêntica situação

Producing space, producing China : a critical intervention

The concepts of the production and representation of space and place are receiving an increasing amount of attention in both the humanities and the social sciences. This paper will use the theoretical knowledge that has and continues to be produced on the subject to come to a better understanding of the spatial origins that constitute the place that is Chinese nation state. The analysis of spatial practises should shed light on the question what China is and wherefrom it receives the legitimacy for its social-spatial integrity. It will be argued that the arrival of modernity and its universal measurement of time and space were essential components in the gradual transformation from ethnocentric place to a territorially defined nation state. The political production and organisation of space employed for the formation of the nation state is argued to be the consequence of the same (globalising) logic that is now said to question and undermine its territorial integrity. Modernity and globalisation are in this paper, in other words, considered to be similar, if not identical, spatial-temporal concepts that both help to create and destruct places. This is arguably best visible in the constant production and reproduction of the most sophisticated of spatial organisations: our cities. I will argue that despite the changing face of cities, of which the disputed contemporary "globalisation" is but one of many, the spatial reality that is the modern nation state remains the same. This is not to return to an orthodox realist interpretation but to understand the very "stuff" that space and place are made of

Geo-Information Technology and Its Applications

Geo-information technology has been playing an ever more important role in environmental monitoring, land resource quantification and mapping, geo-disaster damage and risk assessment, urban planning and smart city development. This book focuses on the fundamental and applied research in these domains, aiming to promote exchanges and communications, share the research outcomes of scientists worldwide and to put these achievements better social use. This Special Issue collects fourteen high-quality research papers and is expected to provide a useful reference and technical support for graduate students, scientists, civil engineers and experts of governments to valorize scientific research

the Interitance and Transformation of Traditional Huizhou Elements into New Forms: Redesigning Lu Village

The hardest part in the preservation of traditional culture is the inheritance of its spiritual meaning. Therefore, it is important to adhere to the creation of regional architecture through the interpretation of local environment and climate, ethnic culture and architecture influenced by traditional philosophies. In the context of global acculturation, it is necessary to revitalize domestic architectural expression by promoting the fusion of world culture and local traditional culture. The historic Huizhou region lies in what is now Anhui province. With all the tangible and intangible cultural heritage it bestows, it is not only one of the many cultural treasures of China, but also provides possible inspiration for modern architectural design. Therefore, by research of Huizhou area, this thesis defines the hidden order as well as the ethic and spiritual connotations of traditional culture and architecture of Huizhou by examining the intangible cultural factors affecting architecture. The ultimate goal is to apply these interpretations of intangible cultural heritage hidden behind the tangible cultural heritage to a contemporary architectural expression in Huizhou in addition to preserving existing historical buildings. After the research part, the Section 2 demonstrates preservation and redesign of a particular case in Huizhou, namely the Lu Village. By exploring the tangible and intangible characteristics of Lu Village, the aim is to find the harmonious relationship between past, present and future. Therefore, the rehabilitation and redevelopment plan of Lu Village is based on the discussion on Huizhou in general (section1) and special features of Lu Village in order to preserve old when appropriate and to design new in accordance to the spirit of place, and to improve the living conditions which ensures life of future generation

Disposable empties. Reading Economic Phenomena through Architecture

L'abstract è presente nell'allegato / the abstract is in the attachmen

Building a tiered rehabilitation system: the case of Yunnan Province

Research purposes: The hierarchical rehabilitation system model of Yunnan Province is built to provide a reference for the establishment of a standardized three-level rehabilitation system so as to meet the patient demands for different functional rehabilitation at different stages during the whole treatment. Research methods: 1. The General System Theory model is adopted as a guidance for the organizational structure construction of the hierarchical rehabilitation system model in rehabilitation centers, rehabilitation sub-centers, and rehabilitation stations in Yunnan Province. Standardized hierarchical rehabilitation hardware construction for these rehabilitation institutions of different levels helps form an exemplary structural model of a three-level standardized rehabilitation system. 2. The Learning Cycle Theory model is adopted as a guidance for the unified standardized training for patient rehabilitation management in the exemplary rehabilitation institutions of the three-level system. The researchers regularly guide, supervise, and summarize the standard implementation situations of patient rehabilitation management in these institutions and assess the operational quality and management efficiency of the hierarchical rehabilitation system model in Yunnan Province, finally forming the exemplary and standardized three-level rehabilitation system model. 3. The researchers analyze the operating parameters of the medical institutions at all levels in the three-level standardization rehabilitation system and evaluate the structural process and operational efficiency of the three-level standardized rehabilitation system model based on the analysis results.O modelo do sistema de reabilitação hierárquico da Província Yunnanfoi concebido comoumreferencial para a implementação de um sistema de reabilitação estruturado em três níveis, de modo a responder às necessidades dos doentes nas diferentes fases da sua reabilitação funcional. Como guias metodológicos foram adotadosa Teoria Geral dos Sistemas e o LearningCycleTheory, entre outros contributos teóricos considerados relevantes. Os investigadores participantes supervisionaram a operacionalização do sistema e avaliaram as instituições de cada um dos três níveis, quanto àestrutura, ao processo e à eficiência operacional. Quanto aos resultados houve uma clara perceção dos ganhos obtidos em várias dimensões. Pelo lado das instituições governamentais, pela redução dos recursos utilizados e pela maior mobilização e empenhamento dos profissionais e por parte dos doentes, pela maior rapidez de resposta às suas necessidades e a uma redução do tempo da sua reintegração no mercado de trabalho. A reputação deste sistema implicoutambém ganhos significativos nas receitas obtidas, que aumentaram em mais de 10% em dois anos, tendo mesmo algumas serviços atingido incrementos de 89,6%. A mudança de cultura organizacional das instituições envolvidas,no sentido da inovação e da proatividadeé também um facto a reter com particular relevância. Como conclusão, poderemos referir que este modelorespondeu as expectativas de todos os stakeholders, desde o governo, aos doentes e ao público em geral, bem assim como às das instituições de saúde implicadas e os seus profissionais. Deste modo, este modelo pode fornecer contributos sustentados de aprendizagem para a conceção e implementação de sistemas de reabilitação regional de um modo rápido e estruturado