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。     

需求分布规律变化情况下的报童订货策略

在需求分布规律变化情况下，报童在进行订货决策时会因为错误判断需求分布规律而导致期望库存成本增加。为了解决这一问题，本文集成传统历史需求信息和非传统需求信息以正确地认知需求分布规律，在此基础上决策订货量。假设需求服从均值不同、方差相同的两种类型的正态分布，每一种正态分布的概率已知。利用信号检测理论构建基于历史需求信息与需求分布概率的报童最优订货策略，并与只基于需求分布概率的直觉规则订货策略进行对比。结果表明：只要排除需求分布概率很大或很小两种极端情况，最优订货策略比直觉规则订货策略在控制期望库存成本方面的作用更明显，即利用历史需求信息可以有效修正报童对实际需求分布的检测结果，从而提高实际订货决策的准确性。研究结果对传统历史需求信息和非传统需求信息的集成以及需求信息交换等有一定的管理学启示和应用价值。     

Effective tax rates and firm size in Ethiopia

The literature on Effective Tax Rates (ETRs) focuses on high‐ and middle‐income countries, but there is very little evidence on low‐income countries. This article addresses this gap with new evidence from Ethiopia. We investigate corporate ETRs in Ethiopia and whether the distributional effects they have in practice are in line with the corporate tax policy design. We calculate ETRs in line with the literature in this field, using profit tax at the numerator and gross profit at the denominator. We then analyse ETRs not only using panel data, focusing particularly on their relation to firm size, but also including other explanatory variables. Our main result is that, despite a proportional tax rate, small firms face a higher effective tax burden than larger firms, while middle‐sized firms face the lowest burden of all. We highlight that tax systems can have practical implications that differ largely from their policy design, due to compliance costs and imperfect enforcement. Measures to reduce compliance costs for small firms are particularly recommended.     

The “Socialization of Elderly Hospitalization” in China: Development,Problems, and Solutions

ABSTRACT

Objectives to analyze the development of the elderly patients with chronic diseases and to make some suggestions for the elderly social hospitalization. Methods By using yearbook data and theoretical analyses, the paper respectively presents the problems and furthermore solutions of China's elderly services. Results The elderly patients with chronic illnesses have formed a new group, and the phenomenon of “socialization of elderly hospitalization” has become a major social risk. Discussions China needs to promote the idea of “long-term care” in elderly social security, establishing long-term care insurance and fostering a private, professional elderly service system.     

改进区间可接受度的证券投资组合区间二次规划模型

本文首先基于Markowitz的经典均值方差模型，针对不确定环境下的投资组合问题，把证券的收益率、风险损失率和流动性用区间数描述，建立了一种新的含交易成本的证券投资组合区间二次规划模型。其次，为求解该模型，提出了改进的区间可接受度确定性转换方法，通过引入优化水平α与可接受水平η将不确定二次规划转化为确定型规划。最后，通过数值实验将提出的方法与传统方法进行比较，结果表明本文所提出的方法与模型具有相对较好的可行性与实用性。     

老年流动人口的就医行为及影响因素研究

近年来,我国老年流动人口的规模持续上升。文章使用2015年全国流动人口动态监测调查数据,从门诊治疗和住院治疗两个方面出发,使用Logit模型和Heckman两步法检验分析老年流动人口的就医行为及其影响因素。结果显示,在患小病时,70岁及以上、以家庭其他成员收入为主要收入来源、家庭人均月收入水平较高、患有高血压或糖尿病的流动老年人选择门诊就医的可能性更高,差异有统计学意义(P<0.05)。在患需要住院治疗的疾病时,以离退休金/养老金为主要收入来源、自评身体健康的老年流动人口更有可能选择住院治疗。参加医疗保险的类型也对老年流动人口的就医行为存在着显著的影响。此外,外出务工、依靠子女和退休养老三类老年流动人口在门诊就医行为及其影响因素方面也存在显著差异。     

The trinity of wage setting in EMU: A policy proposal

Diverging labor cost developments are often considered to be one of the most important factors that led to large current account imbalances in the euro area (EA) in the run-up to the global financial crisis. It has also been shown that wage growth differentials have significantly lowered the co-movement of EA countries’ business cycles – the most widely used meta-criterion for optimum currency areas. Against this background, this paper develops a wage-setting benchmark that aims to keep the economy in internal equilibrium and to maintain price stability, while it also exhibits the capacity to correct for external imbalances. The proposed wage benchmark is very simple and may serve as an anchor for the macroeconomic dialogue in Economic and Monetary Union. In order to demonstrate the potentially beneficial effects of such a wage benchmark we present some simulations showing how current account balances and labor costs would have developed across EA countries if the rule had served as a benchmark already in the run up to the crisis.     

To live an ordinary life: resource needs and additional costs for people with a physical impairment

Disabled people face increased risks of living in poverty largely due to lower incomes and extra resource requirements compared to non-disabled people. This study incorporated the social model of disability with an economic approach to costing to estimate the additional costs required by people with a physical impairment to achieve an adequate standard of living in New Zealand. Budgets estimating the additional equipment, modifications, transport, support and time required to achieve an adequate standard of living were developed and validated through focus groups with community members. The findings suggest that reducing barriers involves substantial costs ranging from NZ$645–$2,348 per week.     

“…and they are really lying”: Clean evidence on the pervasiveness of cheating in professional contexts from a field experiment

We investigate the pervasiveness of lying in professional contexts such as insurance fraud, tax evasion and untrue job applications. We argue that lying in professional contexts share three characterizing features: (1) the gain from the dishonest behavior is uncertain, (2) the harm that lying may cause to the other party is only indirect and (3) lies are more indirect lies by action or written statements. Conducted as a field experiment with a heterogenous group of participants during a University “Open House Day”, our “gumball-machine-experiment” provides field evidence on how preferences for lying are shaped in situations typically found in professional contexts which we consider to be particularly prone to lying behavior compared to other contexts. As a key innovation, our experimental design allows measuring exact levels of cheating behavior under anonymous conditions. We find clean evidence that cheating is prevalent across all sub groups and that more than 32% of the population cheats for their own gain. However, an analysis of the cheating rates with respect to highest educational degree and professional status reveals that students cheat more than non-students. This finding warrants a careful interpretation of generalizing laboratory findings with student subjects about the prevalence of cheating in the population.