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.     

北京市人口老龄化对人均储蓄的影响分析

以北京市1985-2012年的数据为样本,考察北京市人口老龄化对于城镇居民人均储蓄的影响,采用普通最小二乘法进行模型估计,结论表明:少年儿童抚养比、人均可支配收入与储蓄正相关;GDP增长率、消费价格指数CPI和老年抚养比与储蓄负相关.采用二次移动平均法对北京市未来人口年龄结构的变化做出预测,针对预测的人口老龄化的加剧及其对居民储蓄产生的影响,可提出相应的政策建议.     

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.     

老年抑郁症相关因素分析与防治对策

随着老龄化社会进程的加快,老年抑郁症的发病率呈逐步上升趋势。分析和研究老年抑郁症发生的各类相关因素,提出切实可行的防治应对策略,对提高老年抑郁症患者的生活质量,维护和促进老年人的身心健康,构建和谐健康的老龄化社会,有着深刻的社会意义和深远的历史意义。     

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.     

制度环境约束下的农村合作医疗制度分析

农村合作医疗制度变迁的路径选择以及制度绩效的发挥,除了取决于制度本身的特点之外,在很大程度上也会受到所处的制度环境的影响.对新农村合作医疗制度的评价,不能脱离其所依赖的制度环境.为保证新型农村合作医疗制度能够得到良好的实行效果,除了要对制度本身进行不断的优化设计外,也要注意进一步改善影响制度运行的制度环境因素.     

Comparative analysis of health care costs in Japan and the United States: a simulation of productivity and savings behavior

Japan and the United States, though contrastive in terms of the percentage of the elderly in their population and the ratio of their health care costs to GDP, both face soaring medical expenditures. Sato et al. [Health Care Systems in Japan and the United States: A Simulation Studies and Policy Analysis. Kluwer Academic Publishers, Hingham, MA] developed a model to solve this problem by increasing the productivity of the non-health care sector. This study has applied that model to estimate national savings, and compared these savings with estimated health care costs. The results show that in order for savings to exceed expenditures the US needs to have a higher savings rate and a higher interest rate than Japan.