社区医疗发展的新模式研究——以贵阳为例

社区医疗在我国得到了大力发展与支持,但依旧叫好不叫座,为了解其原因,更好地促进社区医疗的发展、受益民众,文章在研究的基础上,了解国内外社区医疗模式及我国城市社区医疗服务模式现状,通过对居民结构式访问与社区医院无结构访谈,以及综合分析的基础上提出以第三产业发展带动社区医疗发展模式。     

Impact of urban-rural health insurance integration on health care: Evidence from rural China

In recent years, Chinese local governments have experimented with integrating the social health insurance system segmented between rural and urban areas to unify the administration, policy, and funds of various health insurance programs. In this study, we take advantage of the staggered implementation of the urban-rural health insurance integration across cities over time to examine the impacts of the integration on rural residents' health care utilization and health outcomes. Based on an original city-year level policy dataset and the China Health and Retirement Longitudinal Study (CHARLS) for the years 2011, 2013, and 2015, we find that the integration significantly increases the middle-aged and older rural residents' inpatient care utilization and this positive effect is particularly salient in poor areas. Moreover, we find that the positive policy effect of integration is attributed to enhanced health insurance benefits, such as a higher reimbursement rate for inpatient care. However, the integration has limited impacts on the middle-aged and older rural residents' health outcomes. This study reveals the partial success of urban-rural health insurance integration to reduce health care inequality in China.     

Analysis of hospital technical efficiency in China: Effect of health insurance reform

This paper investigates the regional hospital efficiency in China during the 2002–2008 period, especially for how the health insurance reform of New Rural Cooperative Medical System (NRCMS) impacts on efficiency. Adopting the non-parametric technique of data envelopment analysis (DEA) to handle the feature of multiple outputs and undesirable outputs in the hospital industry, empirical estimates indicate that hospital efficiency is moderate that increased slightly from 0.6777 to 0.8098 during the sample period. However, it ranges widely from 0.396 to 1 across provinces. The regression analysis on examining determinants of efficiency suggests that a higher proportion of for-profit hospital and high quality hospital is helpful to enhance technical efficiency. We find a negative relationship between government subsidy and efficiency for coastal regions. While technical efficiency varies considerable across provinces, there is no significant difference between coastal and non-coastal regions being found, after controlling for other variables. Crucially, the medical reform of NRCMS overall has a significant efficiency-enhancing effect, particularly for non-coastal regions, ceteris paribus. It highlights the effectiveness of NRCMS on promoting medical service accessibility for rural residents.     

Does health insurance decrease health expenditure risk in developing countries? The case of China

This article studies the impact of health insurance on individual out‐of‐pocket health expenditures in China. Using China Health and Nutrition Survey data between 1991 and 2006, we apply two‐part and sample selection models to address issues caused by censored data and selection on unobservables. We find that, although the probability of accessing health care increases with the availability of health insurance, the level of out‐of‐pocket health expenditure decreases. Our results from a selection model with instrumental variables suggest that having health insurance reduces the expected out‐of‐pocket health expenditure of an individual by 29.42% unconditionally. Meanwhile, conditional on being subjected to positive health expenditure, health insurance helps reduce out‐of‐pocket spending by 44.38%. This beneficial effect of health insurance weakens over time, which may be attributable to increases in the coinsurance rates of health insurances in China.     

The effect of health insurance reform: Evidence from China

This paper estimates the impact of a health insurance reform on health outcomes in urban China. Using the China Health and Nutrition Survey¹ we find that this reform increases the rate of health insurance coverage significantly among workers in Non-State Owned Enterprises. The double difference (DD) estimations show that the reform also leads to better health outcomes: workers are less likely to get sick and more likely to use preventive care. Using an instrumental variable (IV) approach to look at the causal effect of health insurance, we find those with health insurance use more preventive care but do not report significantly better health outcomes, an increase in health care utilisation, or an increase in out-of-pocket medical expenditure.     

Refined racial discrimination: A case study of public employment in a southeastern city

Summary and Conclusion Though the preceding findings are not conclusive, 9 they are strongly supportive of the refined discrimination hypothesis and closely parallel Long’s conclusions in his study of job discrimination in the federal government.     

Collective forest tenure reform and household energy consumption: A case study in Yunnan Province,China

The recent Collective Forest Tenure Reform in China has started the process of devolving forest management rights from village collectives to households since 2003. In this paper, we study the impact of the reform on rural energy consumption. Devolving forest tenure improves farmers' access to forest products on their newly acquired forestland, and is therefore expected to increase farmers' fuelwood consumption. The reform also allows farmers to adopt some revenue-enhancing forest technologies which may lead to energy switching in farmer households. Our empirical study finds that the devolution significantly increases household fuelwood consumption for both lower and higher income households; the lower income households benefit more. This is welfare-improving in places where alternative fuels are still too costly. We find limited evidence that higher income households in Yunnan begin to substitute alternative commercial fuels for fuelwood when those are available. Our findings suggest further devolution of forest rights, especially in the poor, forest-rich regions.     

基于SWOT分析的城市专利运营体系构建——以苏州市为例

随着创新驱动战略的深入实施,我国进入产业转型升级的新阶段,国内关于专利运营的研究探索逐渐兴起。但由于我国在专利运营领域起步较晚,企业对于专利运营的主动意识不够以及市场环境等因素,笔者认为城市专利运营体系的建立需要针对不同运营主体采取不同运营模式,充分利用区域内现有资源,文章以苏州市为例进行SWOT分析,构建有针对性的专利运营体系。     

Impact of demographic dynamics on food consumption — A case study of energy intake in China

Most existing studies of food demand focus on economic factors, such as income and price. Physical factors which determine human energy intake requirement, given economic conditions, such as gender and age structures of the population as well as occupation, are usually not incorporated. While this is appropriate in the situation of a continuous, stable development of demographic structure, it might lead to biased result if drastic and irregular demographic changes have taken place. This paper provides a case study of China of the impact of demographic dynamics on the change of physical requirement and energy intake demand. The unique population pyramid in China, resulted from the big famine in the early 1960s and then the “One Child” policy” starting from the 1980s, has led to the irregular evolution of age groups and the consequent changes in the proportion of the “big-eaters”. As a result, given food price and income, the very age structure of the population at the time affects the overall weighted energy intake level of the population significantly. Using household survey data ranging from year 1991 to 2009, the index of Adult Male Equivalent Scale (AMES) is constructed to reflect the varying per capita physical requirement resulted from the demographic dynamic over the years in China. The AMES index, together with food price and income, has been applied to the per capita energy intake model. The empirical results show that the AMES index has statically strong impact on per capita energy intake, and the inclusion of the AMES index into the model has improved the model fitness. This finding sheds light on a possible way for improvement in projecting China's food demand in the future by incorporating the country's changing demographic factors.     

Impact of land tenure policy on agricultural investments in China: Evidence from a panel data study

The goal of this paper is to examine the impact of changes in China's rural land policy on agricultural investments. Dramatic changes occurred in China's rural land policies after 2000, including the extension of rural land contractual period, restriction of land reallocation among villages and villagers groups, elimination of agricultural taxes for responsibility land, and rapid development of rural land rental markets. These changes have given farmers more secure tenure on collectively controlled responsibility land and have strengthened farmers' income rights for responsibility lands, incentivizing them to increase their investments on responsibility lands. A panel data method was used to quantitatively investigate the impact of land policy changes on agricultural investment. We considered the application of organic fertilizer as an indicator for long-term agricultural investment, and compared the use of organic fertilizer between private plots and responsibility lands operated by the same household. The results showed that the difference in organic fertilizer use between private plots and responsibility land for the same household has become smaller from 2000 to 2008. Our findings suggest that recent changes in rural land policies have provided farmers incentives to increase land quality investment on their responsibility lands.     

浙江省永康市县域环境功能区划研究

文章探讨了县域环境功能区的划分思路、保护目标以及管控措施等。以浙江省永康市为例,落实省级环境功能区划的要求,从城市总体定位开展分析,对永康市环境功能区进行了划分。文章同时提出了永康市各环境功能区保护目标与管控措施,在环境保护的同时加强环境管理,为永康市环境保护工作提供科学依据。     

Performance signals in the public sector: the case of health care

Although there are no traditional markets and money prices inthe public sector, consumers and providers may respond to signalsof organisational performance. We present a simple dynamic modelof the demand and supply for elective surgery in the UK NationalHealth Service in which waiting time acts as the prime indicatorof performance. The model is tested using a panel of quarterlydata for 123 English health authorities over an eight-year period.We find that supply is increasing and demand is decreasing inmeasures of the previous period waiting time. The results implythat health care systems which are rationed by waiting do respondto indicators of waiting times. The paper adds to the smallbut consistent body of research which demonstrates that publicsector systems respond to important aspects of reported performance.     

聚焦医改热点引领民营医院走向国际新模式——香港新世纪国际投资集团林国彪总裁专访

香港新世纪国际投资集团总部设在亚洲金融中心——香港,由上海市侨界企业家协会副会长林国彪先生一手创办.是集医疗、药品、外贸、房产、生化科研及影视制作于一体的多元化、智能化、综合性高科技企业集团.其分支企业遍及全国二十余个省市,拥有员工2000余人.随着中国加入WTO,集团陆续与美国、英国、法国、日本、新加坡、澳大利亚、西班牙等国家,以及台湾地区知名企业共同建立了全方位的合作关系,开辟了集团国际化发展的新纪元.集团一贯把"力争成为国际化优质品牌"作为企业核心目标,坚持经济、社会、医疗领域等多方面共同发展.在集团总裁林国彪先生的带领与集团领导、员工间长期共同努力下,集团业绩领先于同行业,尤其是在医疗领域,集团旗下的医疗机构都有着不俗的成绩.     

BT-to-VAT reform and firm productivity: Evidence from a quasi-experiment in China

China recently initiated a major tax reform to convert business tax to value-added tax (BT-to-VAT reform), which opened up the tax deduction chain between industries. We used difference-in-differences model and an administrative firm-level dataset from 2011 to 2017 to explore the effect of BT-to-VAT reform on productivity. We found that in contrast to control firms, this reform increased the productivity of the treated firms by 14.6% on average. The positive effects tended to be strengthened in private, large-scale, and capital-intensive firms, as well as in firms with tight financing constraints. Moreover, these positive results of the BT-to-VAT reform appeared to be driven by its positive effect on fixed asset investment, R&D expenditure, and specialization. These findings demonstrate the transformation of tax system has multiple economic effects in developing countries.     

关于我国农村流通领域中经营主体改革的一个新构想

改革开放30年来,我国农村流通领域取得重要进展,但目前我国农村流通领域仍存在比较突出的问题。本文主要从流通领域中的经营主体出发,分析了目前多元化主体存在的问题,提出了一个对经营主体改革的一个新构想。     

The health cost of living in a city: The case of France at the end of the 19th century

Despite a long standing debate over urban living conditions during industrialization, the impact of rural–urban migrations on health and mortality remains an open question. We observe both mortality and geographical mobility in a large longitudinal dataset of French males and show that rural–urban migrants benefited from clear advantages over those who already lived in the city. However, this benefit fades in a few years. Further we find no evidence of a spike in mortality among rural migrants as they encountered the more severe disease environment of cities, instead it seems their initially superior physical human capital was depleted over time.     

Education and welfare program compliance: Firm-level evidence from a pension reform in China

This study examines how firms with heterogeneous human capital quality respond differently to a welfare policy shock. In 2002, China expanded pension mandates from state-owned enterprises (SOEs) to private enterprises. Based on data covering all median and large manufacturers in China (around 250,000 firms), we find that their compliance rates varied widely across firms and increased in the average education level of employees. Utilizing these heterogeneous responses at the firm level, we estimate that the pension reform might have increased the return to education of employees by 8.75%. To address endogeneity in firms' human capital levels, we exploit the historical scale of local university as an instrumental variable. Moreover, we use SOEs as a control group, which was not directly affected by the policy shock. We find our empirical estimates robust to both measures.     

Land reform: Lessons for South Africa from the Republic of China on Taiwan

Before the implementation of land reform in 1949, the skewed distribution of land ownership and the unhealthy tenancy system in the Republic of China on Taiwan was of great concern to the Kuomitang Nationalist government. Apart from hindering economic development, it also threatened the social and political stability of the island. Taiwan is today regarded as one of the newly industrialized countries. Its remarkable economic achievements are to a large extent closely linked to the successful execution of a land reform programme. Faced with similar problems of an unhealthy distribution of land ownership, policy makers and those who have influence on policy in South Africa can learn a great deal from the Chinese experience.     

Urban pollution and road infrastructure: A case study of China

Urban road infrastructure is crucial in affecting air pollution. Yet, little is known about the roles played by road width vs road length. This paper attempts to fill this gap by estimating the effects of road infrastructure on PM₁₀ using city-level data from China. Our robust modeling results show that the road density index, defined as the ratio of road surface area to city territory size, is negatively correlated with PM₁₀. More importantly, when the road width and length components of the road density variable are separately included in the regression models, the width is found to be significantly and negatively correlated with PM₁₀, whereas the correlation with the length variable is insignificant. This is expected as increases in road width can help mitigate congestion, improve fuel efficiency, and thus reduce emissions. On the contrary, extending roads to new or unconnected areas is likely to bring more vehicles onto the roads and extend average driving time. Our findings appeal for careful consideration of the trade-off between road width (lane numbers) and road length when planning and constructing urban road infrastructure.     

淮安市某二级医院实行委托管理的实践研究

文章采用现场调查表和现场访谈相结合,对托管医院的改革措施和运行数据进行分析,了解医院的运行效率及托管效果,以便了解淮安市某二级医院实行委托管理以来的实践措施及运行情况,为进一步完善医院托管提供参考。经研究发现,淮安市某托管医院整体运行情况良好,三级医院对二级医院托管已取得显著成效,对派驻管理人员充分授权,全面依附受托医院的综合管理能力和技术水平,为派驻人员提供政治、经济保障,注重文化品牌的打造是进一步细化、完善托管制度的有效方法。