In the realm of public goods game,punishment,as a potent tool,stands out for fostering cooperation.While it effectively addresses the first-order free-rider problem,the associated costs can be substantial.Punishers in...In the realm of public goods game,punishment,as a potent tool,stands out for fostering cooperation.While it effectively addresses the first-order free-rider problem,the associated costs can be substantial.Punishers incur expenses in imposing sanctions,while defectors face fines.Unfortunately,these monetary elements seemingly vanish into thin air,representing a loss to the system itself.However,by virtue of the redistribution of fines to cooperators and punishers,not only can we mitigate this loss,but the rewards for these cooperative individuals can be enhanced.Based upon this premise,this paper introduces a fine distribution mechanism to the traditional pool punishment model.Under identical parameter settings,by conducting a comparative experiment with the conventional punishment model,the paper aims to investigate the impact of fine distribution on the evolution of cooperation in spatial public goods game.The experimental results clearly demonstrate that,in instances where the punishment cost is prohibitively high,the cooperative strategies of the traditional pool punishment model may completely collapse.However,the model enriched with fine distribution manages to sustain a considerable number of cooperative strategies,thus highlighting its effectiveness in promoting and preserving cooperation,even in the face of substantial punishment cost.展开更多
Since the Harris-Todaro model was proposed in 1970,it has played a crucial role in analyzing various environmental and trade issues in developing countries.This paper analyzes the effects of the amount of public inter...Since the Harris-Todaro model was proposed in 1970,it has played a crucial role in analyzing various environmental and trade issues in developing countries.This paper analyzes the effects of the amount of public intermediate goods provided by the government,the increase in the fixed wage rate in the urban sector,and the changes in the relative international prices of agricultural and manufacturing goods on labor employment,unemployment,and the economic welfare in the context of a small open economy.It also proposes relevant policies to reduce the unemployment rate while improving national welfare.展开更多
This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their percep...This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their perceptions of mobile payment.The findings indicate that perceived usefulness and perceived ease of use have significant effects on users'attitude.Furthermore,network externality is also an important factor influencing the adoption.But customers have weak perceptions of the risks of M-payment.The results may provide further insights into mobile payment strategies.展开更多
Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on ...Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.展开更多
In this paper, we study the public goods games with punishment by adopting the well-known approximate best response dynamics. It shows that the evolution of cooperation is affected by two aspects when other parameters...In this paper, we study the public goods games with punishment by adopting the well-known approximate best response dynamics. It shows that the evolution of cooperation is affected by two aspects when other parameters are fixed. One is the punishment mechanism which can avoid the dilemma of lacking investment, and the other is the degree of rationality. Theoretical analysis and numerical results indicate that the existence of punishment mechanism and distribution of rationality are the keys to the enhancement of cooperation level. We also testify that they can heavily influence the payoffs of system as well. The findings in this paper may provide a deeper understanding of some social dilemmas.展开更多
Objective: An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China(mainland), in an attempt to offer a clue to further contro...Objective: An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China(mainland), in an attempt to offer a clue to further control the costs.Methods: The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page(IMRHP) dataset.The data were then processed with SAS(Version 9.3; SAS Institute, Cary, NC, USA). Indicators like means,increase(decrease) percentages were used to descriptively analyze the average hospitalization expense of each time(AHEET) and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results:In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance(URBMI)were the next,and those covered by New Rural Cooperative Medical System(NRCMS)had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions:The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.展开更多
In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance syst...In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease (COPD), a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before (n=1569) and after the integrated case payment reform (n=4764) were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment (including price-cap case payment and fixed-reimbursement case payment) and clinical pathway (including clinical pathway A, clinical pathway B and clinical pathway C). Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment (β=2382.988, P〈0.001) and fixed-reimbursement case payment β=2613.564, P〈0.001), and clinical pathway C (β=1996.467, P〈0.001) were risk factors of per capita total medical expenses. Clinical pathway A (β=-1443.409, P〈0.001) and clinical pathway B (β=-1583.791, P〈0.001) were protective factors. The interactive effects of case payment with hospital level (β=0.710, P〈0.001) lowered the readmission rate within 30 days. Meanwhile, clinical pathways A (β=18.949, P〈0.001), B (β=-19.752, P〈0.001) and C (β=-1.882, P〈0.1) were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.展开更多
In Victorian Age, many literary works recorded the social realities and traditional social value system, and Oscar Wilde's The Importance of Being Earnest is a good case in point. In this play, males are valued in...In Victorian Age, many literary works recorded the social realities and traditional social value system, and Oscar Wilde's The Importance of Being Earnest is a good case in point. In this play, males are valued in terms of both birth condition and economic basis, which are two general standards from the traditional value system of the mainstream society. Oscar Wilde in this play satirizes the restrained and distorted traditional values and the hypocritical Victorian society. This paper will probe into how the social status and economic conditions determine males' fate in Victorian Age and on Oscar Wilde's creation.展开更多
The connotation of rural public goods is expounded.The rural public goods refer to the products and labors that satisfy the production and living of rural residents,economic growth and social progress.The rural public...The connotation of rural public goods is expounded.The rural public goods refer to the products and labors that satisfy the production and living of rural residents,economic growth and social progress.The rural public goods is characterized by non-excludability,non-competitiveness and indispensability of other general public goods.The supply situation of Chinese government to rural public goods is analyzed,as well as the demand situation of rural public goods,which includes farmers' demand on training,the assistance demand of rural weak groups,farmers' demand on comfortable living conditions and farmers' demand on "soft" public goods.The paths for innovating the supply mechanism of rural public goods are put forward,which cover perfecting the decision mechanism of public goods supply;scientifically distributing the supply responsibility of rural public goods;facilitating the reform of each supporting equipment and exploring the multiple capital collecting channels of rural public goods.展开更多
Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to phys...Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to physician's average work load and massive responsibilities. This paper reviewed the constitution of the PPS in China, and further discussed the problems and issues to be addressed with respect to pay for performance. Our study indicated that the lower basic salary and bonus distribution tied to "profits" was the major contributor to the physician's profit-driven incentive and the potential cause for the speedy growth of health expenditures. We recommend that government funding to hospitals should be increased to fully cover physicians' basic salary, a flexible human resource and talent management mechanism needs to be established that severs personal interest between physicians and hospitals, and modern performance assessment and multiplexed payment systems should be piloted to encourage physicians to get the more legitimate compensation.展开更多
Theoretical expositions of public goods supply by the liberalism,new institutionalism and the school of public choice are conducted in the perspective of organizational competition.And the theoretical foundation of ru...Theoretical expositions of public goods supply by the liberalism,new institutionalism and the school of public choice are conducted in the perspective of organizational competition.And the theoretical foundation of rural public goods is put forward.Then,the changes of the supply mode of rural public goods are discussed before and after the tax reform,that is,the "Community Cooperation" supply mode of rural public goods before the tax reform and the "Organization Cooperation" supply mode of rural public goods after the tax reform.Finally,the diversification of rural public goods supply in China in future is forecasted.展开更多
This paper studies the evolutionary process of cooperative behavior in a public goods game model with heterogeneous investment strategies in square lattices.In the proposed model,players are divided into defectors,coo...This paper studies the evolutionary process of cooperative behavior in a public goods game model with heterogeneous investment strategies in square lattices.In the proposed model,players are divided into defectors,cooperators and discreet investors.Among these,defectors do not participate in investing,discreet investors make heterogeneous investments based on the investment behavior and cooperation value of their neighbors,and cooperators invest equally in each neighbor.In real life,heterogeneous investment is often accompanied by time or economic costs.The discreet investors in this paper pay a certain price to obtain their neighbors'investment behavior and cooperation value,which quantifies the time and economic costs of the heterogeneous investment process.The results of Monte Carlo simulation experiments in this study show that discreet investors can effectively resist the invasion of the defectors,form a stable cooperative group and expand the cooperative advantage in evolution.However,when discreet investors pay too high a price,they lose their strategic advantage.The results in this paper help us understand the role of heterogeneous investment in promoting and maintaining human social cooperation.展开更多
Large goods transported in railway are kinds of special goods and they are very important in national construction. In order to transport safely, loading and reinforcing schemes must be made first. How to design a rea...Large goods transported in railway are kinds of special goods and they are very important in national construction. In order to transport safely, loading and reinforcing schemes must be made first. How to design a reasonable scheme will be affected by many factors. This paper presents the characteristic of the large goods, summarizes the process of designing a loading and reinforcing scheme of large good, then probes the factors of affecting the loading and reinforcing scheme and gives a detail analysis. It’s considered that those out-of-gauge and overweight degree of goods, center-of- gravity height of a loaded wagon, position of center-of-gravity of goods, type of wagon for using, reinforcement material and reinforcement method, transport expense and transport organization could affect a scheme in the aspects of safety, economy, rapidity and convenience. This conclusion will instruct and help to make a good scheme.展开更多
From a global perspective, the develop ment of 3G services in China is quite different from other countries. The factors that influence users' adoption of mobile payment are worth ex ploring. This study employs the T...From a global perspective, the develop ment of 3G services in China is quite different from other countries. The factors that influence users' adoption of mobile payment are worth ex ploring. This study employs the Technology Ac ceptance Model (TAM) to examine determinant factors affecting consumers' acceptance intentions of mobile payment. We adopt Hofstede's cultural dimensions as moderators to extend the TAM model for exploring the impact of uncertainty a voidance on mobile payment acceptance.展开更多
Payments for Ecosystem Services(PES)have been studied extensively over the past decade as an important policy tool for coordinating ecological protection and regional socioeconomic development.One of the greatest chal...Payments for Ecosystem Services(PES)have been studied extensively over the past decade as an important policy tool for coordinating ecological protection and regional socioeconomic development.One of the greatest challenges of PES implementation is to understand where to pay,i.e.,spatial targeting,which can directly impact PES effectiveness and efficiency.In this study,we conducted a systematic review of spatial targeting methods based on literature analysis using Citespace.Firstly,peer-reviewed articles related to spatial targeting of PES were selected from the Web of Science database based on keywords.Cases applying PES spatial targeting methods were then chosen and analyzed after all articles were read.In total,70%of the chosen cases focused on improving the compensation efficiency of biodiversity or another single environmental objective,whereas the remaining cases focused on coordinating trade-offs between equity and efficiency or multiple environmental objectives.The main PES spatial targeting approaches included cost-benefit analysis,multi-objective optimization,data envelope analysis and other methods aimed at specific issues.Of these,cost-benefit analysis has been most widely applied at different scales,including county,regional and watershed scales.Significant differences among the different PES spatial targeting methods were found,including in PES spatial targeting dimensions,efficiency optimization approaches and method application conditions.The practice of PES spatial targeting requires the selection of appropriate methods based on contextual biophysical and socioeconomic conditions as well as relevant environmental issues.The combined application of PES spatial targeting methods,compensation willingness of stakeholders and dynamic implementation of PES spatial targeting should be considered in future research.展开更多
<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for...<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. <strong>Methods: </strong>Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. <strong>Results:</strong> Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). <strong>Conclusion/recommendation:</strong> Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.展开更多
We investigate the evolution of cooperation with evolutionary public goods games based on finite populations, where four pure strategies: cooperators, defectors, punishers and loners who are unwilling to participate ...We investigate the evolution of cooperation with evolutionary public goods games based on finite populations, where four pure strategies: cooperators, defectors, punishers and loners who are unwilling to participate are considered. By adopting approximate best response dynamics, we show that the magnitude of rationality not only quantitatively explains the experiment results in [Nature (London) 425 (2003) 390], but also it will heavily influence the evolution of cooperation. Compared with previous results of infinite populations, which result in two equilibriums, we show that there merely exists a special equilibrium cooperation. In addition, we characterize that loner's and the relevant high value of bounded rationality will sustain payoff plays an active role in the maintenance of cooperation, which will only be warranted for the low and moderate values of loner's payoff. It thus indicates the effects of rationality and loner's payoff will influence the cooperation. Finally, we highlight the important result that the introduction of voluntary participation and punishment will facilitate cooperation greatly.展开更多
Purpose:This paper examines factors of payment decision as well as the role each factor plays in casual configurations leading to high payment intention under systematic and heuristic information processing routes.Des...Purpose:This paper examines factors of payment decision as well as the role each factor plays in casual configurations leading to high payment intention under systematic and heuristic information processing routes.Design/methodology/approach:Based on heuristic-systematic model(HSM),we propose a configurational analytic framework to investigate complex casual relationships between influencing factors and payment decision.In line with this approach,we use fuzzy-set qualitative comparative analysis(fsQCA)to analyze data crawled from Zhihu.com.Findings:The number of previous consultations is a necessary element in all five equivalent configurations which lead to high intention in payment decision.The heuristic processing route plays a core role while the systematic processing route plays a peripheral role in payment decision-making process.Research limitations:Research is limited in that moderating effect of professional fields has not been considered in the framework.Practical implications:Configurations in results can assist managers of knowledge communities and paid Q&A service providers in the management of information elements to motivate more payment decision.Originality/value:This paper is one of the few studies to apply HSM theory and fsQCA method with respect to the payment decision in paid Q&A.展开更多
In this paper,we introduce the combining stated preference and revealed preference methods which is the state-ofthe-art method for the valuation of non-market goods.Revealed preference methods and stated preference (S...In this paper,we introduce the combining stated preference and revealed preference methods which is the state-ofthe-art method for the valuation of non-market goods.Revealed preference methods and stated preference (SP) methods have both been applied by economists in valuing non-market goods;however both methods have inherent weaknesses.In order to exploit the strengths of the various approaches while minimizing their weaknesses,combining the two methods has become an important methodological option.Up to now,a growing number of literatures of studying combing the two types of data have evolved,and researchers developed three types of models to estimate combining revealed preference and stated preference data in academic fields:discrete choice model,continuous choice model and mixed choice model.Combining stated and revealed preference methods have been developed fast especially in the transport study field in which ideas could also be leant for environmental economic studies.展开更多
Plotinus' account of matter in Ennead III 6[26] 11-15 serves two purposes. The terms, evil and ugly, present the negative side of matter's causality, providing for the change characteristic of the sensible world and...Plotinus' account of matter in Ennead III 6[26] 11-15 serves two purposes. The terms, evil and ugly, present the negative side of matter's causality, providing for the change characteristic of the sensible world and the possibility of ontological evil and privation as well as of moral evil among human beings. The receptacle and other images from Plato's Timaeus present the positive side of this causality, matter as allowing for the presence of forms in the bodies of the sensible world. Plotinus explicitly articulates the linguistic problem surrounding the nature of matter, since language is derived from the corporeal and thus needs constant correction when applied to matter as incorporeal. His use of language, thus, always has two phases, first, capturing the nature of matter as aptly as possible, and second, highlighting the difference between matter and the image, analogy, or metaphor used to help explain it.展开更多
基金the Open Foundation of Key Lab-oratory of Software Engineering of Yunnan Province(Grant Nos.2020SE308 and 2020SE309).
文摘In the realm of public goods game,punishment,as a potent tool,stands out for fostering cooperation.While it effectively addresses the first-order free-rider problem,the associated costs can be substantial.Punishers incur expenses in imposing sanctions,while defectors face fines.Unfortunately,these monetary elements seemingly vanish into thin air,representing a loss to the system itself.However,by virtue of the redistribution of fines to cooperators and punishers,not only can we mitigate this loss,but the rewards for these cooperative individuals can be enhanced.Based upon this premise,this paper introduces a fine distribution mechanism to the traditional pool punishment model.Under identical parameter settings,by conducting a comparative experiment with the conventional punishment model,the paper aims to investigate the impact of fine distribution on the evolution of cooperation in spatial public goods game.The experimental results clearly demonstrate that,in instances where the punishment cost is prohibitively high,the cooperative strategies of the traditional pool punishment model may completely collapse.However,the model enriched with fine distribution manages to sustain a considerable number of cooperative strategies,thus highlighting its effectiveness in promoting and preserving cooperation,even in the face of substantial punishment cost.
文摘Since the Harris-Todaro model was proposed in 1970,it has played a crucial role in analyzing various environmental and trade issues in developing countries.This paper analyzes the effects of the amount of public intermediate goods provided by the government,the increase in the fixed wage rate in the urban sector,and the changes in the relative international prices of agricultural and manufacturing goods on labor employment,unemployment,and the economic welfare in the context of a small open economy.It also proposes relevant policies to reduce the unemployment rate while improving national welfare.
基金supported by China Fundamental Research Funds for the Central Universities under Grant No.BUPT2011RC1005
文摘This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their perceptions of mobile payment.The findings indicate that perceived usefulness and perceived ease of use have significant effects on users'attitude.Furthermore,network externality is also an important factor influencing the adoption.But customers have weak perceptions of the risks of M-payment.The results may provide further insights into mobile payment strategies.
文摘Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.
基金Project supported by the National Natural Science Foundation of China (Grant No. 10672081).
文摘In this paper, we study the public goods games with punishment by adopting the well-known approximate best response dynamics. It shows that the evolution of cooperation is affected by two aspects when other parameters are fixed. One is the punishment mechanism which can avoid the dilemma of lacking investment, and the other is the degree of rationality. Theoretical analysis and numerical results indicate that the existence of punishment mechanism and distribution of rationality are the keys to the enhancement of cooperation level. We also testify that they can heavily influence the payoffs of system as well. The findings in this paper may provide a deeper understanding of some social dilemmas.
基金supported by National Natural Science Foundation of China (No. 71403189)
文摘Objective: An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China(mainland), in an attempt to offer a clue to further control the costs.Methods: The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page(IMRHP) dataset.The data were then processed with SAS(Version 9.3; SAS Institute, Cary, NC, USA). Indicators like means,increase(decrease) percentages were used to descriptively analyze the average hospitalization expense of each time(AHEET) and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results:In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance(URBMI)were the next,and those covered by New Rural Cooperative Medical System(NRCMS)had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions:The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.
基金This project was supported by grants from the National Natural Science Foundation of China (No.71373091, No. 71603132) and by the Humanities and Social Sciences Research Program of the Ministry of Education of China (No. 16YJA840013).
文摘In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease (COPD), a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before (n=1569) and after the integrated case payment reform (n=4764) were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment (including price-cap case payment and fixed-reimbursement case payment) and clinical pathway (including clinical pathway A, clinical pathway B and clinical pathway C). Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment (β=2382.988, P〈0.001) and fixed-reimbursement case payment β=2613.564, P〈0.001), and clinical pathway C (β=1996.467, P〈0.001) were risk factors of per capita total medical expenses. Clinical pathway A (β=-1443.409, P〈0.001) and clinical pathway B (β=-1583.791, P〈0.001) were protective factors. The interactive effects of case payment with hospital level (β=0.710, P〈0.001) lowered the readmission rate within 30 days. Meanwhile, clinical pathways A (β=18.949, P〈0.001), B (β=-19.752, P〈0.001) and C (β=-1.882, P〈0.1) were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.
文摘In Victorian Age, many literary works recorded the social realities and traditional social value system, and Oscar Wilde's The Importance of Being Earnest is a good case in point. In this play, males are valued in terms of both birth condition and economic basis, which are two general standards from the traditional value system of the mainstream society. Oscar Wilde in this play satirizes the restrained and distorted traditional values and the hypocritical Victorian society. This paper will probe into how the social status and economic conditions determine males' fate in Victorian Age and on Oscar Wilde's creation.
文摘The connotation of rural public goods is expounded.The rural public goods refer to the products and labors that satisfy the production and living of rural residents,economic growth and social progress.The rural public goods is characterized by non-excludability,non-competitiveness and indispensability of other general public goods.The supply situation of Chinese government to rural public goods is analyzed,as well as the demand situation of rural public goods,which includes farmers' demand on training,the assistance demand of rural weak groups,farmers' demand on comfortable living conditions and farmers' demand on "soft" public goods.The paths for innovating the supply mechanism of rural public goods are put forward,which cover perfecting the decision mechanism of public goods supply;scientifically distributing the supply responsibility of rural public goods;facilitating the reform of each supporting equipment and exploring the multiple capital collecting channels of rural public goods.
基金supported by Guiyang Science and Technology Correspondent Program of China(No.2012207)
文摘Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to physician's average work load and massive responsibilities. This paper reviewed the constitution of the PPS in China, and further discussed the problems and issues to be addressed with respect to pay for performance. Our study indicated that the lower basic salary and bonus distribution tied to "profits" was the major contributor to the physician's profit-driven incentive and the potential cause for the speedy growth of health expenditures. We recommend that government funding to hospitals should be increased to fully cover physicians' basic salary, a flexible human resource and talent management mechanism needs to be established that severs personal interest between physicians and hospitals, and modern performance assessment and multiplexed payment systems should be piloted to encourage physicians to get the more legitimate compensation.
文摘Theoretical expositions of public goods supply by the liberalism,new institutionalism and the school of public choice are conducted in the perspective of organizational competition.And the theoretical foundation of rural public goods is put forward.Then,the changes of the supply mode of rural public goods are discussed before and after the tax reform,that is,the "Community Cooperation" supply mode of rural public goods before the tax reform and the "Organization Cooperation" supply mode of rural public goods after the tax reform.Finally,the diversification of rural public goods supply in China in future is forecasted.
基金Project supported by the Open Foundation of Key Laboratory of Software Engineering of Yunnan Province(Grant Nos.2020SE308 and 2020SE309).
文摘This paper studies the evolutionary process of cooperative behavior in a public goods game model with heterogeneous investment strategies in square lattices.In the proposed model,players are divided into defectors,cooperators and discreet investors.Among these,defectors do not participate in investing,discreet investors make heterogeneous investments based on the investment behavior and cooperation value of their neighbors,and cooperators invest equally in each neighbor.In real life,heterogeneous investment is often accompanied by time or economic costs.The discreet investors in this paper pay a certain price to obtain their neighbors'investment behavior and cooperation value,which quantifies the time and economic costs of the heterogeneous investment process.The results of Monte Carlo simulation experiments in this study show that discreet investors can effectively resist the invasion of the defectors,form a stable cooperative group and expand the cooperative advantage in evolution.However,when discreet investors pay too high a price,they lose their strategic advantage.The results in this paper help us understand the role of heterogeneous investment in promoting and maintaining human social cooperation.
文摘Large goods transported in railway are kinds of special goods and they are very important in national construction. In order to transport safely, loading and reinforcing schemes must be made first. How to design a reasonable scheme will be affected by many factors. This paper presents the characteristic of the large goods, summarizes the process of designing a loading and reinforcing scheme of large good, then probes the factors of affecting the loading and reinforcing scheme and gives a detail analysis. It’s considered that those out-of-gauge and overweight degree of goods, center-of- gravity height of a loaded wagon, position of center-of-gravity of goods, type of wagon for using, reinforcement material and reinforcement method, transport expense and transport organization could affect a scheme in the aspects of safety, economy, rapidity and convenience. This conclusion will instruct and help to make a good scheme.
基金the National Natural Science Foundation of China,the State Major Science and Technology Special Projects,the Science Technology Innovation Foundation for Young Teachers in BUPT
文摘From a global perspective, the develop ment of 3G services in China is quite different from other countries. The factors that influence users' adoption of mobile payment are worth ex ploring. This study employs the Technology Ac ceptance Model (TAM) to examine determinant factors affecting consumers' acceptance intentions of mobile payment. We adopt Hofstede's cultural dimensions as moderators to extend the TAM model for exploring the impact of uncertainty a voidance on mobile payment acceptance.
基金supported by the Second Tibetan Plateau Scientific Expedition and Research(STEP)program(Grant No.2019QZKK0307)the China National Social Science Funding of Major Projects(Grant No.18VSJ100)National Natural Science Foundation of China(Grant No.41925005).
文摘Payments for Ecosystem Services(PES)have been studied extensively over the past decade as an important policy tool for coordinating ecological protection and regional socioeconomic development.One of the greatest challenges of PES implementation is to understand where to pay,i.e.,spatial targeting,which can directly impact PES effectiveness and efficiency.In this study,we conducted a systematic review of spatial targeting methods based on literature analysis using Citespace.Firstly,peer-reviewed articles related to spatial targeting of PES were selected from the Web of Science database based on keywords.Cases applying PES spatial targeting methods were then chosen and analyzed after all articles were read.In total,70%of the chosen cases focused on improving the compensation efficiency of biodiversity or another single environmental objective,whereas the remaining cases focused on coordinating trade-offs between equity and efficiency or multiple environmental objectives.The main PES spatial targeting approaches included cost-benefit analysis,multi-objective optimization,data envelope analysis and other methods aimed at specific issues.Of these,cost-benefit analysis has been most widely applied at different scales,including county,regional and watershed scales.Significant differences among the different PES spatial targeting methods were found,including in PES spatial targeting dimensions,efficiency optimization approaches and method application conditions.The practice of PES spatial targeting requires the selection of appropriate methods based on contextual biophysical and socioeconomic conditions as well as relevant environmental issues.The combined application of PES spatial targeting methods,compensation willingness of stakeholders and dynamic implementation of PES spatial targeting should be considered in future research.
文摘<strong>Introduction:</strong> With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. <strong>Methods: </strong>Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. <strong>Results:</strong> Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). <strong>Conclusion/recommendation:</strong> Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.
基金Supported by National Nature Science Foundation under Grant No.60904063the Tianjin municipal Natural Science Foundation under Grant Nos.11JCYBJC06600,11ZCKF6X00900,11ZCKFGX00900
文摘We investigate the evolution of cooperation with evolutionary public goods games based on finite populations, where four pure strategies: cooperators, defectors, punishers and loners who are unwilling to participate are considered. By adopting approximate best response dynamics, we show that the magnitude of rationality not only quantitatively explains the experiment results in [Nature (London) 425 (2003) 390], but also it will heavily influence the evolution of cooperation. Compared with previous results of infinite populations, which result in two equilibriums, we show that there merely exists a special equilibrium cooperation. In addition, we characterize that loner's and the relevant high value of bounded rationality will sustain payoff plays an active role in the maintenance of cooperation, which will only be warranted for the low and moderate values of loner's payoff. It thus indicates the effects of rationality and loner's payoff will influence the cooperation. Finally, we highlight the important result that the introduction of voluntary participation and punishment will facilitate cooperation greatly.
基金National Natural Science Foundation of China(Grant No.71271087)。
文摘Purpose:This paper examines factors of payment decision as well as the role each factor plays in casual configurations leading to high payment intention under systematic and heuristic information processing routes.Design/methodology/approach:Based on heuristic-systematic model(HSM),we propose a configurational analytic framework to investigate complex casual relationships between influencing factors and payment decision.In line with this approach,we use fuzzy-set qualitative comparative analysis(fsQCA)to analyze data crawled from Zhihu.com.Findings:The number of previous consultations is a necessary element in all five equivalent configurations which lead to high intention in payment decision.The heuristic processing route plays a core role while the systematic processing route plays a peripheral role in payment decision-making process.Research limitations:Research is limited in that moderating effect of professional fields has not been considered in the framework.Practical implications:Configurations in results can assist managers of knowledge communities and paid Q&A service providers in the management of information elements to motivate more payment decision.Originality/value:This paper is one of the few studies to apply HSM theory and fsQCA method with respect to the payment decision in paid Q&A.
文摘In this paper,we introduce the combining stated preference and revealed preference methods which is the state-ofthe-art method for the valuation of non-market goods.Revealed preference methods and stated preference (SP) methods have both been applied by economists in valuing non-market goods;however both methods have inherent weaknesses.In order to exploit the strengths of the various approaches while minimizing their weaknesses,combining the two methods has become an important methodological option.Up to now,a growing number of literatures of studying combing the two types of data have evolved,and researchers developed three types of models to estimate combining revealed preference and stated preference data in academic fields:discrete choice model,continuous choice model and mixed choice model.Combining stated and revealed preference methods have been developed fast especially in the transport study field in which ideas could also be leant for environmental economic studies.
文摘Plotinus' account of matter in Ennead III 6[26] 11-15 serves two purposes. The terms, evil and ugly, present the negative side of matter's causality, providing for the change characteristic of the sensible world and the possibility of ontological evil and privation as well as of moral evil among human beings. The receptacle and other images from Plato's Timaeus present the positive side of this causality, matter as allowing for the presence of forms in the bodies of the sensible world. Plotinus explicitly articulates the linguistic problem surrounding the nature of matter, since language is derived from the corporeal and thus needs constant correction when applied to matter as incorporeal. His use of language, thus, always has two phases, first, capturing the nature of matter as aptly as possible, and second, highlighting the difference between matter and the image, analogy, or metaphor used to help explain it.