Analysis of inpatient payments of breast cancer patients with different medical insurance coverages in China(mainland) in 2011–2015

Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.

The Expected Discounted Tax Payments on Dual Risk Model under a Dividend Threshold

In this paper, we consider the dual risk model in which periodic taxation are paid according to a loss-carry-forward system and dividends are paid under a threshold strategy. We give an analytical approach to derive the expression of gδ(u) (i.e. the Laplace transform of the first upper exit time). We discuss the expected discounted tax payments for this model and obtain its corresponding integro-differential equations. Finally, for Erlang (2) inter-innovation distribution, closedform expressions for the expected discounted tax payments are given.

Differentiated payments for environmental services schemes: A methodology proposal

Payment schemes for environmental services face serious budget constraints in Mexico. Payments are equally distributed among forest owners, and the governmental agencies that make payments to beneficiaries do not evaluate the amount of environmental services produced by forested areas. This lack of evaluation could lead to economic and environmental deficiencies that restrict the possible benefits of such programmes. In general, these programmes do not achieve their conservation objectives, and local beneficiaries are not involved in the design or application of these programmes. Similarly, the Payments for Hydrological Environmental Services(PHES) programme of the State of Mexico, Mexico, makes equal payments to beneficiaries of forested areas considering tree density. The objective of the present work was to create a methodology for determining differentiated payments schemes for hydrological environmental services, prioritising areas that contribute the most to groundwater recharge and promote the participation of society. In the Nevado de Toluca Natural Protected Area, the environmental criteria of forest type, tree density and aquifer overexploitation as well as social participation were considered in a multi-criteria analysis implemented in a Geographic Information System. A methodology was developed to determine differentiated payments based on specific forest characteristics that influence the potential capacity of forests to recharge groundwater reserves in addition to the level of social participation. In particular, social participation is key as it could ensure the viability of PHES programmes as conservation alternatives in forested areas with high groundwater recharge potential.

Payments for Ecosystem Services Incentives and Adoption of Land Use Interventions in Uluguru Mountains, Tanzania

The role played by Payments for ecosystem services (PES) in promoting land use interventions is increasingly being recognized as an important instrument for changing land use management worldwide. Despite the increase, adoption of land use interventions promoted by PES and factors influencing it are not well understood. This study was carried out to assess the adoption of land use interventions promoted by PES scheme four years after its implementation in the Uluguru Mountains, Tanzania. The specific objectives of this study were to assess the adoption and factors that influenced it. The study employed questionnaire survey method to collect data from 219 households selected randomly. Focus group discussions and key informant interviews were also conducted to complement information obtained through questionnaire surveys. Descriptive and inferential statistical analyses were employed. Binary logistic regression was used to analyse quantitative data obtained, while content analysis was applied to qualitative data. Results revealed that during the project implementation, 40% of the households did not adopt any of the promoted interventions. Unexpectedly, four years after the project ended, every household sampled had adopted the interventions. Households headed by younger heads and those with land ownership, households which received PES incentives and lived for a long time in the same area and those with more labour force and access to extension services were found to have adopted more interventions (p ≤ 0.05). Thus, the study concludes that socioeconomic characteristics, agricultural extension services and incentives initially provided to farmers are key factors influencing the adoption of land use interventions. Therefore, it is recommended to the government that it should support farmers to get land tenure and to provide them with more incentives to improve their farms through adopting technologies.

Necessary Conditions and Situational Variables of Payments for Ecosystem Services

Clarifying the necessary conditions for the emergence of payments for ecosystem services (PES) and the situational variables that affect PES is the basis for their interpretation, prediction, and selection. This article proposes an analytical framework for the emergence of PES and argues that the key to determining whether PES can occur and whether a selected PES program is appropriate is to evaluate the net gain. When payers anticipate that a PES program will provide a satisfactory number of ES and a net gain over the opportunity cost and will cover all costs, it is assumed that the program will be implemented. When it is difficult to accurately evaluate the net gain of PES, the situational variables that affect the costs and benefits need to be examined. The group characteristics, ES characteristics, spatial and temporal contacts between the suppliers and demanders, correlation with private goods and additionality are important situational variables that affect the emergence and choice of PES.

Assessment of the Affordability of Out-of-Pocket Payments among Some Selected People Living with HIV in Kano, Nigeria

Introduction: With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. Methods: Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. Results: Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). Conclusion/recommendation: Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.

The Effect of COVID-19 on Cashless Payments

The outbreak of the SARS-CoV-2 coronavirus(COVID-19)has impacted the whole world.To stop the virus’s spread,governments enforced regulations requiring face masks and social isolation and also promoted social seclusion,hand-washing,and other hygienic measures.People’s movements and consumption were significantly reduced as a result of government-imposed lockdowns,with internet purchasing overtaking in-store purchasing in a particularly noticeable way.Most importantly,people’s habits during times of restrictions and lockdowns seemed to reduce overall desire to do cash transactions.Cashless transactions became the most preferred option for daily payment as it helped reduce contact with others and prevent them from becoming infected.These factors contribute to future intentions to eliminate cash payments once the pandemic is ended as well as the choice of payment methods currently in use.Even after the pandemic,people are using digital cashless payments for their daily transactions.This study investigates the impact of the coronavirus on consumer demand for cash and cashless payments during the COVID-19 crisis and beyond.This study utilizes the secondary research method by employing the annual statistical report of European Central Bank(ECB)(2021).The data were extracted from the warehouse of ECB,and rigorous analysis was performed to assess the intentions of customers for using digital transactions for payments.In the study,a regression analysis shows that a greater increase in the number of cards used for payment per year occurred during the COVID-19 pandemic than before the pandemic.The study demonstrates that there was a significant correlation between the adoption of cashless payment systems and the restrictions imposed on consumers because of the pandemic.Customers prefer cashless transactions when there is a higher danger of infection while handling cash.

Evaluation of the inclusive payment system based on the diagnosis procedure combination with respect to cataract operations in Japan------A comparison of lengths of hospital stay and medical payments among hospitals

Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.

A Structural Topic Model for Exploring User Satisfaction with Mobile Payments

This study explored user satisfaction with mobile payments by applying a novel structural topic model.Specifically,we collected 17,927 online reviews of a specific mobile payment(i.e.,PayPal).Then,we employed a structural topic model to investigate the relationship between the attributes extracted from online reviews and user satisfaction with mobile payment.Consequently,we discovered that“lack of reliability”and“poor customer service”tend to appear in negative reviews.Whereas,the terms“convenience,”“user-friendly interface,”“simple process,”and“secure system”tend to appear in positive reviews.On the basis of information system success theory,we categorized the topics“convenience,”“user-friendly interface,”and“simple process,”as system quality.In addition,“poor customer service”was categorized as service quality.Furthermore,based on the previous studies of trust and security,“lack of reliability”and“secure system”were categorized as trust and security,respectively.These outcomes indicate that users are satisfied when they perceive that system quality and security of specific mobile payments are great.On the contrary,users are dissatisfied when they feel that service quality and reliability of specific mobile payments is lacking.Overall,our research implies that a novel structural topic model is an effective method to explore mobile payment user experience.

An Inventory Model for Deteriorating Items under Conditionally Permissible Delay in Payments Depending on the Order Quantity

The purpose of this inventory model is to investigate the retailer’s optimal replenishment policy under permissible delay in payments. In this paper, we assume that the supplier would offer the retailer partially permissible delay in payments when the order quantity is smaller than a predetermined quantity (W). The most inventory systems are usually formed without considering the effect of deterioration of items which deteriorate continuously like fresh fruits, vegetables etc. Here we consider the loss due to deterioration. In real world situation, the demand of some items varies with change of seasons and occasions. So it is more significant if the loss of deterioration is time dependent. Considering all these facts, this inventory model has been developed to make more realistic and flexible marketing policy to the retailer, also establish the result by ANOVA analysis by treating different model parameters as factors.

Mobile payments could replace cash, cards

Mobile payments may replace cash and bank cards to become the mainstream method of payment by 2020, as reported by China Daily.

Dividend Payments with a Threshold Strategy in a Markov-Dependent Risk Model

In this paper,a Markov-dependent risk model with a threshold strategy is considered. The expected discounted dividend payments satisfy some integro-differential equations. The analytical solutions to these systems are given. Finally,some numerical exam-ples in some special cases are provided.

Payments Imbalances

This paper presents the view that it is not constructive to start the analysis of international payments imbalances from the US current account deficit. It is more informative to start from excess of savings over investment in Asia. This imbalance principally arises because of a fall in the investment ratio rather than a rise in the saving ratio, and traces its origin to the after-effects of the Asian Crisis of 1997/98. In the final section the case of China is addressed, and the view is put forward that the combination of rapid economic growth, a fixed exchange rate and persistent current account surpluses is not sustainable into the medium term, and it is in China＇s domestic interests to adjust its exchange rate. Whether or not this has an appreciable influence on other countries＇ balance of payments positions is of secondary importance.

How to enhance agricultural plastic waste management in China?Insights from public participation

Agricultural plastics play a pivotal role in agricultural production.However,due to expensive costs,agricultural plastic waste management(APWM)encounters a vast funding gap.As one of the crucial stakeholders,the public deserves to make appropriate efforts for APWM.Accordingly,identifying whether the public is willing to pay for APWM and clarifying the decisions’driving pathways to explore initiatives for promoting their payment intentions are essential to address the dilemma confronting APWM.To this end,by applying the extended theory of planned behavior(TPB),the study conducted an empirical analysis based on 1,288 residents from four provinces(autonomous regions)of northern China.Results illustrate that:1)respondents hold generally positive and relatively strong payment willingness towards APWM;2)respondents’attitude(AT),subjective norm(SN),and perceived behavioral control(PBC)are positively correlated with their payment intentions(INT);3)environmental cognition(EC)and environmental emotion(EE)positively moderate the relationships between AT and INT,and between SN and INT,posing significant indirect impacts on INT.The study’s implications extend to informing government policies,suggesting that multi-entity cooperation,specifically public payment for APWM,can enhance agricultural non-point waste management.

A zoological perspective on payments for ecosystem services

The concept of payments for ecosystem services is being developed as an important means of providing a more diverse flow of benefits to people living in and around habitats valuable for conservation.The Kyoto Protocol,under the United Nations Framework Convention on Climate Change,includes a Clean Development Mechanism to provide for payments for certain forms of carbon sequestration that may benefit animal species(at least as an incidental benefit).Other market-based approaches for paying for carbon sequestration services outside the Kyoto framework are being promoted in various parts of the world.Another common form of payment for ecosystem services is compensating upstream landowners for managing their land in ways that maintain downstream water quality;this can include habitat management that benefits wild animal species.While biodiversity itself is difficult to value,it can be linked to other markets,such as certification in the case of sustainably-produced forest products.This paper expands on some of the markets for ecosystem services that also benefit wildlife,identifies relevant sources of information,and highlights some of the initiatives linking such markets to poverty alleviation.Making markets work for ecosystem services requires an appropriate policy framework,government support,operational institutional support,and innovation at scales from the site level to the national level.Zoologists have much to contribute to all of these steps.

The impact of transfer payments on urban-rural income gap--Based on fuzzy RD analysis of China’s midwestern counties data

In this paper,using 1054 counties data of 15 provinces in Midwestern China from 2000 to 2007,we analyze the impact of transfer payments on urban-rural income gap.By choosing Develop-the-west Strategy that is a quasi-natural experiment and using regression of discontinuity of location,the result shows that local government in western China pays more transfer payments than in the central region,however,the income gap between urban-rural residents in the western region increases by 20%.The widening effects are robust in different bandwidth situation such as distance or latitude and longitude.Meanwhile,the mechanism analyses find that urban residents benefit more than rural residents from transfer payments.Therefore,we believe that transfer payments should be more targeted to invest in rural areas,at the same time,the central government should rationalize the structure of transfer payments as soon as possible,and correct the urban bias and structure bias of local fiscal expenditure.

Out-of-pocket payments and economic consequences from tuberculosis care in eastern China:income inequality

Background:Despite the availability of free tuberculosis(TB)diagnosis and treatment,TB care still generates substantial costs that push people into poverty.We investigated out-of-pocket(OOP)payments for TB care and assessed the resulting economic burden and economic consequences for those with varying levels of household income in eastern China.Methods:A cross-sectional study was conducted among TB patients in the national TB programme networks in eastern China.TB-related direct OOP costs,time loss,and coping strategies were investigated across households in different economic strata.Analysis of Variance was used to examine the differences in various costs,and Kruskal-Wallis tests were used to compare the difference in total costs as a percentage of annual household income.Results:Among 435 patients,the mean OOP total costs of TB care were USD 2389.5.In the lower-income quartile,OOP payments were lower,but costs as a percentage of reported annual household income were higher.Medical costs and costs prior to treatment accounted for 66.4 and 48.9%of the total costs,respectively.The lower the household income was,the higher the proportion of medical costs to total costs before TB treatment,but the lower the proportion of medical costs patients spent in the intensive phase.TB care caused 25.8%of TB-affected households to fall below the poverty line and caused the poverty gap(PG)to increase by United States Dollar(USD)145.6.Patients in the poorest households had the highest poverty headcount ratio(70.2%)and PG(USD 236.1),but those in moderately poor households had the largest increase in the poverty headcount ratio(36.2%)and PG(USD 177.8)due to TB care.Patients from poor households were more likely to borrow money to cope with the costs of TB care;however,there were fewer social consequences,except for food insecurity,in poor households.Conclusions:Medical and pretreatment costs lead to high costs of TB care,especially among patients from the poorest households.It is necessary to train health system staff in general hospitals to promptly identify and refer TB patients.Pro-poor programmes are also needed to protect TB patients from the medical poverty trap.

Payments for watershed ecosystem services:mechanism,progress and challenges

Introduction:Payment for watershed ecosystem services(PWES),a policy instrument for compensating for the externality of watershed ecosystem/environmental services,has gained in policy importance in China over the past two decades.Many scholars and researchers have contributed to the conceptualization of this policy framework by developing operational mechanisms as well as compensation standards for PWES.Outcomes:This article reviews 27 PWES schemes piloted in China and in 10 other countries,with a particular emphasis on successful cases of land-use conversion programs,such as the Paddy Land to Dry Land Program and Sloping Land Conversion Program that have been implemented in China.Discussion:By comparing different cases,the authors attempt to answer the following questions:what were the ecological and institutional contexts in which these schemes were established and how did they work?What were the actual efficiencies and impacts of these piloted schemes?Which scheme worked better in certain ecological,socio-economic,and institutional contexts?Conclusion:Based on case studies,the authors draw the following conclusions about Chinese PWES:(1)to establish an acceptable standard for a PWES program,it is necessary to estimate the economic and social costs regarding the livelihoods of households;(2)multistakeholder negotiation mechanism for PWES,including intermediaries,such as the local government,NGO/NPOs,village committees,and user associations,should be used;(3)ES,non-market services,should acquire positive externalities to accomplish an optimal win–win pattern concerning both environmental goals and the livelihoods of local resource users.

An EOQ model with backordering for perishable items under multiple advanced and delayed payments policies

This study investigated an economic order quantity (EOQ) model with completebackorder for fixed lifetime perishable items under multiple advance and delayedpayments policies. Here, a new type of business policy is consideredwhere supplieroffers the retailer to pay a fraction of the purchasing cost before the order deliverybymultiple equal installments starting from the ordering time and the rest amountafter the delivery by multiple equal installments. Here, some theoretical results areillustrated to determine the conditions of existence and uniqueness of the optimalsolutions. A closed form solution is determined to solve the proposed model underapproximation. Some numerical examples are provided to examine the validity ofthe proposed model. Finally, sensitivity analyses are presented to obtain the effectof optimal policy and provide some managerial insights of the model.

Design of the contingent royalty rate as related to the type of investment

This study investigates the design of the royalty rate in a first-price auction across three types of investments:incremental and lumpy with or without an exogenously given intensity.A bidder’s investment cost comprises private information.This,together with the stochastic evolution of the price of the output generated from the auctioned project,precludes the seller from setting the exact dates of investment with the winner.However,the seller can set the royalty rate to equate the winner’s royalty payment with the winner’s information rent so that the winner acts as if to maximize the seller’s revenue.We derive two main conclusions.First,compared with the case in which investment is lumpy with an exogenously given intensity,the seller can set a lower royalty rate on incremental investment because she can collect additional royalty payments from the winner,who has the option to later expand capacity.Second,the impact of output price uncertainty on the optimal royalty rate for the three types of investments exhibits two different patterns.When investment is either incremental or lumpy with an exogenously given intensity,greater output price uncertainty reduces the royalty rate.When investment is lumpy with variable intensity,greater output uncertainty raises the royalty rate.Our results imply that auctioneers may charge differential royalty rates for different types of investments.