Background: While public municipal hospitals in Japan are supported by public financing and are less likely to fail than private hospitals, more than half are in financial deficit. Hospitals running at a deficit may h...Background: While public municipal hospitals in Japan are supported by public financing and are less likely to fail than private hospitals, more than half are in financial deficit. Hospitals running at a deficit may have poorer outcomes and less investment in maintenance of human or physical capital, as well as increased rates of patient adverse events. We sought to clarify the relationship between municipal hospital surpluses or deficits and salary expenditures. Methods: We extracted financial data for 253 general hospitals of 300 beds or more from financial statements for the 2013 fiscal year available in the Yearbook of Public Firms, Edition for Hospital. From these data, we calculated account balance ratios and compared the average value of the ratio of labor to the output (salary ratio) for each group using analysis of variance (ANOVA). Results: The salary ratios of hospitals in the surplus group were significantly lower than the salary ratios of hospitals in the deficit group (55.5% vs. 49.4%;p p = 0.342). In the surplus group, the average value of salary ratios was different among the three-bed count groups (mean salary ratio: 53.0% vs. 48.5% vs. 47.4%;ANOVA p = 0.012). In addition, there was a significant difference in mean value between the 300-bed group and ≥500 beds group (mean salary ratio: 53.0% vs. 47.4%;p = 0.002). Conclusion: This study suggests that maintaining a favorable salary ratio to the current account balance is a useful proxy of fiscal health, and interventions to improve the salary ratio may be effective in improving municipal hospital management. Furthermore, among well-managed municipal hospitals, larger hospital size may confer some advantage in purchasing power.展开更多
Demographic transitions occur at different times and speed across different economies, and age structures consequently differ across regions. Using a solvable four-phase model, we show that economies with a higher pro...Demographic transitions occur at different times and speed across different economies, and age structures consequently differ across regions. Using a solvable four-phase model, we show that economies with a higher proportion of working-age force and a lower dependency ratio tend to have higher savings rates. Because the demographic ＂ center of gravity＂for investment demand falls at a younger point in the age distribution than that of savings supply, countries with a younger age-distribution like those described above generate national savings in excess of domestic investment, resulting in a current account surplus. Numerical simulation supports this hypothesis. But the relative youth or age of a country＇s population reflects temporary demographic trends which change continuously. Therefore, while trade imbalances caused by demographic factors are structural and long-term, they are not permanent, and may be reversed by changes in age structure.展开更多
This paper investigated the relationship between demographic structure and international capital flows with panel data of 190 countries over the past 60 years＇ and projection data for the 21st century. As found, from...This paper investigated the relationship between demographic structure and international capital flows with panel data of 190 countries over the past 60 years＇ and projection data for the 21st century. As found, from a global perspective, the current account balance （CAB） is negatively related to the dependency ratio, and orresponding to continuous change, international eapital flows tend to move from ＂adult countries＂ to ＂aged or young countries.＂ Since the middle of the 20th century, the U.S., Europe, Japan, China, Southeast Asia, Central Asia, South Asia, West Asia and Africa took turns in exporting capital to other countries. In the 2lst century, Europe, the U.S., Australia and Singapore will keep importing capital, while China in the 2030s, and Southeast Asia in the 2050s will in turn become the main capital importers. Given the demographic structure of China and the world, the future pattern of the international capital flows requires more serious concern and responses.展开更多
文摘Background: While public municipal hospitals in Japan are supported by public financing and are less likely to fail than private hospitals, more than half are in financial deficit. Hospitals running at a deficit may have poorer outcomes and less investment in maintenance of human or physical capital, as well as increased rates of patient adverse events. We sought to clarify the relationship between municipal hospital surpluses or deficits and salary expenditures. Methods: We extracted financial data for 253 general hospitals of 300 beds or more from financial statements for the 2013 fiscal year available in the Yearbook of Public Firms, Edition for Hospital. From these data, we calculated account balance ratios and compared the average value of the ratio of labor to the output (salary ratio) for each group using analysis of variance (ANOVA). Results: The salary ratios of hospitals in the surplus group were significantly lower than the salary ratios of hospitals in the deficit group (55.5% vs. 49.4%;p p = 0.342). In the surplus group, the average value of salary ratios was different among the three-bed count groups (mean salary ratio: 53.0% vs. 48.5% vs. 47.4%;ANOVA p = 0.012). In addition, there was a significant difference in mean value between the 300-bed group and ≥500 beds group (mean salary ratio: 53.0% vs. 47.4%;p = 0.002). Conclusion: This study suggests that maintaining a favorable salary ratio to the current account balance is a useful proxy of fiscal health, and interventions to improve the salary ratio may be effective in improving municipal hospital management. Furthermore, among well-managed municipal hospitals, larger hospital size may confer some advantage in purchasing power.
基金This research is supported by： National Social Science Foundation ＂ Study on China＇s imbalanced foreign trade from the perspective of intra-product specialization＂ （10BJY079）.
文摘Demographic transitions occur at different times and speed across different economies, and age structures consequently differ across regions. Using a solvable four-phase model, we show that economies with a higher proportion of working-age force and a lower dependency ratio tend to have higher savings rates. Because the demographic ＂ center of gravity＂for investment demand falls at a younger point in the age distribution than that of savings supply, countries with a younger age-distribution like those described above generate national savings in excess of domestic investment, resulting in a current account surplus. Numerical simulation supports this hypothesis. But the relative youth or age of a country＇s population reflects temporary demographic trends which change continuously. Therefore, while trade imbalances caused by demographic factors are structural and long-term, they are not permanent, and may be reversed by changes in age structure.
文摘This paper investigated the relationship between demographic structure and international capital flows with panel data of 190 countries over the past 60 years＇ and projection data for the 21st century. As found, from a global perspective, the current account balance （CAB） is negatively related to the dependency ratio, and orresponding to continuous change, international eapital flows tend to move from ＂adult countries＂ to ＂aged or young countries.＂ Since the middle of the 20th century, the U.S., Europe, Japan, China, Southeast Asia, Central Asia, South Asia, West Asia and Africa took turns in exporting capital to other countries. In the 2lst century, Europe, the U.S., Australia and Singapore will keep importing capital, while China in the 2030s, and Southeast Asia in the 2050s will in turn become the main capital importers. Given the demographic structure of China and the world, the future pattern of the international capital flows requires more serious concern and responses.
