Research on social medical insurance of migrant workers --A case of Suqian city in Jiangsu province

City migrant workers, as one part of the city＇s development, economic development and other aspects of urban to make a great contribution, but the delay with the local residents do not enjoy the same level of medical care treatment is always blocked in outside the city＇s health care system, have less relevant departments, there is no practical system introduced regulations and policies, these things tell us to pay attention to the people, and the introduction of appropriate medical insurance of migrant workers possibly things, and timely medical security system of such groups and the local people medical protection for long support. Make medical insurance system can cities try it＇s best to help foreign workers Medicare, Medicare for the development of China has made a modest contribution.

Research on Social Medical Insurance of College Students in Shenyang

Objective To discuss the methods of improving the social insurance of college students by taking the application of college students’social insurance in Shenyang as an example.Methods The investigation and literature method were applied mainly.Results and Conclusion Through the questionnaire,the main problems for college students’medical insurance were analyzed in this paper,and proposals such as compulsory insurance,improving the level of medical services in colleges and hospitals,and strengthening commercial insurance and publicity were finally put forward.

AI赋能哲学社会科学研究、传播及评价

人工智能正在改变整个人类社会,丰富人们的文化生活,促进科技创新与发展,是各行各业“新质化”的促进剂。人工智能可为哲学社会科学提供高效的研究工具和研究场景,将深刻影响哲学社会科学研究、传播及评价的方方面面。加速人工智能在哲学社会科学研究、传播及评价领域的深入应用,提升哲学社会科学研究效率,促进哲学社会科学的创新与发展,构建自主知识体系,是当下哲学社会科学工作者的重要使命。为推进AI赋能哲学社会科学(AI4SS),2024年9月28日,由西华大学、四川省社会科学学术期刊协会主办,西华大学学术期刊部、四川省社会科学重点研究基地四川学术成果分析与应用研究中心承办的“AI赋能社科研究与评价天府论坛”在西华大学举行。来自南京大学、中国人民大学、四川大学等高校与科研机构的20位专家学者,从不同学科、研究领域出发,就人工智能赋能哲学社会科学研究、传播及评价进行了深入交流。文章为20位专家学者在论坛上所作报告的主要观点。这些报告议题包括AI赋能人文社科研究方法的变革,法学、教育学、经济学、图书情报学、新闻传播等社会学科视域下的人工智能,AI辅助社会科学研究的学术伦理,人工智能在医疗健康、大宗商品价格风险监测、大学生高阶思维能力培养等方面的应用,AI赋能学术期刊出版与传播,AI赋能哲学社会科学评价新模式、新平台、新场景,等等。这些议题共同描绘了一个由AI技术驱动的多学科融合与创新的新时代。

Cost-Utility Analysis of Liraglutide in Type 2 Diabetes Patients in China after Chinese Reformation of Medical Care System

Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical trial conducted in Asia. Methods: We applied a Markov model to estimate the quality-adjusted life years, medical cost and incidence of diabetes-related complications for patients receiving the Liraglutide as an add-on to the metformin treatment. Baseline characteristics were taken from a China’s study while the treatment effect is from an Asian study. The related medical cost and utility score were obtained from a local study in China. Having set 30 years’ simulations, the incremental cost-effectiveness ratio was calculated comparing with glimepiride treatment. The ratio would be compared with the willingness to pay for a quality-adjusted-life-year (QALY) which is three times of the GDP per capita in Beijing. Sensitivity analysis was also performed. Result: During a period of 30 years, the base-case analysis which takes discount rate at 3% shows that Liraglutide 1.8 mg results in an average incremental cost of CNY 82,671.49, an improvement in 0.12 QALYs and a reduction of incidence of diabetes-related complications comparing to glimepiride. The associated incremental cost-effectiveness ratio is CNY 688,929.08. Conclusion: Long-term project shows that taking Liraglutide as an add-on to the metformin treatment will lead to increasing quality-adjusted life years and reduction of incidence of diabetes-related complications. When the price of Liraglutide is reduced by 43 percent in China’s yuan, Liraglutide will be cost-effective in China from the healthcare system perspective taking three times of GDP per capita as our WTP threshold.

Optimization of Actuarial Model for Individual Account of Rural Social Pension Insurance

This paper firstly analyzes different payment methods of individual account and the pension replacement rate under the pension payment method.Results show that it will be more scientific and reasonable for the individual account of new rural social pension insurance to adopt the actuarial model of payment according to proportion of income and periodic prestation at variable amount.The Guiding Opinions on New Rural Social Pension Insurance sets forth individual account should be paid at fixed amount,and the insured voluntarily selects payment level as per criteria set by the State.The monthly calculation and distribution amount of pension is the total amount of individual account divided by139.Therefore,it should start from continuation of policies and make adjustment of payment level in accordance with growth of per capita net income of rural residents.When condition permits,it is expected to realize transition to payment as per income proportion and periodic prestation at variable amount.

“镇江模式”的形成及其特征研究

“镇江模式”的形成基本经历了4个阶段:试点起步阶段、探索调整阶段、深化发展阶段、优化完善阶段。目前,已初步构建起多层次全民社会医疗保障的总体框架。“镇江模式”主要有以下4个方面的特征:保障体系具有开放性、医疗需求具有适应性、参保缴费具有连续性、道德风险具有防范性。

An Ensemble Methods for Medical Insurance Costs Prediction Task

The paper reports three new ensembles of supervised learning predictors for managing medical insurance costs.The open dataset is used for data analysis methods development.The usage of artificial intelligence in the management of financial risks will facilitate economic wear time and money and protect patients’health.Machine learning is associated withmany expectations,but its quality is determined by choosing a good algorithm and the proper steps to plan,develop,and implement the model.The paper aims to develop three new ensembles for individual insurance costs prediction to provide high prediction accuracy.Pierson coefficient and Boruta algorithm are used for feature selection.The boosting,stacking,and bagging ensembles are built.A comparison with existing machine learning algorithms is given.Boosting modes based on regression tree and stochastic gradient descent is built.Bagged CART and Random Forest algorithms are proposed.The boosting and stacking ensembles shown better accuracy than bagging.The tuning parameters for boosting do not allow to decrease the RMSE too.So,bagging shows its weakness in generalizing the prediction.The stacking is developed using K Nearest Neighbors(KNN),Support Vector Machine(SVM),Regression Tree,Linear Regression,Stochastic Gradient Boosting.The random forest(RF)algorithm is used to combine the predictions.One hundred trees are built forRF.RootMean Square Error(RMSE)has lifted the to 3173.213 in comparison with other predictors.The quality of the developed ensemble for RootMean Squared Error metric is 1.47 better than for the best weak predictor(SVR).

社会资本与民营非营利性医疗机构的发展空间

社会资本指的是社会组织的特征,如信任、规范和网络,它是无形的,可以通过促进合作行动提高社会效率。随着我国医疗改革的深入,由民间资本创立,旨在提供社会公共卫生服务的非营利性医疗机构将作为国有非营利性与民营营利性医疗机构的有效补充在医疗市场发挥作用。树立民营非营利性医疗机构的良好社会公众形象并获得群众大力支持和帮助,赢得慈善机构捐资、争取企业或个人赞助等均是非营利性医疗机构创造并利用社会资本,赢得生存和发展空间的关键。

Analysis of Drug Medical Insurance Access Pricing Based on the Perspective of Binary Equilibrium

Objective To study the influencing factors in the process of national medical insurance negotiation and drug pricing from the dualistic equilibrium perspective,and to provide reference for the harmonious management of drug pricing in China.Methods Through the literature analysis and policy review,the pricing subject,pricing basis and price control system in the pricing process of medical-accessed medicines were analyzed from the perspective of binary equilibrium and harmonious management.Results and Conclusion It is found that four balances in the drug pricing process,two balances in pricing basis and three balances in price control system need to be considered,respectively.Drug pricing is the key content of national medical insurance access,which is also the hotspot of the policy in the pharmaceutical fields in recent years.Drug pricing not only reflects the value of drugs,but also reflects a lot of top-level designs of binary equilibriums in medical insurance policy.While the rational design of drug pricing requires the joint efforts of the government,pharmaceutical companies and relevant experts to comprehensively consider many equilibriums,so as to improve the relevant systems.

An Empirical Study on the Effects of Social Endowment Insurance Reform in China

In recent years,China,the world’s largest population country,has also become an aging society.Social endowment insurance is not only a major source of income after retirement but also plays a major role in social stability.In 2005,large-scale social endowment insurance reform was conducted in China.Through this reform,the social endowment insurance became unified and normalized,and the participation of the social endowment insurance was obligated for an employee.In addition,the government has issued various welfare policies so that the unemployed,free job and rural residents can join social endowment insurance.Then,this paper analyzes the effect of the reform of China social endowment insurance on the amount of Insurance premium of social endowment insurance and the distribution of family expenditure by using the DID model and the fixed effect model.

A Study on the Public Awareness of Hierarchical Medical System in Taiwan

The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this research aims to discuss the public awareness of hierarchical medical system in Taiwan for the reference of health policy makers. We obtained our research data using a questionnaire survey;the total number of qualified patients was 1340. This research finds that more subjects agreed to the hierarchical medical system and medical referral system, but many people still disagreed with changes to their healthcare seeking choices due to policy promotion. Subtle changes, therefore, are observed that imply a crisis in terms of the trust in healthcare. The healthcare seeking behavior will not change if there is a difference between the medical awareness of patients and policy implementation, and the government needs to be concerned with this result when making policies.

“镇江模式”的社会经济分析

就“镇江模式”实施效果从社会和经济的角度对其进行分析。研究表明,“镇江模式”实施后产生了良好的社会经济效果。基本医疗保险覆盖面不断扩大,职工的基本医疗得到保障,社会认同度高,多层次医疗保险发展势头喜人,困难人群的医疗需要得到较好保障,基金收支平衡、略有结余,共济能力增强,医疗费用过快增长的势头得到有效遏制,费用支出结构合理,个人医疗负担相对适中。

Software Process Modeling with UML in Development of Medical Insurance MIS

This paper describes how to use the Unified Modeling Language (UML) to modeling software processes in medical insurance MIS, and compares UML Modeling method with classic PO(Process Oriented) Modeling method. It indicates that the whole performance of application system model described by UML is much better than the one described by PO.

农民工医疗保险在统筹地区实施的可行性分析

农民工医疗保险政策尚处在探索中,客观上需要进行政策可行性分析。而利益集团是影响政策可行性的重要因素。因此,拟采用Stakeholder分析方法对利益集团的正面和负面影响因素、调用资源的能力进行综合分析。结果显示,支持与反对力量相当,揭示在当前政治、经济、社会条件下农民工医疗保险政策在统筹地区实施没有明显的优势。建议根据集团立场,动用资源的综合实力,采取适宜策略,分配物资和精力,以便用高效、节省的方式确保政策实施。

Non-equilibrium Analysis of Migrant Workers ' Medical Insurance System under the Background of Citizenization

The participation of migrant workers in medical insurance of urban workers is a formal institutional arrangement. However,in reality,the insurance participation rate of migrant workers is low and the medical insurance taken by the migrant workers is not sufficient,which seriously hinders the process of the citizenization of migrant workers. The main reason lies in the unbalanced supply and demand of the current system. With the continuous advancement of the citizenization process,the rural migrant workers' demand for medical insurance has changed.However,our research found that the supply of medical insurance system for migrant workers is seriously inadequate,the system and the institutional environment are disconnected,the internal contradictions of the system are increasing,and a large amount of potential profits are accumulated under the current system. Potential profit is the motive force to promote institutional innovation and promote the reform of current system to strike a balance.

农村医疗保障:新型农村合作医疗该向何处去

认为新型农村合作医疗的设计具有内在的制度缺陷,在产生和发展路径上具有对传统合作医疗、城市社会医疗保险和商业医疗保险制度的严重依赖,但各制度面对的环境和基础却并不相同。农村医疗保障体系的建立,必须立足于我国农村现有的社会结构和传统文化环境,根据不同地区经济社会和人文发展的分异性与不同保障形式所要求的制度基础和条件,选择不同的农村医疗保障模式。同时,要注重发挥非正式保障制度的作用。

浅析医疗责任保险的难点与对策

随着医疗形势日益严峻,医院作为高风险行业,必须寻求一种社会风险共担、转移机制来保障医务人员的利益,强化他们的风险意识,提高医疗质量和服务水平,使患者在损害中能得到公平的赔偿,有利于社会稳定和医疗卫生事业的长远发展。医疗责任保险是医院风险分担、转移的一种有效途径,但由于我国的医疗责任保险尚处于初级阶段,制度还不够完善,作用发挥不充分。本文探讨了医院在医疗责任保险过程中遇到的困难并对解决方法提了一些看法和建议。

Research Status of Xinchang private SMEs social security issues

With the rapid development of China＇s market economy well, China＇s private SMEs have become the main force of economic growth. However, the development of social insurance is not optimistic. Therefore, to do private SMEs of social insurance is not only about their own development, but also closely linked to the country＇s economic and social stability. In this paper, the status of social insurance run Xinchang private small and medium-depth and detailed analysis, there are some improved measures to land, thereby improving the status of social insurance by private SMEs Xinchang.

The sustainability study of medical insurance fund in China under the background of aging

the arrival of the aging means being able to direct production value to reduce the proportion of people, the elderly population gradually become pure consumer groups, and the elderly because of its body function gradually blurred, risk is higher than that of other age members of society, medical consumption occupy a large proportion in the consumption structure. As the degree of aging, the country＇s medical expenses will be bigger, that is to say, in an aging society, may because the elderly medical consumption spending huge, and affect the sustainable development of society. And as countries deeper levels of population aging in our country, can very good deal with the impact of the aging of medical insurance fund, guarantee the sustainability of the medical insurance fund, also determines the sustainable and stable development of our country. Therefore, under the background of aging degree deeper, the development of the medical insurance fund is to seek new paths, to cope with increasing aging population is particularly important