劳动力价格、信息不对称与农户精细管理技术投入——基于质量识别能力差异的视角

近年来,劳动力价格的快速上涨已然成为中国农业生产所必须面对的内在挑战。对于机械作业难度相对较大的劳动密集型作物而言,在缓解劳动力约束瓶颈的同时,更应通过精细化的果园管理,以提高产品质量,进而提高其市场价格。然而,由于农产品具有典型的经验品属性,在信息不对称的外部约束下,农户通常难以获得应有的"质量溢价"。基于此,本文通过构建理论分析框架,以果品质量关键环节的精细管理技术作为研究对象,系统分析在劳动力价格上涨背景下农户精细管理技术投入的决策机制,以及在不同农产品质量识别程度中,劳动力成本变化对其影响的异质性,并基于全国18个省份农户的调研数据进行实证研究。研究结果表明:农户交易对象质量识别能力的提高,能够缓解农户与购买者之间存在的信息不对称性,将农产品质量信息传递给购买者,使农户获得更高的销售价格,进而在有效提高农户精细管理技术投入水平的同时,能够弱化劳动力价格对其所产生的负面影响。     

基于BIM技术的工程造价精细化管理研究

为实现工程造价精细化管理目标,需要各个环节的相互配合来达到资源优化配置。BIM技术依托虚拟建模技术,实现了对工程项目的数字化建造管理。实践证明,将BIM技术融入项目工程造价管理体系中,有助于提升工程造价管理的整体质量。论文立足工程造价精细化管理的内涵,剖析了BIM技术在工程造价精细化管理中的应用价值,并提出了BIM技术在工程造价精细化管理中的具体应用策略。     

在热电联产企业中精益成本管理的评价指标及应用对策

论文从热电联产企业的特征入手,通过对精益成本管理理论的研究,总结出热电联产企业精益成本管理的评价指标,并通过对指标的分析总结出精益成本管理在热电联产企业实际应用中的管理对策。     

集成管理理论在建设项目全过程造价咨询业务中的应用研究

建筑企业为了进一步扩大盈利空间,在项目运行期间于造价管理工作中引入集成管理理论,采用全过程造价咨询管控方式,提升项目成本管控能力。论文考虑到造价管理对建筑企业的重要性,着重介绍集成管理理论在全过程造价咨询领域的应用方式。     

企业数字化转型程度对融资成本的影响

近年来，大量企业基于数字化转型实现了弯道超车。选取2007—2021年A股上市公司数据，利用企业年报中数字关键词的词频来描述数字化转型程度，研究企业数字化转型程度对企业融资成本的影响。研究发现：企业数字化转型与融资成本显著负相关；检验延长时间窗口发现，在企业实施数字化转型后的一段时间内，数字化转型仍然降低了融资成本；根据异质性分析，数字化转型对非国有企业降低融资成本产生的效果更好，且东部地区企业深化数字化转型降低成本的作用更显著。     

险资股权投资的结构性改革研究*——基于险资投资的倒U型效应分析

保险资金作为重要的机构投资者能否发挥促进公司绩效提升的作用在已有研究和监管政策制定上都存在较大争议。本文以2005-2017年A股上市公司为研究样本，发现险资持股比例对上市公司绩效以及估值影响存在显著的倒U型曲线效应，相应机制研究表明险资持股通过显著影响两类代理成本的渠道发挥治理作用。在适度持股比例以下，险资增持能够降低被投资公司管理费用率和其他应收款占比，并提高资产周转率，从而降低两类代理成本；持股超过一定比例反而造成两类代理成本上升。险资持股比例变化对保险机构调研次数的影响则从公司治理参与角度印证了以上结论。对倒U型曲线效应的深入分析既有助于深化对机构投资者影响公司绩效的多重效应和机制的认识，同时为在金融机构层面落实金融供给侧结构性改革、增强险资服务实体经济能力提供参考。     

Medication,equipment, and supply costs for common interventions providing extended post-surgical analgesia following total knee arthroplasty in US hospitals

Aims: To estimate the cost to hospitals of materials (i.e. medications, equipment, and supplies) required to administer common interventions for post-surgical analgesia after total knee arthroplasty (TKA), including single-injection peripheral nerve block (sPNB), continuous peripheral nerve block (cPNB), periarticular infiltration of multi-drug cocktails, continuous epidural analgesia, intravenous patient-controlled analgesia (IV PCA), and local infiltration of bupivacaine liposome injectable suspension (BLIS).

Materials and methods: This analysis was conducted using a mixed methods approach combining published literature, publicly available data sources, and administrative data, to first identify the materials required to administer these interventions, and then estimate the cost to the hospital of those materials. Medication costs were estimated primarily using the Wholesale Acquisition Costs (WAC), the cost of reusable equipment was obtained from published sources, and costs for disposable supplies were obtained from the US Government Services Administration (GSA) database. Where uncertainty existed about the technique used when administering these interventions, costs were calculated for multiple scenarios reflecting different assumptions.

Results: The total cost of materials (i.e. medications, equipment, and supplies) required to provide post-surgical analgesia was $41.88 for sPNB with bupivacaine; $756.57 for cFNB with ropivacaine; $16.38 for periarticular infiltration with bupivacaine, morphine, methylprednisolone, and cefuroxime; $453.84 for continuous epidural analgesia with fentanyl and ropivacaine; $178.94 for IV PCA with morphine; and $319.00 for BLIS.

Limitations: This analysis did not consider the cost of healthcare providers required to administer these interventions. In addition, this analysis focused on the cost of materials and, therefore, did not consider aspects of relative efficacy or safety, or how the choice of intervention for post-surgical analgesia might impact outcomes such as length of stay, re-admissions, discharge status, adverse events, or total hospitalization costs.

Conclusions: This study provided an estimate of the costs to hospitals for materials required to administer commonly used interventions for post-surgical analgesia after TKA.     

Assessing cost‐effectiveness when environmental benefits are bundled: agricultural water management in Great Barrier Reef catchments

Using economic analysis to prioritise improvements in environmental conditions is particularly difficult when multiple benefits are involved. This includes ‘bundling’ issues in agricultural pollution management, where a change in management action or farming systems generates multiple improvements, such as reductions in more than one pollutant. In this study, we conceptualise and compare two different approaches to analysing cost‐effectiveness when varying bundles of benefits are generated for a single project investment. Each approach requires data to be transformed in some way to allow the analysis to proceed. The index approach requires the transformation on the benefits side so that the effects of multiple pollutant changes can be combined into a measure for each project which can then be compared to costs. By comparison, the disaggregation approach requires the transformation on the costs side where costs for each project have to be apportioned across the different pollutants involved. The paper provides novel insights with an application to agricultural water quality improvements into the Great Barrier Reef in Australia, demonstrating that while both approaches are effective in prioritising projects by cost‐effectiveness, the disaggregation approach provides more insightful results and values that may be relevant for use as upper value guidelines in future project selection.     

Cost comparison of continued anticoagulation with rivaroxaban versus placebo based on the 1-year EINSTEIN-Extension trial efficacy and safety results

Aims: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (vs placebo) after 6–12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo, based on the EINSTEIN-EXT event rates.

Methods: Total healthcare cost was calculated as the sum of treatment and clinical event costs from a US managed care perspective. Treatment duration and event rates were obtained from the EINSTEIN-EXT study. Adjustment on treatment duration was made by assuming a 10% non-adherence rate. Drug costs were based on wholesale acquisition costs. Cost estimates for clinical events (i.e. recurrent deep vein thrombosis [DVT], recurrent pulmonary embolism, major bleeding, clinically relevant non-major bleeding) were determined from the literature. Results were examined over a ±20% range of each cost component and over 95% confidence intervals (CIs) of event rate differences in deterministic (one-way) and probabilistic sensitivity analyses (PSA).

Results: Total healthcare cost was $1,454 lower for rivaroxaban-treated (vs placebo-treated) patients in the base-case, with a lower clinical event cost fully offsetting drug cost. The cost savings of recurrent DVT alone (–$3,102) was greater than drug cost ($2,723). Total healthcare cost remained lower for rivaroxaban in the majority (73%) of PSA (cost difference [95% CI]?=?–$1,454 [–$2,396, $1,231]).

Limitations: This study was conducted over the 1-year observation period of the EINSTEIN-EXT trial, which limited “real-world” applicability and examination of long-term economic impact. Assumptions on drug and clinical event costs were US-based and, thus, not applicable to other healthcare systems.

Conclusions: Total healthcare costs were estimated to be lower for patients continuing rivaroxaban therapy compared to those receiving placebo in VTE patients who had completed 6–12 months of VTE treatment.     

Pharmaceutical cost‐sharing systems and savings for healthcare systems from parallel trade

This paper studies the consequences of parallel trade in a two‐country model. It compares a coinsurance scheme (consumers pay a percentage of the drug price) and an indemnity insurance scheme (reimbursement is independent of the drug price) with respect to changes in copayments and public health expenditure. In the destination country, copayments for patients decrease to a larger extent under indemnity insurance, whereas reductions in public health expenditure occur only under coinsurance. In the source country, copayments increase less under coinsurance, whereas health expenditure is reduced more under indemnity insurance. In both countries, total expenditure under parallel trade is lower.