参加医疗保险对农村居民健康的影响——基于CHARLS 2015数据的实证分析

基于CHARLS 2015数据,采用倾向得分匹配法实证分析参加医疗保险对农村居民健康的影响。研究发现:参加医疗保险对农村居民的日常活动能力和自评健康影响不显著,参加医疗保险对农村居民认知能力具有显著的正向影响。据此提出,应进一步提升社会医疗保险保障水平、扩大社会医疗保险保障范围、促进商业医疗保险有序发展、推进"三医"高效协同联动等,以充分发挥医疗保险的健康保障功能,从而进一步提升参加医疗保险对农村居民健康的正向影响。     

Beyond Piketty: A new perspective on poverty and inequality in India

The socio-economic literature has focused much on how overall inequality in income distribution (frequently measured by the Gini coefficient) undermines the “trickle down” effect. In other words, the higher the inequality in the income distribution, the lower is the growth elasticity of poverty. However, with the publication of Piketty’s magnum opus (2014), and a subsequent study by Chancel and Piketty (2017) of evolution of income inequality in India since 1922, the focus has shifted to the income disparity between the richest 1% (or 0.01%) and the bottom 50%. Their central argument is that the rapid growth of income at the top end of millionaires and billionaires is a by-product of growth. The present study extends this argument by linking it to poverty indices in India. Based on the India Human Development Survey 2005–12 – a nationwide panel survey-we examine the links between poverty and income inequality, especially in the upper tail relative to the bottom 50%, state affluence (measured in per capita income) and their interaction or their joint effect. Another feature of our research is that we analyse their effects on the FGT class of poverty indices. The results are similar in as much as direction of association is concerned but the elasticities vary with the poverty index. The growth elasticities are negative and significant for all poverty indices. In all three cases, the disparity between the income share of the top 1% and share of the bottom 50% is associated with greater poverty. These elasticities are much higher than the (absolute) income elasticities except in the case of the poverty gap. The largest increase occurs in the poverty gap squared – a 1% greater income disparity is associated with a 1.24% higher value of this index. Thus the consequences of even a small increase in the income disparity are alarming for the poorest.     

中国扶贫70年:基于实现共富的三重向度研究

消除贫困、实现共同富裕是社会主义的本质要求，也是中国共产党人的“初心”和“使命”。新中国成立70年来，党和政府为实现全体人民共同富裕的奋斗目标，带领全国人民持续向贫困宣战，成功探索出了一条具有中国特色的扶贫道路，取得了举世公认的扶贫成就。基于实现共富的三重向度来回顾中国扶贫70年的发展历程：在历史向度上，中国扶贫道路经历了救济式扶贫、体制改革式扶贫、开发式扶贫、参与式扶贫和精准扶贫等5个发展阶段；在实践向度上，中国扶贫始终坚持实事求是思想路线，发挥党的领导和政府主导相结合的政治优势，积蓄扶贫物质的经济力量，形成了独具中国特色的“中国经验”；在价值向度上，中国扶贫70年所形成的“中国经验”为世界减贫理论、减贫事业的发展贡献出了“中国智慧”和“中国方案”，具有极其重要的世界意义。     

Developing and testing a mobile application for breastfeeding support: The Milky Way application

BackgroundSupporting women to continue breastfeeding is a global challenge. The Milky Way Program is an effective face to face intervention to increase breastfeeding rates up to six months postpartum. The sustainability and access to the Milky Way Program could be enhanced by transforming it into a mobile application allowing women to access relevant information from their own place at a convenient time.AimTo explore the process of transforming the Milky Way Program into an acceptable and usable mobile health application.MethodStakeholders including multidisciplinary researchers and end-users designed the application based on the Milky Way Program by using Persuasive System Design principles. A mixed-method approach was used in the development and evaluation process. Seven women were recruited through convenience sampling to pilot test the application. The women’s feedback was collected through an online survey six weeks after birth and individual interviews at four months postpartum.FindingsWomen in the pilot study reported that the breastfeeding application was well designed, easy to use, interactive, reassuring and evidence-based with credible sources of information.ConclusionThe Persuasive System Design model combined with end-user engagement can feasibly inform the development of an acceptable and usable mobile health application for breastfeeding based on a proven clinical intervention. Further rigorous testing is required to evaluate the effectiveness of the application on breastfeeding initiation and duration.     

"指标困局":农村贫困治理的实践与反思

在国家的扶贫实践中，地方政府的行为策略是影响扶贫绩效的关键变量。通过对精准扶贫政策实践的调研发现，中央政府不断升级的治理手段为重构央地关系创造了条件，地方政府对国家扶贫理念转型认知的偏差以及在形成路径依赖之后的策略行为不仅容易产生对总体局势的误判，还为后期的政策困局埋下了伏笔。在此背景下，地方扶贫工作遭遇“指标困局”，即地方政府很难实事求是去识别贫困户，只能在既有的指标约束下进行精准识别，扶贫工作陷入了反复识别，却仍难实现精准的怪圈。     

乡村振兴视阈下农户多维贫困测度及扶贫策略

乡村振兴的关键是打赢脱贫攻坚战。集中连片特困地区是我国精准扶贫的重点区域，致贫因素复杂，扶贫任务艰巨。基于秦巴山区农户的调查数据，运用A-F测度方法对农户多维贫困进行测度与分解，并运用Probit回归模型对其影响因素进行实证分析。结果表明：农户在厕所类型、做饭燃料、健康状况和受教育程度等方面存在严重的问题，贫困现象普遍。K=3时，农户多维贫困发生率高达90.56%，多维贫困指数为0.391 6；农户家庭65岁以上人数、耕地面积、地理位置和地理环境对农户多维贫困有显著正向影响；户主婚姻状况、受教育水平、健康状况、家庭人口数量等对农户多维贫困有显著负向影响。建议从生活水平、健康医疗、养老保障和教育等方面进行重点扶贫，使农户早日脱贫致富。     

安徽省大别山区旅游扶贫效率时空格局演化及影响机理

采用DEA模型对安徽省大别山区旅游扶贫效率的综合测度影响因素分析可知:安徽省大别山区旅游扶贫效率处于中等偏低水平,呈现波动上升的趋势,主要受规模效率驱动;旅游扶贫规模效率和旅游扶贫综合效率的空间分异特征较为类似,均呈现出区域中间高南北低的分布,旅游扶贫纯技术效率高值区呈现出由区域北部和南部片状集中分布逐渐向四周不断分散分布的演化态势;投入规模、人力支持水平、可达性水平、信息化水平对大别山区旅游扶贫效率产生正向影响,且影响强弱呈现为信息化水平>人力支持>可达性水平>投入规模。     

医疗信息共享对患者转移数量和服务质量水平影响研究

当前我国医院间存在严重的"信息孤岛"，医院参与医疗信息共享意愿不高，患者的诊疗信息被静态碎片化储存而无法充分有效地利用。考虑到医院进行医疗信息共享将降低患者转移成本，本文构建一个多阶段双寡头动态博弈模型研究医疗信息共享对医院竞争过程中患者转移数量和服务质量水平决策的影响。首先，根据是否存在转移成本，将患者分为新患者和经验性患者，借助Hotelling模型刻画患者的效用函数，分析患者就诊决策。然后，在政府价格规制和不考虑医院利他性情景下，构建了医院累积期望收益目标函数，使用动态规划方法，求解实现医院累积期望收益最大化的服务质量水平，获得了实现患者相互转移且医院在市场中共存的马尔可夫完美均衡。最后，根据医院参与医疗信息共享后患者转移成本降为零，分析与比较信息共享前后患者转移数量和服务质量水平变化。研究发现：在不同医院间本身存在患者转移背景下，医院参与信息共享后，患者转移数量增加但存在一个上限，增加的转移量与患者在医院间的转移成本呈正相关，与初始感知效用的差值范围呈负相关；医院参与信息共享后，均衡状态下的医院服务质量水平高于信息共享前的服务质量水平。因此，在不改变当前医保支付方式下，要加快推进医疗信息共享，政府部门可以根据医院的患者数量和服务质量水平变化对其进行定期补贴，以激励医院积极参与医疗信息共享，本文给出了这个补贴的量化表达。     

A Leadership Training Group for at Risk Fifth & Seventh Graders: Results from A Brief Strength-Based Group Program

ABSTRACT

An increasing number of youth are exhibiting social, emotional, and behavioral problems that hinder their ability to function at grade level. Subsequently, school mental health services have not been able to address the need for services particularly among students who are minority and poor. A mixed methodology study was conducted to determine the treatment outcomes from a brief strength-based leadership training group for primarily students who are African American and poor. Pre–post scores on three scales and focus group data revealed significant positive changes in regard to internal areas of functioning and social skills, anger management skills, and school attitude. Gender and age significantly impacted outcomes.