Research on impetus of purchasing consortia based on related total cost

By comparing the related total cost before and after the formation of purchasing consortia, the impetus of formation is analyzed. Moreover, pointed to different transportation and storage policies, the formation impetus is studied in detail and some conclusions are arrived at. Finally the research orientation of the formation impetus of purchasing consortia is exploratory presented under more complicated conditions, and purchasing consortia in more cross-zones and multi-segment will occur in China.

Hyperglycemia is associated with increased length of stay and total cost in patients hospitalized for congestive heart failure

Objectives: Hyperglycemia is a well-known marker of poor clinical outcomes in acute myocardial infarction and critical illness;however, its effect in congestive heart failure (CHF) is controversial. We hypothesized that persistent hyperglycemia is associated with increased length of stay (LOS) and increased total cost in patients admitted with CHF. Methods: We studied 203 consecutive patients admitted with a primary diagnosis of CHF. Patient characteristics, admission glucose, mean blood glucose (MBG) during the entire hospital stay, length of stay, total cost, and readmission rates were assessed. Persistent hyperglycemia was defined as a MBG level ≥140 mg/dl. Results:Patients with persistent hyperglycemia had longer mean LOS (8.1 vs 5.2 days, p = 0.001) and higher total hospital costs (median $8940 vs $6892, p = 0.01) independent of diabetes status. Similarly, prolonged hospital stay >7 days (38% vs 21%;p = 0.01) and total cost >$10,000/patient (46% vs 29%;p = 0.01) were seen more commonly in patients with poor glucometrics. Neither admission glucose >140 mg/ dL or diabetes status was predictive of total costs or LOS. In multivariate linear regression, only MBG ≥ 140 mg/dl was associated with increased LOS and total cost. Patients with persistent hyperglycemia also had higher 6 months all-cause readmission rates (51% vs 37%;p = 0.03). Conclusion: Persistent hyperglycemia (MBG > 140 mg/dL), but not admission glucose, was associated with increased LOS, total cost and readmission rates independent of diabetes status. Our study emphasizes the need to further examine the role of glycemic control in patients admitted with CHF.

Charging Ahead with E-Buses: Benefits, Costs, and Transition Roadmap

This paper reaches a recommendation for the 10-year e-bus transition roadmap for New York City. The lifecycle model of emission reduction demonstrates the ecological and financial impacts of a complete transition from the current diesel bus fleet to an all-electric bus fleet in New York City by 2033. This study focuses on the NOx pollution, which is the highest among all major cities by Environmental Protection Agency (EPA) and greenhouse gases (GHG) with annual emissions of over five million tons. Our model predicts that switching to an all-electric bus fleet will cut GHG emissions by over 390,000 tons and NOx emissions by over 1300 tons annually, in addition to other pollutants such as VOCs and PM 2.5. yielding an annual economic benefit of over 75.94 million USD. This aligns with the city mayor office’s initiative of achieving total carbon neutrality. We further model an optimized transition roadmap that balances ecological and long-term benefits against the costs of the transition, emphasizing feasibility and alignment with the natural replacement cycle of existing buses, ensuring a steady budgeting pattern to minimize interruptions and resistance. Finally, we advocate for collaboration between government agencies, public transportation authorities, and private sectors, including electric buses and charging facility manufacturers, which is essential for fostering innovation and reducing the costs associated with the transition to e-buses.

Catastrophic total costs in tuberculosisaffected households and their determinants since Indonesia’s implementation of universal health coverage

Background:As well as imposing an economic burden on affected households,the high costs related to tuberculosis(TB)can create access and adherence barriers.This highlights the particular urgency of achieving one of the End TB Strategy’s targets:that no TB-affected households have to face catastrophic costs by 2020.In Indonesia,as elsewhere,there is also an emerging need to provide social protection by implementing universal health coverage(UHC).We therefore assessed the incidence of catastrophic total costs due to TB,and their determinants since the implementation of UHC.Methods:We interviewed adult TB and multidrug-resistant TB(MDR-TB)patients in urban,suburban and rural areas of Indonesia who had been treated for at least one month or had finished treatment no more than one month earlier.Following the WHO recommendation,we assessed the incidence of catastrophic total costs due to TB.We also analyzed the sensitivity of incidence relative to several thresholds,and measured differences between poor and non-poor households in the incidence of catastrophic costs.Generalized linear mixed-model analysis was used to identify determinants of the catastrophic total costs.Results:We analyzed 282 TB and 64 MDR-TB patients.For TB-related services,the median(interquartile range)of total costs incurred by households was 133 USD(55-576);for MDR-TB-related services,it was 2804 USD(1008-4325).The incidence of catastrophic total costs in all TB-affected households was 36%(43%in poor households and 25%in non-poor households).For MDR-TB-affected households,the incidence was 83%(83%and 83%).In TB-affected households,the determinants of catastrophic total costs were poor households(adjusted odds ratio[aOR]=3.7,95%confidence interval[CI]:1.7-7.8);being a breadwinner(aOR=2.9,95%CI:1.3-6.6);job loss(aOR=21.2;95%CI:8.3-53.9);and previous TB treatment(aOR=2.9;95%CI:1.4-6.1).In MDR-TB-affected households,having an income-earning job before diagnosis was the only determinant of catastrophic total costs(aOR=8.7;95%CI:1.8-41.7).Conclusions:Despite the implementation of UHC,TB-affected households still risk catastrophic total costs and further impoverishment.As well as ensuring access to healthcare,a cost-mitigation policy and additional financial protection should be provided to protect the poor and relieve income losses.

Variability in total cost of vehicle ownership across vehicle and user profiles

Widespread adoption of electric vehicles(EVs)is a common and critical component of international strategies to mitigate environmental pollution,climate change and oil dependency.The ability of consumers to assess the total cost of ownership(TCO)of EVs relative to internal combustion engine vehicles(ICEVs)remains an important factor for EV uptake.The TCO of vehicles is not universal across different car segments and user profiles.We analyse and compare the TCO of ICEVs and EVs from 17 car segments across short-and long-term ownership periods,and further advance existing TCO approaches by integrating detailed activity-based driving profiles,taxation,grant structures and pricing.Results show that EV options in the most popular Irish car segments have existing battery EV options with a TCO averaging respectively 26% and 42% less than their equivalent petrol and diesel ICEV options over a 4-year ownership term when the current grant is included.This integrated method for granular TCO evaluation offers important insights for this market and affords scope to investigate how changes in travel patterns,car-segment pricing,taxation,grant policy,fuel costs,and carbon pricing and other transport policies can all affect TCO values over time across a broad range of market offerings.

热泵精馏耦合吸收处理含盐氨水

针对含盐氨水的回收与处理,利用蒸发除盐、精馏脱氨并耦合吸收制备一定浓度的氨水。采用一系列节能技术对蒸发和精馏进行计算优化,即双效蒸发与塔顶蒸汽直接压缩热泵精馏耦合吸收工艺(SchemeⅠ)、热泵蒸发与塔顶蒸汽直接压缩热泵精馏耦合吸收工艺(SchemeⅡ)和热泵蒸发与塔底闪蒸再压缩热泵精馏耦合吸收工艺(SchemeⅢ)。选用ELECNRTL电解质模型计算物系的热力学数据和相平衡数据,并以年总费用、综合能耗和热力学效率等作为工艺评价指标,对提出的以上3种处理工艺进行模拟与优化。研究结果表明,与SchemeⅠ相比,SchemeⅡ和SchemeⅢ可分别节省年总费用22.18%和31.66%;节约能耗47.56%和57.87%;而热力学效率则分别提高了8.59%和2.28%。显然,SchemeⅢ在年总费用与能耗方面更具优势,SchemeⅡ在热力学效率方面更具优势。

基于生命周期碳排放和总拥有成本的公交车队更新优化

为探索电能和氢能源作为常规公交替代燃料的优势和潜力,确定公交车队更新时序的优化方案,从生命周期的角度综合考虑碳排放和总拥有成本的影响,提出了一种混合整数规划模型.基于柴油、天然气、油电混合、纯电动和氢燃料电池5种动力类型公交的运营数据,分析了电力结构、制氢方式、车辆购置成本和氢能源使用成本的不确定性对车队更新方案的影响.结果表明:电动公交车是当前公交车队更新的最佳选择;在现有的车辆技术水平和制氢方式情景下,不宜选择氢燃料电池公交;在蓝氢或绿氢得到大规模商业化之前,不建议通过财政补贴的方式全面推广氢燃料电池公交;采用该方法可以在不同情景和预期目标下确定公交车队的更新优化方案,促进绿色可持续发展.

技术融合与企业出口产品质量--来自中国工业企业的经验证据

技术融合是提高科技成果转化和产业化水平、实现经济高质量发展取得新突破的关键。推动中国迈向贸易强国的背景下,研究技术融合究竟如何影响中国企业出口产品质量的问题尤为重要。使用2000—2013年中国工业企业数据作为研究样本,构建固定效应模型,系统考察技术融合对企业出口产品质量的影响及作用机制。研究发现,技术融合的深化显著提升了企业出口产品质量。异质性分析表明,技术融合对企业出口产品质量的提升作用在非国有企业、非外资企业以及沿海企业中表现更为突出。机制检验发现,技术融合深化能够提升企业全要素生产率以及固定成本投入效率,最终实现企业出口产品质量升级;市场化程度以及政府支持力度会在技术融合提升企业出口产品质量过程中发挥正向调节作用。因此,应进一步深化技术融合,搭建高效的交流合作平台,加速优质要素资源流动,重点培育本土企业自主创新能力,实现出口产品质量升级。

技术进步、反鲍莫尔成本病与制造业占比

根据鲍莫尔的非均衡增长理论,技术进步会导致服务业占比上升,制造业占比下降,这就使得我国既要坚持创新驱动,又要保持制造业占比基本稳定面临理论上的悖论。本文立足我国服务业全要素生产率增速已经高于制造业全要素生产率增速的新变化,指出我国存在着反鲍莫尔成本病现象,即制造业领域而不是服务业领域存在鲍莫尔成本病,这修正了鲍莫尔理论模型,从技术进步角度找到了我国制造业占比下降的根本原因,为创新驱动和保持制造业占比基本稳定同步实现提出了逻辑一致的理论解释。此外,论文借助WIOD数据库2000—2014年17个制造业细分行业数据进行实证研究,结果显示,2011年起制造业TFP增速每提高1%,制造业占比将提高2.3%,TFP水平提升会增强制造业国际竞争力。

集装箱港口集疏运重卡电动化的经济性分析

为分析集装箱港口集疏运重卡电动化的经济性,考虑购置税优惠、补贴、贷款、排放成本等因素,建立广义总拥有成本现值估算模型,构建经济性分析指标,并分析“购买底盘+电池”(方案1)和“购买底盘+租赁电池”(方案2)的经济性。结果表明,在设定条件下,无论是否考虑排放成本,两种方案都不具经济性,但考虑排放成本能有效缓解重卡电动化的成本劣势。当考虑排放成本且其他因素不变时,若电池租金<5.61万元,或电价≤1.28元/(kW·h),或油价≥8.48元/L,或柴油重卡能耗强度≥0.40 L/km,或电动重卡能耗强度≤1.34 (kW·h)/km,方案2具有经济性。类似地,若使方案1具有经济性,应满足电池价格<22.11万元,或电价<1.23元/(kW·h),或油价>8.72元/L,或柴油重卡能耗强度≥0.41 L/km,或电动重卡能耗强度≤1.28 (kW·h)/km。免征电动重卡购置税能有效改善两种方案的经济性指标。调增单位排放成本或电动重卡补贴额度虽能确保两种方案都具有经济性,但其所需调增幅度较高,可能增加重卡司机或政府的经济负担。

企业税负结构、税收成本粘性与全要素生产率

从税源的纳税人结构来看,我国税收收入主要源于企业,宏观层面的税制结构在微观领域主要投射为企业税负结构,税制结构对经济效率的宏观影响会通过企业税负结构对微观全要素生产率的促进或抑制来实现。因此,基于上市公司微观主体实证检验企业税负结构变化对微观全要素生产率的影响,可以验证税制结构对经济效率的宏观治理效应。研究结果表明:现行以间接税为主的企业税负结构对全要素生产率具有显著的抑制作用,具体表现为企业增值税负与企业所得税负比值越大,对全要素生产率抑制作用越强。进一步研究结果表明:企业税负结构是通过增加税收成本粘性对全要素生产率产生抑制作用;在当前税收立法水平与税制安排下,税收征管在企业税负结构抑制全要素生产率中发挥了正向调节作用。

绿色信贷政策会影响企业产品市场竞争力吗?——一个全面成本管理的视角

通过成本驱动效应,绿色信贷政策不仅会激励企业加强全面成本管理,还会激励企业进行研发创新,从而提升其产品市场竞争力。基于2009—2022年我国A股上市企业的数据,本文运用双重差分模型进行实证检验,结果表明绿色信贷政策的确能够显著提升企业产品市场竞争力。机制检验结果显示,绿色信贷政策通过降低全面成本管理成本和提高全要素生产率,对产品市场竞争力产生显著正面影响。异质性检验结果表明,在两职合一、民营企业和小规模的企业样本中,绿色信贷政策对企业的产品市场竞争力的影响更大。由此可见,绿色信贷政策能够助力企业实现绿色转型,有利于企业实现高质量可持续发展。

Cost Containment of Total Knee Arthroplasty in the US: DEA Analysis on Regional Cost and Clinical Comparison between 2010 and 2013

The purpose of this research is to evaluate clinical and cost effectiveness of total knee replacement surgery (TKA) for adults hospitalized in the United States between 2010 and 2013. We tried to answer the question that whether lower length of stay and higher utilization of post-op facilities would be helpful to control the overall costs. Using the National Hospital Discharge Survey (NHDS) database and cost data from Blue Cross Blue shield, this study seeks to identify which U.S. region renders the highest quality patient care during a three-year span of 2008-2010. Using length of stay and discharge disposition (2010) as input factors, and regional TKA costs (2013) as output factors, Data Envelopment Analysis (DEA), a non-parametric method, illustrated the efficiency ranking of four regions in the US on TKA expenditures. The result shows the West is the most efficient region on controlling the overall cost by shrinking the length of stay and increasing the utilization of short-term/long-term care facilities.

全面成本控制管理在消毒供应中心的应用效果

目的探讨全面成本控制管理在消毒供应中心的应用效果。方法回顾性分析2021年1—12月医院消毒供应中心成本管理数据,按照管理方法不同分组,2021年1—6月消毒供应中心实施基础成本管理为对照组,2021年7—12月消毒供应中心实施全面成本控制管理为观察组。比较两组的人员情况及工资、医用无菌耗材费用、设备维护和能源供给等各项支出、核心设备故障情况及临床消毒物品质量满意率。结果观察组人员素质及团队结构优于对照组,人员工资、医用无菌耗材费用、设备耗材及指示剂费用、设备维护费用、能源供给费用等各项支出及核心设备故障率低于对照组(P<0.05);观察组临床医务人员对消毒物品质量满意率高于对照组(P<0.05)。结论在医院消毒供应中心实施全面成本控制管理,可实现提升作业人员素质、推进科室健康发展、降本增效、提高临床满意度的良好管理效果。

面向薄弱配电网的农村多能互补系统储能协同优化配置

位于配电网薄弱区域的农村常常存在供能可靠性不足的问题,导致接入大规模光伏的多能互补系统难以在此类地区广泛开展。储能系统作为新型能源系统融合的纽带,能够有效提升此类地区的供能可靠性。为此,文中提出一种面向薄弱配电网的农村多能互补系统(rural multi-energy complementary system,RMES)储能协同优化配置策略。首先,明确包含生物质废弃物能源转化系统的RMES架构。然后,以系统缺供损失成本作为评判依据,提出一种储能配置评价准则。最后,建立计及储能全生命周期成本的RMES多元储能协同优化配置模型。针对该模型的特性,将其解耦转化为包含规划-运行两阶段的双层优化模型,并采用粒子群算法和Gurobi求解器相结合的混合策略进行求解。算例分析表明,所提储能配置评价准则有效激发了RMES配置储能的积极性。此外,构建的多元储能协同配置模型使得RMES表现出更好的经济效益和环境效益,并且在提升系统运行可靠性方面具有优越性。

数字经济和实体经济融合对企业全要素生产率的影响

文章以中国A股2011—2021年上市公司为研究对象,实证检验了数字经济和实体经济融合对企业全要素生产率的影响。结果表明,数字经济和实体经济融合显著正向影响企业全要素生产率,数字化转型和交易成本发挥着中介效应。进一步分析表明,数字经济和实体经济融合对企业全要素生产率的积极影响在东部地区、制造业、高人力资本以及大企业中更为明显。地方政府可通过实施差异化的发展战略加深数实融合;同时应重视企业数字化转型升级,为中小企业发展提供政策倾斜和资金支持。

数字化与对外直接投资新优势——基于我国A股上市工业企业的分析

随着数字技术与实体经济深度融合,数字化已成为企业发展的新优势。本文基于2009—2021年我国A股上市工业企业样本,并匹配具有代表性的对外直接投资(OFDI)数据,研究数字化优势对我国企业OFDI的影响及其作用机制。研究发现,数字化能够显著且稳健地提高我国企业OFDI的可能性、投资广度和投资深度,进而提升我国OFDI的活力和韧性,并且解释力度高达企业OFDI传统优势研发密度的48.3%~53.8%。全要素生产率提升和海外经营成本降低是数字化优势促进企业OFDI的两条潜在机制。异质性分析表明,数字化优势的OFDI促进效应在绿地投资、传统行业和高竞争性行业中表现更加突出。此外,我国OFDI“走进东道国”过程中,跨国公司数字化优势与东道国数字化优势间的竞争效应大于互补效应,因而数字化优势对我国企业OFDI的正向作用在高数字化水平东道国的样本中受到抑制。本文研究结论对新形势下我国如何利用数字化优势推动高水平对外开放,构建以国内大循环为主体、国内国际双循环相互促进的新发展格局具有启示意义。

2020年北京市中医药总费用实际与预测对比分析

目的探究北京市2013-2020年中医药总费用的流向情况,对比受新冠疫情影响的2020年实际与预测中医药总费用的差距。方法采用灰色模型GM(1,1)预测2020年北京市中医药总费用。结果北京市中医药总费用主要流向医院、药品零售机构和基层医疗卫生机构,2020年中医药总费用下降明显,其中仅门诊部中医药总费用达到预测值,医院和药品零售机构中医药总费用与预测值相差较大,中医药总费用进一步流向基层医疗卫生机构。结论北京市需加速推进医院复工复产工作,进一步提高基层医疗卫生机构中医药服务能力,加强公共卫生机构中医药建设,推动中医药发展。

中国零碳商用车市场渗透率建模:以重型长途牵引货车为例

商用车碳减排已经成为我国道路交通减碳的关键瓶颈,新能源商用车被视作重型商用车减碳的重要途径,但是新能源商用车的市场渗透率远低于其他车辆部门;但与此同时,现阶段新能源零碳商用车的发展还存在着应用场景复杂、技术路径多样化、同时成本较高的显著的瓶颈。本研究构建了基于新能源汽车总拥有成本(total cost of ownership,TCO)、使用便利性等因素的多元Logit离散选择模型——零碳商用车市场演进模型(discrete choice-based market evolution of green truck model,DC-MEGT),使用自下向上的方法计算TCO,并将车辆使用便利性使用补能时间成本进行货币化量化,构建综合效用函数对纯电动车、燃料电池汽车及零碳燃料等不同动力类型从目前到2060年的市场渗透率演进情况进行预测分析。研究以重型长途牵引场景为例进行分析,结果表明2060年主要的技术路径包括燃料电池汽车、纯电动车、天然气及柴油车,占比分别为48%、28%、12%和10%。政策推广、技术进步、商业模式等因素的不确定性会引发纯电动车和燃料电池汽车2060年市场份额17%~19%的波动。

互联网应用对中国制造业全要素生产率的影响研究

基于中国A股上市公司数据,实证检验制造业企业互联网应用对全要素生产率的影响及作用机制。结果显示:互联网应用通过节约交易成本这一主要渠道显著地提升了制造业企业全要素生产率;互联网应用对西部地区制造业企业、资本密集制造业企业、出口型制造业企业全要素生产率的提升效果更显著;互联网应用通过节约销售成本和管理成本提升了制造业企业全要素生产率,且管理成本节约对全要素生产率提升的作用更大。因此,应提升制造业企业互联网应用的深度与广度,将节约的销售成本与管理成本投入研发活动之中,推动制造业全要素生产率提升。