2010—2018 年长三角地区医疗服务效率比较

目的分析2010—2018年长三角地区医疗服务效率,为促进各地优化卫生资源配置、提高卫生服务水平提供参考。方法通过定性和定量相结合的研究方法,建立数据包络分析模型,对医疗服务效率进行统计描述和模型分析,并结合文献综述和专家访谈,阐释效率分析结果。结果长三角地区各地医疗服务效率特征各异。上海市业务效率较高,浙江省业务效率发展快速,江苏省效率其次,安徽省较低。应将各地的医疗服务效率分析结果置于各自卫生发展的背景条件、资源禀赋和战略定位下进行分析。结论在当前经济新常态、防控新型冠状病毒肺炎疫情的环境下,控制卫生费用的不合理增长显得更加迫切和必要。建议合理配置资源,提高医疗资源使用效率,进一步控制医疗费用上升。要强化政府在公立医院补偿机制中应该发挥的作用,鼓励和引导多元主体参与医疗服务提供,满足群众多层次、多样化的健康需求。此外,还应促进区域协同发展,推进区域健康一体化建设。

A comparative research on built-land changes between Fujian and Taiwan provinces

Comparative study of LUCC between Fujian and Taiwan provinces could be a good case for study because of their geographical proximities and historical, cultural similarities. Fujian and Taiwan had gone through and currently are in different economic development stages. Taiwan is in the stage of post-industrialization and Fujian is in the intermediate stage of industrialization. By using the official statistics, changes of built-land in Fujian and Taiwan were analyzed in details. The results showed that these two provinces seemed to have the same characteristics of built-land changes, i.e., accelerating development, and concentrated distribution on both sides of the Taiwan Straits, forming a pattern with the economic layout of two sides acting in cooperation with eath other. If comparing different industrialized areas in Fujian with industrialized stages in Taiwan, it is clear that these two provinces seemed to have the same characteristics of synthesized index of built-land change （Lc）, i.e., which is from stabilization or comparative stabilization at the initial stages of industrialization to high expansion at the intermediate stages of industrialization, then followed by low consumption at later stages of industrialization, but the Lc of the initial and the later stages of industrialization in Taiwan were slightly higher than those in Fujian. The results from comparison on relevant indexes have shown： The industrial structure changing rate of Fujian is actually higher than that of built-land in Taiwan, but its using efficiency of regional built-land is also obviously lower than that in Taiwan in the intermediate and later stages of industrialization of Fujian. The major driving forces of the built-land changes in both provinces were analyzed in Causal Models of Path Analysis, and its result indicated that the difference in built-land changes of the two provinces is closely related to their economic development stages and industrial structure. Countermeasure for the realization of sustainable utilization of built-land in Fujian put forward in this article is to strengthen its intension and tap the latent power.

A comparison of atmospheric CO_2 concentration GOSAT-based observations and model simulations

Satellite observations of atmospheric CO2 are able to truly capture the variation of global and regional CO2 concentration.The model simulations based on atmospheric transport models can also assess variations of atmospheric CO2 concentrations in a continuous space and time,which is one of approaches for qualitatively and quantitatively studying the atmospheric transport mechanism and spatio-temporal variation of atmospheric CO2 in a global scale.Satellite observations and model simulations of CO2 offer us two different approaches to understand the atmospheric CO2.However,the difference between them has not been comprehensively compared and assessed for revealing the global and regional features of atmospheric CO2.In this study,we compared and assessed the spatio-temporal variation of atmospheric CO2 using two datasets of the column-averaged dry air mole fractions of atmospheric CO2(XCO2)in a year from June 2009 to May 2010,respectively from GOSAT retrievals(V02.xx)and from Goddard Earth Observing System-Chemistry(GEOS-Chem),which is a global 3-D chemistry transport model.In addition to the global comparison,we further compared and analyzed the difference of CO2 between the China land region and the United States(US)land region from two datasets,and demonstrated the reasonability and uncertainty of satellite observations and model simulations.The results show that the XCO2 retrieved from GOSAT is globally lower than GEOS-Chem model simulation by 2 ppm on average,which is close to the validation conclusion for GOSAT by ground measures.This difference of XCO2 between the two datasets,however,changes with the different regions.In China land region,the difference is large,from 0.6 to 5.6 ppm,whereas it is 1.6 to 3.7 ppm in the global land region and 1.4 to 2.7 ppm in the US land region.The goodness of fit test between the two datasets is 0.81 in the US land region,which is higher than that in the global land region(0.67)and China land region(0.68).The analysis results further indicate that the inconsistency of CO2concentration between satellite observations and model simulations in China is larger than that in the US and the globe.This inconsistency is related to the GOSAT retrieval error of CO2 caused by the interference among input parameters of satellite retrieval algorithm,and the uncertainty of driving parameters in GEOS-Chem model.

Numerical tests for tropical cyclone track prediction by the global WRF model

This work use the global WRF model containing quadruply nesting with which the highest resolution reached 10 km to simulate the typhoons landed on the coast of China in 2011.The model is driven by the reanalysis data fnl with the resolution of 1°x 1°.The study assess the feasibility and applicability of the global WRF model in the 1-7 days prediction of Tropical Cyclone(TC)track by comparing it with the regional WRF model containing the same setting(physical scheme,dynamical frame,model resolution and nesting grid domain).The global model obtain a similar forecast accuracy to the regional model in 1-7 days,with a difference less than 50 km.The forecast accuracy of the global model for 1,2,3,4,5,6 and 7 days is about 70 km,120 km,180 km,240 km,320 km,400 km,and 500 km,respectively.The reason of the significant TC track errors in the forecast more than 3 or 4 days is analyzed,it is due to the poor representation of typhoon and its steering flow under the situation of binary typhoon system.The study show that the global WRF model can be exploited to proceed the high resolution TC simulation and make the TC track forecast up to 7 days but not in the case of multiple typhoon.