A Comparative Analysis of the Control Effect of Medical Expenses between General Hospitals and Traditional Chinese Medicine Hospitals from 2012 to 2021

Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.

Effects of formal credit on pastoral household expense: Evidence from the Qinghai-Xizang Plateau of China

Formal credit is critical in agricultural production,allowing more expenditure and productive input,thereby improving farmers'welfare.In pastoral China,formal financial institutions are gradually increasing.However,a limited understanding remains of how formal credit affects herders'household expenses.Based on a survey of 544 herders from the Qinghai-Xizang Plateau of China,this study adopted the propensity score matching approach to identify the effect of formal credit on herders'total household expenses,daily expenses,and productive expenses.The results found that average age,grassland mortgage,and other variables significantly affected herders'participation in formal credit.Formal credit could significantly improve household expenses,especially productive expenses.A heterogeneity analysis showed that formal credit had a greater impact on the household total expense for those at higher levels of wealth;however,it significantly affected the productive expense of herders at lower wealth levels.Moreover,the mediating effect indicated that formal credit could affect herders'household income,thus influencing their household expenses.Finally,this study suggests that policies should improve herders'accessibility to formal credit.

Carbamazepine in osteoarthritis treatment:A novel approach targeting Nav1.7 channels

Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.

Cumulative Effect of Debt and Tax on Firm Value:Optimal Capital Structure Theories in the Light of EMM

We have shown that cornerstone articles considering effects of corporate debt on the firm value and constituting the basis of the trade-off theory of capital structure are wrong.Their main mistake is in ignoring the business securing expenses(BSEs).In the framework of the extended Merton model(EMM),we consider the cumulative effect of debt and corporate taxes on the firm value and its survival,in other words,we revisit Modigliani-Miller Proposition 3(MMP3).We show that(1)debt affects the firm value and its survival,(2)this effect is negative,diminishing the firm value and its chances to survive,(3)the pressure increases as the debt grows provoking the firm’s default,(4)the main factors depressing the levered firm are its debt payments added to the BSEs of the identical unlevered firm and the length of debt maturity,(5)corporate taxes cause development of positive skewness in the asset distribution,but do not affect the location of this distribution in the asset axis.The presented model helps estimate the consequences of choosing this or that level of debt in the presence of corporate taxes and can make a useful instrument for practicing financial managers.

Study on the Application Effect of Enhanced Recovery After Surgery (ERAS) in Patients Undergoing Spinal Fracture Surgery

Objective:To study the application effect of the Enhanced Recovery After Surgery(ERAS)model in patients undergoing spinal fracture surgery.Methods:A randomized controlled trial was designed,and 86 patients undergoing spinal fracture surgery were randomly divided into the ERAS group and the conventional care group.Postoperative recovery outcomes of the two groups were compared.Results:The ERAS group showed better outcomes in terms of postoperative pain scores,activities of daily living,length of hospital stay,and adherence to rehabilitation training compared to the conventional care group,with shorter hospital stays and lower medical expenses(P<0.05).Conclusion:The ERAS model significantly improves the postoperative recovery quality of patients undergoing spinal fracture surgery,reduces hospital stay and medical costs,and increases patient satisfaction.

Analysis of Hospitalization Costs and Influencing Factors of AKI in Adult Patients

Objective:To investigate the economic burden of patients with acute kidney injury(AKI)by analyzing the distribution of hospitalization expenses and its influencing factors in the Affiliated Hospital of Hebei University.Methods:The hospitalization information of patients with AKI from January 2020 to January 2023 was collected and sorted through the hospital charging system and the factors affecting the total hospitalization cost were analyzed by multiple linear regression.Results:Univariate analysis showed that age,occupation,marriage,length of hospitalization,recovery of renal function,and stage of AKI had significant effects on hospitalization cost(P<0.05).The result of the multiple linear regression analysis model showed that age(t=4.11,P<0.0001),length of hospitalization(t=16.10,P<0.0001),recovery of renal function(t=3.26,P<0.0001),AKI stage(t=5.23,P=0.002)are factors affecting the economic burden of patients with AKI.Conclusion:AKI patients should be managed according to age stratification to effectively control the progression of the disease and improve the quality of the medical services provided.This will reduce the economic burden of patients.

Study on the Changes of Medical Income Structure in Governmentrun Hospitals of Traditional Chinese Medicine from 2012 to 2021

Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put forward corresponding suggestions for further optimizing their income structure.Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out.Then,descriptive analysis method was used to analyze the changes of related indicators.Besides,structural change method was applied to investigate the changes of outpatient income and inpatient income.Results and Conclusion From 2012 to 2021,the growth of medical income in government-run hospitals of TCM tended to be stable,and the proportion of medical service income increased from 22.62%(2012)to 29.38%(2021),but the average annual growth rate was only 0.68%.The main items that caused the change of outpatient income structure were medicine revenue,laboratory tests,diagnosis and treatment,and the cumulative contribution rate was 89.15%.The main items that caused the change of inpatient income structure were medicine revenue,sanitary materials,and auxiliary examinations income,with a cumulative contribution rate of 80.04%.However,the contribution rate of registration,diagnosis,treatment,surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small.The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable,but the medical service income increased slowly,and not all indicators achieved the expectations.To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services,it is necessary to further improve the relevant policy mechanism.

Analysis on Medical Expenses of Hypertensive Inpatients in Urban Areas from 2010 to 2013-Evidence from Two Provinces in South of China

Along with the development of society and the rapid economic growth in the past decades, hypertension and other chronic diseases have become important reasons for people＇s poverty caused by illness in China. This study collected a total of 5857 people from 2010 to 2013 randomly from the database of the Medical Insurance Department （MID）, including 3229 people in Hubei province and 2628 people in Guangdong province. One-way ANOVA was used to compare the total medical expense, out-of-pocket （OOP） expense and hospital stay between variables. A multiple linear regression analysis was done to identify possible risk factors of total medical expense. The results showed that the average total medical expense per capita was 5709.89 yuan, and the medical expense per capita was 7053.58 and 4555.97 yuan in Guangdong province and Hubei province, respectively. The medical expense of hypertensive inpatients decreased from 7222.32 yuan in 2012 to 4894.66 yuan in 2013. There were no significant differences in medical expenses between different genders of hypertensive patients （P〉0.05）. People of different ages, provinces, medical insurances and medical institution levels showed significant differences in medical expenses. The government should increase the investment in chronic disease management and treatment in the central and western regions to narrow the gap with the eastern region. Medical insurance fund payment should be improved to ensure the fairness of the use of medical services in different medical insurances. And measures should be taken to encourage chronic patients to visit primary medical institutions to effectively reduce medical expenses.

Role of Media Coverage in Keeping Lid on Government Expenses

Information monopoly of bureaucrats helps them maximize discretionary budget. Public disclosure of budget can alleviate information asymmetry between government and the public and empower public supervision on government budget. With information intermediary function and reputational governance function, the media exert a budget intervention effect in the public disclosure of government budget, which further increases the effect of government budget disclosure. This paper investigates how media reports influence "three public expenses"(TPE) budget planning of central government departments by examining media reports on the disclosure of budget and final accounts and using TPE budget as a proxy variable for discretionary budget of bureaucrats. We have reached the following findings:(1) The higher the TPE budget implementation rate, the greater budget growth will be. But this correlation can be restrained by media attention;(2) Different stance of the media may exert different governance effects on TPE budget. Good news about TPE may motivate bureaucrats to restrain the positive impact of TPE budget implementation on budget growth. However, bad news about TPE will exert its budget intervention effect only when administrative governance mechanism intervenes. This study has broadened research on the media's governance effect from the perspective of government budget transparency and verified that under China's unique institutional background, the media may still play a positive role in public sector governance.

Reducing Hospital Utilization and Related Expenses at the Community Level

The reduction of health care expenses continues to be a major challenge for the economy and society of the United States and other nations. This study focused on a major source of health care expenses, inpatient hospitals, at the community level. It was based on the assumption that fewer inpatient hospital admissions per population contribute to lower health care costs. The study demonstrated that the hospitals of Syracuse, New York have generated fewer inpatient admissions and discharges than those of other New York State metropolitan areas per population. It suggested that the application of utilization rates for inpatient hospitalization in Syracuse to some other New York State areas could result in substantial savings. Between 2016 and 2017, the hospital discharge rates in Syracuse were 1.6 - 3.1 percentage points lower than those of Albany, 2.2 - 5.0 percentage points lower than those of Rochester, 4.1 - 4.9 lower than those of New York City, 5.4 - 8.2 percentage points lower than those of Buffalo, and 17.2 - 18.3 percentage points lower than those of Utica. The study suggested that the conservative hospitalization rates in Syracuse were developed and sustained over long periods of time through the use of ambulatory surgery, reduction of admissions through hospital emergency departments, and limitation of the inpatient bed supply. This was a lengthy process that resulted in a conservative hospital admission pattern. The study demonstrated, more recently, that specific programs such as the reduction of inpatient hospital readmissions and hospital lengths of stay have supported additional reductions of hospital and related utilization in Syracuse.

Cultural Practice in Cote d'Ivoire: An Ethnography of the Feminization of Funeral Expenses

The“Letagonins”:a concept socially constructed to designate the“beating”women of Ivorian society,evokes those who have as their leitmotif,a self-realization through work.The purpose lies in their ability to free themselves from male domination.This concept means in one of the local Ivorian languages,notably the Gouro1:female boy.These women of Gouro ethnicity show a deep passion for the marketing of food products in Abidjan.However,behind this passion for food is their commitment to funeral expenses;a cultural activity customary lying with agnatic parentage.The transgression of custom by the latter under the prism of their social repositioning is the symbolic manifestation of the destandardization of the traditional relationship between man and woman in the organization of funerals in Gouro country,in the central West Ivorian.Understanding this relational reconfiguration has fuelled our passion as a researcher.In fact,ethnography has been mobilized as a method of observing the funeral practices of these women.In this regard,the study traces the strategies for negotiating access to the land as well as those used to negotiate access to information.

Minimum Expenses,Maximum Savings:How to Live in China Smartly

For more information,please click www.echinacities.com While it's at least very annoying,and at most woefully erroneous that many Chinese people judge all foreigners to be totally minted,it's not hard to see why,when many foreigners are here living decadent lifestyles,partying on weekends(and weekdays),travelling all over the country and mincing around town with Macbooks,iPods and Ray Bans.But then there are the secret 'squirrelers',who scrimp together just enough cash to

Income and Expenses for Ordinary People

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上海市耐多药结核病患者经济负担研究

目的基于上海市近年结核病诊疗费用减免政策,探索耐多药结核病(multidrug resistant tuberculosis,MDR-TB)患者疾病经济负担及其影响因素,为优化MDR-TB诊疗费用减免政策和综合管理模式提供依据。方法收集上海市2017—2019年确诊MDR-TB患者情况和诊疗费用减免情况数据,开展针对疾病经济负担的问卷调查,建立涵盖患者人口和社会经济情况、临床特征、疾病经济负担和诊疗费用减免情况数据库,明确患者疾病经济负担和灾难性卫生支出(catastrophic health expenditure)发生情况。以多元线性回归法分析可能影响患者疾病经济负担的因素,以多因素logistic回归法分析不同比例下灾难性卫生支出发生的影响因素。结果196例纳入研究分析的MDR-TB患者平均年龄为(44±16)岁,男性139例(占70.9%),上海户籍占46.4%,49%的患者为家庭主要劳动力。治疗期间,患者自付诊疗费用中位数为4.0(四分位数区间2.0~6.5)万元。113例患者获得减免诊疗,减免费用中位数为2.6(四分位数区间1.3~4.9)万元。若自付费用占家庭年收入的40%及以上,有47.8%的患者会发生灾难性支出;若不考虑减免政策,有59.8%的患者发生灾难性卫生支出。上海户籍(OR=0.3,95%CI为0.1~1.0)、更低家庭收入水平(P_(trend)=0.002)、医疗保险类型[(农村合作医疗保险/外来人口综合保险(OR=13.3,95%CI为1.0~171.2),无医疗保险(OR=17.5,95%CI为2.7~113.0)]和既往结核病治疗史(OR=3.3,95%CI为1.1~10.0)可能影响灾难性卫生支出的发生。结论上海市MDR-TB患者的自付诊疗费用较高。医疗保障力度较小和家庭经济情况不佳的患者更易发生高额自付费用,导致灾难性卫生支出。上海市MDR-TB诊疗费用减免政策有效降低了患者的经济负担。

药品集中带量采购对糖尿病患者住院费用的影响

目的评价药品集中带量采购对糖尿病患者住院总费用及各类构成费用的影响。方法基于研究医院的9852份糖尿病患者病案首页数据,整理患者基本信息、医疗服务利用信息及各项医疗费用信息,综合运用普通最小二乘法(ordinary least square,OLS)和倾向性得分匹配法(propensity score matching,PSM)进行数据分析。结果集中带量采购政策确实能够降低糖尿病住院患者的药品费用(t=-2.27,P<0.05),但是对住院总费用、医疗服务性费用影响不显著。OLS回归低估了药品集中带量采购对患者检查化验耗材费用的增费效应(t=2.26,P<0.05)。结论在进一步加强宣传教育的同时,要有序扩大药品集中带量采购,系统推动医药领域集约式改革,持续放大改革红利,实现患者总体医疗负担减轻,让政策福利遍及更多患者。

上海市静安区区级医院慢性肾衰竭患者住院总费用负担评价

目的 对上海市静安区2015—2019年区级医院慢性肾衰竭患者住院总费用负担进行评价,探讨导致住院总费用负担增加的主要因素,为控制住院总费用、减轻患者本人和社会经济压力提供可行性建议。方法 利用基于松弛变量的数据包络分析法对住院总费用技术效率进行测算。结果 各年度的住院总费用技术效率均低于0.8,其中2015年技术效率值最高,而2019年技术效率值最低。各类医疗费用中治疗费和检查化验费技术效率值较低。不同医院之间技术效率值存在显著差异。结论 慢性肾衰竭患者住院总费用负担呈逐年上升趋势。慢性肾衰竭住院患者药费支出较为合理。降低治疗费和检查化验费是控制住院总费用的关键。各医疗机构诊疗行为的不同是造成疾病经济负担差异的重要因素。

No-Arbitrage in Financial Economics: Solution of the Mystery of Implied Volatility and S&P 500 Volatility Index

We have shown that classic works of Modigliani and Miller, Black and Scholes, Merton, Black and Cox, and Leland making the foundation of the modern asset pricing theory, are wrong due to misinterpretation of no arbitrage as the martingale no-arbitrage principle. This error explains appearance of the geometric Brownian model (GBM) for description of the firm value and other long-term assets considering the firm and its assets as self-financing portfolios with symmetric return distributions. It contradicts the empirical observations that returns on firms, stocks, and bonds are skewed. On the other side, the settings of the asset valuation problems, taking into account the default line and business securing expenses, BSEs, generate skewed return distributions for the firm and its securities. The Extended Merton model (EMM), taking into account BSEs and the default line, shows that the no-arbitrage principle should be understood as the non-martingale no arbitrage, when for sufficiently long periods both the predictable part of returns and the mean of the stochastic part of returns occur negative, and the value of the return deficit depends on time and the states of the firm and market. The EMM findings explain the problems with the S&P 500 VIX, the strange behavior of variance and skewness of stock returns before and after the crisis of 1987, etc.

Research on the Effect of R&D Investment Intensity and Sales Expense on the Performance of Biomedical Enterprises

Objective To explore the influence of new drug R&D investment and sales expense on the performance of biomedical enterprises.Methods The financial statements of 76 listed biomedical enterprises for 5 consecutive years were selected,and the data were modeled to study the effect of R&D investment and sales expense on the performance of biomedical enterprises by using financial indicators as tools and statistical methods of multiple linear regression.Results and Conclusion Under the premise that the weak related factors such as enterprise scale,life cycle and asset-liability ratio are set as unrelated variables,the R&D investment intensity of biomedical enterprises is negatively correlated with the current performance,which also shows that the R&D of biomedical enterprises has the characteristics of high risk.Besides,the influence of early R&D investment is delayed.However,the sales expense of leading biomedical enterprises with large scales have higher proportion.Meanwhile the greater sales expense of the same enterprise in different periods,the better the enterprise performance is.Biomedical enterprises should consider their own development stage to develop more patented drugs.Besides,they must formulate plans for allocating reasonable sales personnel and cost expense to ensure that enterprises can obtain better benefits.

Urban Plazas:The Politics of Space in Urban Constraints

The most crucial notion in built environment studies,space,is forced to undergo a reinterpretation due to the influence of numerous social phenomena and cultural movements,such as postmodernism,the information age,and globalization.The traditional concept of time subverts time division and space restriction,along with the changes brought on by contemporary urbanization and postmodernist cultural norms.As a result,the urban plaza area,which is a unique cultural space,begins to take shape.It brings together previously different places,such as“public and private,”“political and daily,”“working and leisure,”as well as“physical and virtual.”The urban plaza is a useful research subject since it is a public area where the majority of cultural traits associated with urbanization are found.The spatial politics of the urban plaza experience a historic shift from macro politics to micro politics under the influence of postmodernism.Premised on this notion,the purpose of this study is to investigate the specific space of today’s cities,which is the urban plaza,as well as the politics of space and the in-depth interpretation of space culture.This study uses techniques from many other fields that are related to spatial ideas,including philosophy,political science,cultural studies,and geography.This study expands the cultural space of post-modernist interpretation of cultural depth of character based on the theoretical paradigm in multidisciplinary cross-application in order to enhance individuals’awareness of urban plaza cultural forms and further their understanding of its political and cultural space power traits as well as underlying meaning.This paper examines the role and culture of urban plaza from the perspectives of numerous well-known spatial culture theories in the context of the analysis.In addition to identifying the nature of the cultural politics,this paper addresses the significance of spatial politics of urban plazas.

美国促进技术创新的税收优惠制度评价

沿革为了刺激技术创新,美国很早就制定颁布了相应的税收优惠制度。1954年美国《国内税收法典》就确立了研发费用扣除制度(174节)。但是令人遗憾的是,研发费用扣除制度没有带来预想的效果。数据显示,研发投资与国民生产总值的比例从1968年的2.01%下降到1975年的1.58%。更重要的是,美国将其大部分研发投资都用于国防工业。与其他发达国家相比,它的非国防研发支出(civilian research expense)是比较少的。1970-1980年间,美国的研发投入与GDP的比例始终在1.5%到2%之间徘徊。而在同时段的德国和日本,这一比例从来没有低过1.9%。