医疗器械产业创新集群的现状及路径研究——以宁波市为例

产业集群能提高企业、区域和国家竞争力。当前以产业创新集群为代表的新一轮产业集群正在各地兴起。通过行业融合、知识外溢和集体行动，产业创新集群促进相关企业和支持性机构紧密互动而加速创新。医疗器械产业科技含量高，创新性强，是当前少数几个涉及学科最多的产业之一。以医疗器械产业为研究对象，从集群和区域创新发展的要义出发，挑选宁波地区的医疗器械行业，测算其行业集中度和产业集群效应，提出提升医疗器械行业集群度，激发产业创新集群活力的对策建议。     

“城居保”对中国农村家庭消费支出异质性实证研究

[目的]全面分析城乡居民基本养老保险制度对农村家庭各项消费支出现状的影响,就进一步完善该项政策和稳定农村消费市场提供重要的理论参考。[方法]文章以消费和储蓄生命周期理论为分析框架,通过选取合理的样本面板数据,运用系统GMM回归分析方法探究了城乡居民基本养老保险制度对农村家庭消费支出水平的影响。[结果]财产性收入是影响农民参与城乡居民基本养老保险制度的主要因素以及投保档次的制约因素,作以存量财富为基础的财产性收入要比流量形式存在的财富具有更强抵御风险的能力,即财产性收入在很大程度上可以增加农村家庭对养老保险的依赖程度。另外,城乡居民基本养老保险制度对农村家庭消费能力表现出异质性影响。其中,城乡居民基本养老保险制度对农村家庭生活消费支出、食品性等日常性支出、文体消费支出水平明显要高于对医疗消费支出水平。[结论]国家要加大宣传城乡居民基本养老保险制度的积极和辐射作用,让广大农村家庭能够真正了解这项政策的意图。同时,要逐步破解城乡二元结构等制度性障碍,让更多农村家庭能够享受到与城镇居民相同的养老待遇。     

基于预约策略的医院CT设备使用优化研究

预约检查是对有限的医疗检查资源的一种调度优化。以攀枝花市A医院CT检查为例,通过实地调研,统计CT设备的服务能力,门诊患者,住院患者和急诊患者的平均到达率,接受患者的单位检查收益和拒绝患者的单位检查损失。通过调整预约策略使有限的资源设备产生更多的收益,并运用仿真模拟不同预约策略下的收益效果。研究结果对医院重要设备的预约使用提供了一定参考价值。     

Economic burden associated with inadequate antidepressant medication management among patients with depression and known cardiovascular diseases: insights from a United States–based retrospective claims database analysis

Abstract

Aims: The current study examined the association between insufficient major depressive disorder (MDD) care and healthcare resource use (HCRU) and costs among patients with prior myocardial infarction (MI) or stroke.

Methods: This was a retrospective study conducted using the MarketScan Claims Database (2010–2015). The date of the first MI/stroke diagnosis was defined as the cardiovascular disease (CVD) index date and the first date of a subsequent MDD diagnosis was the index MDD date. Adequacy of MDD care was assessed during the 90 days following the index MDD date (profiling period) using 2 measures: dosage adequacy (average fluoxetine equivalent dose of ≥20?mg/day for nonelderly and ≥10?mg/day for elderly patients) and duration adequacy (measured as the proportion of days covered of 80% or higher for all MDD drugs). Study outcomes included all-cause and CVD-related HCRU and costs which were determined from the end of the profiling period until the end of study follow-up. Propensity-score adjusted generalized linear models (GLMs) were used to compare patients receiving adequate versus inadequate MDD care in terms of study outcomes.

Results: Of 1,568 CVD patients who were treated for MDD, 937 (59.8%) were categorized as receiving inadequate MDD care. Results from the GLMs suggested that patients receiving inadequate MDD care had 14% more all-cause hospitalizations, 4% more all-cause outpatient visits, 17% more CVD-related outpatient visits, 13% more CVD-related emergency room (ER) visits, higher per patient per year CVD-related hospitalization costs ($21,485 vs. $17,756), higher all-cause outpatient costs ($2,820 vs. $2,055), and higher CVD-related outpatient costs ($520 vs. $434) compared to patients receiving adequate MDD care.

Limitations: Clinical information such as depression severity and frailty, which are potential predictors of adverse CVD outcomes, could not be ascertained using administrative claims data.

Conclusions: Among post-MI and post-stroke patients, inadequate MDD care was associated with a significantly higher economic burden.     

Medical innovation and its diffusion: Implications for economic performance and welfare

We study the impact on economic performance and welfare of medical innovations and their endogenous diffusion. We construct a general equilibrium model with a medical sector and overlapping generations subject to endogenous mortality and calibrate it to reflect the development of the US economy and health care over the cardiac revolution during the 1980s and 1990s. By counterfactual analysis we find that (i) medical innovations have increased welfare without compromising GDP growth; (ii) there is a sizeable welfare loss due to the adoption lag involved with imperfect diffusion; and (iii) there is scope for Pareto improvement by way of subsidization of innovative health care.     

Restoring balance: how consumers orchestrate family care following unplanned disruptions

ABSTRACT

How do consumers orchestrate multiple and complex practices of care when faced with unplanned disruptions to their lives, such as chronic health conditions? We conduct a qualitative study of families where a child was diagnosed with Type-1 diabetes. Inspired by a dance metaphor, we explain how families (1) gather materials for movement, (2) link movements into phrases, and (3) develop an orchestrated style of care as they sense and respond to the dynamic requirements of caregiving when faced with insufficient or unfeasible market solutions. Adding this new perspective to the managerial view used by prior consumer research on family care, we propose an extended perspective on care, which better accounts for how families search to restore life balance in challenging circumstances. This extended perspective illuminates new aspects of consumer engagement with paid and non-paid service providers, and opens avenues for future research in the domain of family care.     

Laypeople roles at road traffic crash scenes: a systematic review

This study aimed to identify the roles of laypeople at road traffic injuries (RTIs). A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words of ‘laypeople’, ‘layman’, ‘layperson’, ‘bystander’, ‘first responder’, ‘lay first responder’, ‘road traffic’, ‘road traffic injury’, ‘crash injury’, ‘crash scene’, ‘emergency’, ‘trauma care’, and ‘prehospital trauma care’ were used in combination with the Boolean operators OR and AND. We did electronic search on Google Scholar, PubMed, ISI Web of Science, CINAHL, Science Direct, Scopus, ProQuest. Based on the reviewed studies, some factors such as cultural conditions, knowledge, relief agencies, and demographic factors affect the interventions of laypeople at the crash scene in functional areas. Regarding the permanent presence of people at the crash scene, the present study can provide an opportunity to reduce different side effects of RTIs imposed on the society.     

基于平衡计分卡的银行系寿险公司绩效评价研究

随着金融混业经营趋势不断加强，2009年起中国的银行开始入股保险公司，且以建立寿险公司为主。为了能全面评价银行入股保险公司后的运营绩效，通过构建平衡计分卡模型，从各项评价指标和总绩效角度将银行系寿险公司与传统寿险公司进行比较，发现在三年的时间里，银行系寿险公司发展迅速，且综合绩效较好，相对于传统的中小型寿险公司，具有明显的优势和发展潜力，但与大型的寿险公司相比仍有一定的差距。     

论寿险公司资产投资风险的监管

按照国际惯例,寿险公司监管的核心是偿付能力监管,而偿付能力监管体系中的重点则是确定资产投资风险的风险值。构建对资产投资风险运用参数进行测算的模型,以确定偿付能力额度中资产投资风险的大小。