老年人养老方式选择的影响因素研究——基于CHARLS数据的实证分析

本研究在CHARLS调查所获得的微观数据的基础上进行,首先对老年人养老方式选择的结果和老年人人口特质、健康状况、经济状况等方面的6个变量进行关联分析,再通过二项Logistic回归模型,将是否选择机构养老作为被解释变量进行回归分析。结果表明非机构养老方式仍是老年人的主要选择,年龄、婚姻状况、慢性疾病情况、经济状况等因素与老年人养老方式的选择存在显著的关联并对选择结果产生影响。     

非理性就医对医保费用管理的挑战及应对策略

目的分析参保患者非理性就医现象,积极探索应对策略,为控制不合理增长的医疗费用提供参考。方法结合我院医保工作中对医保基金正确合理使用的管理及参保患者的就医情况,分析近年来参保患者非理性就医的现象、原因及结果,探索应对策略,总结规范化管理的措施。结果小病大治、大病贵治、无病保养等是非理性就医的主要表现,严重影响医保费用的管理,助推了过度医疗和医疗费用的不合理增长。结论应落实国家医药卫生体制改革,完善配套的医疗保险政策,深化医院医保费用管理,科学控制基本医疗付费总额,控制医疗费用不合理增长,从而保障医保基金的安全使用。     

Like a member of the family: including and excluding paid caregivers in performances of family

Abstract

We explore the construction of family in contemporary families that employ professional providers of childcare and elder care. We find that families and caregivers at times construct family together, including the caregiver as a family member, while at other times, consumers construct family in ways that exclude the caregiver. Through our exploration of these various ways of constructing family, we offer three theoretical contributions. First, we challenge traditional distinctions between consumers and producers and highlight the fluid, contextualised nature of family by demonstrating that some contemporary constructions of family include paid service providers. Second, we elucidate the ways in which the provision and consumption of a service, everyday care, produces a liminal position for some service providers. Finally, we develop a broader understanding of the ways in which performances of family protect cultural values.     

内蒙古地区普通高校体育保健课开展情况的调查研究

本文通过文献资料、问卷调查法、专家访谈法、分析法及数理统计法对内蒙古39所高校的体育保健课现状进行调查、分析.找出内蒙古地区普通高校在开设体育保健课的开课状况、教学文件、教学内容、教师结构、场地设备及课余体育活动开展等方面存在的问题,提出自己的一些建议,为内蒙古地区各个高校开设体育保健课提供一些理论与实践的参考.     

内蒙古医药卫生体制改革惠民效应分析

深化医药卫生体制改革是党中央、国务院推行的一项重大惠民工程,也是内蒙古自治区区委、区政府确定的惠民实事之一.新医改固然千头万绪,但评价和衡量其成效的关键在于百姓得实惠.本文正是抓住这一突破口,来了解内蒙古自治区新医改阶段性进展,初步评估医改所取得的效果,分析和研究改革实施过程中出现的新情况和影响因素,为相关部门完善政策措施提供依据和信息支持.     

Using users: When does external knowledge enhance corporate product innovation?

Prior research on corporate innovation highlights the importance of accessing external knowledge from other firms and universities. However, survey evidence indicates that product users are perhaps the most important source of external knowledge. We build on existing theory to identify the conditions under which user knowledge contributes to corporate innovation and when the benefits will be greatest. Using a panel dataset of medical device companies and their collaborative efforts with innovative physicians, we find evidence that inventive collaborations with users enhance corporate product innovation and that the benefits are greatest in new technology areas and in the generation of radical innovations. Copyright © 2013 John Wiley & Sons, Ltd.     

英语教学中需要倾注人文关怀

英语教学要面向全体学生,关注学生的情感和潜能的发挥。多年以来,很多学校学生经过初中三年的英语学习,实际效果并不好,很重要的一个原因在于长期以来,在教学实践中片面重视知识传授和认知能力的发展,忽视具有动力作用的情感,影响学生学习的积极性。由此可见英语教学中还需要对学生倾注更多的人文关怀。     

Interim Realities

Abstract

This paper presents findings from a study of information technology implementation practices in National Health Service hospitals in England. The results suggest that there is a general direction of travel, which involves the progressive linking together of individual systems, so that they are interoperable. We argue that the findings are consistent with meta-governance arguments, but that it is necessary to complement this perspective with an understanding of the nature of information technologies in order to understand them properly. We suggest that ‘interim systems’ will be the reality on the ground for many health care organizations for the foreseeable future.     

Adalimumab,etanercept, and infliximab utilization patterns and drug costs among rheumatoid arthritis patients

Abstract

Objectives:

To evaluate the utilization patterns of the anti-tumor necrosis factor (anti-TNF) agents Humira (adalimumab), Enbrel (etanercept), and Remicade (infliximab) in patients with rheumatoid arthritis (RA) and compare medication costs during the first year of treatment. (Humira is a registered trademark of Abbott Laboratories, IL; Enbrel is a registered trademark of Immunex Corporation, CA; and Remicade is a registered trademark of Janssen Biotech, Inc., PA).

Methods:

This retrospective analysis of medical and pharmacy claims included patients who were aged ≥18 years, had ≥2 RA diagnosis codes, and had ≥365 days of persistence with the index anti-TNF. Patients excluded had claims for anti-TNF agents within 6 months before the index date. Refill patterns for adalimumab and etanercept, number of infliximab infusions, time between infusions, and dose per infusion were analyzed for 12 months. Direct anti-TNF medication costs were compared among anti-TNFs for the initial treatment year.

Results:

Infliximab-treated patients (n?=?457) were significantly older than adalimumab- (n?=?337) or etanercept-treated patients (n?=?902). Time between refills was longer than recommended for 28% and 30% of adalimumab and etanercept refill periods, respectively. Potential cumulative time without therapy was 33 days for adalimumab and 43 days for etanercept. Statistically significant differences in mean per-patient anti-TNF medication costs for the first year were reported for adalimumab, etanercept, and infliximab ($14,991, $13,361, and $18,139, respectively; p?<?0.0001); however, a cost assessment using labeled dosing of the anti-TNF agents with optimal treatment compliance yielded comparable annual medication costs.

Limitations:

This analysis only evaluated utilization patterns for selected anti-TNF agents and was not inclusive of other medications that patients may have been using for RA. Absolute patient adherence could not be assessed due to lack of information on how patients were self-administering adalimumab and etanercept or if samples of the agents were made available.

Conclusions:

This study identified gaps in patients’ refills compared with prescriber recommendations. The infliximab-treated group had infusion patterns consistent with prescribing information. Potential clinical and economic implications of dose attenuation with adalimumab and etanercept should be explored further.