Medical Partnership Research Articles

Pilot Study: Behavioral and Medical Clinical Partnership for Optimization of Positive Airway Pressure Therapy in Pediatric Patients

BackgroundTo assess the effectiveness of a structured algorithm for pediatric positive airway pressure (PAP) initiation for the treatment of obstructive sleep apnea (OSA). MethodsAn algorithm was created to support pediatric PAP use and identify patients who could benefit from early behavioral consultation and education. Sleep providers implemented a unified introduction to PAP therapy with the PAP therapy toolkit. Through a collaborative approach with the medical equipment companies, pediatric patients were provided with PAP equipment before PAP titration studies and were allowed a gradual initiation of PAP therapy. PAP downloads were reviewed to determine improvements in compliance measured by percent of average days used and average minutes per night used. ResultsThirty-eight pediatric patients completed the PAP therapy algorithm. There was significant improvement in PAP compliance in percentage of days used (paired t test P value = 0.04), as well as an improvement (although not statistically significant) in average nightly use. Patients benefitted from close follow-up visits with the sleep advanced practice providers. Patients seen for the consultation with the pediatric behavioral psychologist showed statistically significant improvement in both percentage of days and average nightly use. ConclusionsOur pilot study shows that a behavioral and medical partnership using a structured algorithm was feasible and resulted in improved PAP compliance for our pediatric patients.

Effects of a nurse-led staged integral art-based cognitive intervention for older adults on the Alzheimer's disease spectrum: A randomized controlled trial

BackgroundCombined art activities can improve the neural network function within various brain regions involved in emotions, cognition, and behavior, thereby preventing or reversing cognitive decline. However, few studies have systematically examined its effects. Furthermore, the impact of nurse-led art-based cognitive intervention on cognitive and psychological health is unclear. ObjectiveTo evaluate the effects of a nurse-led staged integral art-based cognitive intervention in older adults on the Alzheimer's disease spectrum. DesignThis was a randomized wait-list controlled trial with allocation concealment and blinding of outcome assessors and data analysts. All data were collected between April 2021 and January 2023 and analyzed from January to March 2023. SettingOne memory clinic and four medical partnership communities. ParticipantsA total of 144 participants with subjective or objective memory decline (aged ≥60 years). MethodsParticipants were randomized into an intervention group (n = 72) and a wait-list control group (n = 72), in a 1:1 ratio. The intervention group underwent a 16-week, 24-session nurse-led staged integral art-based cognitive intervention program, which was based on neurocognitive function training patterns. The control group underwent the program after the follow-up assessment. General and specific domains of cognitive function and other health-related outcomes were measured at baseline (T0), immediately after the intervention (T1), and at the 6-month follow-up (T2). ResultsOf the 144 participants (mean [SD] age, 71.6 [5.8] years; 50 [34.7 %] males and 94 [65.3 %] females), 130 and 115 completed the questionnaires at T1 and T2, respectively. The average attendance rate in the intervention group was 86.0 %. At T1, the intervention group showed greater improvement than the control group did in general cognitive functions (MoCA, between-group mean difference, 1.4 [95 % CIs, 0.4 to 2.5], p = 0.009). Additionally, the intervention group demonstrated statistically significant improvement compared to the control group in language, memory, quality of life, sleep quality and physical activity level at T1. Statistically significant group differences remained in sleep quality (PSQI, between-group mean difference, −1.3 [95 % CIs, −2.5 to −0.1], p = 0.035) at the 6-month follow-up. ConclusionsIn this randomized controlled trial of a nurse-led staged integral art-based cognitive intervention program, older adults on the Alzheimer's disease spectrum who participated in the program experienced improved cognition and psychological health. RegistrationThis study was registered with ChiCTR.org (ChiCTR2100044959) on April 3, 2021. Tweetable abstractA nurse-led staged integral art-based intervention for older adults on the Alzheimer's disease spectrum experienced improved cognition and psychological health.

“Don’t I need research to get a residency?” Incorporating scholarly activity at a regional campus

The impact of Step 1 becoming pass-fail is yet to be known. Many believe the value and power of scholarly activity will increase across specialties, but opportunities for such activities differ across universities and even between campuses. At the Augusta University/University of Georgia Medical Partnership, a regional campus of the Medical College of Georgia, we hoped to better understand our students' current scholarly activity production and their reasoning behind pursuing these activities. Student surveys indicated that the three highest specialties of interest were primary care-based; students, on average, had one or two poster presentations and one or fewer manuscripts published in medical school thus far. The top reasons to pursue research were the transition of Step 1 to pass-fail, interest in a competitive specialty, and the encouragement of mentors. We hope by understanding our current medical students, we can further cater to their needs through the creation and implementation of new scholarly activity opportunity initiatives.

Identifying and Prioritizing Economic Opportunities for Medical Tourism Management: An Analytic Hierarchy process

Background: As a growing industry, medical tourism includes many economic opportunities. This industry is the largest and most diverse industry in the world, with a foreign currency income which is equal to the automotive and military weapons industries. The aim of the current research is to identify and prioritize economic opportunities related to medical tourism management, using the Analytical Hierarchy Process (AHP) as a multi-criteria decision-making tool. Methods: This was a descriptive-survey research with an applied and cross-sectional approach. A survey method was used to collect data, so this study can be classified as field research. The statistical population of the research included 25 people with experience and expertise selected through purposive sampling in the fields of management, tourism, and medicine. The method of collecting data was in the form of library and field studies. The tool for collecting data was a questionnaire of paired comparisons and a check sheet. Data analysis was done with AHP method and Expert Choice 11 software. After collecting the paired comparison questionnaire and calculating the geometric mean, the inconsistency rate of the questionnaires was less than 0.1, which showed that the data had the required validity. Results: First, using library studies, economic opportunities related to medical tourism were identified. These opportunities included cash generation, technological advancements, job creation, diversification of tourism industry, development of health care infrastructure, knowledge transfer and cooperation, services and ancillary industries, and regional development and diversification of economic activity. Opportunities were prioritized using the AHP method. Cash generation with relative importance of 0.191 was ranked first, job creation with relative importance of 0.162 was second, and technological advances was ranked third with relative importance of 0.131. Diversification to economic activities with a relative importance of 0.45 was ranked ninth which was the lowest. Conclusion: Strategic marketing, delivering quality healthcare services, competitive pricing, specialized medical care, patient-centered experience, collaboration and partnership, continuous improvement, and strengthening medical tourism infrastructure are the pillars through which medical tourism management can not only generate sustainable revenue but also provide invaluable healthcare services to patients from across the globe.

Affective relatedness, temporalities, and the politics of care in a medical South-South partnership

Abstract For more than 50 years, Cuba has been one of the most important players in the field of international medical care in the Global South. Between 2013 and 2018, Cuba sent nearly 18,000 Cuban health professionals to Brazil within the framework of the More Doctors Program to assist during the Brazilian public health care system's state of emergency. This article focuses on local encounters and emergent socialities between Cuban physicians and Brazilian patients and medical staff. Their sensitive moments of interaction—with their embodied, emplaced, and political dimensions of past and present—hold the possibility of a fragile intersubjectivity that creates its own temporal and affective dynamics, undermining, for a moment, the prevalent care regimes.

THE RELATIONSHIP ANALYSIS OF INTERPERSONAL CARE AND CONTINUITY OF CARE WITH THE PATIENT SATISFACTION INDEX IN THE OUTPATIENT POLYCLINIC OF TGK.CHIK DITIRO PIDIE REGIONAL HOSPITAL

Patient satisfaction is an important indicator in evaluating health care quality. Outpatient care are one type of hospital service that requires quality assessment aspects, and nursing services are an integral part of hospital services. This research was conducted to determine the relationship between interpersonal care and continuity of care with patient satisfaction index in outpatient polyclinics. This study is quantitative research with a cross-sectional design. The respondents in this study were patients who received outpatient services at the Polyclinic of Tgk. Chik Ditiro Pidie Regional Hospital, totaling 209 respondents selected by Probability sampling. The study was conducted in October 2023. The Spearman test showed a relationship between interpersonal care (p=0,000; r=0.490) with patient satisfaction index, interpersonal communication (p=0.000; r=0.498) with patient satisfaction index, interpersonal style (p=0.000; r=0.509) with patient satisfaction index, decision making p=0.000; r=0.482) with patient satisfaction index. The relationship between continuity of care (p=0,000; r=0,478) with patient satisfaction index, long-term patient and medical partnerships (p=0.000; r=0.508) with patient satisfaction index, doctor and nurse information of patient medical record (p=0.000; r=0.338) with patient satisfaction index and service facilities (p=0.000; r=0.545) with patient satisfaction index at the outpatient polyclinic of Tgk.Chik Ditiro Pidie Regional Hospital. The results of the linear regression test of the service facilities are the most related to the patient satisfaction index (coeff=-0,662; p=0,000). Service facilities are the variables most related to the patient satisfaction index at the outpatient polyclinic of RSUD Tgk. Chik Ditiro Pidie.

Article Watch: December, 2023.

This column highlights recently published articles that are of interest to the readership of this publication. We encourage ABRF members to forward information on articles they feel are important and useful to Clive Slaughter, AU-UGA Medical Partnership, 1425 Prince Avenue, Athens GA 30606. Tel; (706) 713-2216: Fax; (706) 713-2221: Email; cslaught@uga.edu or to any member of the editorial board. Article summaries reflect the reviewer's opinions and not necessarily those of the Association.

Engaging the Asian American Community to Address Cancer Burden: Experiences and Lessons Learned

Abstract: Background: Reducing cancer health disparities in Asian Americans requires orchestrated efforts and partnerships. Objectives: To describe the approach used by the University of Texas MD Anderson Cancer Center, HOPE Clinic, and Asian American organizations to understand and engage Houston's Asian American communities in cancer research, as well as to share lessons learned. Methods: The community-academic-medical partnership used community-based research principles to build the partnership, form the community advisory board, conduct a community needs assessment, and offer cancer prevention engagement and education. Results: Some lessons learned included balancing language needs with limited resources, incorporating more time and resources to conduct health research in an ethnically diverse community, and promoting awareness of research and its role in cancer prevention in Asian American communities. Conclusions: Community–academic–medical partnerships are promising ways to engage the community, draw on combined expertise, and create research and programs that are scientifically strong and meaningful to the community.

Motivators and barriers for rural community preceptors in teaching: A qualitative study.

Increasing challenges in recruiting and retaining community-based teaching physicians (e.g., community preceptors) call for a better understanding of motivators and barriers community preceptors perceive in their teaching role. Given the importance of medical school partnerships with community-based sites for student training, it is essential to understand the perspectives of community preceptors as teaching physicians in a context away from the medical school, such as rural, and the factors affecting their career choice to engage in teaching while practising medicine. We conducted semi-structured interviews with rural community preceptors and used open coding to conceptualise data and axial coding to connect codes into categories. We used the socio-cognitive career theory framework to organise categories into themes. Eleven rural community preceptors from two medical schools participated. Specialties included family medicine, internal medicine and paediatrics; clinical practice and teaching experience ranged from 3-36 and 2-29 years, respectively. Readiness for teaching ('self-efficacy') was pivotal in community preceptors' decision to teach and derived largely from vicarious learning from teaching attendings in medical school or residency; social persuasion and encouragement from clinical partners; and their accomplishments as practising physicians. However, limited faculty development, incomplete knowledge of expectations, disengagement from the medical school and lack of current mentors hindered their self-confidence. Teaching fulfilled their aspirations ('outcome expectations') to give back to the profession, but they felt undervalued and disconnected from other clinician educators. Teaching increased job satisfaction, but clinical workload, and financial impact impeded their goals for achieving excellence ('performance'). Self-efficacy was a pivotal motivator in rural community preceptors' decision to teach. Role models from early training inspired them to teach. Internal awards sustained teaching efforts. Future research should explore structural barriers influencing rural community preceptors' teaching experiences to better support their career choice to become medical educators.

Abstract 17200: PAD Raising Awareness in Sacred Environments “Praise”

Introduction: Atherosclerotic peripheral artery disease (PAD) leads to a great burden of cardiovascular and limb-related morbidity and mortality in African Americans (AA) compared to White Americans. Medical center partnerships with churches may be an effective method to improve PAD awareness and detection in the AA community. Hypotheses: We hypothesized that implementing a medical educational program in partnership with churches would increase PAD familiarity and identify participants with undiagnosed PAD. Aims: To determine (1) PAD familiarity before and after a one-time educational intervention and (2) the prevalence of PAD in older, church-going Nashville residents. Methods: Using a community-engaged research (CER) model, we partnered with 5 churches to enroll participants ≥ 50 years of age. Participants were given a 16-point pre- and post-educational program assessment to determine baseline and post-intervention PAD knowledge. Pre- and post-intervention scores were compared using Wilcoxon signed-rank test. Ankle-brachial index (ABI) testing was used to screen for PAD (ABI < 0.9). Results: We enrolled 120 participants (mean age [SD]: 64.67 [8.33] years, 74% women, 80% AA). The prevalence of PAD was 10.83%. Pre-intervention PAD awareness was low (mean score (MS): 10.89 [4.24]) and improved significantly post-intervention in all participants (MS: 13.88 [2.76; p=2 x 10 -12 ). Participants without PAD (ABI ≥ 0.9-1.39) (MS: 10.81 [4.28] vs. 13.91 [2.79]; p= p=4 x 10 -11 ) and with indeterminate status (ABI>1.4) (MS [SD]: 10.00 [5.03] vs. 14.10 [1.73; p=0.01) showed significant improvement in PAD awareness pre vs post intervention. Participants with PAD (ABI <0.9) (MS: 12.15 [3.26] vs. 13.46 [3.26; p=0.40) did not have significant improvement in their awareness scores. Conclusions: The PRAISE study demonstrates an effective CER partnership with churches as a method to increase PAD awareness and early detection of PAD, specifically among AAs.

Pediatric precision oncology: "better three hours too soon than a minute too late".

Precision oncology is defined as the selection of an effective treatment for a cancer patient based upon genomic profiling of the patient's tumor to identify targetable alterations. The application of precision oncology toward pediatric cancer patients has moved forward more slowly than with adults but is gaining momentum. Clinical and pharmaceutical advances developed over the past decade for adult cancer indications have begun to move into pediatric oncology, expanding treatment options for young high-risk and refractory patients. As a result, the FDA has approved 23 targeted drugs for pediatric cancer indications, moving targeted drugs into the standard of care. Our precision oncology program is in a medium sized children's hospital, lacking internal sequencing capabilities and bioinformatics. We have developed methods, medical and business partnerships to provide state-of-the-art tumor characterization and targeted treatment options for our patients. We present here a streamlined and practical protocol designed to enable any oncologist to implement precision oncology options for their patients.

Japanese Universities’ International Medical Partnerships: Reciprocity and Stratification

Recently, study abroad and elective programs have been facilitated via university partnerships based on student-exchange agreements. This study examined international medical student exchange agreements, focusing on reciprocity and stratification in the Japanese context. An empirical analysis was conducted using 581 agreements involving student exchanges with medical institutions in foreign countries based on a survey conducted by the Japanese Ministry of Education. We found that the average reciprocity rate via mutual tuition waivers was 52.84%: equivalent in Asia, slightly lower in Europe (49.61%), and higher in North America (58.06%). Europe has a balanced inbound and outbound exchange, Asia has a higher inbound exchange, and North America has an excess of outbound exchange from Japan. Moreover, selective institutions, such as former imperial or medical universities, have more than twice the number of agreements per university compared to others. In conclusion, it can be observed that international medical university partnerships are stratified, and reciprocity is intertwined with tuition waivers and the number of exchange students in the partnering institutions. As the results highlight the distinct characteristics of international education partnerships in Japan’s medical field compared to partnerships in all academic fields, it is necessary to investigate and develop international partnerships separately by field.

Low-Income Caregiver Perspectives on a State Education Savings Program and Receptivity to Clinic-Based Financial Counseling

Background and ObjectiveIn 2019, Pennsylvania launched a Children’s Development Account (CDA) program that invests $100 in an education savings account for every child born in the state. However, as of 2021, only 10.6% of families claimed the investment. Low-income communities may stand to benefit most from educational investments, but few studies have assessed barriers and facilitators of uptake in these communities. We sought to examine low-income caregivers’ perceptions of and barriers and facilitators to participation in a statewide CDA program and their receptivity to clinic-based financial counseling through a medical financial partnership. MethodsWe surveyed 100 caregivers of Medicaid-insured children from 2 primary care practices serving a predominantly low-income community. From these 100, we purposively sampled 30 caregivers for follow-up interviews. ResultsThe 100 survey participants were predominantly female (83%), Black or African American (92%), and non-Hispanic or Latino (93%). Twenty-nine percent of survey participants were aware of the CDA program, 4% had enrolled, and 64% were interested in clinic-based financial counseling. In interviews, caregivers identified several barriers to and facilitators of engagement in the CDA program. They also identified several strategies to boost engagement, including simplifying registration, providing additional and personalized program information, expanding the investment amount, and providing clinic- and community-based outreach. ConclusionsLow-income caregivers identified several barriers to enrollment in a statewide CDA program and strategies to boost enrollment, including clinic-based financial counseling. Future research should examine the effectiveness, cost-effectiveness, and long-term financial and health consequences of clinic-based financial services for low-income families.

Hospital Health Promotion Program Influence on Stroke Patients’ Motivation for Medical Rehabilitation

Stroke is the second leading cause of death and the third leading cause of disability. World Health Organization in 2021 found that around 70% of disability and 87% of deaths due to stroke occur in low- and middle-income countries. One of Indonesia’s efforts to minimize disability in post-stroke patients is medical rehabilitation. In an effort to maintain the patients’ motivation to adhere to medical rehabilitation, hospitals employ the hospital health promotion program. The purpose of this study is to analyze the effect of the hospital health promotion program on stroke patients' motivation for medical rehabilitation. This quantitative analytic study with a cross-sectional approach was conducted at Haji Adam Malik Central General Hospital and Medan Haji General Hospital. The research population was 124 post-stroke patients (48 patients from Haji Adam Malik Central General Hospital and 76 patients from Medan Haji General Hospital) and all of them were used as samples (total sampling). Data collection was conducted using a valid and reliable questionnaire (validity and reliability test carried out). Analysis was carried out using frequency distribution, chi-square, and double-log regression analysis. This study found that 90 out of 124 participants had high motivation for medical rehabilitation, while the rest had low motivation. The results showed that the hospital health promotion program had a significant effect on the motivation of stroke patients for medical rehabilitation, namely empowerment (OR=2.842), atmosphere building (OR=2.937), advocacy (OR=3.028), and partnerships (OR=2.738). Advocacy has the most impact on the patient’s motivation with OR=3.028. It can be concluded that hospital health promotion program has a positive influence on stroke patients’ motivation to undergo medical rehabilitation. Hence, implementation of similar health promotion program on other hospitals are highly encouraged to influence stroke patients’ motivation for medical rehabilitation.

Revitalizing General Practice: The Critical Role of Medical Schools in Addressing the Primary Care Physician Shortage

The shortage of primary care physicians is a growing crisis that threatens the stability and effectiveness of healthcare systems. This paper explores a multi-pronged approach to addressing this issue by focusing on the modernization of medical curricula, the establishment of new medical schools, fostering collaboration between institutions, and implementing policy innovations. The cases of South Tyrol, Italy, and Tyrol, Austria, are examined to highlight the challenges faced in establishing new medical schools. This paper proposes that a comprehensive strategy, including the incorporation of general practice content and experience in medical education, is crucial for preparing future physicians for careers in primary care. Furthermore, intensifying efforts to establish new medical schools, particularly in regions such as South Tyrol, which lack native-language medical university education, can provide additional benefits in addressing regional needs and augmenting the number of graduates. Collaboration between existing and new medical schools, regional partnerships, and policy innovations are essential to support the establishment of institutions with a particular focus on general practice and the modernization of curricula at existing universities. By embracing this approach, stakeholders can collectively shape the medical education landscape and address the growing crisis of physician shortages in primary care.

Article Watch: July, 2023.

This column highlights recently published articles that are of interest to the readership of this publication. We encourage ABRF members to forward information on articles they feel are important and useful to Clive Slaughter, AU-UGA Medical Partnership, 1425 Prince Avenue, Athens GA 30606. Tel; (706) 713-2216: Fax; (706) 713-2221: Email; cslaught@uga.edu or to any member of the editorial board. Article summaries reflect the reviewer's opinions and not necessarily those of the Association.

“Vets Restoring Vets”

Introduction
 Military Veterans disproportionately experience mental health issues due to unique service-related experiences. Peer and social support interventions have shown promise in improving Veterans’ mental health alongside clinical mental health interventions yet there are limited studies on Veteran-designed and Veteran–led peer or social support interventions. This study explored the perceptions and experiences of Veterans participating in an innovative Veteran-designed and Veteran-led peer and social support program. It was a preliminary study in a long-term Community Based Participatory Research partnership between Indiana University School of Medicine-Northwest regional campus and Operation Combat Bikesaver (OCB).
 Methods 
 This mixed methods study utilized a limited dataset from pre-and-post-session surveys collected by OCB between September 2019 and August 2021. We examined pre-post differences in participants’ self-rated “feelings” (i.e., emotional state) with the following independent variables through Linear Mixed Models in SPSS: OCB location, OCB event attended, day of the week, time of day, duration of attendance, frequency of attendance, and social assistance. We analyzed participants’ qualitative OCB experiences using inductive thematic analysis in Dedoose. This study was reviewed and exempted by The Indiana University Human Research Protection Program (Protocol # 12499) on August 16, 2021.
 Results 
 A total of 128 participants completed pre-post surveys for 746 OCB sessions. There was a statistically significant pre-post session increase in participants’ feelings (mean=34.6; SD=21.7; p<0.001), with increasing effects by duration (p=0.002) in an OCB session. There was no linear trend in individual pre-and-post session changes in feelings over time. The following themes describe participants’ OCB experiences: sense of purpose and meaning, regaining comradery and brotherhood, “Vets restoring Vets,” satisfaction with OCB structure and processes, and experiencing OCB impacts. 
 Conclusions 
 Convening Veterans with shared experiences around innovative and supportive social activities may develop their perceived sense of purpose, belonging, and mutual support and produce improvements in perceived mental health. Future research within this community-regional medical campus research partnership will explore jointly determined research questions to follow-up on the main findings and limitations of the current study.

COVID-19 Vaccination and the Role of Informed Consent: England as a Case Study.

Informed consent (IC), following the Supreme Court judgment in Montgomery v Lanarkshire Health Board, [2015] UKSC 11, constitutes a key patients' right. There is a vast literature exploring the significance of this right, while an analysis of the role that this has played in England during the COVID-19 vaccine distribution has been under-explored. Using England as a case study, this paper argues that IC has received limited protection in the COVID-19 vaccination context of the adult population, upholding at its best only a minimalistic approach where mere 'consent' has been safeguarded. It suggests that new approaches should be brainstormed so as to more properly safeguard IC in a Montgomery-compliant-approach, namely in a way that enhances patients' autonomy and medical partnership, and also to better prepare and respond to future pandemics.

Outcomes of a mobile medical unit for low-threshold buprenorphine access targeting opioid overdose hot spots in Chicago

IntroductionOpioid overdoses in Chicago are unevenly distributed, affecting medically underserved neighborhoods most acutely. Innovations in reaching patients perceived to be hard-to-reach (e.g., unstably housed, marginalized), especially in these underserved neighborhoods, are urgently needed to combat the overdose crisis. This study characterizes the pilot year of a mobile medical unit partnership between a large urban academic center and a community-based harm reduction organization in Chicago. MethodsThis is a retrospective cohort study of all patients who were seen on a mobile medical unit focused on providing low-threshold buprenorphine and primary care in areas with high opioid overdose rates on Chicago's West Side. Treatment episodes were accrued between July 1, 2021, and June 30, 2022 in the first year of operation. The main outcomes were number of patients seen, demographic characteristics of patients, and reason(s) for visit over time. ResultsThe study saw 587 unique patients on the mobile medical unit between July 1, 2021, and June 30, 2022. Approximately 64.6 % were African American, and more than half lacked active insurance or could not confirm insurance status at the time of visit. The most common reason for initial visit was COVID-19 vaccination (42.4 %), and the most common reason for follow-up visit was buprenorphine treatment (51.0 %). Eleven patients initially presented for other health concerns and later returned to initiate buprenorphine. ConclusionsThe mobile medical unit successfully reached nearly 600 patients in traditionally medically underserved Chicago neighborhoods with the highest overdose rates. The mobile unit's integrated approach met a variety of health needs, including buprenorphine initiation, with a unique opportunity for postoverdose initiation. Several patients initiated buprenorphine after presenting for different health concerns, showing the potential of an integrated approach to build on past mobile outreach programs and reach people with opioid use disorder who are not yet ready to initiate treatment.

Effects of and Prospects for the Hierarchical Medical Policy in Beijing, China.

Hierarchical medical policies are widely used worldwide to reduce healthcare costs, rationalize the use of healthcare resources, and improve accessibility and fairness of healthcare services. However, few case studies have evaluated the effects and prospects of such policies. Medical reform efforts in China have distinct goals and characteristics. Therefore, we investigated the effects of a hierarchical medical policy in Beijing and assessed the future potential of the policy to yield insights for other countries, especially developing countries. Different methods were used to analyze multidimensional data from official statistics, a questionnaire survey of 595 healthcare workers from 8 representative public hospitals in Beijing, a questionnaire survey of 536 patients, and 8 semi-structured interview records. The hierarchical medical policy had strong positive effects on improving access to healthcare services, balancing the workload of healthcare workers in various levels of public hospitals, and improving the management of public hospitals. The remaining obstacles include severe job stress among healthcare workers, the high cost of some healthcare services, and the need for improvement in the development level and service capacity of primary hospitals. This study provides useful policy recommendations regarding the implementation and extension of the hierarchical medical policy, including the need for governments to improve the hospital assessment system and for hospitals to actively participate in developing medical partnerships.