Medical Reform Research Articles

FORMATION OF CLUSTERS OF MEDICAL INSTITUTIONS AS AN ADMINISTRATIVE TOOL OF MANAGEMENT IN THE INDUSTRY OF HEALTH CARE IN THE CONDITIONS OF DECENTRALIZATION

The health care management system involves the application of administrative methods of managing medical facilities, which are a tool of state regulation in the field of health care. The transformation of the health care system through medical reform is aimed at providing citizens of Ukraine with equal access to quality medical services and reorienting the system so that the patient is at its center. The article examines the management of health care institutions in the process of reform, finds out the relevant issues of the infrastructural stage of the medical reform and the effective functioning of medical institutions in conditions of decentralization. Attention is focused on the transformation of the health care system in the form of the formation of clusters of medical institutions, which is proposed by the Ministry of Health of Ukraine and aims to improve the quality and availability of medical care through the creation of a new network of medical institutions in accordance with the principle of hospital districts. The structure of the cluster distribution of medical institutions within the framework of the medical reform and the characteristics of a capable network of medical institutions in the Odesa region are considered. The significance of the division of territories into hospital clusters in the process of balancing the advantages and disadvantages of decentralization and the maximum approximation to the modern European system of providing medical care is emphasized. A promising direction of further research on this issue is to solve the problem of «community hospitals», which are not included in the capable network of the hospital district (region) and, due to uncertainty, create a risk of reducing the availability and quality of medical care for residents of territorial communities.

How heavy is the medical expense burden among the older adults and what are the contributing factors? A literature review and problem-based analysis.

In recent years, the aging population and increasing medical expenses among the older adults have emerged as significant public health concerns. National governments must conduct medical expense accounting and implement measures to reduce the burden of medical costs on the older population. However, limited studies have focused on total medical expenditure from a macro perspective, with many researches exploring individual medical expenses from different perspectives. This review introduces the trend of population aging and its impact on health cost change, reviews research on the medical expense burden of the older population and contributing factors, and points out underlying problems and limitations of current studies. Based on the present studies, the review emphasizes the necessity of medical expense accounting and analyzes the medical expense burden of the older population. Future studies should explore the impacts of medical insurance funds and health service system reforms on reducing medical expenses and developing a supporting medical insurance reform plan.

Resource Allocation Efficiency of Urban Medical and Health Financial Expenditure Under the Background of Employees' Health.

The study proposes a method based on difference-in-differences (DID) to improve the resource allocation efficiency of medical and health financial expenditure to better guarantee the health level of enterprise employees. The DEA method is utilized to measure the comprehensive technology, pure technology, and scale as the resource allocation efficiency values of urban medical and health financial expenditure. The proposed method includes the use of DEA to measure the resource allocation efficiency values of urban medical and health financial expenditure. The benchmark regression model and DID model are used to analyze the impact effect, robustness, and parallel trend of the policy. The study shows that the proposed method effectively evaluates and analyzes the impact of medical comprehensive reform on the resource allocation efficiency of urban medical and health financial expenditure. The comprehensive medical reform can improve the comprehensive efficiency and scale efficiency of urban medical and health financial expenditure, leading to improved resource allocation efficiency of urban employees' medical and health financial expenditure. The results also indicate a significant positive effect on the time trend, which can have a long-term impact and effectiveness. The proposed method can provide useful insights into the resource allocation efficiency of medical and health financial expenditure, which can help improve the health level of enterprise employees. The study suggests that comprehensive medical reform can be an effective way to improve resource allocation efficiency and guarantee the health of employees in urban areas. Further research can be conducted to evaluate the impact of medical reform on other aspects of health care, such as quality and accessibility.

Multifunctional high-simulation 3D-printed hydrogel model manufacturing engineering for surgical training.

Advanced bionic organ models with vivid biological structures and wetness and softness are essential for medical-surgical training. Still, there are many challenges in the preparation process, such as matching mechanical properties, good feedback on surgical instruments, reproducibility of specific surgical scenarios, and distinguishability between structural levels. In this paper, we achieved tissuemimicking dual-network (DN) hydrogels with customizable stiffness by adjusting the composition of the hydrogel matrix and the immersion time of the ionic solution to match different biological soft tissues precisely. Combined with advanced threedimensional (3D) printing fabrication techniques, various performance-tunable bionic hydrogel organ models with structural complexity and fidelity, including kidney, liver, pancreas, and vascular tissues, were perfectly fabricated. The simulation and applicability of the model were also simulated for the forced change of the suture needle in the puncture and suture of a single tissue and between different tissues, the cutting of substantive organs by ultrasonic scalpel, the coagulation and hemostasis of blood vessels, the visualization of the internal structure under ultrasound, and the microwave ablation of liver tumors. By constructing advanced biomimetic organ models based on hydrogel with specific and tunable properties, the development of surgical training, medical device testing, and medical education reform will be significantly promoted.

Functions, advantages and challenges facing private healthcare organisations in China’s healthcare system: a qualitative analysis through open-ended questionnaires

ObjectivesThe medical reform in 2009 stimulated the growth of private healthcare organisations in China, but there is still room for their further development in the healthcare market. The objectives of...

MANAGEMENT OF FINANCIAL SECURITY OF THE ACTIVITIES OF MEDICAL INSTITUTIONS OF UKRAINE

The economic essence of such categories as «management», «financial resources»and «financial support»in the medical field was studied, which allowed us to generalize the main characteristics inherent in them. Certain characteristic features of financial support, which are specific to medical institutions in order to maintain their effective activity and further development, are considered.The original provisions of the Concept of the reform of the financing of the health care system, adopted in 2017, which played a key role in the reform of the medical industry, were considered. An analysis of the financing system of health care institutions was carried out, starting from 2018 (transition period) until 2021.It was determined that the goal of financial support is the formation of a new model of financing health care institutions, which is determined by transparent state guarantees of providing free medical care to citizens, improving the financial protection of the population in case of illness, effective and fair distribution and use of public funds and reducing informal payments, application incentives for improving the quality of providing medical services to citizens by medical institutions of all forms of ownership. Therefore, the problem of improving the process of managing the financial support of medical institutions is the most urgent.The positive consequences of the medical reform have been proven, namely: medical institutions apply market principles of functioning; use methods of rational management of financial flows (incoming and outgoing); the autonomy of medical institutions and the possibility of self-sufficiency and self-financing, obtaining the status of an enterprise, are increasing; the effectiveness of medical institutions increases due to market orientation, purposefulness and responsibility for their activities; the institution's competitive advantages increase.

A Multimodal, Resident-led Newborn Emergencies Night Curriculum.

Following graduate medical education duty hour reform, many programs have migrated to a night float model to achieve duty hour compliance. This has led to increased focus on optimizing nighttime education. A 2018 internal program evaluation of the newborn night rotation revealed that most pediatric residents received no feedback and perceived little didactic education during their four-week, night float rotation. One hundred percent of resident respondents were interested in increased feedback, didactics, and procedural opportunities. Our objective was to develop a newborn night curriculum to ensure timely formative feedback, enhance trainee didactic experience, and guide formal education. A multimodal curriculum was designed to include senior resident-led, case-based scenarios, a pre- and post-test, a pre- and post-confidence assessment, a focused procedure "passport," weekly feedback sessions, and simulation cases. The San Antonio Uniformed Services Health Education Consortium implemented the curriculum starting from July 2019. Thirty-one trainees completed the curriculum in over 15 months. There was a 100% pre- and post-test completion rate. Test scores rose from an average of 69% to 94% (25% increase, P < .0001) for interns and an average of 84% to 97% (13% increase, P < .0001) for third-year residents (PGY-3s). When averaged across domains assessed, intern confidence rose by 1.2 points and PGY-3 confidence rose by 0.7 points on a 5-point Likert scale. One hundred percent of trainees utilized the on-the-spot feedback form to initiate at least one in-person feedback session. As resident schedules evolve, there is an increased need for focused didactics during the night shift. The results and feedback from this resident-led and multimodal curriculum suggest that it is a valuable tool to improve knowledge and confidence for future pediatricians.

Regional Differences, Dynamic Evolution and Convergence of Public Health Level in China.

People's health is a necessary condition for the country's prosperity. Under the background of the COVID-19 pandemic and frequent natural disasters, exploring the spatial and temporal distribution, regional differences and convergence of China's provincial public health level is of great significance to promoting the coordinated development of China's regional public health and achieving the strategic goal of a "healthy China". Based on China's provincial panel data from 2009 to 2020, this paper constructs an evaluation index system for China's public health level from five dimensions: the popularization of a healthy life, optimization of health services, improvement of health insurance, construction of a healthy environment, and development of a health industry. In this paper, the entropy method, Dagum Gini coefficient, Kernel density function and spatial econometric model are used to analyze the spatiotemporal distribution, regional differences, dynamic evolution and convergence of China's public health level since the new medical reform. The study found that, first, China's public health level is generally low, structural contradictions are prominent and the construction of a healthy environment has become a shortcoming hindering the improvement of China's public health level since the new medical reform. The public health level of the four major regions showed a spatial distribution pattern of "high in the eastern, low in the northeastern, central and western" areas. Second, the overall Gini coefficient of China's public health level showed a "V-shaped" trend of first decreasing and then rising, but the overall decrease was greater than the increase, among which the regional difference was the main source of regional differences in China's public health level, but its contribution rate showed a downward trend. Third, except for the basic maintenance of a healthy environment, the Kernel density curves of China's public health level and its sub-dimensions have shifted to the right to a certain extent, and there is no polarization phenomenon. Finally, the level of public health in China has a significant spatial correlation. Except for the northeast region, the growth rate of low-level public health provinces in China and the other three major regions is higher than that of high-level public health provinces, showing a certain convergence trend. In addition, the impact of economic development, financial pressure, and urbanization on the convergence of public health levels in the four major regions is significantly heterogeneous.

Analysis of Influencing Factors and Demand Forecast of Single Disease Demand in Chinese Public Hospitals

Objectives: In this study, we examine influencing factors and demand forecast of single disease demand in Chinese public hospitals. Methods: We conducted a preliminary screening of the literature, according to a literature search strategy and inclusion and exclusion criteria. Related Chinese and English articles between 2000 and 2022 were searched in the Chinese National Knowledge Infrastructure, Wanfang, PubMed, and Elsevier databases and Google Scholar. The Jadad literature scoring mechanism was used, and Stata/SE version 12.0 software was used to perform a meta-analysis of the effect size of literature statistics. The outcome index was the 2-week visit rate. Results: We included 13 articles for meta-analysis. Their combined effect size and 95% confidence interval for chronic disease, age, gender, economic factors, medical insurance form and education level were 3.43 (2.26, 5.51), 2.53 (1.74, 3.68), 1.3 (1.16, 1.46), 2.31 (1.16, 4.61), 3.2 (2.98, 3.45) and 1.35 (1.14, 1.6), respectively. Results revealed that for patients with chronic diseases, those>60 years of age and families with better economic conditions and higher levels of education correlated with a higher demand for medical services among families with medical insurance for urban residents. Conclusion: Using meta-analysis, we analyzed the factors that affect the demand for medical services in China. From demographic and economic factors, national medical insurance policies and residents' health status, we analyzed the relationship between patients with a single disease and other factors. With respect to the influence of medical service demand, relevant departments should take effective measures to increase medical service demand according to the influencing factor of the 2-week visit rate and simultaneously provide scientific theoretical guidance for medical reform.

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.

Evaluation of comprehensive reform effect of public hospitals in Sanming, Fujian Province

The reform of public hospitals is a complex process, involving multiple subsystems and the interaction of related factors. This paper conducts a preliminary evaluation of the joint reform of medication, medical care, and medical insurance in Sanming using quantitative and qualitative methodologies. The method of system dynamics is applied to model the three subsystems of medication, medical care, and medical insurance in Sanming and analyze the cause-and-effect relationship between different factors in the subsystem. Based on the analysis, the evaluation index is determined to evaluate the effect of the medical reform in Sanming. The analysis results show that Sanming’s public hospitals have experienced a comprehensive reform that includes changing the way pharmaceuticals are procured, cutting prescription prices, and raising hospital worker wages. To maximize the hospital revenue structure, the medical insurance payment system was changed. The expense of patient therapy was reduced, and the development of hierarchical diagnosis and treatment was encouraged.

Influence Factors for Family Physician Contract Services’ Motivation in China: An Empirical Analysis From Jiangsu Province

Since the medical reform implemented by the Chinese government in 2016, more attention has been paid to family doctors and the key role they play in safeguarding citizens’ health. Therefore, it is necessary to explore the factors that affect the motivation of family doctors to provide contracted services. In this study, factors influencing the motivation of family doctors to provide contract services are divided into intrinsic motivation and extrinsic motivation. Intrinsic motivation includes family doctors’ sense of professional belonging, occupational motivation, and occupational efficacy, while extrinsic motivation includes the attraction, support, and promotion of contract services, as well as pressure from government and community health service institutions. And the environment in which family doctors operate during their contracted services. The questionnaire was designed with a sample size of 536 family doctors in Jiangsu Province using logical reasoning method. Stata16 software is used for empirical analysis using linear regression method. The empirical analysis is conducted using the linear regression method. A family physician’s motivation is categorized into two perspectives: intrinsic and extrinsic motivation. Significant findings unveiled that; (i) Family physicians’ sense of professional belonging ( β = .026, p &lt; .01), professional motivation ( β = .076, p &lt; .05), and professional efficacy ( β = .148, p &lt; .01) had a significant positive on their contract services, (ii) Promotion ( β = .085, p &lt; .01), the attractiveness of family physicians’ contract services ( β = .092, p &lt; .01) and contract service support ( β = .137, p &lt; .01) showed a positive effect, whereas (iii) intense pressure ( β = −.079, p &lt; .01) experienced by family physicians could negatively affect their contract services. Among the intrinsic and external factors, only intense pressure negatively affects family physician contracted services. This finding indicates that decision-makers should adopt feedback mechanisms at the various health levels to encourage workers to measure motivational levels and output themselves.

AVAILABILITY AND QUALITY OF MEDICAL SERVICES IN UKRAINE UNDER MARTIAL LAW CONDITIONS: ASPECTS OF MANAGEMENT

The article investigates special features of health care policies under martial law conditions. It determines that the national model of the health care system management has been in an active phase of the medical reform since 2015. The reform covers about 20,000 health care facilities. Under COVID19 pandemic conditions, the national model of health care management operates on the principles of synchronous action of all entities at all levels of management. In the conditions of the full-scale war, since February 24, 2022, the national model of the health care system has undergone structural and functional changes and its facilities operate as critical infrastructure institutions in an asynchronous mode. The health care institutions management in an asynchronous mode is mainly entrusted to local self-government bodies, and ensuring the sustainability of medical institutions depends on the operational situation in the area where medical institutions are located. At the central level of branch administration, a number of measures of legal, economic and organizational support for the implementation of Ukraine’ state policy aimed at the availability and quality of medical care under martial law conditions have been introduced.

Formation of Market Foundations of Health Care Organization in Ukraine (Commercial Legal Aspect)

In the article were analyzed the state and prospects of further medical reform in Ukraine. The authors set themselves the goal of conducting a study of the essence of health care reform, and during this process advantages and disadvantages of implemented changes in this area were characterized. The importance of this study lies in the fact that human health and life are recognized at the constitutional level as the highest price, and therefore their protection requires special attention from the state. Promoting the development of health care system improve the quality of life of the population, which in the future will have a positive effect on the economic development of the country. Four main directions of the reform were developed in the work, such as improving the quality of medical services, optimizing the financing of the health care system, improving the management system, and changes in the pharmaceutical sector. An important achievement of the reform is the introduction of the medical services market, which has its own specific features and base on the principle of free competition and financial transparency. The article focuses on the legal regulation of public relations in the field of health care. Legislative provision of this is considered from the point of view of creating a competitive market for medical services, which is opposed to the administrative model of ensuring citizens' health care. The institutional nature of the organization of such market with relevant entities providing services competing with each other is emphasized; medical service in its commodity-value aspect; introduction of the principle of consumer choice of medical service and the entity that provides it; creation of a special state agency that pays the cost of the provided medical service to the relevant subject of medical activity for the benefit of the beneficiary-consumer, who chose this particular subject. Accordingly, the driving force of the market is recognized the actual medical economic activity. Taking into account the above, the article, based on the analysis of the relevant legal acts, concludes that relations in the field of health care have been transformed in the direction of the economic and legal nature of their regulation. This is evidenced by the use of stable constructions of economic law, namely: economic activity; non-commercial management; communal non-commercial enterprise; state regulation of economic activity; subject of organizational and economic powers, etc. The continuation of scientific researches on this issue will contribute to the further development of the national health sector, including by improving the public management of this component of the national economy.

Marketing Strategies of Public Hospitals – Take A Public Hospital in Hebei as an Example

In the environment of health and medical care reform, public hospitals need to conduct more effective marketing management for their own survival and development, this can increase the influence of the hospital and at the same time increase its revenue. This paper analyzed the status of the marketing strategies of the hospital and proposed suggestions to improve its marketing strategy.

The impact of medical insurance payment systems on patient choice, provider behavior, and out‐of‐pocket rate: Fee‐for‐service versus diagnosis‐related groups

AbstractThe medical insurance payment system (MIPS) is a key mechanism to ensure the public's access to medical services. In a game‐theoretic model, we examine the impact of two MIPSs, fee‐for‐service (FFS) and diagnosis‐related groups (DRG), on patient choices, provider behavior, and out‐of‐pocket rate. We find that neither FFS nor DRG can dominate the other in all three aspects: social welfare, provider profit, and total patient surplus. In particular, under DRG, the out‐of‐pocket rate for patients is lower, and the total patient surplus is higher than that under FFS. However, patients with lower illness severity tend to not participate in DRG, while FFS can make all patients participate in the program. Furthermore, when the marginal cost of medical services is high, the profit of the provider and social welfare under DRG is higher than those under FFS, otherwise lower. After interviewing hospital leaders, we further investigate two extended (pilot) payment systems: DRG with two price groups, and the hybrid model incorporating both FFS and DRG. We find that both models contribute to improving provider behavior, making more patients choose the provider, but are still not perfect payment systems due to lower provider profit or social welfare. Our findings offer important insights for policymakers regarding implementing medical insurance reform in practice.

A study of primary health care service efficiency and its spatial correlation in China

BackgroundChina’s primary health care system has undergone major changes since the new round of medical reform in 2009, but the current status of primary health care institution service efficiency is still unsatisfactory. The purpose of this study is to compare and evaluate the China’s primary health care institution service efficiency and provide a reference for improving the efficiency and promoting the development of primary health care institution.MethodsBased on panel data of 31 provinces (municipalities directly under the central government and autonomous regions) in mainland China from 2011 to 2020, using the super efficiency slack-based measure-data envelopment analysis model, to analyze the data from a static perspective, and the changes in the efficiency of primary health care services were analyzed from a dynamic perspective by using the Malmquist index method. Spatial autocorrelation analysis method was used to verify the spatial correlation of primary health care service efficiency among various regions.ResultsThe number of Primary health care institutions increased from 918,000 in 2011 to 970,000 in 2020. The average primary health care institution service efficiency in the northeastern region including Jilin (0.324), Heilongjiang (0.460), Liaoning (0.453) and northern regions such as Shaanxi (0.344) and Neimenggu (0.403) was at a low level, while the eastern coastal regions such as Guangdong (1.116), Zhejiang (1.211), Shanghai (1.402) have higher average service efficiency levels. The global Moran’s I showed the existence of spatial autocorrelation, and the local Moran’s I index suggested that the problem of uneven regional development was prominent, showing a contiguous regional distribution pattern. Among them, H–H (high-efficiency regions) were mainly concentrated in Jiangsu, Anhui and Shanghai, and L-L regions (low-efficiency regions) were mostly in northern and northeastern China.ConclusionThe service efficiency of primary health care institution in China showed a rising trend in general, but the overall average efficiency was still at a low level, and there were significant geographical differences, which showed a spatial distribution of “high in the east and low in the west, high in the south and low in the north”. The northwestern region, after receiving relevant support, has seen a rapid development of primary health care, and its efficiency was steadily improving and gradually reaching a high level. The average primary health care institution service efficiency in the northeastern region including the northern region of China was at a low level, while the average efficiency in the eastern coastal region and some economically developed regions was high, which also verifies the dependence and high symbiosis of primary health care institution service efficiency on regional economy.

Establishment and application of the performance appraisal system for hierarchical diagnosis and treatment in China: A case study in Fujian province.

Hierarchical diagnosis and treatment, as an important measure and direction for China's medical reform, are conducive to improving the capacity of medical services and the national level of health. In this study, a hierarchical diagnosis and treatment performance evaluation index system is established to identify the effects of different influencing factors on developing hierarchical diagnosis and treatment. In this study, samples collected from 23 representative integrated medical institutions in nine Fujian cities from 2018 to 2020 are taken as subjects. A hierarchical diagnosis and treatment performance appraisal system is established based on the mechanism of research on the operation of hierarchical diagnosis and treatment. This is combined with the evaluation index system established by the Health Development Research Center, the National Health Commission of the People's Republic of China for the evaluation of hierarchical diagnosis and treatment and the construction of the medical treatment alliance, including studies carried out by related scholars. The weight of each evaluation index is determined with the CRITIC method, and the hierarchical diagnosis and treatment effects on 23 subjects are quantitatively evaluated by the Gray correlation method based on the weight of each index. The hierarchical diagnosis and treatment performance evaluation index system is established from three aspects, namely allocation of hierarchical diagnosis and treatment resources, establishment of the hierarchical diagnosis and treatment management system, and hierarchical diagnosis and treatment implementation effect; 27 tertiary indexes are formed in total. The Gray correlation of each year in Fujian exceeds 0.5, but <0.53. Gray correlation of each year in Fujian has gradually increased. But there is still room for improvement. The government departments must improve the investment in medical resources with measures adjusted according to local conditions, promote a balanced allocation of resources for hierarchical diagnosis and treatment, increase communication and interaction between upper and lower medical institutions, and optimize the allocation of resources for hierarchical diagnosis and treatment. Then determine the types of disease to be treated, expand the coverage of chronic disease management, establish standardized chronic disease health management, and strengthen training of health management staff.

Research on the Innovation and Future Development of China's Medical Insurance Negotiation Mechanism

In recent years, China's medical insurance negotiations have achieved remarkable results but still have shortcomings. China's medical insurance reform is currently in the exploratory stage. This article looks at the characteristics of the dual role played by the Chinese government in medical insurance negotiations, and analyzes the advantages and drawbacks of enterprises accessing or not accessing medical insurance. The article argues that China cannot replicate foreign medical insurance mechanisms but must establish its own innovative mechanisms. This paper describes the progress and current status of medical insurance negotiations in China and elaborates on the five stages of medical insurance negotiations including preparation, declaration, expert evaluation, negotiation, and announcement. The article highlights some essential points and misconceptions of the negotiation stage. By investigating the medical insurance negotiation mechanisms in the United States, Canada, and Germany, this paper summarizes the practical experiences of developed countries in the control of drug prices and the use of negotiation mechanisms. The article reveals the existing problems of China's medical insurance mechanism and proposes pragmatic and feasible suggestions. It has important theoretical and practical significance for improving the medical insurance mechanism and promoting the healthy development of the drug industry.

Continuity and Change in Dao Yin: Comparing and Contrasting the Therapeutic Exercises in Yin Shu (The Book of Pulling, c. 2nd Century BCE) and Zhu Bing Yuan Hou Lun (Treatise on the Origins and Manifestations of Various Diseases, 610 CE)

The manuscript Yin Shu (The Book of Pulling), excavated from Zhangjiashan Han Tomb No. 247, is the earliest surviving text on therapeutic exercise known as Dao Yin (lit. guiding and pulling). Discovered in 1983, this Dao Yin text, together with the drawings of 44 figures performing “guiding and pulling” exercises found in the Mawangdui Han Tomb in 1974, are of great significance to the study of the early history of Dao Yin. Prior to these discoveries, researchers into Dao Yin relied mainly on material found in the Dao Zang (the Daoist Canon), compiled in 1145. This led to their conclusion that Dao Yin was essentially Daoist. The development of Dao Yin reached its zenith during the Sui Dynasty (581–618 CE), when it became one of the three medical departments at the imperial medical education institution. As part of the medical reform of the second Sui Emperor, Yang Di, Dao Yin became the treatment of choice, and the employment of a large number of Dao Yin specialists to the Sui court transformed the state medical service. The compilation of Zhu Bing Yuan Hou Lun (Treatise on the Origins and Manifestations of Various Diseases) under Yang Di’s decree, incorporated an abundance of resources on Dao Yin, enabling physicians to potentially “prescribe” Dao Yin to their patients. Situating both Yin Shu and Zhu Bing Yuan Hou Lun in their social and historical contexts, this article analyses their editorial treatments, examines their different objectives, styles, and readerships, and compares the various exercises described in the two texts. It emphasizes the fact that over a period of nearly a thousand years, from the late Warring States (475–221 BCE) to the Sui and Tang periods, Dao Yin was an important medical practice, culminating in its institutionalization by the Sui government.