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To assess significant changes of health status in people receiving health care, distribution-based and anchor-based methods have been proposed. However, there is no real consensus on what method is the best for evaluating clinically meaningful change. To maximize the internal and external validity of outcome assessment, we propose combining two approaches as recommended by recent practical guidelines on this field. Specifically, we suggest applying longitudinal hierarchical linear models on subgroups of patients showing reliable change and reliable and clinically significant change. This combined approach improved the model’s ability (1) to quantify the magnitude of changes to be reliable and clinically meaningful and (2) to select significant predictors of changes. An empirical application on a prevalence sample of Italian outpatients attending four community mental health services was done. A cross-sectional model and three longitudinal models were applied on the entire study sample and reliable and clinically meaningful change subsamples to investigate the magnitude of change and the predictive effect on outcomes of clinical, socio-demographic and process variables on different patients’ subgroups. Differences were found suggesting that both the statistical method and the sample used to calculate individual changes affect the estimates. The main conclusion is that ignoring the longitudinal data structure or including patients with unreliable change at the follow-up might result in misleading inferences that can alter the real magnitude of changes and the contributions of predictors. The approach proposed provides robust feedback to clinicians on clinically significant change and can be recommended in outcome studies and research. 相似文献
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Intereconomics - Italy, which is sometimes considered a laggard in terms of social and economic reforms, can boast a pension system that is, by and large, functioning sufficiently well in terms of... 相似文献
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Pietro Reichlin 《The Scandinavian journal of economics》2019,121(3):1125-1153
I analyze a life‐cycle economy with old age productivity risk where wages, employment, and severance payments are set through efficient bargaining between risk averse unions and risk neutral firms. Allocations with limited union membership are second‐best inefficient as they generate too little labor supply in young age, too much consumption before retirement, too little employment of older workers (early retirement), and too little insurance against old age unemployment. Providing public transfers to early retirees (disability benefits or early pensions) might help to increase the degree of risk sharing at the cost of lower old age employment. Depending on whether absolute risk aversion is increasing or decreasing in consumption, these policies might or might not produce efficiency gains at equilibrium. 相似文献
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Pietro Alessandrini Michele Fratianni Andrew Hughes Hallett Andrea F. Presbitero 《Open Economies Review》2014,25(1):3-34
This paper presents two views of the European sovereign debt crisis. The first is that countries in the South of the Eurozone were fiscally irresponsible and failed to implement pro-competitive supply side policies. The second view holds that the crisis reflects a deep divide between the external surpluses of the North and external deficits of the South. Basic stylized facts cast doubt on the explanation based on the first thesis alone. A relatively simple model shows how poor fundamentals can create a debt problem independently of fiscal responsibility. The empirical analysis of the determinants of government bond yield spreads relative to Germany suggests that both views in fact provide useful insights into the roots of the current sovereign crisis. However, differences in growth and competitiveness and capital flows between North and South have assumed a much more dominant role since the onset of the global crisis. 相似文献
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Francisco-Javier Canto-Cuevas María-José Palacín-Sánchez Filippo di Pietro 《Applied economics letters》2016,23(13):945-948
This article analyses the determinants of the trade credit in Spanish manufacturing small and medium-sized enterprises (SMEs) from a new perspective. Specifically, we focus on the relationship between trade credit and other relevance financial resources: bank credit and self-financing. For the first time in the literature, a quantile regression approach is used, which takes into account the heterogeneity of firms in different quantiles of trade credit distribution. Our results show that the relationship between trade credit and other financial sources presents dissimilarities, including differences in sign, on SMEs with different degrees of trade credit. Our findings help to clarify the confusing results achieved in previous research on this topic. 相似文献
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The debate on spectrum reforms has mostly focused on the choice between a property rights and a commons regime. This article argues that moving to a property right system requires careful attention to details in order to avoid that “micro” rather than “macro” factors may prevent efficient trades from taking place. It provides a framework to conduct this assessment, identifies a number of possible concerns and puts forward some solutions. 相似文献
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Europe no longer suffers from Eurosclerosis; unemployment, notably long-term unemployment, had decreased substantially for more than a decade. Mobility across labour market states increased in those countries where unemployment has been falling the most. Institutional reforms -- such as declining employment protection for new entrants in the labour market and less generous unemployment benefits -- account for this increase in mobility. Focusing on these reforms, we rationalize why EU workers, including those with permanent contracts, are increasingly unhappy about labour market conditions in spite of the disappearance of mass unemployment in Europe. Due to these perceptions, policy reversals cannot be ruled out. Governments wishing to minimize the risk of going back to Eurosclerosis should move towards flexicurity configurations, compensating workers for higher risks of job loss, and introduce tenure tracks to the labour market, preventing the development of dual labour market structures. This would avoid dissipating the employment gains of the last decade during this recession.
--- Tito Boeri and Pietro Garibaldi 相似文献
--- Tito Boeri and Pietro Garibaldi 相似文献
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The relative performance of open economies is analyzed in an endogenous growth model with asymmetric trade. A resource-rich country trades resource-based intermediates for final goods produced by a resource-poor economy. The effects of an increase in the resource endowment depend on the elasticity of substitution between resources and labor in intermediates' production. Under substitution (complementarity), the resource boom generates higher (lower) income, lower (higher) employment in the primary sector and faster (slower) growth in the resource-rich economy. In the resource-poor economy, the shock induces a higher (lower) relative wage and positive (negative) growth effects that are exclusively due to trade. 相似文献