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.     

The evaluation of Istanbul airspace design from the perspective of complexity and safety

The approach, descent, and climb phases of flights in terminal maneuvering areas (TMAs) are some of the critical parts of a flight in which more than half of accidents happen. For an ANSP (Air Navigation Service Provider), to fulfill the responsibility with a high-quality service degree while maintaining safety, these difficult areas should be designed carefully and equipped with the most efficient procedures. Point merge system (PMS), which is defined as a systemized method for sequencing arrival flows, is launched in Istanbul's new TMA (LTFM TMA) being designed by DHMI (Devlet Hava Meydanları Isletmesi) to improve safety and efficiency. In this paper, the airspace complexity is based on adjusted density and structural index, and safety indicators. To investigate the effects of the radical changes made in re-organized LTFM TMA on the safety issue in comparison with the previous terminal maneuvering area, LTBA TMA, six months' data consisting of 75215 arrival and departure flights are used. Results reflect that the LTFM TMA, one of the world's busiest terminal airspaces, has statistically significantly lower scores in terms of conflict numbers per aircraft, complexity metrics, adjusted density, the hour of interactions, and flight hours than LTBA TMA. Lastly, there exists no longer a significant relationship between conflict types and complexity after launching the new design and structure.     

对于新会计制度下如何加强事业单位财务管理的剖析

财务管理是事业单位财务活动当中非常关键的环节,其有效性为事业单位的财产安全提供了保障。但是,随着新会计制度的出台和实施,事业单位的财务管理中存在的问题和不足逐渐暴露出来,这些问题严重阻碍了事业单位的持续发展。为了保障事业单位在新会计制度下实现长期健康发展,有必要就其财务管理当中存在的问题进行深入讨论,并提出可行的解决方案。     

国有林场贫困测定与差异性研究

基于2008—2017年国家林业局对中国28个省(市、区)国有林场的调研数据,运用等价性检验的方法从地理位置、经济状况、可持续经营和发展能力层面上对国有林场的贫困测度和差异性进行实证分析。研究结果表明:国有贫困林场不一定位于贫困县,并且与国有非贫困林场之间的差异逐渐缩小;国有贫困林场区域异质性强,经济发展水平较低;国有贫困林场在森林资源基础、人力资源基础、基础设施和生产条件等方面的可持续发展能力较差。因此,提出了相关林业部门应该鼓励国有贫困林场发展特色林产品;加大扶贫资金投入;改善职工生计条件;加强资金管理意识等政策建议。     

福利多元主义视角下宅基地资格权的性质与实现路径——以北京市魏善庄镇试点为例

研究目的:明确农村宅基地资格权的权利属性与内涵,从理论和实践的角度探索资格权实现的路径框架,为深化农村宅基地制度改革提供理论支撑。研究方法:文义解释、历史分析、文献研究和案例分析。研究结果:针对当前宅基地资格权的权利内涵不清、实现路径不明、实践经验不足等问题,本文从保障性内涵和现行制度体系适应性出发,认为资格权应当具备成员权内涵,具有身份性、无偿性、长期性、均等性等特征,并基于此从福利多元主义视角构建了宅基地资格权的实现路径理论框架,提出在宅基地资格权的实现过程中,应设立政府、集体、市场和家庭的四元供给主体,并通过城乡统筹保障农民宅基地资格权的多元动态实现,同时运用此理论框架对北京市大兴区魏善庄镇羊坊三村宅基地改革实践经验进行了案例研究和分析。研究结论:资格权应当在兼顾主体意愿和历史根源基础上以成员资格为依据进行主体认定,以资格公平性和均等性为原则,以"实物+货币"双重动态机制和城乡统筹机制构建实现路径,推动"户有所居",并通过宅基地资格权的多元动态实现推动农村住房保障体系的完善。     

关键核心技术攻关新型举国体制研究

面对新一轮科技革命,传统创新组织和模式已难以适应新形势的要求,美国科技界认为会聚创新模式将成为推动科技发展的重大战略举措。本文深入分析会聚创新兴起的内在机理,以人工智能领域为切入点,广泛借鉴国际创新组织不同模式经验,提出构建社会主义市场经济条件下关键核心技术攻关新型举国体制的若干建议。     

新时代大学生知行合一问题研究

我国已从高速增长阶段进入高质量发展阶段,新通信技术、新媒体、互联网的迅速发展,不同价值理念传播速度前所未有,对大学生的冲击力度巨大,一定程度上造成大学生认知上的模糊和混乱。大学生知行不一的问题应当引起高等院校管理部门及师生的高度重视。大学生知行不一主要表现在两个方面:一是思想认识上的模糊和错误;二是行为表现距离社会规范的要求差距比较大。造成大学生知行不一的原因有三:一是道德认知本身存在众多分歧和争议;二是道德选择与现实利益之间的冲突和矛盾;三是情感在道德选择中的作用。要不断完善促进大学生知行合一的基本路径:一是落实思想政治理论课“立德树人”的目标;二是创新教学方式方法;三是改革和完善教学科研管理制度;四是加强校园文化能力建设。     

Experiencing forest products – An innovation trend by rural entrepreneurs

There is increasing emphasis on innovation as a driver of continued prosperity in the rural economy. Globalisation poses challenges to rural areas given technological advances and intensified competition in agricultural markets, ageing rural populations and expansion of urban areas. However, in recent years, the conception of rural areas has shifted from places of production to places of consumption. In line with an increasing urban demand for consumption of products and services close to nature within the rural landscape, we observe the emergence of experiential offers based around non-wood forest products (NWFP) where the consumer is closely connected to the harvesting and use of the products. In this paper, we examine how such intersecting demands have created new forms of market for NWFP, by analysing in-depth four innovative examples in Austria and the United Kingdom. Semi-structured interviews were conducted with the managers of these businesses, and cases were analysed through application of both the experience economy and the innovation systems approach. We found that all four businesses were on the one hand derived from traditional, regional cultural skills and values and, on the other hand, directly connected to new consumers’ demands. The apparent success of these emerging business models lies in the accretion of new social values onto traditional products. Thus creative approaches blending offers designed to enhance cosumers’ experiences into traditional sectors, such as forestry, would have potential in the future. However, our results indicate that there is a lack of institutional support for the development of such businesses in both countries. Better suited innovation policies and support structures would be important for mainstreaming or encouraging the development of similar businesses, innovations and knowledge.     

Spatial and temporal analyses of potential land use conflict under the constraints of water resources in the middle reaches of the Heihe River

With the rapid urbanization in China, land resources are becoming increasingly scarce. Identifying and resolving land use conflict is essential for reasonably using land resources and achieving land sustainability. Taking the middle reaches of the Heihe River as an example, we included the constraints of local water resources to construct a multi-criteria evaluation system for assessing land use competitiveness in 2000 and 2015 based on land use, socio-economic, and nighttime light data. By comparing the competitiveness of cultivated land, construction land and ecological land, we then derived the spatiotemporal patterns of potential land use conflicts. Actual land use changes supported the hypothesis that land use tended to convert into the type with higher competitiveness at areas with intense conflict, which better indicated that our assessment model was effective. The results showed that the potential land use conflict was more acute in the central and northwest but weak in the southeast and northeast, and its pattern showed a significantly positive spatial autocorrelation. The conflict between cultivated land and construction land was most prominent and mainly occurred in the transitional zone from urban to rural areas. Rapid urban development and water shortage were the main causes of the potential land use conflict. Assessing land use multi-functions and making a tradeoff among ecological, economic, and social services will be an effective way to guide future land use to solve land use conflict. Our research provides scientific evidence for sustainable land use planning and management in the arid areas.     

内蒙古黄河干流跨盟市水权试点研究

为了全面总结内蒙古自治区水权试点工作,介绍了内蒙古黄河干流跨盟市水权试点过程中强化行业监管方面的一些做法,总结了试点过程中坚持问题导向、坚持两手发力、强化节水管理、创新体制机制的一些重要经验。