Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC...Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods: We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan(CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup(hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results: A total of 2356 patients with a mean age of 57.4 years were included, 57.1 % of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3%of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups(P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more,whereas those with a lower household income and those who underwent surgery spent less(all P < 0.05).Conclusions: For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic,and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.展开更多
Japanese medical expenditures have increased rapidly in recent years and are predicted to continue rising. Indeed, it remains uncertain whether the current Japanese medical system can be sustained. In this paper, we a...Japanese medical expenditures have increased rapidly in recent years and are predicted to continue rising. Indeed, it remains uncertain whether the current Japanese medical system can be sustained. In this paper, we analyzed the medical expenditures for educational hospitalization of patients with type 2 diabetes. A dataset of 6173 patients from 36 hospitals was used in the analysis. The sample period was from July 2008 to March 2012. We analyzed the medical expenditures in two ways. First, we analyzed the length of hospital stay (LOS). Next, we analyzed the daily expenditure per patient. The Box-Cox transformation model was used in the first analysis and the ordinary least squares method in the second. Comorbidities and complications prolonged LOS and increased daily expenditures. The LOS was significantly different among hospitals. On the other hand, the differences in daily expenditures among hospitals were relatively small, such that LOS was the main determinant of medical expenditures. Previous studies suggested that LOS could be shortened without degradation of medical quality. Moreover, LOS could be controlled by introducing proper critical paths and improving and standardizing educational programs. Hence, it would be possible to control the medical expenditures for this disease.展开更多
Agricultural development is indispensible to financial support. On the basis of data of the financial expenditure for agriculture( FEA) and per capita net income of farmers( PCIF) of Jiangsu Province in 1990-2012,with...Agricultural development is indispensible to financial support. On the basis of data of the financial expenditure for agriculture( FEA) and per capita net income of farmers( PCIF) of Jiangsu Province in 1990-2012,with the aid of software R,this paper established the linear regression model for the relation between financial expenditure for agriculture and per capita net income of farmers through the function lm. Using the function summary,this paper obtained the summary statistical data,and made diagnostic check of regression model from image command plot and variance analysis table. Finally,it came up with pertinent recommendations including increasing financial expenditure for agriculture,optimizing expenditure structure,and balancing regional development.展开更多
Based on the account of the vital role which the national finance played in supporting agriculture,the thesis presents the current situation of financial support for agriculture in China,in terms of the limited scale ...Based on the account of the vital role which the national finance played in supporting agriculture,the thesis presents the current situation of financial support for agriculture in China,in terms of the limited scale and irrational structure of financial support expenditure in agriculture.On the basis of the brief introduction of the current level of Chinese farmers' income,the thesis discusses the effects of scale and irrational structure of financial support expenditure in agriculture on the farmers' income,according to the related data of financial support expenditure in agriculture and rural per capita net income.The results indicate that the calculating regression equation has a remarkable explanation power,reflecting the positive role of financial support expenditure in agriculture played by national finance in increasing the farmers' income.As regards the structure of financial support expenditure in agriculture at present,according to the proportion from high to low,the expenditure primarily consists of three parts from high to low in sequence as follows:productive expenditure and funds for public undertakings,capital construction expenditure,and rural relief expenditure plus science and technology funds.Such sequence deviates from the marginal production effects of financial support expenditure in agriculture and the correlation of farmers' income,which demonstrates the severe irrationality of the structure of financial support expenditure in agriculture.Corresponding countermeasures are put forward as follows:on one hand,we should continue intensifying the efforts to support agriculture financially in order to form a regular increase mechanism;on the other hand,we should adjust and optimize the structure of financial support expenditure in agriculture,and further crystallize the investment flows.展开更多
The introduction of the New Public Management （NPM） has not bridged the differences among the various European accounting traditions. In Italy, in particular, there are still different accounting methods in all publ...The introduction of the New Public Management （NPM） has not bridged the differences among the various European accounting traditions. In Italy, in particular, there are still different accounting methods in all public sectors. In the healthcare system, these differences have emerged more strongly. The recent Italian reform on accounting harmonization seems to be the answer to this accounting disharmony and represents a means of controlling public expenditure. This study aims to analyze the consolidated financial statement and the consolidated cash flow statement of the regional healthcare system as a new tool for the accounting harmonization. This paper is divided into two logical parts： In the first part, the authors analyze how the new accounting model is evolving under the current reform; in the second part, the authors analyze the consolidated financial statement and the consolidated cash flow statement that has been applied experimentally over the last two years in the Umbria Region.展开更多
In recent years, with the deepening of financial reform, administrative institutions continue to strengthen the reforms of financial management, and gradually established a relatively sound system of budge management,...In recent years, with the deepening of financial reform, administrative institutions continue to strengthen the reforms of financial management, and gradually established a relatively sound system of budge management, revenue and expenditure management. However, in the current system of financial management, there are still many problems that can not be ignored.展开更多
基金supported by the grants from the Beijing Hope Run Special Fund(#LC2012YF44)National Natural Science Foundation of China(No.81402740)+1 种基金Specialized Research Fund for the Doctoral Program of Higher Education(No.20131106120014)The National Health and Family Planning Committee of P.R.China
文摘Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods: We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan(CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup(hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results: A total of 2356 patients with a mean age of 57.4 years were included, 57.1 % of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3%of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups(P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more,whereas those with a lower household income and those who underwent surgery spent less(all P < 0.05).Conclusions: For patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic,and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.
文摘Japanese medical expenditures have increased rapidly in recent years and are predicted to continue rising. Indeed, it remains uncertain whether the current Japanese medical system can be sustained. In this paper, we analyzed the medical expenditures for educational hospitalization of patients with type 2 diabetes. A dataset of 6173 patients from 36 hospitals was used in the analysis. The sample period was from July 2008 to March 2012. We analyzed the medical expenditures in two ways. First, we analyzed the length of hospital stay (LOS). Next, we analyzed the daily expenditure per patient. The Box-Cox transformation model was used in the first analysis and the ordinary least squares method in the second. Comorbidities and complications prolonged LOS and increased daily expenditures. The LOS was significantly different among hospitals. On the other hand, the differences in daily expenditures among hospitals were relatively small, such that LOS was the main determinant of medical expenditures. Previous studies suggested that LOS could be shortened without degradation of medical quality. Moreover, LOS could be controlled by introducing proper critical paths and improving and standardizing educational programs. Hence, it would be possible to control the medical expenditures for this disease.
文摘Agricultural development is indispensible to financial support. On the basis of data of the financial expenditure for agriculture( FEA) and per capita net income of farmers( PCIF) of Jiangsu Province in 1990-2012,with the aid of software R,this paper established the linear regression model for the relation between financial expenditure for agriculture and per capita net income of farmers through the function lm. Using the function summary,this paper obtained the summary statistical data,and made diagnostic check of regression model from image command plot and variance analysis table. Finally,it came up with pertinent recommendations including increasing financial expenditure for agriculture,optimizing expenditure structure,and balancing regional development.
基金Supported by Liaoning Academy of Social Sciences
文摘Based on the account of the vital role which the national finance played in supporting agriculture,the thesis presents the current situation of financial support for agriculture in China,in terms of the limited scale and irrational structure of financial support expenditure in agriculture.On the basis of the brief introduction of the current level of Chinese farmers' income,the thesis discusses the effects of scale and irrational structure of financial support expenditure in agriculture on the farmers' income,according to the related data of financial support expenditure in agriculture and rural per capita net income.The results indicate that the calculating regression equation has a remarkable explanation power,reflecting the positive role of financial support expenditure in agriculture played by national finance in increasing the farmers' income.As regards the structure of financial support expenditure in agriculture at present,according to the proportion from high to low,the expenditure primarily consists of three parts from high to low in sequence as follows:productive expenditure and funds for public undertakings,capital construction expenditure,and rural relief expenditure plus science and technology funds.Such sequence deviates from the marginal production effects of financial support expenditure in agriculture and the correlation of farmers' income,which demonstrates the severe irrationality of the structure of financial support expenditure in agriculture.Corresponding countermeasures are put forward as follows:on one hand,we should continue intensifying the efforts to support agriculture financially in order to form a regular increase mechanism;on the other hand,we should adjust and optimize the structure of financial support expenditure in agriculture,and further crystallize the investment flows.
文摘The introduction of the New Public Management （NPM） has not bridged the differences among the various European accounting traditions. In Italy, in particular, there are still different accounting methods in all public sectors. In the healthcare system, these differences have emerged more strongly. The recent Italian reform on accounting harmonization seems to be the answer to this accounting disharmony and represents a means of controlling public expenditure. This study aims to analyze the consolidated financial statement and the consolidated cash flow statement of the regional healthcare system as a new tool for the accounting harmonization. This paper is divided into two logical parts： In the first part, the authors analyze how the new accounting model is evolving under the current reform; in the second part, the authors analyze the consolidated financial statement and the consolidated cash flow statement that has been applied experimentally over the last two years in the Umbria Region.
文摘In recent years, with the deepening of financial reform, administrative institutions continue to strengthen the reforms of financial management, and gradually established a relatively sound system of budge management, revenue and expenditure management. However, in the current system of financial management, there are still many problems that can not be ignored.
