The study of technology acceptance for e-wallets application of clinic fees payment

The purpose of this study was to investigate the demand of application of e-wallet in domestic retail industry by examining the needs of adoption of small amount paying method and the reasons for customers’ using of IC stored value card in this industry and aimed at providing suggestions on the e-development of small amount paying methods for domestic retail and banking industries. This study was developed in a way that the model constructs in TAM were adapted to the context of using e-wallets for clinic fees. Scale items on the survey include those measuring perceived usefulness, perceived ease of use, a user's attitude toward using and intention. The questionnaire contains no identifying information about the individual participants. A total of 320 Taipei City Hospital patients’ feedbacks were collected. Results indicate most of the relationships in the proposed model are statistically significant and in the predicted directions. Each observed variables influence with two ways: direct effect and indirect effect, and the total effect is the sum of direct effect and indirect effect. The Main effect of most of these observed variables is direct effect, but the information technology experience with the perceived usefulness. In this study, it could be finding that the perceived usefulness, the perceiver ease of use is positively associated with users’ attitude toward using, and the perceiver ease of use is positively associated with the perceived usefulness. It means the useful and easily operation of payment clinic fees with e-wallet products (such as Taipei Easy Card) is very important for the users. Besides, the easier for e-wallet using, the more people think it is usefulness. This suggestion is the same as the point at issue of Davis [1]. The users’ attitude toward using is positively associated with the intention using.

Payment for Water-Related Ecosystem Services as a Strategic Watershed Management Approach

Payments for ecosystem services (PES) have been created worldwide to assist watershed management and improve or maintain water quality. Considering their importance, we conducted a holistic review of payment for water-related ecosystem services to understand how this instrument has been applied in watershed management worldwide. First, we identified the watershed management actions considered by the PES programs and the challenges of implementing water-related PES. After we identified the methods and criteria used to define priority areas for water-related PES. Our review considered articles published on the Web of Science from 2011 to 2022. We found 236 articles relating PES to water resources, highlighting the main water conservation strategies: native vegetation conservation, native vegetation restoration, and implementing best agricultural practices. The method most frequent was interview, followed by the use of technologies, document analysis, and hydrological models. Another significant result was that priority areas for receiving PES are mainly riparian zones, areas near or with native vegetation cover, areas with higher erosion potential, steep areas, and areas with socially vulnerable communities. This review was crucial to identify efficient water resource conservation strategies and potential challenges in the implementation and development of PES programs.

我国药学服务收费探索与现状分析

目的 总结中国药学服务收费的探索历程及现状,并结合国外实践进行分析,为中国药学服务收费相关政策的进一步完善提供参考。方法 检索国家及各省卫生健康委员会、医疗保障局的官方网站,归纳中国药学服务收费相关政策的变革及各省最新的药学服务收费政策。同时检索中国国家知识基础设施(CNKI)、维普中文科技期刊数据库、Pubmed等数据库,总结关于药学服务收费相关研究。结果 国内关于药学服务成本测算和收费标准的研究较多,但多集中在药房调剂服务,对具体药学服务的技术劳务价值探讨较少,国外这方面研究相对较多。目前国内共8个省和1个直辖市公布了药学类医疗服务价格项目,收费项目、收费标准、医疗保险支付比例及监测评估指标各有差异。结论 将药学服务收费纳入国家医疗服务价格体系是对药学服务转型和药师价值的认可,但尚在起步阶段,仍有完善和改进空间。

Supplemental feeding on rangelands:new dynamics of the livestock in the El Ouara rangelands in southern Tunisia

Fodder production in arid rangelands has been traditionally considered as the main source of nutrition for livestock.However,the production of these fodder may be influenced by some socio-economic and climatic factors.This study aims to identify the various rangeland use forms and determine the types of livestock feeding system in the El Ouara rangelands of Ben guarden District in southern Tunisia by analysing the importance of supplemental feeding and main determinants of this practice.Data were collected by a survey that targeted a sample of 50 breeders in the El Ouara rangelands.Descriptive statistics and binary logistic regression were used to analyse the data.The results showed that there are two types of association practiced by breeders:“Cherka”association practiced by 10.00% of breeders and cash payment association practiced by 53.00% of breeders.Then,transhumance,sedentary,and semi-urban forms are the main ways in which breeders use the rangelands.There are four livestock feeding systems in the El Ouara rangelands being used to feed livestock:natural rangeland,rangeland-based,mixed,and concentrate-based feeding systems.Supplemental feeding has become fundamental for the livestock feeding system in the El Ouara rangelands.The breeders with the largest camel size still use the natural rangeland feeding system,while the breeders who have the largest herd size practice the mixed feeding system.The logistic regression results reveal that breeder age,cereal area,herd size,migrant remittance,second activity,and agricultural development group membership can significantly impact the supplemental feeding.In summary,this study can help policy-makers plan innovative practices based on climatic change,ensure the sustainability of livestock feeding system,and make effective decisions for local development.

Financial literacy,behavioral traits,and ePayment adoption and usage in Japan

This study investigates how financial literacy and behavioral traits affect the adoption of electronic payment(ePayment)services in Japan.We construct a financial literacy index using a representative sample of 25,000 individuals from the Bank of Japan’s 2019 Financial Literacy Survey.We then analyze the relationship between this index and the extensive and intensive usage of two types of payment services:electronic money(e-money)and mobile payment apps.Using an instrumental variable approach,we find that higher financial literacy is positively associated with a higher likelihood of adopting ePayment services.The empirical results suggest that individuals with higher financial literacy use payment services more frequently.We also find that risk-averse people are less likely to adopt and use ePayment services,whereas people with herd behavior tend to adopt and use ePayment services more.Our empirical results also suggest that the effects of financial literacy on the adoption and use of ePayment differ among people with different behavioral traits.

Online payment fraud:from anomaly detection to risk management

Online banking fraud occurs whenever a criminal can seize accounts and transfer funds from an individual’s online bank account.Successfully preventing this requires the detection of as many fraudsters as possible,without producing too many false alarms.This is a challenge for machine learning owing to the extremely imbalanced data and complexity of fraud.In addition,classical machine learning methods must be extended,minimizing expected financial losses.Finally,fraud can only be combated systematically and economically if the risks and costs in payment channels are known.We define three models that overcome these challenges:machine learning-based fraud detection,economic optimization of machine learning results,and a risk model to predict the risk of fraud while considering countermeasures.The models were tested utilizing real data.Our machine learning model alone reduces the expected and unexpected losses in the three aggregated payment channels by 15%compared to a benchmark consisting of static if-then rules.Optimizing the machine-learning model further reduces the expected losses by 52%.These results hold with a low false positive rate of 0.4%.Thus,the risk framework of the three models is viable from a business and risk perspective.

数字金融与商业银行审计费用

以2011—2021年中国商业银行为研究对象,探究数字金融对审计费用的影响机理与传导效应。研究发现:数字金融发展初期会增加商业银行的审计费用,当数字金融发展到一定水平后,金融科技增强带来的审计费用下降效应会超过因审计投入和审计风险提升的审计费用上升效应,进而降低商业银行的审计费用,说明数字金融与审计费用之间呈先扬后抑的倒U形关系。机制检验发现,数字金融主要通过作用于代理冲突和信息不对称导致审计风险与成本变动,最终影响审计费用。异质性分析显示,审计主体来自国内四大审计事务所时,数字金融对审计费用的非线性作用增强;审计客体是上市银行与资本充足率较高的商业银行时,数字技术能更有效地对审计费用产生非线性效应;商业银行在市场化程度和法律水平较高、数字金融监管较严的地区时,数字金融与审计费用的倒U形关系更显著。研究结论从审计费用角度丰富了数字金融经济后果研究,为商业银行实施数字化转型战略、注册会计师审计收费决策提供参考。

Inspiration of Foreign Innovative Drug Pricing Methods and Medical Insurance Payment Standards to China

Objective To study the innovative drug pricing methods and medical insurance payment standards in foreign countries and to provide reference for China’s government.Methods The official websites were searched for information and related literature,and literature review was used.Results and Conclusion In foreign countries,the clinical value of innovative drugs and their impact on medical insurance funds were comprehensively evaluated based on factors such as quality-adjusted life years,clinical benefit,and improvement of clinical benefit.Then,the evaluation results were taken as an important basis for whether innovative drugs were admitted to the medical insurance catalog and establishing medical insurance payment standards.By using international experience for reference,innovative drug pricing methods and medical insurance payment standards for China’s national conditions can be improved by establishing a basic database of clinical value and drug economic evaluation of innovative drugs,as well as innovative drug payment models based on decision thresholds.

隐性关联关系与审计费用——基于供应链工商大数据的研究

近年来,上市公司将其供应链商业关系隐藏化以规避信息披露要求的趋势越来越明显,不利于投资者评估和判断上市公司的交易性质和盈利能力。本文从审计师角度出发,以2010-2021年度我国A股上市公司为研究对象,基于供应链工商大数据度量隐性关联关系,分析隐性关联关系与审计费用之间的关系,结果发现上市公司与重要交易对象之间存在隐性关联关系提高了审计费用,一系列稳健性检验结果保持一致。在渠道检验中,研究发现隐性关联关系通过影响审计师投入,进一步影响审计费用。在分组检验中,研究发现隐性关联关系对审计费用的影响在高市场化进程地区、低信息透明度的公司以及当上市公司为事务所重要客户时更为显著。本文研究为审计师如何判断隐性关联关系问题提供了经验数据。

减税降费对企业投资效率的影响研究

减税降费政策是促进企业发展、提高市场活力的重要举措,对提高企业投资效率、推进供给侧改革具有重要意义。本文通过我国沪深A股上市公司2012-2020年的数据,对减税降费对企业投资效率的影响进行研究。研究结果表明:减税降费能够有效提升企业的投资效率;机制检验表明,减税降费可以通过缓解融资约束,减少企业投资不足的行为,通过降低信息不对称程度抑制过度投资的行为。通过进一步研究发现,减税降费对提高民营企业、低自由现金流企业投资效率的效果更为显著;政策对不同成长机会的企业影响效应有所区别;政策对市场化程度较高地区的企业投资不足的作用更加明显,而对市场化程度较低地区的企业过度投资的作用更为明显。本文还提出了推进减税降费政策,从而提高企业投资效率、促进企业高质量发展的政策建议。

未来5~10年中国医疗保障待遇设计的改革思路

医疗保障待遇包括起付线、报销比例、封顶线等内容。典型国家社会医疗保险报销起付线多设置在人均年收入的3%以内,对门诊、住院和药剂服务设立了不同的支付政策,医疗费用个人自付占可支配收入的比例在0.25%~2%。借鉴国际经验,展望中国社会医疗保险制度未来的发展,建议提高门诊保障待遇,以可支配收入为基数设置报销起付线,不同层级医疗机构实行相同的报销比例,设置个人自付封顶线,取消门诊报销封顶线,门诊和住院共用个人最高自付限额。

我国不同付费模式信用评级校验机制研究

我国债券市场刚性兑付被打破后,不断出现高评级债券违约事件。为此,监管部门积极发展多种评级,以期提高债券评级质量。通过理论建模与实证分析,研究了不同付费模式信用评级如何综合发挥校验作用。基于博弈模型的理论分析发现,不同付费模式评级发挥校验作用的机制在于投资者的反应:当投资者付费和发行人付费两种模式评级差值增大,投资者不以单一评级结果进行债券定价,而是根据评级差值调整债券价格。基于2011—2020年企业债评级数据的经验证据显示,随着评级差值增大,发行人付费评级机构会降低后续评级,且评级差值对单一信用评级与债券信用利差之间的负向关系具有抑制作用。进一步检验发现,发行人付费评级机构提供的偏正面的私有信息会降低债券信用利差,而以中债资信为代表的投资者付费评级机构提供的私有信息则不会显著影响债券信用利差,均体现出单一评级模式在定价方面的弊端。因此,监管部门应继续鼓励发展投资者付费评级模式,并鼓励机构投资者发展内部评级,以充分发挥多种评级模式的交叉校验作用。

价值支付视角下门诊按人头付费的理论内涵和改革建议

按人头付费是医保门诊统筹改革的核心任务之一。价值支付视角下按人头付费应具有控制医疗成本、提升服务质量、改善患者健康结果的价值目标,其核心要素包括:以整合型医疗卫生服务组织和基层家庭医生签约团队为供方主体,为特定疾病人群或签约人群提供连续性医疗服务;支付标的为固定时间范围内发生的医疗费用总额,通过合理设定人头基础费率和风险调整因子,建立以质量和健康结果为核心的绩效支付和结余分享、风险分担机制等,建立起支付方、供方、患者三方价值均衡且相容的激励约束机制。

惠民保可持续发展研究

在多层次医疗保障体系建设中,惠民保是连接基本医疗保险与商业健康保险的中间层,是化解重大疾病风险、推进共同富裕的一项保障。本文探讨惠民保在多层次医疗保障体系中的地位,分析其参保、赔付以及产品现状,总结惠民保面临参保率不足、参保人群结构不良、赔付率不稳定且赔付不均等问题。基于此,本文提出实行基于DRG/DIP按病组支付的惠民保发展模式,旨在不影响相关主体利益的基础上改善参保率,优化参保结构,增强参保人获得感,从而吸引健康人群投保,提升制度普惠性和可持续性,为完善多层次医疗保障体系建设做出贡献。

以价值为导向的住院康复服务价值调节因子构建研究

目的:本研究旨在建立实现康复治疗效果可比的价值调节因子,为将康复服务价值作为医保支付依据、基于现行医保制度建立按价值付费机制提供可行思路。方法:课题组于2022年1月1日—2023年3月31日收集样本医院脑损伤住院患者功能相关信息,并与样本地区医保结算清单数据库关联。采用神经网络模型拟合康复结果与康复效果影响因素之间的函数关系,根据康复结果实际值与预测值差值的分布区间判断康复服务价值。结果:共计878例脑损伤患者的住院康复病案与医保结算清单资料纳入分析;根据预测精度评价指标及其标准,选取了最优模型,并根据其预测结果对康复治疗效果进行了评价,确定了包含四个档次的价值调节因子。结论:本研究构建的价值调节因子,不仅为评价住院康复服务治疗效果、实现康复效果可比提供了重要工具,也为进一步推动医保对住院康复服务实施按价值付费提供了可行方向。

基于疾病特征的医保支付方式优化策略研究——以结核病为例

目的:探索符合结核病疾病特征的医保支付方式。方法:基于文献研究,分析当前我国结核病的医保支付方式。结果:当前我国结核病支付政策存在制度安排与临床实际不匹配、患者经济负担较重等问题,有必要从疾病特征出发,优化结核病医保支付方式。结论:实行科学动态的结核病门诊单病种支付方式,紧扣疾病特征优化按病种分值付费支付方式,建立全程治疗管理体系,探索捆绑支付模式,减轻结核病患者经济负担。

基于双重差分法的DRG付费对中医医院的影响研究

目的:评估按疾病诊断相关分组(DRG)付费对中医医院住院患者例均总费用、费用结构、住院时长、出院人数及中医特色的影响。方法:以某中医类国家区域医疗中心为研究对象,使用双重差分回归模型(DID)分析付费改革政策实施前后医保患者(干预组)与非医保患者(对照组)的各项指标差异,通过平行趋势检验和安慰剂检验证实模型可靠性和稳定性。结果:例均住院总费用、病例数、住院天数、医疗服务收入占比、饮片收入占比等十一项指标的DID交互项系数显著(P<0.05),费用指标回归系数均小于0。饮片使用率、中医非药物疗法收入占比等四项指标DID交互项系数不显著(P>0.05)。结论:DRG付费政策显著降低付费病组例均总费用,其中耗材、医技费用下降显著,费用结构优化,中药饮片费用占比略微下降。应持续关注DRG付费对中医医院影响,进一步扩大样本范围,跟踪分析政策影响,全面评价DRG付费政策对我国中医医疗机构的影响。

公共图书馆非基本服务项目收费的现实需求、困境与对策

非基本服务项目收费是推动公共图书馆社会化发展的重要举措。虽然公共图书馆非基本服务项目收费在我国有着强烈的现实需求和法律政策依据,但实践中面临着诸多困境,主要表现为:非基本服务项目收费的法律政策不够完善,收费行为影响基本服务项目的高质量供给,收费审批程序、定价和用途较为随意,容易形成“以文养文”的局面。解决之道包括:完善非基本服务项目的收费政策,加强政府的主体保障责任,规范收费审批程序、定价及用途。参考文献19。

中外创新药物医保支付的比较研究

按疾病诊断相关分组(DRG)付费是当前我国医保支付改革的重要研究方向,但在一定程度上限制了创新药物的临床推广使用。许多国家已对创新药物的额外支付进行了深入研究。该文以美国、法国、德国为例,分析总结DRG付费体系下创新药物额外支付的国际经验,并结合我国创新药物医保支付现状及DRG付费对创新药物发展的影响,提出了明确的纳入标准、选择合适支付模式、建立动态调整机制、完善支付方式等政策建议,以期在全面推进DRG付费改革中,为进一步建立和完善我国创新药物医保支付机制提供参考。

企业信息安全对审计决策的影响

在国家安全战略背景下,确保企业信息安全,维护企业经营的安全性、稳定性和连续性显得尤为重要。外部审计师是否能够识别企业信息安全,并对企业强化信息安全提供助力?本文以我国2013-2021年A股上市公司为样本,从审计费用的角度检验审计师对企业信息安全的反应,发现企业信息安全能够降低企业的审计费用。机制检验发现,企业信息安全通过缓解企业的经营风险进而降低审计费用。进一步研究发现,当企业的关键信息基础设施安全保护需求较高以及独董信息技术背景比例较高时,企业信息安全对审计费用的影响更加显著。本研究丰富了企业信息安全和审计费用的相关文献,有助于了解企业信息安全对审计师决策的影响,为上市公司加强信息安全建设提供了经验证据。