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21.
    
This study discusses political and electoral reasons for the allocation of intergovernmental transfers in a federal state. We tested the influence of political alignment with the federal government and deputies, and the effects of elections and changes in alliance status upon Brazilian discretionary transfers. We performed a panel data analysis encompassing 2,856 municipalities from 1999 to 2011. The results suggest that the federal government buys support in Congress by awarding grants to deputies. Moreover, the alignment between the municipal and federal chief executives is central to the allocation of grants, and a negative correlation exists when the mayor is affiliated with an opposition party and when an opposition deputy has a strong support base within the municipality. Furthermore, changes in alliance status between the budget‐voting and budget‐implementation stages influence the number of transfers. The federal government also increased the allocation of grants in years featuring municipal and federal elections, particularly the latter.  相似文献   
22.
    
Abstract

Objectives: Real-world evidence (RWE) may provide good estimates of absolute event probabilities and costs in patients in actual clinical practice, but their use in decision-analytic models poses many challenges. A literature review based on a systematic search was conducted to summarize the limitations of using RWE in decision-analytic modeling reported in the literature, but also to identify existing recommendations about real-world modeling.

Methods: A literature search was performed on Medline and Embase databases, as well as relevant websites. No restrictions in language or geographical scope were imposed.

Results: A total of 14 references were included. RWE is recognized as a valuable source of data for market access and reimbursement, and as a complement to clinical trial evidence for treatment pathways, resource use, long-term natural history, and effectiveness. The main limitations identified in the literature were: confounding bias, missing data, lack of accurate data related to drug exposure and outcomes, errors during the record-keeping process, protection of private data, and insufficient numbers of patients. Although most submission guidelines recognized the potential biases associated with RWE, guidance on the appropriate methods to deal with these biases, and approaches to review different relevant evidence to inform model development, were scarce. Several initiatives have attempted to provide guidance on the use of RWE in decision-modeling.

Conclusions: RWE is likely to be particularly valuable for informing healthcare policy-makers when formulating appropriate treatment pathways, encouraging the optimal allocation of scarce resources, and improving aggregate patient outcomes. However, little guidance is available on the relative merits of using efficacy and/or effectiveness evidence in Health Technology Appraisal submissions. Further research is needed to better understand these methods and their potential applications in a broader range of scenarios and simulation studies, and their impact on economic modeling.  相似文献   
23.
    
This paper analyses profit efficiency of selected retail firms in South Africa over the 2005–2006 period. A stochastic frontier analysis method is used. The 24 retail firms covered are ranked in terms of their efficiency performance over this period. Their efficiencies have also been tracked over time. Approximately 50% of the firms are estimated to have profit efficiency estimates higher than the average estimated for the sampled firms. The top 10 firms are performing significantly better than the average profit efficiency of 0.39. The profit efficiency of the top three firms is more than double the observed average profit efficiency performance of the sampled retail firms. However, the bottom 50% of the retail firms has performed poorly.  相似文献   
24.
Technology usage lags   总被引:1,自引:0,他引:1  
We present evidence on the differences in the intensity with which ten major technologies are used in 185 countries across the world. We do so by calculating how many years ago these technologies were used in the U.S. with the same intensity as they are used in the countries in our sample. We denote these time lags as technology usage lags and compare them with lags in real GDP per capita. We find that (i) technology usage lags are large, often comparable to lags in real GDP per capita, (ii) usage lags are highly correlated with lags in per-capita income, and (iii) usage lags are highly correlated across technologies. The productivity differentials between the state-of-the-art technologies that we consider and the ones they replace, combined with the usage lags that we document, lead us to infer that differences in the intensity of usage of technologies might account for a large part of cross-country TFP differentials. The views expressed in this paper solely reflect those of the authors and not necessarily those of the National Bureau of Economic Research, Federal Reserve Bank of San Francisco, nor those of the Federal Reserve System as a whole. This research was completed when Emilie Rovito was an economist at the Federal Reserve Bank of New York. We appreciate the financial assistance of the NSF (Grants # SES-0517910 and SBE-738101) and the C.V. Starr Center for Applied Economics. We would like to thank Mark Bils, Hitesh Makhija, Andres Rodríguez-Clare, Romain Wacziarg, and Matt Wiswall for comments and suggestions.  相似文献   
25.
    
Aim: To conduct a cost-effectiveness analysis to compare ocrelizumab vs subcutaneous (SC) interferon beta-1a for the treatment of relapsing multiple sclerosis (RMS).

Methods: A Markov cohort model with a 20-year horizon was developed to compare ocrelizumab with SC interferon beta-1a from a US payer perspective. A cohort of patients with relapsing-remitting MS (RRMS) and Expanded Disability Status Scale (EDSS) scores of 0–6, who initiated treatment with ocrelizumab or SC interferon beta-1a, were entered into the model. The model considered 21 health states: EDSS 0–9 in RRMS, EDSS 0–9 in secondary-progressive multiple sclerosis (SPMS), and death. Patients with RRMS could transition across EDSS scores, progress to SPMS, experience relapses, or die. Transition probabilities within RRMS while patients received ocrelizumab or SC interferon beta-1a were based on data from the two SC interferon beta-1a-controlled Phase III OPERA I and OPERA II trials of ocrelizumab in RMS. Transitions within RRMS when off-treatment, RRMS-to-SPMS transitions, transitions within SPMS, and transitions to death were based on the literature. Utilities of health states, disutilities of relapses, costs of therapies, and medical costs associated with health states, relapse, and adverse events were from the literature and publicly available data sources. The model estimated per-patient total costs, incremental cost per life year (LY) gained, and incremental cost per quality-adjusted LY (QALY) gained. Deterministic sensitivity analyses (DSA) and probabilistic sensitivity analysis (PSA) were conducted to evaluate the robustness of the model results.

Results: Ocrelizumab was associated with a cost savings of $63,822 and longer LYs (Δ?=?0.046) and QALYs (Δ?=?0.556) over a 20-year time horizon. The results of the model were robust in the DSA and PSA.

Limitations: The model did not consider subsequent treatments and their impact on disease progression.

Conclusions: The results suggest that ocrelizumab is more cost-effective than SC interferon beta-1a for the treatment of RMS.  相似文献   
26.
    
This paper assesses the relationship between trade openness and economic growth in Africa by accounting for the heterogeneity of African countries. In addition, the paper contributes to the literature on trade openness and economic growth nexus by applying the instrumental variable panel smooth transition regression, a methodology that accounts for nonlinearity and endogeneity in the relationship between the two variables. The results of the empirical analysis reveal that the investment ratio is a channel through which trade openness affects economic growth in the African continent. In addition, the relationship between trade openness and economic growth varies according to the degree of a country's development in Africa. The study finds a negative relationship between openness and growth in low-income countries. Conversely, for upper-income countries, the coefficients of trade indicators are positive and statistically significant. The results indicate that African countries are not homogeneous, especially concerning trade openness and economic growth nexus.  相似文献   
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29.
We use modern and novel techniques to study the problems associated with detection and analysis of multitudinous seismic events, which form the background for isolated great earthquakes. This new approach involves multivariate analysis of low and large magnitude events recorded in space over a couple of centuries in time. We propose here the deployment of the clustering scheme both for extracting small local structures and large-scale trends in synthetic data obtained from four numerically simulated models with: uniform properties (U), a Parkfield-type asperity (A), fractal brittle properties (F), and multi-size-heterogeneity fault zone (M). The mutual nearest neighbor (mnn) clustering scheme allows for extraction of multi-resolutional seismic anomalies in both the spatio-temporal and multi-dimensional feature space. We demonstrate that the large earthquakes are correlated with a certain pathway of smaller events. Visualization of the anomalies by using a recently introduced visualization package Amira reveals clearly the spatio-temporal relationships between clusters of small, medium and large earthquakes, indicating significant stress relaxation across the entire fault region. We demonstrate that this mnn scheme can extract distinct clusters of the smallest events, which precede and follow a singularly large magnitude earthquake. These clusters form larger spatio-temporal structures comprising a series of large earthquakes. The link between the large and medium magnitude events is not so clearly understood. Short-ranged correlations are dominated by strong spatio-temporal anomalies, thus reflecting the global seismic properties of the entire fault zone.  相似文献   
30.
Little published research exists to guide self-regulators in their evaluation of advertising directed to children. Academic researchers have principally studied the effects of advertising upon children, rather than children's perceptions of specific commercials and ads. Research on such questions as fantasy, using famous presenters, scale disclosures and disclaimers would undoubtedly show age-related differences of perception. This might call into question the advertisers' responsibilities to the pre-school, pre-literate child. The situation is more complex when the advertiser seeks to address older children at times when younger children are also watching. Research will never satisfy the critics, but industry and self-regulators should pursue the question of how children perceive advertising.  相似文献   
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