新型农村合作医疗的运行效率、筹资与基层政府行为

现阶段新型农村合作医疗制度试点的重点之一是如何在公平与效率之间找到新的均衡。这项制度在农村稳步推开,缓解了医疗服务中长期存在的公平效率问题。但自该项制度实施以来.调查点居民卫生可及性公平仍有待改善,筹资存在垂直不公平问题,卫生服务利用公平性有所增强,但改进余地很大。资源配置效率有所提高,但并不明显;医疗机构间缺乏竞争,成本软约束导致医疗机构低效率运行。因此新农合制度实施过程中的公平性,还有待政府进一步改善,同时以公平为前提,提高资源配置和服务效率。     

Why is Price Dispersion Higher Online than Offline? The Impact of Retailer Type and Shopping Risk on Price Dispersion

When physically similar products, of similar quality, are offered by retailers both online and offline, we often observe that the dispersion in prices of these products online is greater than the price dispersion offline. This observation runs counter to early theories that suggested price dispersion online would be smaller than that offline due to the ease of search and information availability online. This paper investigates and provides an explanation for this puzzling phenomenon by examining the impact of two important drivers of price dispersion: retailer type and consumers’ shopping risk. Retailer type refers to whether a retailer is a pure offline, pure online, or dual channel retailer. Shopping risk is defined as the product of consumers’ perceived risk of shopping and the transaction uncertainty related to shopping at different types of retailers.A game-theoretic approach is adopted to model consumers’ price search and product purchase, as well as price competition within and across retailer types in online and offline markets. Equilibrium pricing strategies are derived for different retailer types competing for different consumer segments with different levels of perceived shopping risk. The impact of retailer type and shopping risk on online versus offline price dispersion are quantified, and conditions when price dispersion is greater online than offline are identified.Results indicate that price dispersion is greater online when the number of pure online retailers is sufficiently large and is increasing in the number of pure online retailers. In addition, a reduction in online shopping risk may actually increase online price dispersion. Results further suggest that even without any online sales, dual channel retailers should maintain their online presence for the purpose of information dissemination, which justifies the importance for pure offline retailer to incorporate webrooming strategies, where consumers can search for prices online but purchase offline.     

Clinical and economic benefits of professional CGM among people with type 2 diabetes in the United States: analysis of claims and lab data

Background: It is estimated that one in 10 people in the US have a diagnosis of diabetes. Type 2 diabetes accounts for 95% of all cases in the US, with annual costs estimated to be $246 billion per year. This study investigated the impact of a glucose-measuring intervention to the burden of type 2 diabetes.

Objective: This analysis seeks to understand how professional continuous glucose monitoring (professional CGM) impacts clinical and economic outcomes when compared to patients who are not prescribed professional CGM.

Methods: This study utilized a large healthcare claims and lab dataset from the US, and identified a cohort of patients who were prescribed professional CGM as identified by CPT codes 95250 and 95251. It calculated economic and clinical outcomes 1 year before and 1 year after the use of professional CGM, using a generalized linear model.

Results: Patients who utilized professional CGM saw an improvement in hemoglobin A1C. The “difference-in-difference” calculation for A1C was shown to be –0.44%. There was no statistically significant difference in growth of total annual costs for people who used professional CGM compared to those who did not ($1,270, p?=?.08). Patients using professional CGM more than once per year had a –$3,376 difference in the growth of total costs (p?=?.05). Patients who used professional CGM while changing their diabetes treatment regimen also had a difference of –$3,327 in growth of total costs (p?=?.0023).

Conclusion: Significant clinical benefits were observed for patients who used professional CGM. Economic benefits were observed for patients who utilized professional CGM more than once within a 1-year period or who used it during a change of diabetes therapy. This suggests that professional CGM may help decrease rising trends in healthcare costs for people with type 2 diabetes, while also improving clinical outcomes.     

Evaluating drug cost per responder and number needed to treat associated with lixisenatide on top of glargine when compared to rapid-acting insulin intensification regimens on top of glargine,in patients with type 2 diabetes in the UK,Italy, and Spain

Objectives: This study investigated the cost per responder and number needed to treat (NNT) in type 2 diabetes mellitus (T2DM) patients for lixisenatide compared to insulin intensification regimens using composite endpoints in the UK, Italy, and Spain.

Methods: Efficacy and safety outcomes were obtained from GetGoal Duo-2, a 26-week phase 3 trial comparing lixisenatide vs insulin glulisine (IG) once daily (QD) and three times daily (TID). Response at week 26 was extrapolated to 52 weeks, assuming a maintained treatment effect, based on long-term evidence in other T2DM populations. Responders were defined using composite end-points, based on an HbA1c threshold and/or no weight gain and/or no hypoglycemia. The HbA1c threshold was varied in sensitivity analyses. Annual treatment costs were estimated in euros (1 GBP?=?1.26 EUR), including drug acquisition and resource use costs. Cost per responder was computed by dividing annual treatment costs per patient by the proportion of responders.

Results: Lixisenatide was associated with the lowest cost per responder for all composite end-points that included a weight-related component. For the main composite end-point of HbA1c ≤7.5% AND no weight gain AND no symptomatic hypoglycemia, cost per responder results were: UK: 6,867€, 8,746€, and 12,410€; Italy: 7,057€, 9,160€, and 12,844€; Spain: 8,370€, 11,365€, and 17,038€, for lixisenatide, IG QD, and TID, respectively. The NNT analysis showed that, for every 6.85 and 5.86 patients treated with lixisenatide, there was approximately one additional responder compared to IG QD and TID, respectively.

Limitations: A limitation of the clinical inputs is the lack of 52-week trial data from GetGoal Duo-2, which led to the assumption of a maintained treatment effect from week 26 to 52.

Conclusions: This analysis suggests lixisenatide is an efficient economic resource allocation in the UK, Italy, and Spain.     

我国渔业补贴政策及其改革探索

我国的渔业补贴政策在一定程度上是积极有效的,但同时也存在补贴总量不足、渔业补贴结构不合理、补贴种类不齐全和补贴核算指标体系不规范等问题。针对存在的问题,我国应从补贴结构、补贴种类和核算方法三个方面对渔业补贴予以改进：从SCM协定中渔业补贴分类、产业结构和补贴方式三方面调整渔业补贴结构;从逐渐削减渔船燃油补贴、加大远洋渔业补贴、新增休闲渔业补贴、建立政府支持型渔业保险制度等方面调整渔业补贴种类;把生产者补贴等值法（PSE）作为渔业补贴核算方法。     

转移支付类型对省内县际间财力不均等的贡献——按收入来源进行的基尼系数分解

转移支付结构是影响财力均等化效应的重要因素之一,然而,对于一些特定类型转移支付的均等化效应,理论界和实践界都存在较大争议。文章运用基尼系数的收入来源分解法,对1999-2004年全国27个省、自治区的省内县际间财力差异进行分解,得到不同类型转移支付对财力不均等的贡献率。结果表明,因素法转移支付的均等化效果并不十分理想;转移支付类型对均等化效应的影响还存在一定的区域性差别,需要政策上的区别处理。     

浅析大学“国际贸易”教学中的“参与型”课型教学模式

国际贸易课程是一门实践性很强的应用型课程,旨在培养学生从事国际贸易的基本技能和良好的专业素质,传统的教学方法存在一些弊端,为适应我国高等教育的发展形势,培养高素质创新型人才,提出把参与型教学理念引入教学实践中,对教学方法进行了相关的改革,从而为社会培养出更多高素质的国际贸易人才。     

气溶胶灭火系统在海上平台的应用

重点介绍了气溶胶灭火系统的分类及特点,并与几种常见气体灭火系统进行了比较。通过分析比较,阐述了气溶胶灭火系统应用在海上平台电气房间的可行性。以绥中36-1油田Ⅰ期调整项目中WHPJ平台的改造为例,详细介绍了气溶胶灭火系统的计算过程。根据计算的结果,并结合其他几个工程案例,指出气溶胶灭火系统适宜应用在新建的简易井口平台或者平台的改造项目中。     

粮食钢板筒仓储粮特性与工艺设计要点

论述了我国粮食钢板筒仓的应用发展概况,分析粮食钢板筒仓的类型、制造过程和各自优缺点。介绍了钢板筒仓的结构组成、储粮特性,并从粮食钢板筒仓工艺设计方面出发,对粮食钢板筒仓工程的工艺流程设计、工艺布置、筒仓容积计算及配套设备做了较全面的探讨。最后,强调了钢板筒仓工程设计中的安全事项。     

Type of diversification and firm resources: new empirical evidence from the Spanish tourism industry

This paper analyses the diversification strategies followed by tourism firms from the perspective of the resource‐based view. More specifically, it seeks to verify whether the composition of the firms' resources has a bearing on the decision to undertake one type of diversification or another (related or unrelated). From a mail survey to 80 Spanish tourism firms, we identified 94 entries into new business areas. We applied an ordered logit regression and have statistically confirmed that intangible resources lead to a more related type of diversification. Copyright © 2008 John Wiley & Sons, Ltd.