On the efficiency of the negligence rule

The three versions of the negligence rule discussed in the literature differ regarding whether a negligent injurer is liable for the entire loss or only for the incremental loss; or regarding whether negligence is defined as failure to take at least due care or failure to take a cost‐justified precaution. It is shown in the paper that the incremental version with untaken precaution notion of negligence is not efficient; not even for the unilateral case. The paper also establishes, for the bilateral case, the efficiency of the incremental version with the shortfall‐from‐due‐care way of defining negligence.     

Community health service centers in China, not always trusted by the populations they serve?

Based on the idea that healthcare needs to be managed by individuals and that basic health services should be provided by the community, this paper examines the factors that impact urban outpatients' preferences for particular community health service centers (CHSCs) and hospitals. Rational consumption of healthcare is influenced by a patient's beliefs, beyond simple demographics and social structure. Ignorance of basic health issues leads to non-rational patient behavior, which also explains the confusion in Chinese health reform regarding people's mistrust of CHSCs. Health education in the form of self-managed care may increase personal health knowledge and encourage individuals to make use of the basic health services that are supplied by CHSCs.     

论“公正”重于“关护”———对中国就业弱势群体税收支持政策的哲学反思

随着我国就业弱势群体的出现,财政部和国家税务总局陆续出台了一系列促进就业的税收政策,但由于这些税收政策在“公正”与“关护”两个基本原则运用上存在侧重点的偏差,导致这些政策的作用效果并不明显。“公正”与“关护”同属人类伦理学理论资源中的两个基本道德诉求。在就业弱势群体税收支持政策制定中,两者缺一不可、互相关联,但从国家宏观就业指导方针、道德原则的稳定性、持久性以及普遍性的角度看,应该坚持“公正”重于“关护”。     

Treatment effects of selection behavior in managed care plans: evidence from Medicaid

This paper tests whether capitated payments to Medicaid managed care plans induce to plans strategic undercutting of treatment for specific diagnostic groups. I focus on treatment (measured by length of stay and cost) in acute care hospitals in Massachusetts. I use a differences-in-differences-in-differences approach, where the third differences compare treatment patterns between managed care plans that receive capitated payments with those that do not. I find that the first reduce treatment significantly more to mental health patients than to patients in other disease groups, whereas the latter reduce hospital resource use more uniformly across disease groups. These results highlight the importance of using payment mechanisms in public programs that reflect the variability in costs of beneficiaries.Received: September 2002, Accepted: May 2003, JEL Classification: I11I thank Randall Ellis, Kevin Lang and Thomas McGuire and anonymous referees for valuable comments and suggestions. I also thank seminar participants at The Brookings Institution and Harvard/MIT/BU Health Economics Seminar. The Portuguese National Science Foundation (B.D. 5910/95) and NIMH (NIMH R01 MH59254) provided financial support. I am indebted to the Massachusetts Division of Health Care Finance and Policy for kindly providing the data to me for this project. I am responsible for any errors that may remain.     

江苏应对人口老龄化问题的政策研究报告

对南京、扬州、张家港等地老年人的生存和精神状况进行实地调研，深度剖析江苏人口老龄化问题及其相关政策。江苏城镇养老服务社会化工作已初见成效，但是存在老年社会保障财政压力渐显、老年社会保障差异化加剧、现行老年保障体系呈现“碎片化”状态等问题。针对现存问题，提出完善江苏老年社会保障体系的对策和路径。     

Accidental injuries among the elderly within the Vienna community: Epidemiology,risk factors and preventive measures

Abstract

Unintentional injuries ('accidents’) among elderly people are a significant burden in public health because such accidents happen frequently and because the proportion of older age groups in the population will continue to rise during the coming decades. One aim of this study, which was done in Vienna, the capital of Austria, was to broaden the preventive concept, adding lifestyle and living conditions to already well-known risk factors following the health promotion approach. Furthermore, characteristics that predispose older residents to accidents should be identified in order to design preventive measures for reducing injuries in this age group.

809 interviews with people 60 years of age and over were conducted, concerning accidents, outcomes of accidents, physical fitness, drug intake, type of house or dwelling, equipment in the household incorporating safety features, psychological well-being and social relations. The information collected was used to draw cross-sectional comparisons between participants who reported having experienced at least one accident in the previous 12 months and those who did not. Furthermore, the accident incidents were classified into 2 groups: incidents without injuries and injurious accidents. The latter served as a base for the epidemiology of injuries for people 60 years of age and over within the Vienna community.

20% of all senior citizens suffer at least one unintentional injury every year, in addition to which 8% experience critical incidents (mostly falls) without injury. Most accidents occur at home or involve pedestrians in public traffic areas. Over 90% of all accidents are falls, and 20% result in fractures. The most important risk factors for accidents in the elderly are gender, increasing age, poor physical fitness and low physical activity, the type of household and household equipment, poor psychological well-being, low income and loneliness.

The findings regarding falls suggest some possible opportunities for reducing the risk of falls by improving buildings and dwellings of the elderly. A promising attempt at practical implementation of these findings is being conducted by the Vienna-based Austrian Institute for Home and Leisure Safety in cooperation with the Vienna City Council. These two organizations are implementing a long-term program that aims at mobilizing institutions and organizations involved in working with the elderly.     

Attitudes toward Use of Advertising and Various Media Practices by Physicians

Advertising by physicians is a relatively recent phenomenon. The purposes of this study were to determine (a) consumers’ attitudes toward advertising by physicians; (b) whether certain potential consumer demographic variables account for any significant difference in attitudes toward physicians who advertise; and (c) which media consumers feel are appropriate for physicians’ advertising. The intent was to discover information that would be useful to physicians in planning promotional strategies and improving the quality of their advertising. The study seems to confirm the belief of many professionals that advertising and promotion clearly have a place in the future of health care services.     

OSI参考模型在新型农村合作医疗中的应用

本文在介绍新型农村合作医疗概念的基础上,引入了OSI参考模型,同时阐述了OSI参考模型在合作医疗中的优缺点,以及OSI在新型农村合作医疗中的应用。     

对现阶段中国长期护理保险产品的开发建议

卫生部调查数据显示：中国60岁以上老年人余寿中有2／3的时间带病生存，平均1／4左右的时间处于机体功能受损状态。2008年底，中国60岁以上人口总数达到1．49亿，医疗保障需求极为旺盛，然而，通过保险解决医疗费用支出的比例微乎其微。从中国现行社会保障体系的实际情况出发，结合国外长期护理领域的成熟产品以及中国老年人群的特点和护理需求，对如何做好老年人群的产品规划，促进保险产品创新，提出相应建议。