Research on the Risk Associated with Rural Drinking Water Safety Based on Catastrophe Theory

In this study, based on the analysis of the catastrophic risk of rural drinking water, with the representative villages in Ya’an as study objects and setting the four evaluation standards: water quality, water quantity, the Guarantee Probability for water Supply and the Convenience Level of the Access to Water Supply as the ba- sic framework, a Rural Drinking Water Safety Assessment was developed (RDWSA). Research showed that Catastrophe Theory was applicable in the RDWSA. Adding RDWSA based on Catastrophe Theory to the supportive system for decision-making in Ecological Hydrographic Management Decision Support System of Ya’an helped obtain the rank and results of RDWSE by the automatic calculation of programs, which could assist the risk assessment and risk management associated with rural drinking water in Ya’an.

Research on the Model of Household Credit Risk Evaluation of Rural Microfinance

Since rural microfinance is a credit which grants loans without collateral and guarantees to farmers,it is considerably important to evaluate and control the household credit risk.Through establishing the evaluation index system and then using catastrophe progression theory,three common types of catastrophe system and the normalization formula,we get the comprehensive evaluation.Finally,we take the empirical test and the result shows that this method is simpler and more objective which can be used by the credit cooperatives to decide whether to authorize the loans.

基于Fairlie分解的流动人口灾难性医疗支出的城乡差异及影响因素分析

目的:分析流动人口灾难性医疗支出的城乡差异及影响因素,为促进城乡流动人口健康公平提供建议参考。方法:基于2018年全国流动人口动态监测调查,运用卡方检验探究城乡流动人口特征分布差异,利用基于logistic回归的Fairlie分解法分析流动人口灾难性医疗支出的城乡差异及影响因素。结果:流动人口灾难性医疗支出发生率为24.25%,其中城镇发生率显著低于农村(P<0.05);Fairlie分解显示流动人口灾难性医疗支出的城乡差异中特征效应占95.53%,系数效应占4.47%,收入水平、健康状况、婚姻情况、医保报销情况及是否接受健康教育对该差异产生作用(P<0.05)。结论:农村流动人口的灾难性医疗支出风险高于城镇,收入水平和健康状况差异起主要作用。应加强农村流动人口的健康教育与劳动保障,提高城乡健康公平性,通过改进医保报销机制缩小流动人口灾难性医疗支出的城乡差异。

城乡居民医保整合对农村居民灾难性医疗支出的影响研究

目的:以城乡居民医保整合为契机,分析城乡医保整合对农村居民灾难性医疗支出的影响,以评估城乡医保整合的政策效应。方法:本文使用中国家庭追踪调查数据(CFPS)2016年、2018年、2020年三期数据,采用多期双重差分模型,实证评估城乡居民医保整合对农村居民灾难性医疗支出的影响。结果:城乡居民医保整合后,农村居民灾难性医疗支出发生率降低9%;基于年龄分组,18—34岁年龄组灾难性医疗支出发生率降低0.16%,但55岁及以上老年人群灾难性医疗支出发生率提高3%,对35—54岁中年人群影响不显著;基于收入分组,城乡居民医保整合后,中低收入家庭灾难性医疗支出发生率降低7.4%,但对于高收入家庭影响不显著。结论:城乡居民医保整合降低了农村居民灾难性医疗支出发生率,对缩小城乡居民医疗保障水平差距有促进作用,对中低收入人群政策实施达到预期效果,但对于老年人医疗支出风险应进一步关注,后续应向老年人群实施倾斜性补偿政策。

结核病灾难性卫生支出的研究进展

我国是全球结核病患者数最多和高负担的国家之一,沉重的灾难性卫生支出给我国患者、家庭及社会带来艰巨的任务和挑战,使得结核病防控措施无法彻底落实。笔者围绕灾难性卫生支出的定义、研究现状及影响因素进行综述,旨在探讨我国本领域研究的不足,为后续研究及制定措施提供建议和参考。

Assessment of the Indirect Cost of Drug Resistant Tuberculosis Treatment to Patients in a High Burden, Low Income Setting in Mozambique

Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the catastrophic costs DRTB patients incur.

大病保险对克服农村中老年群体多维贫困的影响——基于CFPS数据的实证分析

目的:从多维贫困角度考察大病保险对农村中老年群体的减贫效果。方法:基于中国家庭追踪调查(CFPS)三期面板数据,采用渐进双重差分法实证分析大病保险对农村中老年居民多维贫困的影响及其作用机制。结果:第一,大病保险使农村中老年群体的多维贫困指数显著降低了0.022,对样本多维贫困有明显抑制作用。第二,在中年、低收入群体和东部地区,大病保险产生的减贫效应更强。第三,削弱灾难性医疗支出的发生强度是大病保险减轻农村中老年人群多维贫困的主要路径。结论:大病保险有效减轻了农村中老年人群的多维贫困,但要进一步增强减贫效应,还需要从健全筹资机制、优化制度设计、加强政企合作、做好制度衔接等方面进行改进。

医保整合背景下城乡家庭灾难性卫生支出发生率研究

目的为探究城乡居民医保整合是否能实现提升居民疾病经济风险保护能力,缩小城乡差距的政策目标,本研究使用中国家庭追踪调查(CFPS)2016、2018年家庭样本,从医保整合政策效果分析灾难性卫生支出发生率变化情况。方法研究使用多水平logistic回归模型分析医保整合对城乡家庭灾难性卫生支出发生率的影响。结果家庭灾难性卫生支出发生率在医保整合前后差异有统计学意义(χ^(2)=5.64,P=0.018)。在控制家庭和户主特征后,发现医保整合降低了农村家庭灾难性卫生支出发生风险(β=-0.118,P<0.001),但城镇家庭未有显著变化(β=-0.064,P=0.242)。结论灾难性卫生支出的发生情况在城乡家庭、不同经济社会学特征家庭中存在差异。农村家庭发生率高于城镇家庭;低收入组家庭发生率最高,高收入组家庭发生率最低;城乡家庭灾难性卫生支出在医保整合后的发生率均有下降,医保整合对降低农村家庭发生情况的效果更加明显。

Vulnerability assessment of marine economic system based on comprehensive index and catastrophe progression model

The sustainable development of the marine economic system to accurately grasp the dynamic evolution characteristics and main driving factors of the vulnerability of the marine economic system so as to effectively identify the problems in the operation of the marine economy is extremely important.Based on the establishment of a three-level assessment index system for the vulnerability of the marine economic system,the vulnerability of the marine economic system of Jiangsu Province in 2008-2016 was evaluated by using the comprehensive index model and the catastrophe progression model,and the results were compared based on the unified evaluation criteria.The main influencing factors were analyzed by principal component analysis and Pearson correlation analysis.It’s found that 2014,2015,and 2012 are in a general state,2009 and 2010 are in a poor state,and the vulnerability state from 2008 to 2011 is lower than that in 2012.The overall volatility is small indicating a stable system.Among them,the scale of marine industry and profit and loss of marine resources are the main components of marine economic system vulnerability having the highest correlation with the vulnerability of marine economic system.This study enriches the theoretical method and empirical research on the vulnerability of the marine economic system and has practical significance in allowing for timely targeted control measures to affect the vulnerability of the marine economic system.

基于综合可压性的深层页岩气压裂经济效益预测方法

水力压裂是实现深层页岩气藏经济有效开发的关键技术,但深层页岩气储层构造复杂、甜点识别困难、地质条件差,中浅层页岩综合可压性评价方法不再适用;此外,深层页岩气建井及压裂等工程成本高,试采产量低,经济开发矛盾尖锐。为此,通过研究不同地质工程参数对水平井页岩气开采产量影响规律,确定影响页岩气产量因素,通过突变理论综合页岩储层地质、缝网发育程度、岩石基质、流体用量、施工参数等特性,建立了地质-工程综合可压性预测压裂经济效益方法,利用互补准则,降低主观因素干扰,并根据可压性模型评价类型构建经济效益预测模型。以X区块DS2井为例,结合试气产量验证了模型的可靠性,该模型能客观评价页岩气开发和预测工程经济效益。实例计算表明,压裂经济效益预测方法可预测经济回报周期、净现值、内部收益率等,并可通过优化调整工程参数提升经济预测结果。研究结果对于矿场进行预期开采规划,提高深层页岩气可压性评价预测及效益预测具有重要的理论指导意义和矿场应用价值,可实现“降本增效”目标。

Estimation of economic burden throughout course of cervical squamous intraepithelial lesion and cervical cancer in China:A nationwide multicenter cross-sectional study

Objective: Cervical squamous intraepithelial lesion(SIL) and cervical cancer are major threats to females' health and life in China, and we aimed to estimate the economic burden associated with their diagnosis and treatment.Methods: A nationwide multicenter, cross-sectional, hospital-based survey was conducted in 26 qualified hospitals across seven administrative regions of China. We investigated females who had been pathologically diagnosed with SIL and cervical cancer, and included five disease courses(“diagnosis”, “initial treatment”,“chemoradiotherapy”, “follow-up” and “recurrence/progression/metastasis”) to estimate the total costs. The median and interquartile range(IQR) of total costs(including direct medical, direct non-medical, and indirect costs), reimbursement rate by medical insurance, and catastrophic health expenditures in every clinical stage were calculated.Results: A total of 3,471 patients in different clinical stages were analyzed, including low-grade SIL(LSIL)(n=549), high-grade SIL(HSIL)(n=803), cervical cancer stage ⅠA(n=226), ⅠB(n=610), ⅡA(n=487), ⅡB(n=282), Ⅲ(n=452) and Ⅳ(n=62). In urban areas, the estimated total costs of LSIL and HSIL were $1,637.7(IQR:$956.4-$2,669.2) and $2,467.1(IQR:$1,579.1-$3,762.3), while in rural areas the costs were $459.0(IQR:$167.7-$1,330.3) and $1,230.5(IQR:$560.6-$2,104.5), respectively. For patients with cervical cancer stage ⅠA,ⅠB, ⅡA, ⅡB, and Ⅲ-Ⅳ, the total costs were $15,034.9(IQR:$11,083.4-$21,632.4), $19,438.6(IQR:$14,060.0-$26,505.9), $22,968.8(IQR:$16,068.8-$34,615.9), $26,936.0(IQR:$18,176.6-$41,386.0) and $27,332.6(IQR:$17,538.7-$44,897.0), respectively. Medical insurance covered 43%-55% of direct medical costs for cervical cancer patients, while the coverage for SIL patients was 19%-43%. For most cervical cancer patients, the expense was catastrophic, and the extent of catastrophic health expenditure was about twice large for rural patients than that for urban patients in each stage.Conclusions: The economic burden of SIL and cervical cancer in China is substantial, with a significant proportion of the costs being avoidable for patients with LSIL. Even for those with medical insurance, catastrophic health expenditures are also a major concern for patients with cervical cancer, particularly for those living in rural areas.

我国中老年慢性病患者疾病经济风险研究——基于社会-人群-家庭层面

目的:分析我国中老年慢性病患者的疾病经济风险,帮助政策制定者精准定位靶向目标。方法:利用2018年中国健康与养老追踪调查数据,以直接医疗费用、疾病相对风险度、家庭灾难性卫生支出为指标,衡量慢性病给社会、人群、家庭带来的经济风险。结果:2018年我国中老年慢性病患者的门诊总费用4792.48万元,住院总费用3 559.02万元,自我医疗总费用1 998.62万元;在15%、25%、40%的界定标准下,中老年慢性病患者家庭灾难性卫生支出的发生率分别为52.07%、44.97%、36.86%。结论:社会层面,门诊医疗和自我医疗给中老年慢性病患者带来的经济负担高于住院医疗;人群层面,女性、60~89岁、参加城乡居民医保和无医保的患者以及恶性肿瘤患者面临的疾病经济风险更高,承受经济风险的能力更弱;家庭层面,慢性病加剧了家庭发生灾难性卫生支出的严重程度,农村和低保慢性病家庭更易发生灾难性卫生支出。

天津市农村防汛排涝问题与对策——从海河“23·7”流域性特大洪水谈起

对海河“23·7”流域性特大洪水退水过程中天津市农村防汛排涝应急工作进行复盘,分析了近年天津市农村防汛除涝工作整体情况,总结存在农村防汛除涝工程建设能力不足、应急体系和预案体系建设存在缺陷、农村防汛除涝管理能力不足、信息化短板明显、隐患排查发现问题和解决问题的能力不足等方面的问题,提出进一步加强应对极端天气条件下的应急体系建设,规范预案管理,积极利用地方政府专项债券解决农村水利基础设施建管资金难题,加强现代化灌区、现代化灌排泵站建设和高标准农田建设融合,加强防汛隐患排查整治工作等建议。

基于突变理论的低碳经济发展综合评价——以京津冀地区为例

以京津冀地区为研究对象,构建了由低碳系统和发展系统组成的低碳经济发展综合评价体系。结合京津冀地区2010-2019年的统计数据,应用熵值法和突变级数法对低碳经济发展水平进行综合评分。从评价得分结果可知,京津冀地区低碳发展水平较低的原因在于一次能源的消耗过多,另外低碳环保方面基础建设也有欠缺。针对上述结论,从低碳基础建设、技术投入和产业结构方面对提高京津冀地区低碳发展水平提出建议。

我国新农合重大疾病保障制度的政策分析

目的:回顾我国新农合大病保障制度的发展过程,分析政策执行现状和运行效果,为完善政策提供参考。方法:利用政策分析方法,分析新农合大病医疗保障政策的形成背景、执行与效果,其中定量资料用描述性统计方法进行分析。结果:自2010年政策启动,新农合大病保障的病种及试点范围稳步扩大,2012年全国大病保障有99.6万名患者受益,受益率为12.45人次/10万参合人口,东部地区受益率高于中部和西部地区;全国20种大病实际补偿比达65.39%,儿童两病等4类大病的实际补偿比超过70%,中部地区补偿水平略高于东部和西部地区。结论:新农合重大疾病保障政策推进良好,基本实现政策目标,但区域间保障待遇存在差异,保障受益面有待进一步提高,可持续发展也面临挑战。建议:多种方式提高新农合大病保障水平,处理好新农合大病与一般疾病保障的关系,促进保障工作的可持续发展,加强对政策实施的监督与评价。

南方桉树人工林雨雪冰冻经济损失评估与分析

针对雨雪冰冻灾害未满5年轮伐期的4类重灾林分开展经济损失评估。结果表明:在萌蘖经营前,不同重灾林分的经营成本与产量均有所差异,只有4年生的重灾林分木材利润为正值,其平均净收入和平均利润分别为16907.20元·hm-2和2480.85元·hm-2;其余类型的重灾林分因为经营期较短,木材产量较低不足以完全抵销经营期内的成本。在萌蘖经营中,亦只有4年生重灾林分的收益高于未受灾林分(CK),其平均净现值(NPV)、内部收益率(IRR)和产出投入比(B/C)分别达18114.00元·hm-2、57.95%和3.52,比最低分别高98.56%,39.21%和65.79%。不同类型萌蘖经营的NPV和IRR与木材价格和木材产量成正比,而与经营成本和贴现率成反比,IRR不随贴现率的变化而变动。本文还就如何提高灾后桉树人工林的经济效益进行了商讨。

北京市新农合大病保险实施效果分析与评价

目的：测算分析北京市新农合大病保险对患者疾病经济负担的减轻作用,对制度实施效果进行评价。方法：按照经济发展水平和大病保险承办方式选取北京市三个区县,再从中选择大病患者较多的2~3个乡镇。通过与大病保险管理者进行访谈,了解其运行现状;对样本乡镇全部大病患者进行问卷调查了解患者主观感受,收到有效问卷497份。利用新农合管理中心信息平台测算患者疾病经济负担。对定量和定性资料分别采用统计分析与主题框架法进行分析。结果：经大病保险报销,三个区县大病患者平均自付费用明显减轻,实际补偿比均有不同程度的提高,但灾难性卫生支出情况无显著改善。结论：应通过提高大病保险起付线与报销比例,拓宽报销目录等举措提高其补偿水平,重点缓解极重患者疾病经济负担。

安徽省农村居民灾难性卫生支出状况分析

目的:研究安徽省农村居民家庭灾难性卫生支出概况。方法:分析2009年安徽省样本地区新农合补偿前后居民家庭灾难性卫生支出发生率、灾难性卫生支出差距以及灾难性卫生支出集中指数的变化情况。结果:新农合补偿以后,样本地区灾难性卫生支出发生率、平均差距和相对差距均有所下降,而且灾难性卫生支出差距集中指数进一步向0靠近,提示平均差距在补偿后则进一步趋向平衡。结论:安徽省农村家庭现金卫生支出负担相对较重;灾难性卫生支出有从贫困家庭扩大到相对富裕家庭的趋势;新农合补偿降低了灾难性卫生支出的发生,但从整体上看作用有限。

新型农村合作医疗对灾难性卫生支出的影响研究

研究对2006年和2008年山东和宁夏两省(自治区)样本地区新农合补偿前后住院费用造成灾难性卫生支出发生率和灾难性卫生支出平均差距进行了分析。结果发现,新农合补偿在降低灾难性卫生支出发生率和灾难性卫生支出平均差距上起到了越来越明显的作用,但是从目前的整体补偿水平看,这种作用还是比较小的。

当前我国巨灾经济损失补偿机制的探讨

我国是世界上遭受自然灾害最严重的国家之一,自然灾害每年都给我国财政与保险业带来巨大的压力,财政补偿和保险补偿能力不足的弊端已经显现。因此,积极探寻新的巨灾损失补偿机制已经成为我国经济发展的迫切要求。首先对我国目前自然灾害所造成的经济损失情况进行了介绍;以地震和洪水为例,对灾情进行了论述;对我国当前主要采用的巨灾损失补偿机制存在的问题进行了讨论,并对巨灾风险证券化的优势作用以及在我国的实施提出了一些观点与建议。