城市突发事件的协同治理探析

在充满风险的现代城市社会,探讨协同治理问题是当今城市治理理论界和实践界所共同面临的重要课题。要适时引入协同治理的理论和操作模式,为城市突发事件应急管理提供新的思路,这是积极创新城市应急管理组织模式,提高城市应急管理效能的重要要求。     

Economic burden of chemotherapy-treated recurrent and/or metastatic squamous cell carcinoma of the head and neck in France: real-world data from the permanent sample of national health insurance beneficiaries

Aims: Overall survival (OS) of patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) is extremely poor. New therapeutic options emerge but need to establish their economic value. The objective was to describe the direct and related costs of R/M SCCHN in France.

Materials and methods: We selected all adult patients treated with chemotherapy for R/M SCCHN between 1 January 2009 and 31 December 2014 from the permanent sample of the French national health insurance database (EGB). Data were analyzed from the index date (first chemotherapy) until patients’ death or 31 December 2015. “Treatment period” and “end-of-life” (EoL) (from last chemotherapy until death) were distinguished. Costs included all hospitalizations for SCCHN and ambulatory care. Costs of hospitalized and non-hospitalized adverse events (AEs) were estimated.

Results: Among 267 patients identified, 85% were men, 44% had metastases at the index date and the mean age was 62.0 years (±9.9). The most common tumor location was oropharynx (29%) but 39% of patients had multiple locations. Median OS was 9.3 (95% CI: 7.9–11.8) months for the overall population. The average total direct cost per patient was €49,954, broken down into €32,908 (95% CI: 29,525–36,290) for hospitalizations and €17,047 (14,941–19,152) for ambulatory care. Main cost drivers were drug acquisition and administration (€14,538) during the treatment period (209?days on average) and palliative care (€3,750) during the EoL period (125?days). Regarding related costs, around 12% of patients received disability pensions (€1,397 per patient [624–2,171]) and sick leave payments (€1,592 [888–2,297]). “Metabolism and nutrition disorders” and “Infections and infestations” were the most expensive hospitalized AEs (€1,513 and €1,180 per patient, respectively). Febrile neutropenia was the most expensive non-hospitalized AE (€766 per patient).

Conclusions: This analysis of real-world data confirms the poor prognosis of patients with R/M SCCHN and provides cost data for future economic evaluations.     

Healthcare resource utilization and direct medical costs associated with index and recurrent Clostridioides difficile infection: a real-world data analysis

Abstract

Aims: This study aimed to evaluate all-cause economic outcomes, healthcare resource utilization (HRU), and costs in patients with Clostridioides difficile infection (CDI) and recurrent CDI (rCDI) using commercial claims from a large database representing various healthcare settings.

Materials and methods: A retrospective analysis of commercial claims data from the IQVIA PharMetrics Plus database was conducted for patients aged 18–64 years with CDI episodes requiring inpatient stay with CDI diagnosis code or an outpatient medical claim for CDI plus a CDI treatment. Index CDI episodes occurred between 1 January 2010 and 30 June 2017, including only those where patients were observable 6 months before and 12 months after the index episode. Each CDI episode was followed by a 14-d claim-free period. rCDI was defined as another CDI episode within an 8-week window following the claim-free period. HRU, all-cause direct medical costs and time to rCDI were calculated over 12 months and stratified by number of rCDI episodes.

Results: A total of 46,571 patients with index CDI were included. Mean time from one CDI episode to the next was approximately 1 month. In the 12-month follow-up period, those with no recurrence had 1.4 inpatient visits per person and those with 3 or more recurrences had 5.8. Most patients with 3 or more recurrences had 2 or more hospital admissions. The mean annual, total all-cause direct medical costs per patient were $71,980 for those with no recurrence and $207,733 for those with 3 or more recurrences.

Limitations: The study included individuals 18–64 years only. A stringent definition of rCDI was used, which may have underestimated the incidence of rCDI.

Conclusions: CDI and rCDI are associated with substantial healthcare resource utilization and direct medical costs. Timing of recurrences can be predictable, providing a window of opportunity for interventions. Prevention of multiple rCDI appears essential to reduce healthcare costs.     

行业板块股价对重大污染事件的应急反应分析

金融市场有效性争议至今没有定论,中国股票市场有效性判断仍有争议。本文从突发性重大污染事件冲击角度,通过行业板块受突发事件冲击后股票价格在H股与A股两个市场应急反应的对比分析,考察我国股票市场的有效性状况,发现H股表现出的反应不足甚于A股,表明我国股票市场已存在短期动量效应,能在一定程度上对当前公开信息作出反应;但这种反应是不足和滞后的,还未达到半强式有效。可见,我国股票市场处于发育初期,公司治理结构政府主导和环境管制不力等综合因素导致了行业板块股价的特殊走势。     

从“青鸟健身事件”看我国健身行业发展的困境与出路

引起广泛关注的北京青鸟健身俱乐部关门事件从深层次上折射出我国当前健身行业面临的普遍困境。由于经营模式单一,经营成本飙升,健身行业的成长空间受到抑制;行业规范和行业扶持政策的缺失,使健身行业存在着无序竞争的状况,阻碍了健身行业的持续稳定发展。因此,迫切需要建立科学合理的市场准入制度,完善健身行业监管制度,制定完善行业标准,并尽快出台针对体育产业(包括健身行业)的优惠政策,提升健身行业的竞争水平,鼓励和扶持这一朝阳产业的发展。     

嘉兴举办大型体育赛事效应之分析

运用文献资料、访谈调研、案例分析等方法对嘉兴举办大型体育赛事的效应进行了分析,重点从政治、经济、社会和环境方面深入分析了积极效应及要预防的负面效应。提出了嘉兴举办大型体育赛事的策略:要与城市发展相容;加强政府在资金、政策引导和组织协调等方面的作用;重视本土品牌赛事的培育,打造赛事长期效应;重视效果评估与监测,提高赛事抗风险能力。     

我国上市公司捐赠保值效应的实证研究

本研究的对象为发生负面事件的企业,研究企业捐赠的保值效应,拓展了企业捐赠经济效应的研究,对现阶段负面事件频发的中国企业具有重要实践启示。本研究运用事件研究法和回归分析方法,考察了中国企业捐赠的保值效应,即企业捐赠能够在企业负面事件发生时为股东财富提供保值。来自中国上市公司的经验表明,中国企业捐赠具有保值效应。实证结果还支持了事件性质对企业捐赠保值效应影响的研究假设,结果表明,与发生其他负面事件相比,发生竞争性负面事件时企业捐赠为股东财富保值的效果越弱。     

变时滞循环神经网络模型的全局指数稳定性

利用Brouwer不动点定理，推广的Halanay时延微分不等式及Dini导数，讨论了具有变时滞循环神经网络模型的平衡点的存在性和全局指数稳定性，在不要求激活函数连续可导的条件下，得到了非常简单实用的判别条件。     

Adverse event-related costs for systemic metastatic breast cancer treatment among female Medicaid beneficiaries

Objective: This retrospective study compared the real-world incidence and costs of systemic treatment-related adverse events (AEs) in patients with metastatic breast cancer in a Medicaid population.

Methods: Insurance claims data for adult women who received biologic or chemotherapy (± hormonal therapy) for metastatic breast cancer between 2006–2013 were extracted from the Truven Health MarketScan^® Multi-State Medicaid database. Incidence of AEs (per 100 person years) and average monthly AE-related healthcare costs (per-patient-per-month) during each line of therapy (first or later lines) were estimated. The association between AEs and total all-cause healthcare costs was estimated using multivariable regression.

Results: A total of 729 metastatic breast cancer patients were analyzed. Hematological (202.3 per 100 person years) and constitutional AEs (289.6 per 100 person years) were the most common class of AEs reported. Unadjusted per-patient-per-month AE-related expenditure by class were highest for hematological AEs ($1524), followed by gastrointestinal ($839) and constitutional AEs ($795), with anemia ($942), nausea/vomiting ($699), and leukopenia/neutropenia ($550) having incurred the highest total AE-related costs. Adjusted total all-cause monthly costs increased with the number of AEs ($19,701 for >7 AEs, $16,264 for 4???6 AEs, and $13,731 for 1???3 AEs) compared to no AEs ($5908) (all p?Conclusions: Among metastatic breast cancer patients treated with systemic therapy in a Medicaid population, AEs were associated with significant increases in costs, which increased with the number of AEs experienced. Therapies associated with a lower incidence of AEs may reduce cost burden and improve patient outcomes.     

产业聚集:一个动态过程

利用1984~2003年中国制造业的数据分析了制造业聚集的动态过程,使用Dumais、Ellison、Glaeser的方法,将产业聚集变化分解为区域就业平均复归和随机性共同作用的结果。结果发现,中国制造业聚集的净变化增长很快,但产业受到较强的地理移动性的支配,聚集变动并非只与历史偶然事件和过去的聚集水平有关。