How do policy levers shape the quality of a national health system?

Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.     

四种企业成本控制模式的比较分析及启示

面对日趋激烈的市场竞争环境 ,成本控制成为决定企业生存与发展的关键因素。对目前国内外较为典型的四种成本控制模式的比较分析 ,将为我国企业成本控制模式的选择提供有益的启示     

钢纤维混凝土基本性能试验研究

通过对30个立方体试块抗压强度试验,分析了钢纤维对普通混凝土的增强作用;通过对30个小梁试件三分点加载抗折试验,研究了体积率对钢纤维混凝土(SFRC)荷载-挠度关系及荷载-极限应变关系的影响.在脆性基体中掺入钢纤维,有效地提高了复合材料承受荷载时阻止裂缝引发与扩展的能力,达到对混凝土的增强效果,尤其是对于抗折强度的增强作用,使混凝土的破坏形式由脆性破坏变为塑性破坏.     

Two-stage Huber estimation

In this paper we propose a new robust estimator in the context of two-stage estimation methods directed towards the correction of endogeneity problems in linear models. Our estimator is a combination of Huber estimators for each of the two stages, with scale corrections implemented using preliminary median absolute deviation estimators. In this way we obtain a two-stage estimation procedure that is an interesting compromise between concerns of simplicity of calculation, robustness and efficiency. This method compares well with other possible estimators such as two-stage least-squares (2SLS) and two-stage least-absolute-deviations (2SLAD), asymptotically and in finite samples. It is notably interesting to deal with contamination affecting more heavily the distribution tails than a few outliers and not losing as much efficiency as other popular estimators in that case, e.g. under normality. An additional originality resides in the fact that we deal with random regressors and asymmetric errors, which is not often the case in the literature on robust estimators.     

Bias Correction in the Dynamic Panel Data Model with a Nonscalar Disturbance Covariance Matrix

Approximation formulae are developed for the bias of ordinary and generalized Least Squares Dummy Variable (LSDV) estimators in dynamic panel data models. Results from Kiviet [Kiviet, J. F. (1995), on bias, inconsistency, and efficiency of various estimators in dynamic panel data models, J. Econometrics68:53-78; Kiviet, J. F. (1999), Expectations of expansions for estimators in a dynamic panel data model: some results for weakly exogenous regressors, In: Hsiao, C., Lahiri, K., Lee, L-F., Pesaran, M. H., eds., Analysis of Panels and Limited Dependent Variables, Cambridge: Cambridge University Press, pp. 199-225] are extended to higher-order dynamic panel data models with general covariance structure. The focus is on estimation of both short- and long-run coefficients. The results show that proper modelling of the disturbance covariance structure is indispensable. The bias approximations are used to construct bias corrected estimators which are then applied to quarterly data from 14 European Union countries. Money demand functions for M1, M2 and M3 are estimated for the EU area as a whole for the period 1991: I-1995: IV. Significant spillovers between countries are found reflecting the dependence of domestic money demand on foreign developments. The empirical results show that in general plausible long-run effects are obtained by the bias corrected estimators. Moreover, finite sample bias, although of moderate magnitude, is present underlining the importance of more refined estimation techniques. Also the efficiency gains by exploiting the heteroscedasticity and cross-correlation patterns between countries are sometimes considerable.     

Generalized Laplacian approximations in Bayesian inference

This paper presents a new Laplacian approximation to the posterior density of η = g(θ). It has a simpler analytical form than that described by Leonard et al. (1989). The approximation derived by Leonard et al. requires a conditional information matrix R_η to be positive definite for every fixed η. However, in many cases, not all R_η are positive definite. In such cases, the computations of their approximations fail, since the approximation cannot be normalized. However, the new approximation may be modified so that the corresponding conditional information matrix can be made positive definite for every fixed η. In addition, a Bayesian procedure for contingency-table model checking is provided. An example of cross-classification between the educational level of a wife and fertility-planning status of couples is used for explanation. Various Laplacian approximations are computed and compared in this example and in an example of public school expenditures in the context of Bayesian analysis of the multiparameter Fisher-Behrens problem.     

RuCl2[P(C6H5)3]2(NH2CH2CH2NH2)催化苯乙酮加氢反应的研究

优化了以RuCl2[P(C6H5)3]2(NH2CH2CH2NH2)作催化剂催化苯乙酮加氢制备α-苯乙醇的反应条件,考察了反应温度、反应压力、碱的用量及不同的碱对反应的影响,得出了一个较好的反应条件.     

同工异曲的悲歌--《菊花的幽香》与《薄奠》之比较

英国小说大师劳伦斯创作的<菊花的幽香>和中国著名小说家郁达夫创作的<薄奠>具有异曲同工之处,他们分别以象征和写实的笔法描写了一个以男主人公的死亡为结局的家庭悲剧,并对各自社会的罪恶进行了揭露,因而具有进步意义,成为中英文学史上不可多得的佳作.     

对张学良联共抗日思想形成的几点思考

指出中华民族的千古功臣张学良将军,是中国共产党人的一位真正朋友。论述了张学良联共抗日的思想基础、形成及其实现联共抗日的途径。同时,对张学良联共抗日思想与行动进行了评析,从而为学术界进一步研究和评价张学良将军与中国共产党人的关系提供了借鉴。     

抚顺天湖大桥索夹安装方法

抚顺天湖大桥是一座自锚式悬索桥，主缆材料采用钢丝绳，索夹安装前通过主缆与索夹摩阻系数试验，深入研究了高强螺栓预紧力损失的规律，获得了索夹安装的一系列控制参数；介绍了无猫道施工悬索桥使用移动平台安装索夹的方法和索夹安装时高强螺栓的施拧方案。