Does an economic incentive affect provider behavior? Evidence from a field experiment on different payment mechanisms

Aims: This study analyzed discrepancies in the quantity of medical services supplied by physicians under different payment systems for patients with different health statuses and illnesses by means of a field experiment.

Methods: Based on the laboratory experiment of Heike Hennig-Schmidt, we designed a field experiment to examine fee-for-service (FFS), capitation (CAP), and diagnosis-related group (DRG) payment systems. Medical students were replaced with 220 physicians as experimental subjects, which more closely reflected the clinical choices made by physicians in the real world. Under the three payment mechanisms, the quantity of medical services provided by physicians when they treated patients with different health statuses and illnesses were collected. Finally, relevant statistics were computed and analyzed.

Results: It was found that payment systems (sig. = 0.000) and patient health status (sig. = 0.000) had a stronger effect on physicians’ choices regarding quantity of medical services than illness types (sig. = 0.793). Additionally, under the FFS and CAP payment systems, physicians overserved patients in good and intermediate health while underserving patients in bad health. Under the DRG payment system, physicians overserved patients in good health and underserved patients in intermediate and bad health. Correspondingly, under FFS and CAP, the proportional loss of benefits was the highest for patients in bad health and the lowest for patients in good and intermediate health; while under DRGs, patients in good and intermediate health had the largest and smallest loss of benefits, respectively.

Limitations: In order to increase external effects of experiment results, we used the field experiment to replace laboratory experiment. However, the external effects still existed because of the blurring and abstraction of the parameters.

Conclusions: Medical treatment cost and price affected the quantity of medical services provided by physicians. Therefore, we proposed that a mix of payment systems could address the common interests of physicians and patients, as well as influence incentives from payment systems.     

高职学生乡村振兴意愿与影响因素研究——基于广东交通职业技术学院的调研分析

乡村振兴战略是党的十九大提出的一项重大战略,其中人才振兴是乡村振兴的基础,但农村客观上存在很多难以短时间解决的困难,青壮年、大学生都倾向于留在大城市工作,人才紧缺已经成为限制农村发展的重要瓶颈,如何让更多的大学生参与助力乡村振兴中的研究具有重要的社会意义和现实意义。本文针对高职大学生群体进行研究,在“互联网+”时代背景下,分析了高职大学生的就业创业特点、参与乡村振兴的意愿动机,和内外部的影响因素等,试图寻找适合当代大学生投身乡村振兴的方法和模式,同时,也从大学生的角度提出了如何建立健全相关的国家、社会和学校的支持体系。     

Design of Digital Agricultural Extension Tools: Perspectives from Extension Agents in Nigeria

Given the marked heterogeneous conditions in smallholder agriculture in Sub-Saharan Africa, there is a growing policy interest in site-specific extension advice and the use of digital extension tools to provide site-specific information. Empirical ex-ante studies on the design of digital extension tools and their use are rare. Using data from a choice experiment in Nigeria, we elicit and analyze the preferences of extension agents for major design features of ICT-enabled decision support tools (DSTs) aimed at site-specific nutrient management extension advice. We estimate different models, including mixed logit, latent class and attribute non-attendance models. We find that extension agents are generally willing to use such DSTs and prefer a DST with a more user-friendly interface that requires less time to generate results. We also find that preferences are heterogeneous: some extension agents care more about the effectiveness-related features of DSTs, such as information accuracy and level of detail, while others prioritise practical features, such as tool platform, language and interface ease-of-use. Recognising and accommodating such preference differences may facilitate the adoption of DSTs by extension agents and thus enhance the scope for such tools to impact the agricultural production decisions of farmers.     

Capitalization of land development rights in rural China: A choice experiment on individuals’ preferences in peri-urban Shanghai

The capitalization of land development rights is acknowledged as the key to improving compensations for rural landholders and ameliorating land-related social conflicts in peri-urban China. Investigations into reasonable as well as feasible compensation standards and the capitalization mechanism are yet to be done. This study uses a survey-based choice experiment to empirically estimate the value of land development rights in peri-urban Shanghai for three forms of rural land conversion – acquisition, consolidation and (informal) sale. The results show that heterogeneity across individuals’ preferences translates into different utilities from land development, which affects individual’s willingness to participate in this process. This effect is found to be the strongest for land sales on the informal market. If, however, land conversion is managed by local governments and rural collectives, the expected utilities of individuals have no significant effect on the amount of land development. The results suggest that capitalizing land development rights under consideration of land attributes and individuals’ preferences would lift compensation standard to a level that strikes a balance among competing land-related interests. In addition, it would promote China’s land development by bypassing the institutional constraints imposed by the current land tenure system.     

Does the spatial representation affect criteria weights in environmental decision-making? Insights from a behavioral experiment

The need and interest to consider cognitive and motivational biases has been recognized in different disciplines (e.g. economics, decision theory, risk analysis) and has recently reached environmental decision-making. Within this domain, the intrinsic presence of a spatial dimension of both alternatives and criteria calls for the use of maps throughout the decision-making process to properly represent the spatial distribution of the features under analysis. This makes spatial Multi Criteria Decision Analysis (MCDA) a particularly interesting domain to explore new dimensions of cognitive biases. This study proposes a behavioral experiment aimed at discovering to what extent the spatial visualization (i.e. maps) of criteria versus the non-spatial one (i.e. tables) can bias the weight elicitation phase of a spatial MCDA process. The experiment simulates a very common analysis in environmental and land use planning: land suitability analysis. Our findings show that there are significant consequences on how important we perceive a certain criterion to be, depending on whether it is represented as a map or as a table among a mix of maps and tables. Indeed, the map representation of the same criterion leads to higher weights attributed to that criterion compared to the table representation. Visualizing the same information as a map or as a table, although technically equivalent, is thus not psychologically equivalent for Decision Makers. The results of this experiment are expected to have implications for spatial decision-making processes, by generating better awareness on the impacts of map-mediated land suitability analysis.     

互文性理论视角下大学英语写作教学方法探析

互文性理论认为每个语篇都是对其他语篇的吸收和转化，语篇不是孤立的，总是存在于语篇网络中。互文性是西方结构主义和后现代主义文化思潮中产生的文本理论，但是目前对于互文性理论的研究多以文学批评理论的研究和文学作品研究为主，作为教学策略应用于英语教学的研究则为数不多。本文通过探讨互文性理论指导下大学英语写作教学的实践意义及目前大学英语写作教学存在的问题，提出了笔者在教学实践中所积累的几点写作教学法，以期为大学英语写作教学模式提供新的思路。     

构建高校大学生党员教育新模式探索

为进一步提升高校党建实效,高校大学生党员教育工作亟待创新型机制,笔者以高校志愿工作为突破口,通过分析志愿工作之现状,探索其和学生党员教育工作的联动机制,旨在为当前学生党员教育工作注入新的生机和活力。     

中高职三二分段下的学生素质拓展系统的设计与实现

针对高职教育发展的新形势、新政策、新要求，中高职三二分段教育成为高职教育的一部分，传统大学生素质拓展系统均适用于普通高校，设计开发一个适用于高职教育，针对中高职学生特点、职业教育培养目标的学生素质拓展系统非常有必要，有利于职业技能人才的全面培养，也减轻了学校相关工作人员的工作量，为师生带来方便。     

绞股蓝荷叶复配茶包研发

以荷叶和绞股蓝为主要原料,对荷叶与绞股蓝复配比例、过筛目数、水的添加量和冲泡时间4个因素进行单因素试验,并根据单因素试验结果,设计L9(34)正交试验.结果表明,绞股蓝荷叶复配茶包最佳工艺配方为:荷叶添加量与绞股蓝添加量的比例为1:4、过筛目数为70μm、水添加量为150 mL、冲泡时间为7 min,此条件下的荷叶绞股蓝复配茶包感官评分最高,为95分.     

民办院校有机化学实验多元化教学模式探索

民办院校把有机化学实验作为有机化学教学的重要组成部分,多元化教学模式主要从教学方法与手段、教学内容、学习方式、考评体系等方面进行多元化教学模式探索。建立以微课视频、翻转课堂、问题引导,依托基础性实验、综合型实验和创新型实验,依托多元化信息化的教学手段雨课堂、虚拟仿真情景模拟实验、超星尔雅平台,融合多种教学方法,结合“线下”翻转课堂,建立多元化教学模式。这种多元化教学模式能有效提高学生的学习主动性和创新能力。