Factors Determining the Development of Non-cash Payments in Rural Areas in Poland

This article aims at characterization and assessment of the financial behaviors of rural dwellers on non-cash payment markets and identification of factors determining the intensity of using individual methods of payment by the inhabitants of rural areas. The main source of data used for analysis and inference was information originating from the authors＇ own investigations conducted in 2013 on a group of 500 rural households and on a group of 150 trade and service points operating in non-urbanized areas. This work made use of statistical summary measures and Z2 independence test. According to the results of the conducted studies, forms of payment used by rural dwellers depend on many variables, of demographic, economic, and psychological character. Cash payments are more frequently used by persons possessing vocational or secondary education, elderly people, old-age pensioners, annuitants, or households with lower incomes. Also, persons who do not trust financial institutions or do not perceive benefits resulting from the use of non-cash instruments prefer cash. It is a group of households which require urgent educational activities in the area of non-cash payment instruments. A significant barrier to using non-cash payment instruments by rural dwellers was a limited access to non-cash channels. It is connected in the first place with a poorer development of financial infrastructure in rural areas （banks or cash points）, insufficient Internet access conditioning a possibility to use electronic banking points, and also a worse development of credit card acceptance network. As has been demonstrated by the results of conducted studies, the main reason for a lack of point of sale （POS） terminals in retail and service-providing points operating in rural areas, in the opinion of their owners, is the very high interchange fee （50% indications）, which under Polish conditions is one of the highest in the European Union （EU）.

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.

基于间断时间序列分析的医院DRG付费改革成效评价研究

目的:分析DRG付费改革对天津市某三级医疗机构运行的影响。方法:收集2020年1月~2022年12月改革试点医疗机构医疗服务能力、医疗服务效率、医疗服务质量3个维度的月度数据,采用间断时间序列数据模型分析改革前后各类指标趋势的变化。结果:试点医院医疗服务能力提升效果显著,医疗服务效率存在较大提升空间,改革对于医疗服务质量影响甚微。结论:在当前诊疗能力稳步提升的情况下、医保支付改革所倡导的降本增效要求下以及“以治疗为中心”转向“以健康为中心”的医疗服务发展模式下,应完善DRG付费改革促进医疗服务能力、医疗服务效率和医疗服务质量提升的关键机制,多措并举实现公立医院高质量发展。

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.

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.

指尖上的旅行:移动支付能否促进家庭旅游消费?

基于2017年和2019年中国家庭金融调查数据,使用固定效应模型、工具变量估计、Tobit模型和差分模型,研究了移动支付对家庭旅游消费的影响。结果表明:移动支付能够显著提高家庭出游概率、促进家庭旅游消费,且对高收入、高人力资本、城镇和老年家庭影响更大。机制检验发现,移动支付通过提升居民信任水平、提高支付便利性促进家庭旅游消费。鉴于此,应深入发展智慧旅游,驱动旅游消费智慧化、数字化升级。

某三级专科医院DRG分组高倍率病例费用影响因素比较分析

[目的]基于天津市某三级专科医院DRG分组数据探讨专科医院DRG组高倍率病例影响因素,为医院进行有针对性的成本控制提供参考。[方法]收集某专科医院2022年10月1日-2023年9月30日上传的医保患者医保结算清单经分组器分组后正常入组数据,按照进入天津市医保局DRG分组器分组后的全市付费次均费用、平均住院天数计算入组病例费用的倍率,应用logistic回归分析高倍率病例的影响因素,采用灰色关联分析法分析高倍率病例各分项费用与住院总费用的关联度。[结果]入组病例总数为7829例,其中高倍率病例673例,占8.60%。Logistic回归结果显示,DRG合并并发症、15~60岁、非医嘱离院、实际住院天数长是高倍率病例产生的影响因素(P<0.05)。灰色关联结果显示,在10个高倍率的DRG组里,有5个DRG组的诊断费与其呈现最强的相关性,有3个DRG组的药品费与其呈现最强的相关性,有2个DRG组的综合服务费与其呈现最强的相关性。[结论]药品费、诊断费、综合服务费、合并并发症、15~60岁及住院天数长与高倍率住院费用的产生显著相关,是医院进行有指向性成本控制的重要因素。

医保支付方式由治病向健康转型—先期探讨研究

为系统讨论医保支付方式改革驱动由治病向健康转型的可能性和实践模式,以目标—发展重点透视矩阵作为分析框架,以慢性病为切入点,基于安徽省医共体慢性病打包支付的案例,探讨中国情境下的以健康为导向的医保支付方式改革的路径和方法。研究发现,伴随人口结构和社会需求的变化,在理念层面上,医保支付政策已体现出由治病向健康转型的态势,医保支付政策的内容、形式、载体趋向多样化。目前中国复合式医保支付框架已经建立,但改革内容和进展不平衡,尚未发挥向健康转型的激励引领作用。持续推进医保支付方式改革并对改革内容进行适应性调整,将是下一阶段工作的重点。

财政转移支付制度、财政提质增效与经济增长——基于转移支付不确定性的研究

地方政府财政收入的不确定性对其财税行为会造成影响,进而可能影响到财政支出的经济增长效应。使用1998-2007年中国县级层面的财政数据,以2001年民族地区转移支付制度的确立作为工具变量,估算中国地区层面的财政支出乘数,并研究转移支付不确定性对地区层面财政支出乘数的影响,实证结果表明,县级地区转移支付不确定性每增加1个标准差会导致县级地区财政支出乘数减少0.57,专项转移支付不确定性是导致地方政府财政支出乘数下降的主要因素,而一般性转移支付不确定性对地方政府财政支出乘数没有显著影响。机制研究表明,转移支付不确定性通过影响地方政府的财政收支行为,使得地方政府提高当地企业的实际税率,减少了当地企业的产出,进而影响到地区层面产出。

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。

出资义务加速到期规则的解释论

面对注册资本完全认缴制所产生的问题,2023年修订后的《公司法》对有限责任公司改采了限期认缴制,并引入了催缴失权、加速到期等规则予以完善。《公司法》第54条规定,公司不能清偿到期债务的,公司或者已到期债权的债权人有权要求已认缴出资但未届出资期限的股东提前缴纳出资。该条款简明扼要,涵盖了加速到期条件、请求权主体、出资财产入库公司等三重面向。本条规定体现了立法机关的价值判断,实质上系对公司、股东、债权人利益的衡量安排,以公司利益为该制度构建的基点和本旨。该利益衡量方案契合公司法的价值体系,在构成上包括三项旨意:以停止支付而非支付不能为加速到期标准;以公司资本需求为本位允许公司要求加速到期;以入库规则为通道保障公平清偿债权。在规范适用上,出资义务加速到期规则衔接董事催缴义务和催缴失权制度,可以协同保障公司的资本需求和公司利益。

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。

可再生能源投资的政企随机演化博弈研究——基于动态碳价视角

针对传统确定性演化博弈模型的不足,引入几何布朗运动模型模拟动态的碳价参数,构建了具有随机支付矩阵的演化博弈模型,以全国碳市场背景下的发电企业为例,研究了政企双方的演化过程和策略选择,探究了不同因素对演化均衡和政企决策的影响.结果显示:碳价是影响政企决策的重要因素,碳价较低时,政企的最优决策分别是选择作为策略即采取奖惩措施和不投资可再生能源,碳价较高时最优决策转变为不作为和投资.火力发电的成本、收益和碳排放系数以及可再生能源发电的成本、收益和建设成本是影响政府和发电企业策略选择的关键因素.发电企业投资意愿与政府的奖惩力度正相关,政府作为意愿与奖惩力度负相关,短期内提高政府的奖惩力度可激励发电企业的投资行为,但会缩短政府作为时长.

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。

我国社会信用体系建设面临的主要挑战及对策建议

党的十八大以来,国家高度重视社会信用体系建设,在一些基础领域和关键环节取得了重要进展,总体社会信用状况得到明显改善。然而,社会信用体系建设是一项长期且极为复杂的系统工程,目前仍面临着理论研究和法治建设滞后,社会信用体系建设的目标定位和功能边界不够清晰,商务征信体系不健全、企业账款拖欠严重,以及其他发展不平衡不充分等问题。建议在系统总结前期经验教训的基础上,加强理论研究,厘清认识和实践误区,进一步明确社会信用体系建设的目标定位和功能边界,加快推进信用立法,健全商务信用体系,破解企业账款拖欠难题,大力发展信用经济,并做好面向公众的宣传引导工作。

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。

财税政策促进共同富裕:内在逻辑、现实问题与实现路径

财政是国家治理的基础和重要支柱,在扎实推进共同富裕进程中,财政既要促进做大经济发展的“蛋糕”,更要注重“分好蛋糕”,用好财税政策工具,着力缩小区域差距、城乡差距和收入差距,推动基本公共服务均等化。从聚焦构建全国统一大市场、推进城市群和都市圈协同发展、完善转移支付制度、推进城乡协调发展等方面,阐释财税政策发挥作用的内在逻辑和实现路径,分析存在的制约因素,并提出相关政策建议。

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。