卫生政策分析：概念和方法的思考与挑战

许多专家学者就卫生政策分析开展了大量研究,但很少关注如何进行政策分析以及需要什么样的研究设计、理论和方法。本文着眼于卫生政策分析的环境以及面临的挑战,借鉴中低收入国家中一些卫生政策分析的框架、理论、方法和设计,列举了最近的研究案例,并探讨了案例研究的意义以及研究设计的必要性,发现卫生政策研究者的角色、反思和定位在研究过程中非常重要。最后从理论、方法学和研究人员的反思等角度提出了促进卫生政策分析的建议。

Competitive Pressures and Access to Infertility Treatments by Single Women

With the increase in fertility problems and delayed childbearing, demand for infertility treatments has been rising. Today, in-vitro fertilization (IVF) is the most successful infertility treatment but access to IVF is uneven due to its high costs and personal and religious attitudes. To meet rising demand for infertility treatments many markets saw an increased entry of infertility clinics. This study examines the relationship between competitive pressures and access to IVF in the United States by single women. We use US data from 1995 and 2014 to show that competitive pressures improve access to infertility treatments for single women across markets and over time. Overall, this study finds that competition among IVF clinics has a beneficial effect on access to IVF.

Hospital community benefits and the effect of Schedule H: A difference-in-difference approach

Since 1969 private, nonprofit hospitals have qualified for tax exemption as charitable institutions and in exchange for the preferential tax treatment were required to provide community benefits. However, in the absence of mandatory reporting of community benefits at the federal level and in the absence of a clear definition of community benefits, the previous literature provides but ambiguous evidence regarding hospitals’ supply of community benefits. Responding to policymakers’ concerns, the Internal Revenue Service (IRS) mandates all private, non-profit hospitals to report charity care at cost as well as unreimbursed Medicaid costs starting with the tax year 2008. Using data from hospitals in California before and after tax year 2008 (2009 filing), this study examines whether changes in the IRS 990 Schedule H had a significant effect on the supply of community benefits by non-profit hospitals relative to for-profit hospitals. Empirical results suggest that nonprofit hospitals do not supply more community benefits relative to for-profit hospitals for both definitions of community benefits reported in Schedule H. Although the supply of community benefits increased for all hospitals after 2008, the increase was not higher for nonprofits. Moreover, nonprofits supplied significantly less community benefits according to some definitions. Thus, minimum charity care standard is justified.

The Introduction for the Forum ＂The Biology, Psychology, and Economics of Social Reproduction： Health, Wealth, and Happiness in the Modern Chinese Family＂

These essays grow out of a panel organized by Nicole Richardson for the 2011 Association for Asian Studies annual meetings in Honolulu for which I served as commentator. This was a remarkably coherent panel, and the three articles here carefully unpack ideas about social reproduction in the family from the final decade of the Qing dynasty through the middle 1930s. These studies of conceptions of pregnancy, childrearing, and wedding ceremonies advance our understanding of how intellectuals re-conceptualized family management by combining traditional expectations with newer, often imported, scientific concepts and practices. Each author also explains how intellectuals, educators, journalists and state authorities transformed relationships between Chinese families and the state.