中日农村医疗保险制度比较研究

纵向比较分析中日两国农村医疗保险制度的发展历程,从覆盖范围、筹资方式、补偿方式、资金收支情况等方面横向比较中日两国的农村医疗保险制度,探讨中日两国农村医疗保险制度的优缺点,为我国完善新型农村合作医疗制度提供相关建议。     

Indigenous Peoples’ Health Care: New approaches to contracting and accountability at the public administration frontier

Abstract

This article analyses reforms to contracting and accountability for indigenous primary health care organizations in Canada, New Zealand, and Australia. The reforms are presented as comparative case studies, the common reform features identified and their implications analysed.

The reforms share important characteristics. Each proceeds from implicit recognition that indigenous organizations are ‘co-principals’ rather than simply agents in their relationship with government funders and regulators. There is a common tendency towards more relational forms of contracting; and tentative attempts to reconceptualize accountability. These ‘frontier’ cases have broad implications for social service contracting.     

润肤霜的制备工艺及其性能研究

使用混合膜生成法和瞬间成皂法配制润肤霜,论文通过单因素试验法探究了1618醇的含量、乳化温度和乳化时间对润肤霜性能的影响。通过对试验数据进行分析得出如下结论:1618醇含量为4.0%、乳化温度为75~80℃、乳化时间为7~9min时产品质量合格,满足QB/T 1857—2013《润肤膏霜》中对性能的要求。     

Defining Capitalism

This article aims to incorporate the essential features of capitalism in an operational definition that identifies capitalism per se (pure laissez‐faire capitalism), and clearly excludes variations such as welfare capitalism and crony capitalism. By concisely highlighting the fundamental structures and mechanisms of capitalism, this essential definition facilitates defences of it that are more robust than those ordinarily offered. It also clarifies the relation between capitalism and phenomena with which it is frequently associated, and suggests a straightforward way of identifying and measuring the extent of capitalism in mixed economies.     

Unconscious Processes of Organizing: Intergroup Conflict in Mental Health Care

A critical but overlooked issue in Weick’s seminal work, The Social Psychology of Organizing (1969/1979), concerns ‘the heat’ of organizing processes, namely, the underground emotional processes underpinning the organizing of conflictual work relationships. We present a qualitative case study of psychiatric agencies mandated by public policy to collaborate but instead engaged in persistent conflict despite its deleterious effects on their working relationship and on the wellbeing of the clients they intended to serve. To explain these conflictual features of organizing, we integrate Weick’s organizing theory with systems psychodynamics to deepen the understanding of emotions in organizing, specifically the motivational forces underpinning sensemaking and actions between interacting psychiatric agencies. This integration of theories reveals a critical feature of the relationship between the conscious and unconscious organizing processes: When a threat is involved, sensemaking and action are overtaken by social defences, resulting in dysfunctional organizing of the primary task. Drawing on these findings, we enrich Weick’s seminal work by developing a model that portrays organizing as the ritualized interaction of emotions, sensemaking and behavioural responses.     

Exploring the customer's intention to switch firms: The role of customer‐related antecedents

This study examined the customer‐related antecedents of the customer's intention to switch firms. Customer citizenship behavior was a key element in this study. Scholars have extensively studied the antecedents of customer citizenship behavior. However, the way that customer citizenship behavior relates to other attitudinal variables and the intention to switch has scarcely been analyzed. The proposed hypotheses were verified using partial least squares variance‐based structural equation modeling applied to 947 users of beauty care service firms in five countries. The results suggest that customer citizenship behavior is an antecedent of satisfaction, trust, and attitudinal loyalty. Two of these variables influence customers’ intentions to abandon relationships with the service provider. The implications of these findings enhance managers’ and scholars’ understanding of the determinants of customers’ intentions to switch firms.     

A Gendered Model of the Peasant Household: Time poverty and Farm Production in Rural Mozambique

Using insights from a case study on the allocation of labor in subsistence households in Mozambique, this study develops a conceptual framework for examining linkages between time poverty and farm production. An unexpected event such as a health crisis increases the demand for labor provided by women, thus making them more time poor. The model and numerical simulations show that a deterioration in a woman's time constraint will have an adverse effect on agricultural output of the household. This occurs because most women respond to an increase in household work by reducing their work hours on the farm and by reducing their leisure time. The latter outcome is expected to have a negative effect on women's physical and mental health, which will then cause a decline in their productivity on the farm.     

社会医疗保险对老人临终医疗服务利用的影响

本文利用2002-2014年CLHLS死亡人口数据,借助样本选择模型、两部分模型和bootstrap中介效应检验方法,首次比较全面深入地分析了社会医疗保险对老人临终总医疗费用支出和自负医疗费用支出的影响。研究发现,我国社会医疗保险既显著提高了老人临终医疗服务利用,也显著降低了自负水平。不同类型的社会医疗保险对临终医疗服务利用影响存在差异,医疗保险类型对临终医疗服务利用具有直接效应,医疗保险水平发挥了中介作用。医疗保险覆盖率在死亡年份影响临终医疗服务利用中发挥了中介作用。我国应该通过实行健康老龄化战略、加强死亡教育、发展临终关怀和完善医保监管等措施控制临终医疗支出增长以促进医疗保险可持续发展,并提升临终老人生存和死亡质量。     

“以医促养”还是“以养促养 ”:医疗保险与养老金的健康绩效比较

CLHLS2014年数据的结构方程模型估计结果显示,养老金收入能显著提高老年人的主观健康,并且主观健康还能显著增进生理健康。路径模型进一步检验发现养老金能通过显著改善受访者的居住条件、水果摄入量、及时就医、经济状况等途径来提高老年人的生理健康。而医疗保险支出与老年人主观健康、生理健康之间都呈显著负相关关系。相比医疗保险支出,养老金能带来更正面更积极的健康绩效,且促进老年人健康的途径更为丰富。实证结果说明,相比“以医促养”,“以养促养”的老年人健康绩效更优。本文建议我国从以疾病治疗为中心转为依托养老金购买养老服务,提高老年人生活质量的健康保障体系。