Direct medical cost of radiation therapy for cancer patients in Taiwan

Background and purpose: The rising cost of health care is of concern worldwide, in particular, for cancer care. The costs of treatment, including chemotherapeutic drugs and radiotherapy, are no exceptions. The purpose of this study is to explore the direct medical cost of radiotherapy and the annual increasing trend of expenditures in Taiwan. Methods: This study utilized data retrieving from the original claim data of the reimbursement of the Health Insurance Research Database (HIRD) derived from Taiwan’s Health Insurance (HI) program. Detailed data on the direct medical cost within the radiotherapy process for beneficences were extracted from inpatient expenditures by admissions (DD) and ambulatory care expenditures by visits (CD) database according to the reimbursed expenditure code of radiotherapy from January 1, 2000 to December 31, 2005. Prescriptions for radiotherapy were retrieved and the direct medical costs for radiotherapy were collected based on the NHI reimbursement price list of 2005. The annual increasing trend of expenditures was also explored according to the perspective of Bureau Health Insurance of Taiwan. Results: The total direct medical costs of radiotherapy for cancer patients were increasing from 2000 to 2005, which were estimated to US $7.80 million, US $8.09 million, US $7.58 million, US $10.7 million, US $12.2 million and US $15.9 million in 2000, 2001, 2002, 2003, 2004 and 2005, respectively. The increased percentage corresponded to the total healthcare expenditures claimed was increased substantially from 0.82% in 2000 to 1.22% in 2005. The total direct medical costs within the radiotherapy process were also increased gradually if identified by different types of radiotherapy and teaching hospital levels. The direct medical costs attribute to radiotherapy, compared to total health care expenditures in Taiwan, were similar to the costs of anticancer drugs for cancer patients annually. Conclusions: The direct medical costs of radiation therapy increased substantially each year. Further cost analysis on radiation therapy is needed in years beyond 2005.

Estimation of direct and indirect cost of diabetes in Morocco

Due to its chronic nature with severe complications, diabetes needs costly prolonged treatment and care. The high economic burden of diabetes is particularly threatening low and middle income countries. World-wide, studies have shown that the cost of diabetes per person is much higher than the per capita health expenditure. This study is the first to estimate the direct and indirect cost of diabetes in Morocco. The direct cost of diabetes was computed by assuming three scenarios of prices (low, medium and high) due to different prices of insulin, oral drugs and other items used in diabetes treatment and care. Indirect costs of diabetes were estimated by the lifetime forgone earnings caused by premature death and disability due to diabetes. The direct cost of diabetes in Morocco was estimated to be between US $0.47 and US $1.5 billion whereas the indirect cost was estimated to be around US $2 billion accounting for 57% of the total cost of diabetes under the high cost scenario, 69% under the medium scenario and 81% under the low cost scenario. The average per capita indirect cost was estimated to be US $1113, relatively higher than the direct cost of diabetes which was seen to vary from US$ 259 to US $830. The results yielded by this study were compared to those obtained by similar studies in different regions and countries of the world. As a conclusion, the findings of this study indicate a high economic burden of diabetes and stress the importance that Moroccan health decision makers should give to sensitisation, early diagnosis and treatment of diabetes especially with the crucial growing trend of diabetes prevalence.

Direct Cost of Severe Malaria Treatment Borne by the Families of Children Aged 0 - 5 Years at the Fana Reference Health Centre, Mali

Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.

Direct Cost of Primary Open Angle Glaucoma Management

Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic anhydrase inhibitors (OR = 7.4 and p = 0.012) and prostaglandin analogues (OR of 38.2 and p Conclusion: This first study on the direct cost of POAG management in Lomé showed that the economic burden glaucoma represents for the patient, his family and society. The data from this study will allow health decision-makers to adopt strategies to mitigate the effects of glaucoma on the economy.

非常规油气高质量发展战略方向优选

近10年来,化石能源多样化趋势明显,从常规油气领域向致密油/页岩油、致密气/页岩气、煤炭地下气化等非常规领域发展。油气藏类型增多,资源规模、品位、勘探开发难度及效益存在差异。要实现不同类型油气藏规模效益开发及绿色高质量发展,必须对化石能源未来发展方向和类型做出选择。分析国内外能源消费结构变化规律、现状及未来发展趋势,煤炭和石油一直保持主体地位,天然气占比逐年上升。对比研究不同类型化石能源单位体积能量密度、资源规模、开发成本、开发现状、技术成熟度等主要指标,结果显示煤炭地下气化具有能量密度最高、可采资源量最大、开采成本低等特点,在增加天然气供应、推动煤炭行业绿色低碳发展和助力实现碳中和方面拥有技术优势,可优选为非常规油气战略方向,为高质量发展开拓新路径。

文化感知差异对中国对外直接投资的影响

基于House教授GLOBE项目的数据,重新构建了文化差异衡量指数,并实证考察了文化差异对中国对外直接投资的影响,结果显示:中国感知的文化差异与中国的对外直接投资之间存在着“U”型关系,而东道国感知的文化差异对中国对外直接投资的影响并不显著。经过多种稳健性检验和内生性处理后仍然支持了这一结论。机制检验发现,文化差异主要通过增加交易成本和降低双边投资合作信任度对中国对外直接投资产生影响。异质性分析发现,中国感知的文化差异对中国对外直接投资的影响主要存在于发达国家和产业结构合理性更高的国家,而在东道国文化感知差异较大的国家,文化差异对中国对外直接投资的影响更大。因此,应当重视对外直接投资中的文化差异问题,积极推动文化交流互鉴,增强高层互访,提升投资信任度,因地制宜发掘产业转移和结构调整新机遇。

人口老龄化与外商直接投资:影响机制与实证分析——基于中国省级面板数据的实证研究

基于2003—2020年中国省级面板数据,将储蓄率和劳动力成本纳入同一分析框架,从理论和实证两个层面探究人口老龄化对外商直接投资流入的影响及作用机制。研究结果表明,人口老龄化与外商直接投资流入存在显著的倒U形关系,且存在时空异质性:空间异质性,表现为老龄化对外商直接投资流入的影响呈现东、中、西部逐渐下降趋势;时间异质性,表现为2012—2020年人口老龄化对外商直接投资的影响程度明显高于2003—2011年。储蓄率在人口老龄化影响外商直接投资流入的过程中表现出正向调节效应,起到推动作用,而劳动力成本起到部分中介效应,且劳动力成本对外商直接投资流入的影响力随着老龄化的持续加剧而扩大,阻碍了外商直接投资的流入。为此,各级政府要完善劳动权益保障体系,加大人力资本投入力度,制定完善的外资引入机制,引导外商直接投资区域均衡发展。

AI产品侵权归责原则的法经济学考察——兼评欧盟《人工智能责任指令》

AI产品是以AI技术为基础,以销售、使用为目的,依赖研发者设定的固定程序,通过计算进行决策并完成相应任务,被广泛应用于各行业的动产领域;AI产品侵权归责原则大致可分为共同责任侵权原则、严格责任原则和过错侵权原则三类。在适用侵权归责原则时,常见的困境包括共同侵权责任原则缺乏归责上的“共同性”,严格责任原则具有“片面性”,以及过错责任原则难以确定“过错”与“因果关系”。此外,责任主体尚不明确。基于社会成本与委托代理理论,AI产品侵权归责理论可从制度激励、信息不对称与风险分散三个维度解析归责的基本逻辑,以实现社会福利最大化。欧盟《人工智能责任指令》在一般条款外仅规定了举证责任、证据披露和因果关系推定等要素,对产品侵权问题的规制存在漏洞,它所确立的严格责任制度仍具有补充和提升空间。为实现欧盟《人工智能责任指令》下的社会福利最大化,尝试将过错责任原则适用于生产者,将剩余责任即严格责任原则适用于驾驶员,即若生产者存在过错,驾驶员和生产者将以各自的责任份额分担责任;如果生产者被证明遵循了应有的注意义务,那事故损失必须完全由被适用严格责任原则的驾驶员承担。

抑郁症和双相障碍疾病成本研究

目的:测量抑郁症和双相障碍的直接成本和间接成本,探索疾病总成本的影响因素。方法:选取2019年5月至2021年7月铜陵市某二级甲等精神专科医院招募的抑郁症和双相障碍住院患者230例,收集患者过去一年内门诊及住院的医疗花销总费用和自费花费,以及所花费的非医疗费用作为直接成本,将患者因病无法工作的生产力损失,以及因病损坏财务的其他损失作为间接成本。从个人水平和社会水平上测算直接成本和间接成本。采用多重线性回归模型对疾病总成本影响因素进行分析。结果:个人层面抑郁症人均疾病总成本高于双相障碍,而社会层面,双相障碍人均疾病总成本远高于抑郁症。抑郁症和双相障碍的间接费用均高于直接费用。多重线性回归分析显示,工作状态、婚姻状况、收入水平以及疾病严重程度是影响疾病成本的关联因素。结论:抑郁症和双相障碍的经济负担较重,因精神障碍导致的生产力损失是疾病成本的主要部分。

耐候钢低成本生产工艺研究与实践

针对耐候钢生产工艺及成分设计特点,通过成本组成分析,对各工序低成本运行进行精准控制。介绍一种低成本生产控制工艺,通过目标成分的精准控制攻关、工艺路线优化调整、辅料料型搭配优化及耐候废钢定向回收利用等措施,通过在某厂120 t炉区生产实践验证,在保证质量稳定可靠的基础上,可有效地降低耐候钢炼钢生产成本。

数字化与对外直接投资新优势——基于我国A股上市工业企业的分析

随着数字技术与实体经济深度融合,数字化已成为企业发展的新优势。本文基于2009—2021年我国A股上市工业企业样本,并匹配具有代表性的对外直接投资(OFDI)数据,研究数字化优势对我国企业OFDI的影响及其作用机制。研究发现,数字化能够显著且稳健地提高我国企业OFDI的可能性、投资广度和投资深度,进而提升我国OFDI的活力和韧性,并且解释力度高达企业OFDI传统优势研发密度的48.3%~53.8%。全要素生产率提升和海外经营成本降低是数字化优势促进企业OFDI的两条潜在机制。异质性分析表明,数字化优势的OFDI促进效应在绿地投资、传统行业和高竞争性行业中表现更加突出。此外,我国OFDI“走进东道国”过程中,跨国公司数字化优势与东道国数字化优势间的竞争效应大于互补效应,因而数字化优势对我国企业OFDI的正向作用在高数字化水平东道国的样本中受到抑制。本文研究结论对新形势下我国如何利用数字化优势推动高水平对外开放,构建以国内大循环为主体、国内国际双循环相互促进的新发展格局具有启示意义。

一种基于统计分析的多视点视频编码中Direct模式提前终止算法

提出了一种针对多视点视频编码中Direct模式的提前终止算法.该算法基于当前编码宏块相邻视点、时间及空间方向的已编码邻近宏块的编码信息,提出了一个描述当前宏块的邻近块代价影响因子,通过与阈值比较可对多数编码宏块直接选择Direct模式进行编码,从而略过其他模式的相关计算.实验结果表明,与原始的多视点视频编码算法相比,该算法可平均减少约88.2%的编码时间,同时峰值信噪比仅下降约0.29dB,编码比特率增加约0.68%.

考虑绿色度的制造商线上销售模式选择

针对在线销售环境下中小型绿色制造商的销售模式选择问题,通过采用Stackelberg博弈理论,建立了三种决策模型,考虑了直销成本、佣金比例和产品绿色度。结果显示,直销成本较低时选择直销模式可获得最大利润;佣金比例较高时代销模式下产品绿色度更高;佣金较低时转销模式下产品绿色度更高。当直销成本高且佣金比例高时,选择代销模式可实现较高产品绿色度;而转销模式下可获得更多利润。消费者对产品绿色性的敏感度提高将促使制造商增加绿色生产投入,但增加生产成本可能降低绿色生产的积极性。

复合树脂多层修复技术与复合树脂直接粘接修复技术在前牙间隙美学修复中的效果对比

目的:对比分析复合树脂多层修复技术与复合树脂直接粘接修复技术在前牙间隙美学修复中的效果。方法:纳入笔者医院2020年6月-2021年6月收治的98例(共104颗患牙)前牙间隙患者作为研究对象,按照随机数表法分为A组和B组,各49例。A组患者接受复合树脂多层修复技术,B组患者接受复合树脂直接粘接修复技术。对比两组修复效果、美学效果和治疗总费用,比较两组修复前和修复30d后、6个月后的咬合力、咀嚼效率和焦虑自评量表(Self-ratinganxietyscale,SAS)、抑郁自评量表(Self-rating depression scale,SDS)评分。结果:修复30 d后,A组优秀率高于B组(P<0.05),两组良好率和不良率比较无统计学意义(P>0.05)。修复6个月后,A组优秀率和不良率均高于B组(P<0.05),两组良好率比较无统计学意义(P>0.05)。患者的咬合力在时间、交互作用上差异有统计学意义(P<0.05),在组间作用上差异无统计学意义(P>0.05)。患者的咀嚼效率在时间、组间、交互作用上差异均有统计学意义(P<0.05)。修复6个月后,两组患者咬合力和咀嚼效率均较修复30d后和修复前升高,且A组咬合力和咀嚼效率高于B组(P<0.05)。A组修复后的边缘密合性、颜色匹配性、修复体崩裂、继发龋损、形态匹配、修复体脱落和牙龈健康评分均低于B组(P<0.05)。患者的SAS评分和SDS评分在时间、组间、交互作用上有统计学意义(均P<0.05)。修复30d后和修复6个月后,两组患者SAS和SDS评分均较修复前降低,且A组低于B组(P<0.05)。A组治疗总花费高于B组(P<0.05)。结论:与复合树脂直接粘接修复技术相比,在前牙间隙美学修复中应用复合树脂多层修复技术可取得更佳的修复效果,有助于恢复患者咬合力和咀嚼功能,使患者获得良好美学效果,改善其心理状态。但治疗总花费相对较高,临床治疗需结合患者经济情况选择合适治疗方案。

ESG表现对企业融资成本的影响:一个研究述评

“融资难、融资贵”是阻碍我国企业发展的困难之一,因此解决企业融资困境成为现实问题。现行绿色发展背景下,加强自律、提高ESG评级成为企业积极转型的新途径,然而ESG表现对企业融资成本的影响一直是学术界争议较大的话题。通过系统梳理现有相关研究成果可以发现:目前关于ESG表现对企业融资成本的作用机制、中介因素、经济后果等仍然存在不同的观点。因此,以探究两者直接的内在联系为起点,厘清ESG表现和直接、间接融资成本其中的作用机制。基于目前该领域的研究现状,后续研究注重完善该方向的相关研究角度以及方法,继续深挖ESG表现与融资成本之间存在的驱动机制,构建更为完整的理论模型,并为我国企业高质量发展研究提供思路和参考。

外交环境风险影响审计费用吗?

外交环境对于公司的海外发展具有重要影响。以2009—2022年外交部的发言表态次数为基础构建了公司暴露于外交环境风险的指标,检验了外交环境风险对公司审计费用的影响。实证结果表明,公司暴露于外交环境风险的程度越高,审计费用越高。区分审计师异质性后发现,外交环境风险更明显地提升了非国际“四大”的审计费用。机制分析显示,外交环境风险通过提高代理成本和审计投入提高了审计收费。研究结果表明宏观环境风险对审计决策具有影响,丰富了审计费用的影响因素研究。

版权保护自动化实施与言论自由冲突的化解——欧盟的法律实践及其超越

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