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.     

Factors associated with a positive childbirth experience in Brazilian women: A cross-sectional study

BackgroundHaving a positive childbirth experience is an increasingly valued outcome. Few studies evaluated the women’s satisfaction with childbirth through face-to-face interviews out of the health service environment. The objective of this study was to identify factors associated with a higher level of satisfaction with the childbirth experience among Brazilian women.MethodsThis cross-sectional study involved 287 women giving birth in two hospitals in southern Brazil. Women who gave birth to healthy newborns at term were randomly selected. Face-to-face interviews were conducted 31–37 days after delivery, at the mothers’ homes, using a structured questionnaire. Satisfaction with the childbirth experience was measured using a Likert-type scale ranging from very satisfied to very dissatisfied. Prevalence ratios (PR) were estimated using Poisson regression with robust variance.ResultsFollowing hierarchical multivariate analysis, the following factors remained associated with a higher level of satisfaction with the childbirth experience: being satisfied with antenatal care (PR = 1.30; 95% confidence interval [95%CI] = 1.06−1.59), understanding the information provided by health professionals during labor and delivery (PR = 1.40; 95%CI = 1.01−1.95), not having reported disrespect and abuse (PR = 1.53; 95%CI = 1.01−2.31), and having had the baby put to the breast within the first hour of life (PR = 1.63; 95%CI = 1.26−2.11). No association was observed with type of delivery or hospital status (public or private).ConclusionsA higher level of satisfaction with the childbirth experience is related to satisfactory antenatal care, a non-abusive, respectful, and informative environment during childbirth, and to the opportunity to breastfeed the baby within the first hour of life. In clinical practice, greater attention to these basic principles of care during pregnancy and delivery could provide more positive experiences during birth.     

政府动态奖惩机制下绿色建筑供给侧演化博弈研究

从绿色建筑供给侧角度出发，构建消费者效用函数、开发商利润函数和政府与开发商的演化博弈模型，分析消费者绿色偏好、建筑绿色度、成本等因素对建筑价格、需求和利润的影响以及政府动态奖惩政策下系统的演化稳定策略。结果表明：消费者绿色偏好支付系数和建筑绿色度的增大有利于绿色建筑价格、需求和利润的提高，但高成本却使需求和利润降低；政府采用静态补贴与静态税收政策时，博弈系统不存在演化稳定策略，采用动态补贴与静态税收、静态补贴与动态税收、动态补贴与动态税收三种政策组合时，系统存在演化稳定策略；动态补贴与静态税收的政策组合在推动绿色建筑发展方面优于其他政策；开发商开发绿色建筑的概率与补贴上限值呈负相关，与税收上限值呈正相关。     

货币政策反应函数渠道对金融周期影响时变机制的实证研究

在关于货币政策影响经济主体风险承担水平,进而影响金融周期波动机制的研究中,基于风险承担渠道的相关研究较为成熟.区别于以往相关研究多关注货币政策实际采取的立场,文章基于货币政策反应函数渠道探讨了数量型与价格型货币政策反应函数对金融周期波动影响的时变机制.滚动回归的实证结果显示:无论数量型货币政策规则还是价格型货币政策规则,货币政策对信贷波动反应的敏感性主要影响金融周期的波动,但在价格型货币政策规则下,基于信贷视角观察金融周期波动时,货币政策信贷敏感性与货币政策资产价格敏感性对金融周期影响差异较小;较之于价格型货币政策规则,货币政策对信贷波动反应的敏感性在数量型货币政策规则下,对金融周期波动的影响更显著,并在一定程度上表现出随时间扩大的趋势.文章的创新之处在于:强调了货币政策通过政策反应函数渠道而非以往研究中较多关注的狭义风险承担渠道影响金融周期波动的事实,并构建计量模型对货币政策反应函数渠道影响金融周期波动的时变机制进行了详细刻画.     

突发重大疫情网络舆论的生成逻辑､演进特征与治理机制

新形势下突发重大疫情网络舆论不仅给疫情防控带来了严峻挑战，而且给维护国家意识形态安全带来了较大压力。厘清网络舆论的生成逻辑，把握网络舆论发展的演进特征，对做好网络舆论引导与谣言治理意义重大。在现代网络社会，随着交往实践的普遍进行，从现实逻辑、实践逻辑与理论逻辑来看，突发重大疫情网络舆论的生成，是网络议题、网络交往和网络传播相互作用的结果。受网络社会交往实践主体、客体、环体和介体等多种因素影响，突发重大疫情网络舆论又呈现为非线性的发展演进趋势，极易引发“蝴蝶效应”造成舆论秩序失范，甚至导致“塔西佗陷阱”的舆论信任危机，给疫情防控带来复杂变数。必须建立健全网络舆论治理机制，有效管控舆情，提高疫情防控治理水平。     

Leader-member exchange as a linking pin in the idiosyncratic deals - Performance relationship in workgroups

In the current investigation, idiosyncratic deals (i-deals; individualized work arrangements) are modeled as differentiated resources that shape leader-member exchange (LMX) relationships in workgroups. We integrate literature on leader-member exchange (LMX) with research on i-deals to argue that employee evaluations of i-deals received from the grantor –typically the leader- enhance employee perceptions of LMX, which in turn become instrumental in generating positive performance outcomes. Furthermore, because workgroup characteristics have potential implications on the relationship between a deal grantor and the deal recipient, drawing upon social identity theory of leadership, we reason that the i-deals-LMX relationship is affected by the overall value congruence among the group members. Cross-level moderated mediation analyses on multi source data obtained from 289 employees nested in 60 workgroups showed that the mediational role of LMX in the i-deals to performance outcomes relationship was weaker in high value congruence groups.     

Engaging leader – Engaged employees? A cross-lagged study on employee engagement

The goal of this study is to provide a cross-lagged examination of the relationships between engaging leadership, job resources and employee work engagement. We propose a mediation model and we postulate that engaging leadership can increase perceptions of three specific job resources (i.e. autonomy, support from colleagues and opportunities for learning and development) which theoretically correspond to the three facets of engaging leadership (i.e., inspiring, connecting and strengthening, respectively). Subsequently, in keeping with the extant body of Job Demands-Resources (JD-R) research, we link job resources to employee work engagement. Our hypotheses were tested on data collected at two time-points – T1 (N = 759) and T2 (N = 273) –from employees working for a hotel chain in the Netherlands. In line with our expectations, engaging leadership showed a significant cross-lagged relationship with autonomy and support from colleagues, but did not predict learning opportunities and work engagement across time. While we formulated specific hypotheses, we also tested reversed causation relationships. We found no direct effect from engaging leadership on employee work engagement, however, the reversed effect was significant; employee perceptions of engaging leadership were shaped by their own engagement experiences. Importantly, engaged employees at T1 reported more job resources at T2. By providing a cross-lagged examination of our model, we showed that engaging leaders as well as employees’ positive affective state of being engaged, are essential to shaping a resourceful work context. A comprehensive view on the triggers and outcomes of work engagement and engaging leadership is needed, as the traditional unidirectional cause-effect rationale fails to explain how these concepts relate to one another and to employee experiences of job resources.     

中国员工企业伦理态度调查及分析

随着中国市场经济的发展,各种企业丑闻的频发引起业界广泛关注,公司治理越来越受到重视。已有的研究表明,员工企业伦理态度关乎员工承诺度和企业竞争力。本文依据个人层次研究理论,采用实证分析方法,选择国内6家企业的员工为调研对象,沿用国外企业伦理个体层次研究中广泛使用的量表"Attitude Towards Business Ethics Questionnaire"(ATBEQ)即企业伦理态度量表,考察当代中国企业员工对企业伦理态度的看法;另外,也分析了不同的工作年限,性别,学历,户口等因素下的企业员工伦理态度差异。调查结果显示:中国员工的企业伦理观存在困惑;大部分中国员工有企业利益相关者意识;教育对企业员工伦理态度存在显著影响。     

中国特色社会主义制度自信：基本依据·价值意蕴·实现路径

中国特色社会主义制度是立足世情、国情、民情和党情建立起来的制度体系。从历史选择到制度实践构成了我们在新时代夯实制度自信的基本依据；从共同富裕到人的全面发展彰显了制度自信特有的价值意蕴。站在新的发展阶段，既需要大胆借鉴古今中外制度建设的有益成果，又务必坚持在实践基础上以理论创新推动制度创新，以制度借鉴、制度实践和制度创新进一步坚定制度自信。     

历史变局、国家兴衰与发展之路——三次千年变局叠加下的中国特色社会主义发展道路

每当先进的发展制度开始取代落后的发展制度时，整个世界格局就会进入重大的转换阶段。在中国五千年的发展历史中，有两次重大的历史变局完全改变了中国历史发展轨迹并深远地影响了当前中国的发展模式。新时代下的中国作为前两次历史变局影响的客体，曾经既是先进发展制度取代落后发展制度的受益者，也经历过作为落后发展制度主体而被先进发展制度冲击的过程。目前世界正处于第三次先进发展制度与落后发展制度交替的历史变局阶段，作为第三次重大历史变局的主体，在三次千年历史变局叠加的背景下，能否有效地认识、适应并改造利用前两次历史变局的经验与教训，构建系统性、科学性、可行性、领先性的中国特色社会主义制度，将决定中国在本次历史变局中能否顺利成为先进发展制度的主体从而实现民族复兴。