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51.
    
Aims: Patients with psoriasis often undergo treatment with a sequence of biologic agents because of poor/loss of response to initial therapy. With the availability of newer agents like ixekizumab and secukinumab, there is a need for cost-effectiveness analyses to better reflect current clinical practice. This study aimed to assess the cost-effectiveness of a sequence of biologic therapies containing first-line ixekizumab vs first-line secukinumab in patients with moderate-to-severe plaque psoriasis in the UK.

Materials and methods: A Markov model with a lifetime horizon was developed to compare the cost-effectiveness of ixekizumab and secukinumab treatment sequences: ixekizumab → ustekinumab → infliximab → best supportive care (BSC) vs secukinumab → ustekinumab → infliximab → BSC. The model used monthly cycles, and included four health states: trial period, treatment maintenance, BSC, and death. At the end of the trial period, responders transitioned to maintenance therapy; non-responders transitioned to the next biologic in the sequence. An annual discontinuation rate of 20% was assumed for maintenance therapy.

Results: The ixekizumab sequence provided cost savings of £898 (£176,203 vs 177,101) [year 2015 values] and gained 0.03 more quality-adjusted life-years (QALYs: 1.45 vs 1.42) vs the secukinumab sequence over the lifetime horizon. Probabilistic sensitivity analysis showed an 89.8% likelihood that the ixekizumab sequence would be cost-effective at a threshold of £20,000 per QALY gained.

Limitations: The analysis used list prices for drugs rather than confidential, preferentially priced Patient Access Scheme costs. In addition, efficacy input data were based on a network meta-analysis, as there were no head-to-head trials comparing ixekizumab and secukinumab.

Conclusion: First-line treatment with ixekizumab as part of a specific sequential biologic therapy for moderate-to-severe plaque psoriasis in the UK provided slight advantages in cost savings and QALYs gained over a similar treatment sequence initiated with secukinumab. In view of the small magnitude of these differences, factors such as patient preferences (e.g. for number of injections) and long-term safety (e.g. related to time on the market) may also be important for clinical decision-making.  相似文献   
52.
    
In 2002, the German Corporate Governance Code was adopted. This paper examines the overall acceptance of the Code recommendations and identifies its critical standards that receive comparably less agreement among German listed companies. The study is based on the compliance declarations of 408 firms listed at the Frankfurt Stock Exchange. The findings indicate a significantly high level of Code conformity which can be expected to increase in the future. Comparative analyses reveal that company size is positively associated with the extent of Code compliance. Neuralgic norms concern the personal liability and compensation of the board members, the staffing of the boards, the structure of the supervisory board and accounting requirements.  相似文献   
53.
    
Since the turn of the millennium, stocks of foreign reserves held by central banks in many emerging markets and developing countries have exceeded currency in circulation. To steer money market rates, these central banks have been absorbing liquidity from, rather than providing it to, the banking sector in their regular monetary policy operations. When interest rates in countries with major reserve currencies are low, the yield on foreign reserves is low. A higher interest rate on liquidity‐absorbing operations may expose central banks to losses. Although a central bank is not a profit‐maximizing institution, central bank losses can undermine the independence of the central bank. Using data for a large panel of central banks, this paper provides some evidence that central banks tend to apply low‐remunerated reserve requirements when profitability is at stake.  相似文献   
54.
Using a general equilibrium endogenous growth model we explain underperformance in the small and medium enterprise sector as an effect of corruption and non-competitive banking. Limited competition in the banking sector causes a high loan-deposit spread, worsens the initial effect of corruption, and depresses growth. Fostering bank competition, for instance, by allowing foreign bank entry, would be a simple solution to this problem, but frequently, authorities choose to hamper bank competition. Therefore, we explain the persistence of non-competitive banking as a result of governments’ regulatory choice. If the government has a stake in the banking sector there exists a trade-off between current benefits from bank profits and future growth. Firm-level corruption affects intertemporal optimization and distorts the government’s choice towards more restrictive regulation, i.e., less bank competition, even if the deciding institution itself is not corrupt. These results show that the two prominent problems for small and medium enterprises, corruption and finance, are mutually reinforcing.  相似文献   
55.
This study uses a relative purchasing power parity (PPP) model based on price indexes (consumer, CPI or traded-goods price indexes, TPI), interest rate differentials, and a linear forecasting technique to determine the horizon over which such a model outperforms a random walk in forecasting the Yen/U.S. Dollar exchange rates out-of-sample. The results improve if one adjusts a simple CPI-based PPP-model by interest rate differentials, while the best results are obtained using a TPI-based PPP-model. For example, the TPI-based model, adjusted by interest rate differentials, is able to statistically significantly outperform the pure random walk starting at forecast horizons of 1 month.  相似文献   
56.
In developing countries and countries in transition, a lack of finance is regarded as a major reason for the underperformance of the SME sector. The financial sector does not channel funds efficiently from savers to the most efficient investment. In a general equilibrium endogenous growth model, we explain the underperformance of the SME sector by interbank market frictions. High information costs in the interbank market lead to a high loan/deposit spread and hence to a low growth equilibrium. The solution to this problem is twofold. First, central bank policy could reduce interbank information problems by providing effective bank supervision. Second, if the central bank is expected not to have sufficient monitoring capabilities, reputation and reserves, opening up the interbank market to international banks can substitute for insufficient central bank activities.The sources of this advantage in efficiency are stronger incentives for workers and managers (direct connection between effort and return), easier monitoring and greater flexibility (McIntyre 2001).  相似文献   
57.
In 2014 and 2015 the German economy will, according to the joint economic forecast, be in an upswing that is mainly driven by strong internal demand. The institutes assess the risks coming from a possible slump of the Russian economy. Simulations with macroeconometric models show that Germany is more affected than other large economies in Europe such as France and Italy. The new minimum wage is a further risk for the German economy that it is difficult to assess. According to this forecast, the minimum wage will, when it comes into effect in 2015, mainly have an adverse effect on employment. Since in general only jobs with low productivity will be lost, the effect on production will be markedly smaller.  相似文献   
58.
The EU and the African, Caribbean and Pacific countries (ACP) are presently renegotiating their trade relations. Behind these negotiations are the fundamental conflict between the existing arrangement and multilateral trade rules, the frustration regarding poor ACP trade performance, the ineffectiveness of trade and trade-related ACP policies, and the inefficiency of corresponding EU assistance. This article highlights the fundamentals of the envisaged Economic Partnership Agreements (EPAs) between the EU and the ACP countries, sums up previous estimates of their probable economic impact, discusses policy options for ACP countries and sheds light on basic prerequisites, particularly on institutional conditions, that should be fulfilled to ensure the success of EPAs.  相似文献   
59.
Using a new data set for 41 German non‐governmental organisations (NGOs), we analyse the allocation of NGO aid across recipient countries in a Tobit regression framework. By identifying for each NGO the degree of official financing, we address the largely unresolved issue of whether financial dependence on the government impairs the targeting of NGO aid. It turns out that German NGOs are more active in poorer countries, while they do not complement official aid by working under difficult local conditions. Beyond a certain threshold, rising financial dependence weakens their poverty orientation and provides an incentive to engage in ‘easier’ environments. In addition, we find that the NGOs follow the state as well as NGO peers when allocating aid. This herding behaviour is, however, hardly affected by the degree of official financing.  相似文献   
60.
There is considerable quarrel as to what extent the shape and malfunctioning of contemporary African states can be attributed to the colonial experience or whether the precolonial heritage must be taken into account. Generally, the correct answer is that both, precolonial forms of political organization and the imposition of the colonial state, characterize the African situation. Yet, it is possible to distinguish more specifically between the two formative influences and to gauge their particular importance. Empirically, the result of the colonial encounter was, on the one hand, a subversion of traditional concepts of legitimacy and, on the other hand, still is the fact that the development of market economies and liberal democracies remains unlikely. Theoretically, I propose to use the notion of reciprocity to describe and analyze three historical forms of power relations, namely, clientelism, colonialism and cleptocracy. By reconstructing the historicity and malleability of the concept, I try to show its usefulness and adequacy to outline basic features of societal organization.  相似文献   
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