国家治理体系与政府购买公共服务

政府购买公共服务关系到政府职能的转变和政府治理水平的提升,关系到政府与市场之间功能与地位的调整与理顺,因而是国家治理体系的重要一环。政府购买公共服务背后体现的是国家治理体系现代化的取向,那么在理论逻辑上是要以新公共管理理论、政府治理、第三方治理和多中心治理理论为理论基石。目前,我国政府购买公共服务还存在着范围不清、关系不顺、法律不健全的制度现实,因而必须构建科学规范的现代化的政府购买服务制度和配套制度体系,以进一步推进国家治理体系的制度现代化。     

Multi-objective optimization in partitioning the healthcare system of Parana State in Brazil

Motivated by a proposal of the local authority for improving the existing healthcare system in the Parana State in Brazil, this article presents an optimization-based model for developing a better system for patients by aggregating various health services offered in the municipalities of Parana into some microregions. The problem is formulated as a multi-objective partitioning of the nodes of an undirected graph (or network) with the municipalities as the nodes and the roads connecting them as the edges of the graph. Maximizing the population homogeneity in the microregions, maximizing the variety of medical procedures offered in the microregions, and minimizing the inter-microregion distances to be traveled by patients are considered as three objective functions of the problem. An integer-coded multi-objective genetic algorithm is adopted as the optimization tool, which yields a significant improvement to the existing healthcare system map of the Parana State. The results obtained may have a strong impact on the healthcare system management in Parana. The model proposed here could be a useful tool to aid the decision-making in health management, as well as for better organization of any healthcare system, including those of other Brazilian States.     

Sexual Health Services for Homeless Youth: A Qualitative Analysis of their Experiences

The sexual health problems experienced by homeless youth bring into question their use of available sexual health services. Using a qualitative typological analysis, this study aims to identify sexual health services utilization profiles for homeless youth, and to understand the role of the homeless experience on the utilization of sexual health services. Individual interviews were conducted with 33 homeless youth (17 men, 16 women) between 18 and 25?years of age. Typological analysis identified four profiles: (1) a targeted use of sexual health services to determine one’s serological status following a relational change during the homeless experience; (2) a limited use of sexual health services to manage sexual emergencies that arise during the homeless experience; (3) a regular use of sexual health services to avoid the risks associated with the homeless experience; (4) a frequent use of sexual health services to obtain support when engaging in prostitution during the homeless experience. This study shows that the precarious and unstable conditions within the homeless experience incite youth to utilize sexual health services in different ways. These findings point to the importance of rethinking sexual health services to better adapt them to the different utilization profiles of homeless youth.     

Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

The changing landscape of public service delivery systems for disabled people in China: a Shanghai case study

This article will consider the current development of an emerging contract culture for the delivery of social services and its impact on disabled people in China. The discussion is based on an original qualitative study in Shanghai. The past 30 years have seen dramatic changes in China, which in parts have led to improvements in the lives of disabled people. The China Disabled Persons’ Federation (CDPF) became a key player in delivering these changes with the government. However, the CDPF is being criticized by disabled people for being too bureaucratic and not being effective enough in its delivery of services. One of its responses is to work with newly emerging not-for-profit organizations (NPOs) of and for disabled people. The CDPF has now begun to contract the delivery of some services to such NPOs. It is hoped that this may improve their effectiveness but the development of a contract culture in the delivery of services for disabled people may also be seen to pose a threat.     

数据驱动下收货方质量偏好与电商配送服务质量优化

针对"互联网+大数据"优化电商配送服务质量问题，明确不同收货方的质量需求稳定性，引导电商根据收货方不同质量敏感性提供相对精准服务，提升配送服务质量。模拟投票结果的形成过程聚类得到收货方对服务质量偏好的记忆性特征：（1）"无记忆"型收货方；（2）"记忆"型收货方；（3）"不确定"型收货方；（4）收货方总体。进一步推导不同规划类型求解空间，设计得到"无记忆"型收货方动态规划精确求解方法，及其他三种类型近似求解粒子群算法。研究过程中，配送资源质量感知度被嵌入到模型约束；"无记忆"型收货方的质量需求规划问题转化为零库存策略最优解问题，进而证明存在精确解；"记忆"型收货方呈现出对质量感知的累积；"不确定"型收货方模型通过赋值即可得总体收货方表达式。结果表明：数据驱动研究框架借助大数据资源，使得电商更易通过收货方的质量偏好设计更加匹配的配送方案；不确定服务需求得到有效满足，投入成本的利用率更高；通过特征分类的方式，尽可能地抽取能够精确最优化的部分，缩小NP范围，提高整体求解的精确度。     

农业机械化服务对粮食生产成本效率的影响——来自中国小麦主产区的经验证据

运用超越对数SFA模型测算1994—2016年中国15个小麦主产地区成本效率，继而构建空间杜宾计量模型考察农业机械化服务对小麦生产成本效率的直接影响与空间溢出效应。结果表明：中国小麦生产成本效率仍存在17.3%的损失；农业机械化服务对小麦成本效率具有正向显著的直接效应和空间溢出效应，即本区域农机化水平对其他区域小麦成本效率有显著的正向影响；从空间维度来看，农业机械化的空间溢出效应主要表现在经度相近地区之间，纬度相近地区之间并不显著；从时间维度看，2004年前后农业机械化的空间溢出效应具有明显差异，2004年之后空间溢出效应更加明显。据此提出农机补贴向农机服务组织倾斜，建设和推广农机信息平台以及作物种植沿经度布局的政策建议。     

贵州黔南州传统民族特色村寨保护与开发利用研究

贵州省黔南州布依族苗族乡村聚居区在传统民族特色村寨保护与开发利用工作中取得了较大的成效，积累了大量的成功经验，但也存在一些问题及不足：民族特色村寨保护与开发意义的认知有待提升；政府对民族特色村寨保护与开发利用的刚性规划缺失；开发的民族特色村寨功能单一；黔南少数民族传统特色文化的总体情况呈现复兴、衰退和变异并存；民族特色文化精品的培育顶层支撑不足；民族特色村寨开发与传统民族文化融合度不够；对传统特色老旧民宅价值认识不足。针对以上问题，首先应着力提升黔南州民族特色村寨保护开发格局，争取纳入国家改革试验规划；其二，抓住大数据与智慧乡村建设的时机，率先推进民族地区乡村治理现代化示范；其三，创新投融资体制机制，构建“民族特色村寨资源资本化金融服务平台”；其四，探索乡村房屋租赁权跨区域流通的体制机制，不断提升农民的物权收益；其五，加大民族特色村寨品牌建设力度，增加特色村寨旅游产品附加值；其六，完善村寨文化资源资产化经营监管体系，构建村寨文化资源保护利用长效机制。     

城乡差异、就医惯性与老年人卫生服务利用

现有对城乡老年人卫生服务利用不公平的研究多忽略了长期的城乡差异所导致的隐性的农村老年人就医惯性的存在。本研究在控制了收入、医疗保障和就医可及性等因素的条件下，发现就医惯性的存在；并运用集中指数分解法发现，卫生服务的利用存在不公平，偏向于富人，而就医惯性在两种卫生服务利用中的贡献度分别为12%和5%。这种城乡固定差异造成了农村老年人在身体健康、心理健康和自我照料能力上都显著地低于城市老年人。     

Not a lonely crowd? Social connectedness,religious service attendance,and the spiritual but not religious

Using the 2006–2014 General Social Survey and 2006–2012 Portraits of American Life Study, I find that on three dimensions of social connectedness: social interaction frequency, core discussion network size, and number of close ties, that religious service attenders are more connected than religious non-attenders and then either spiritual nor religious, but there are few differences between attenders and the spiritual but not religious. Difference-in-differences and fixed-effects models show little evidence that switches between categories are associated with changes in connectedness, and additional models show that prior social connectedness explains only a small amount of future switches. This paper challenges assumptions that the non-religious are a homogenous group lacking the benefits provided though the social networks of religious congregations and has implications for research on what it means to be spiritual, measuring religion and spirituality, and understanding the role of formal organizations in social life.