Background Taiwan has implemented a National Health Insurance （NHI） program to provide uniform comprehensive coverage since 1995. Forced by the severe financial deficit, global budgeting is introduced to replace the...Background Taiwan has implemented a National Health Insurance （NHI） program to provide uniform comprehensive coverage since 1995. Forced by the severe financial deficit, global budgeting is introduced to replace the original payment system in Taiwan＇s NHI. Under global budgeting system, the total budget is distributed to six geographical regions in Taiwan. There is no pre-determined budget for each hospital. In order to investigate the longitudinal trend of how global budgeting influences health care resource, it is essential to estimate the efficiency of resource allocation in Taiwan＇s NHI. Methods Data Envelopment Analysis （DEA） and Malmquist index （MI） are used to investigate the 8-year panel data of 23 cities and counties which was collected from the annual report from the Department of Health, Taiwan, China. A value of MI greater than 1 indicates that total factor productivity progress has occurred, while a value of MI less than 1 indicates productivity loss. Results As a result, 37 of the 184 DMUs in the analysis were found to be relatively efficient during the period, in which 14 of 23 DMUs are efficient in 2002 right after adopting globe budgeting. A trend of MI declines between 2002 and 2009 implies the volume of health care services decrease after adopting global budgeting system. Production efficiency has been improved after global budgeting implies that behaviors of health providers control cost and avoid wasting resource at macro level. Conclusions The regressive MI indicates the hospitals redistribute health care resource to eliminate unnecessary treatment and to control the growth of service volume under global budgeting system. Hence, a trend of declining MI focuses on health care resource redistribution rather than efficiency improvement in this study.展开更多
The consistency of global atmospheric mass and water budget performance in 20 state-of-the-art ocean-atmosphere Coupled Model Intercomparison Project Phase 5(CMIP5) coupled models has been assessed in a historical exp...The consistency of global atmospheric mass and water budget performance in 20 state-of-the-art ocean-atmosphere Coupled Model Intercomparison Project Phase 5(CMIP5) coupled models has been assessed in a historical experiment. All the models realistically reproduce a climatological annual mean of global air mass(AM) close to the ERA-Interim AM during 1989-2005. Surprisingly, the global AM in half of the models shows nearly no seasonal variation,which does not agree with the seasonal processes of global precipitable water or water vapor, given the mass conservation constraint. To better understand the inconsistencies, we evaluated the seasonal cycles of global AM tendency and water vapor source(evaporation minus precipitation). The results suggest that the inconsistencies result from the poor balance between global AM tendency and water vapor source based on the global AM budget equation. Moreover, the cross-equatorial dry air mass flux, or hemispheric dry mass divergence, is not well represented in any of the 20 CMIP5 models, which show a poorly matched seasonal cycle and notably larger amplitude, compared with the hemispheric tendencies of dry AM in both the Northern Hemisphere and Southern Hemisphere. Pronounced erroneous estimations of tropical precipitation also occur in these models. We speculate that the large inaccuracy of precipitation and possibly evaporation in the tropics is one of the key factors for the inconsistent cross-equatorial mass flux. A reasonable cross-equatorial mass flux in well-balanced hemispheric air mass and moisture budgets remains a challenge for both reanalysis assimilation systems and climate modeling.展开更多
Saltmarshes are carbon-rich ecosystems that play a role in climate regulation by efficiently sequestrating atmospheric CO_(2).Climate change is a major threat to saltmarshes and will impact saltmarsh carbon sequestrat...Saltmarshes are carbon-rich ecosystems that play a role in climate regulation by efficiently sequestrating atmospheric CO_(2).Climate change is a major threat to saltmarshes and will impact saltmarsh carbon sequestration.Notably,porewater-derived carbon outwelling emerges as a crucial pathway for carbon sequestration,but it has been largely overlooked in saltmarshes.Here,we assessed the drivers of dissolved carbon exports and greenhouse gas emissions in a saltmarsh and placed those observations into a global context.In our study site,porewater exchange(PEX)was the major process controlling dissolved carbon and greenhouse gas dynamics.Combining our results with 33 other studies in saltmarshes worldwide,porewater-derived carbon fluxes were equivalent to~48% of average global saltmarsh primary productivity and 2.2 times greater than global organic carbon burial.Hence,our local observations and global upscaling demonstrate the major role played by PEX in saltmarsh carbon budgets.While part of dissolved inorganic carbon returns to the atmosphere as CO_(2),the remaining bicarbonate fraction is stored in the ocean over long time scales.Our findings strengthen global blue carbon assessments and build arguments for the use of saltmarshes as nature-based solutions for global climate change.展开更多
In steady state the stable isotopic composition of nitrogenand oxygen in tropospheric N\-2O is balanced by isotopically light N\-2O emitted from soils and oceans and isotopically heavy N\-2O as a return flux from the ...In steady state the stable isotopic composition of nitrogenand oxygen in tropospheric N\-2O is balanced by isotopically light N\-2O emitted from soils and oceans and isotopically heavy N\-2O as a return flux from the stratosphere. However, no such balance was reached in calculations given by Kim and Craig (1993). Modifications have been made on their calculations based on the most recent reports on annual global emission of N\-2O. It is considered that the nitrogen and oxygen isotope budget in tropospheric N\-2O are approximately in balance if isotopic fractionation effects during the production of N\-2O in soils and furthermore this paper puts forward further evidence for validating the above results.展开更多
Equity and efficiency are two important factors guiding the mitigation of anthropogenic emissions to achieve the Paris climate goals.Previous studies have proposed a range of allocations of global carbon budgets,but f...Equity and efficiency are two important factors guiding the mitigation of anthropogenic emissions to achieve the Paris climate goals.Previous studies have proposed a range of allocations of global carbon budgets,but few have quantified the equity-efficiency interaction.Based on an investigation of the existing allocation literature,this study conducts a novel analysis using a‘mixed’allocation‘big-data’framework to understand the equityeefficiency interaction in the distribution of global carbon budgets under 2℃ and 1.5℃ warming targets.At a global scale,a carbon Gini coefficient and aggregate abatement costs are used as quantitative metrics to reflect equity and efficiency,respectively.Results show an equity-efficiency frontier that reflects the opportunity for the international community to co-improve equity and efficiency on top of existing allocations.However,the frontier also features strong trade-offs to further improve equity and efficiency if national allocations are to be achieved individually.Our analysis verifies that such trade-offs are sensitively dependent on the level of global connection and integration.Linking national mitigation actions and potentials can help promote equity-efficiency synergies and contribute to the efficient achievement of the Paris Agreement's temperature and equity goals.展开更多
文摘Background Taiwan has implemented a National Health Insurance （NHI） program to provide uniform comprehensive coverage since 1995. Forced by the severe financial deficit, global budgeting is introduced to replace the original payment system in Taiwan＇s NHI. Under global budgeting system, the total budget is distributed to six geographical regions in Taiwan. There is no pre-determined budget for each hospital. In order to investigate the longitudinal trend of how global budgeting influences health care resource, it is essential to estimate the efficiency of resource allocation in Taiwan＇s NHI. Methods Data Envelopment Analysis （DEA） and Malmquist index （MI） are used to investigate the 8-year panel data of 23 cities and counties which was collected from the annual report from the Department of Health, Taiwan, China. A value of MI greater than 1 indicates that total factor productivity progress has occurred, while a value of MI less than 1 indicates productivity loss. Results As a result, 37 of the 184 DMUs in the analysis were found to be relatively efficient during the period, in which 14 of 23 DMUs are efficient in 2002 right after adopting globe budgeting. A trend of MI declines between 2002 and 2009 implies the volume of health care services decrease after adopting global budgeting system. Production efficiency has been improved after global budgeting implies that behaviors of health providers control cost and avoid wasting resource at macro level. Conclusions The regressive MI indicates the hospitals redistribute health care resource to eliminate unnecessary treatment and to control the growth of service volume under global budgeting system. Hence, a trend of declining MI focuses on health care resource redistribution rather than efficiency improvement in this study.
基金Natural Science Foundation of Jiangsu Province grant(BK2012465)National Natural Science Foundation of China(41205065,41475045,41005046)+1 种基金National Basic Research Program of China(2010CB428602)Priority Academic Program Development(PAPD)of Jiangsu Higher Education Institution
文摘The consistency of global atmospheric mass and water budget performance in 20 state-of-the-art ocean-atmosphere Coupled Model Intercomparison Project Phase 5(CMIP5) coupled models has been assessed in a historical experiment. All the models realistically reproduce a climatological annual mean of global air mass(AM) close to the ERA-Interim AM during 1989-2005. Surprisingly, the global AM in half of the models shows nearly no seasonal variation,which does not agree with the seasonal processes of global precipitable water or water vapor, given the mass conservation constraint. To better understand the inconsistencies, we evaluated the seasonal cycles of global AM tendency and water vapor source(evaporation minus precipitation). The results suggest that the inconsistencies result from the poor balance between global AM tendency and water vapor source based on the global AM budget equation. Moreover, the cross-equatorial dry air mass flux, or hemispheric dry mass divergence, is not well represented in any of the 20 CMIP5 models, which show a poorly matched seasonal cycle and notably larger amplitude, compared with the hemispheric tendencies of dry AM in both the Northern Hemisphere and Southern Hemisphere. Pronounced erroneous estimations of tropical precipitation also occur in these models. We speculate that the large inaccuracy of precipitation and possibly evaporation in the tropics is one of the key factors for the inconsistent cross-equatorial mass flux. A reasonable cross-equatorial mass flux in well-balanced hemispheric air mass and moisture budgets remains a challenge for both reanalysis assimilation systems and climate modeling.
基金supported by the National Natural Science Foundation of China(Grant No.42006152)the Zhejiang Provincial Natural Science Foundation of China(Grant No.LQ21D060005)funding from the Swedish Research Council(Grant No.2020-00457)。
文摘Saltmarshes are carbon-rich ecosystems that play a role in climate regulation by efficiently sequestrating atmospheric CO_(2).Climate change is a major threat to saltmarshes and will impact saltmarsh carbon sequestration.Notably,porewater-derived carbon outwelling emerges as a crucial pathway for carbon sequestration,but it has been largely overlooked in saltmarshes.Here,we assessed the drivers of dissolved carbon exports and greenhouse gas emissions in a saltmarsh and placed those observations into a global context.In our study site,porewater exchange(PEX)was the major process controlling dissolved carbon and greenhouse gas dynamics.Combining our results with 33 other studies in saltmarshes worldwide,porewater-derived carbon fluxes were equivalent to~48% of average global saltmarsh primary productivity and 2.2 times greater than global organic carbon burial.Hence,our local observations and global upscaling demonstrate the major role played by PEX in saltmarsh carbon budgets.While part of dissolved inorganic carbon returns to the atmosphere as CO_(2),the remaining bicarbonate fraction is stored in the ocean over long time scales.Our findings strengthen global blue carbon assessments and build arguments for the use of saltmarshes as nature-based solutions for global climate change.
基金ThisprojectwasfinanciallysupportedbytheNationalNaturalScienceFoundationofChina! (No .498730 34 )
文摘In steady state the stable isotopic composition of nitrogenand oxygen in tropospheric N\-2O is balanced by isotopically light N\-2O emitted from soils and oceans and isotopically heavy N\-2O as a return flux from the stratosphere. However, no such balance was reached in calculations given by Kim and Craig (1993). Modifications have been made on their calculations based on the most recent reports on annual global emission of N\-2O. It is considered that the nitrogen and oxygen isotope budget in tropospheric N\-2O are approximately in balance if isotopic fractionation effects during the production of N\-2O in soils and furthermore this paper puts forward further evidence for validating the above results.
基金supported by the National Key R&D Program of China(2017YFA0605302)the National Natural Science Foundation of China(72174105).
文摘Equity and efficiency are two important factors guiding the mitigation of anthropogenic emissions to achieve the Paris climate goals.Previous studies have proposed a range of allocations of global carbon budgets,but few have quantified the equity-efficiency interaction.Based on an investigation of the existing allocation literature,this study conducts a novel analysis using a‘mixed’allocation‘big-data’framework to understand the equityeefficiency interaction in the distribution of global carbon budgets under 2℃ and 1.5℃ warming targets.At a global scale,a carbon Gini coefficient and aggregate abatement costs are used as quantitative metrics to reflect equity and efficiency,respectively.Results show an equity-efficiency frontier that reflects the opportunity for the international community to co-improve equity and efficiency on top of existing allocations.However,the frontier also features strong trade-offs to further improve equity and efficiency if national allocations are to be achieved individually.Our analysis verifies that such trade-offs are sensitively dependent on the level of global connection and integration.Linking national mitigation actions and potentials can help promote equity-efficiency synergies and contribute to the efficient achievement of the Paris Agreement's temperature and equity goals.
