推动中医药医保支付方式改革,探索符合中医药特点的支付方法和管理机制具有重要意义。基于国家医疗保障局推行的按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费和现行医保支付中按项目支付方式,借助博弈理论分析两种支付方式下...推动中医药医保支付方式改革,探索符合中医药特点的支付方法和管理机制具有重要意义。基于国家医疗保障局推行的按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费和现行医保支付中按项目支付方式,借助博弈理论分析两种支付方式下中医院的诊疗行为策略选择及其影响因素。结果表明,在按项目支付下中医院会选择过度诊疗的行为策略以谋取更多的利润;在DRG支付下,中医院会从过度诊疗的行为向缩减诊疗的行为转化,最终选择缩减诊疗的行为策略以获得更大的利润。这表明,与现行的支付方式相比,DRG支付可以在一定程度上纠正中医医疗机构的过度诊疗行为,遏制医疗资源的浪费,但仍需充分发掘中医药的适宜技术和优势病种,发挥中医药的独特优势,实现中西医之间的优势互补。展开更多
This paper presents results of the assessment on benefit sharing and payment mechanisms tested by six non-governmental organizations(NGOs)-piloted Reducing Emissions from Deforestation and Forest Degradation(REDD+) in...This paper presents results of the assessment on benefit sharing and payment mechanisms tested by six non-governmental organizations(NGOs)-piloted Reducing Emissions from Deforestation and Forest Degradation(REDD+) initiatives in Tanzania.Results from the assessment indicate that models applied by most of the REDD+ pilot projects have provided most of decisions for the distribution of benefits to the communities through village general assemblies.Based on requirements of the tested models,national benefit-sharing mechanism models are proposed.Major attributes to be considered in the development of national benefit-sharing models should include:(i) ensuring that the existing government structure is not excluded to ensure sustainability;(ii) village general assembly is involved in determining the distribution of the benefits accrued;and(iii) transparency in handling the carbon finance is ensured.Models that are proposed for the national REDD+ benefit sharing apply to two forest management systems,namely Joint Forest Management(JFM) and Community Based Forest Management(CBFM).The paper recommends testing of the two proposed models to determine whether they could be useful in sharing benefits resulting from REDD+ in Tanzania.展开更多
Contractors working with the Public sector encounter numerous challenges in financing projects in Ghana. The challenges which have persisted over the years are both financial and managerial. This paper seeks to ascert...Contractors working with the Public sector encounter numerous challenges in financing projects in Ghana. The challenges which have persisted over the years are both financial and managerial. This paper seeks to ascertain the extent to which contractors’ challenges in acquiring funds to execute public sector projects have been solved. The study involved both qualitative and quantitative methods to ascertain the various strategies the contractors go through to obtain public sector projects focusing on the challenges associated with the project execution. The study revealed that delayed payments and inadequate cash flow on the part of government, lack of credit worthiness and inadequate collateral security from contractors are key determinants to challenges associated with financing public sector projects in Ghana. This paper recommends the establishment of a Construction Development Authority (CDA), within the Ministry of Works and Housing to develop financial plans, policies and laws for this important sector of the economy.展开更多
文摘推动中医药医保支付方式改革,探索符合中医药特点的支付方法和管理机制具有重要意义。基于国家医疗保障局推行的按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费和现行医保支付中按项目支付方式,借助博弈理论分析两种支付方式下中医院的诊疗行为策略选择及其影响因素。结果表明,在按项目支付下中医院会选择过度诊疗的行为策略以谋取更多的利润;在DRG支付下,中医院会从过度诊疗的行为向缩减诊疗的行为转化,最终选择缩减诊疗的行为策略以获得更大的利润。这表明,与现行的支付方式相比,DRG支付可以在一定程度上纠正中医医疗机构的过度诊疗行为,遏制医疗资源的浪费,但仍需充分发掘中医药的适宜技术和优势病种,发挥中医药的独特优势,实现中西医之间的优势互补。
基金the support from Climate Change Impact Adaptation and Mitigation(CCIAM) programme supported by the Royal Norwegian Government and that of Vliruos South Initiatives of Belgium
文摘This paper presents results of the assessment on benefit sharing and payment mechanisms tested by six non-governmental organizations(NGOs)-piloted Reducing Emissions from Deforestation and Forest Degradation(REDD+) initiatives in Tanzania.Results from the assessment indicate that models applied by most of the REDD+ pilot projects have provided most of decisions for the distribution of benefits to the communities through village general assemblies.Based on requirements of the tested models,national benefit-sharing mechanism models are proposed.Major attributes to be considered in the development of national benefit-sharing models should include:(i) ensuring that the existing government structure is not excluded to ensure sustainability;(ii) village general assembly is involved in determining the distribution of the benefits accrued;and(iii) transparency in handling the carbon finance is ensured.Models that are proposed for the national REDD+ benefit sharing apply to two forest management systems,namely Joint Forest Management(JFM) and Community Based Forest Management(CBFM).The paper recommends testing of the two proposed models to determine whether they could be useful in sharing benefits resulting from REDD+ in Tanzania.
文摘Contractors working with the Public sector encounter numerous challenges in financing projects in Ghana. The challenges which have persisted over the years are both financial and managerial. This paper seeks to ascertain the extent to which contractors’ challenges in acquiring funds to execute public sector projects have been solved. The study involved both qualitative and quantitative methods to ascertain the various strategies the contractors go through to obtain public sector projects focusing on the challenges associated with the project execution. The study revealed that delayed payments and inadequate cash flow on the part of government, lack of credit worthiness and inadequate collateral security from contractors are key determinants to challenges associated with financing public sector projects in Ghana. This paper recommends the establishment of a Construction Development Authority (CDA), within the Ministry of Works and Housing to develop financial plans, policies and laws for this important sector of the economy.
