The health issues of the homeless and the homeless issues of the ill-health

In public policy planning and budgeting, the health issues and homeless issues tend to be interrelated and reinforced by each other, but this mutual causality is usually ignored in the existing literature. This paper provides an unbiased estimate of a structural equation model taking endogeneity into account. A questionnaire is designed based on the health-related quality of life (EQ-5D) framework and is given to 322 homeless individuals. Evidence shows that, without timely support, the homeless state and health state will fast deteriorate and reinforce each other. It is therefore arguable to broaden the definition of statutory homelessness, and the “preventative approach” can save, rather than increase, the public resources spent on the homeless.     

Means‐Tested Long‐Term Care and Family Transfers

One of the pervasive problems with means‐tested public long‐term care programs is their inability to prevent individuals who could afford private long‐term services from taking advantage of public care. They often manage to elude the means‐test net through ‘strategic impoverishment’. We show in a simple model how this problem comes about, how it affects welfare and how it can be mitigated.     

The demand for medical care services: evidence from Kuwait based on households’ out-of-pocket expenses

This article used a data set containing information on 1267 households from Kuwait to investigate the determinants of demand for medical care services by examining households’ out-of-pocket expenses. To deal with the problems associated with households’ health expenditure data, a two-part model (TPM) was estimated. Given Kuwait’s demographic composition, the model was estimated for full sample, nationals only and expatriates only. Prior to estimating the model, tests were conducted to select a transformation that reduces problems associated with heteroscedasticity and non-normality of the errors. In addition, tests were performed to determine if differences in the estimated coefficients across population groups were statistically significant.     

AIDS treatment and intrahousehold resource allocation: Children's nutrition and schooling in Kenya

The provision of antiretroviral medications is a central component of the response to HIV/AIDS and consumes substantial public resources from around the world, but little is known about this intervention's impact on the welfare of children in treated persons' households. Using longitudinal survey data from Kenya, we examine the relationship between the provision of treatment to adults and the schooling and nutrition outcomes of children in their households. Weekly hours of school attendance increase by over 20% within 6 months after treatment is initiated for the adult patient. We find some weak evidence that young children's short-term nutritional status also improves. These results suggest how intrahousehold allocations of time and resources may be altered in response to health improvements of adults.     

Health IT adoption,productivity and quality in primary care

Within the last decade, there has been a growing push towards the use of electronic medical records and health information technology (IT) within primary care physician practices. Despite financial subsidies, smaller practices remain reluctant to adopt these information systems. Using a nationally representative survey of physicians, this study explores the relationship between physician, practice and area attributes and the adoption of health IT systems. Controlling for these attributes, the analysis subsequently studies the relationship between health IT, physician productivity and perceived quality of care. It finds that smaller practices and physicians with lower incomes are less likely to adopt health IT systems and that adoption varies with the type of medical conditions the practice typically treats. With regards to productivity, health IT adopters are more likely to see fewer patients and spend a larger amount of time on each visit with marginal increases in time on administrative tasks and no differences in perceived ability to deliver quality health care.     

健康、教育与经济增长

健康与教育是人力资本诸多形成方式中最重要的两种,长期以来内生增长理论强调和重视教育人力资本对于经济增长的贡献和作用,但健康与教育之间的相互影响以及健康人力资本对于经济增长的作用却未得到应有的重视。基于此,本文在Lucas(1988),Van Zon和Muysken(2001)模型基础上,构建了一个包含最终产品、健康和教育的三部门模型。静态均衡、转移动态和仿真实验的结果表明:在总体人力资本的形成过程中,健康对广义人力资本的贡献份额大于教育;健康的增量而非健康人力资本存量水平有利于长期经济增长;健康的改善必须同时辅以教育人力资本的提高才能促进经济增长;政府公共健康支出对于健康人力资本的形成具有重要作用,有助于促进发展机会的均等和减贫;重视人力资本积累的经济体在10-15年后会呈现明显的经济绩效的改善。     

重大突发公共卫生事件科技研发应急体系运行机制研究

在突发事件应急管理过程中,科技研发支撑作用十分关键,亟需建立突发公共卫生事件科研应急体系长效运行机制。基于科技研发应急体系的复杂性、适应性特征,从主体属性和体系架构两个层面入手,分析重大突发公共卫生事件科技研发应急体系的复杂适应系统特征,运用复杂适应系统理论模型和动态闭环螺旋模型,研究重大突发公共卫生事件科技研发应急体系运行机制。研究发现,重大突发公共卫生事件背景下,科技研发应急体系具有复杂适应系统的7个基本特征,是典型的复杂适应系统;科技研发应急体系中,科研攻关专家组、诊疗医院、科技部门等科研主体具有各自内部模型,并通过6大标识进行聚集;科技研发应急体系存在事件—需求引导、主体协同、资源交互、成果转化机制。同时,新冠病毒肺炎疫情应对实践表明,疫情防控救治进程中科技研发应急体系存在并遵循上述运行机制。     

健康风险冲击对农户收入的影响

本文基于中国8个省份、1354个农户、跨度15年的微观面板数据,测算了大病冲击对于农户长期收入的影响以及健康风险冲击持续的时间。我们发现:(1)大病冲击在随后的12年里对于农户人均纯收入都有显著的负面影响;(2)大病冲击对于农户的短期与中期影响使得患病户人均纯收入平均降低5%—6%;(3)健康风险冲击的长期影响可持续大约15年,并且冲击对于中低收入农户的影响更为严重。     

Policy induced increases in private healthcare financing provide short-term relief of total healthcare expenditure growth: Evidence from OECD countries

Healthcare reforms have long been advocated as a cure to the increasing healthcare expenditures in advanced economies. Nevertheless, it has not been established whether a market solution via private financing, rather than public financing, curb aggregate healthcare expenditures. To our knowledge, this paper is the first that quantifies the impact of reforms that significantly increases (decreases) the private (public) share of healthcare financing on total healthcare expenditures relative to income in 20 OECD countries. Our reform measure is based on structural break testing of the private share of total expenditures, and verification using evidence of policy reforms. To quantify the effect of these reforms we apply Propensity Score Matching and Inverse Probability Weighted regression analysis. Over a 5-year evaluation period the reforms lead to an accumulated cost saving 0.45 percentage points of GDP. The yearly effects of the reforms are largest in the first years in the post-reform period and decreases in size as a function of time since the reform. Our findings suggest that the investigated healthcare reforms have a relatively short-lived effect on aggregate health spending relative to GDP. The findings are robust to various sensitivity tests.     

我国社会保障支出的地区差异分析

文章首先运用GE指数分解法,分析我国社会保障支出区域差异及贡献率;然后运用GINI系数分解法,分析社会保障各项支出对总体差异的贡献率。结果表明:三大区域总体、区域内及区域间的差异基本呈下降趋势,期间略有起伏,但区域内差异远远大于区域间差异;东部、中部和西部地区差异变动趋势不一致,且对总体差异的贡献率差别较大;社会保障各项支出的贡献率差异较大,其中社会保障补助支出成为总体差异的主体因素。文章最后对实际测算结果作进一步分析,并提出相应的政策建议。