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.     

类型化视域下自然保护地立法的制度建构

自然保护地在维持生态平衡,实现生态系统服务功能中可以发挥重要作用,但不同类型自然保护地的主导生态系统服务功能供给存在一定差异.《自然保护地法》立法工作须依赖理论上对自然保护地的类型化,并在此基础上建构对应型的规划建设、运营管理等方面的具体制度.因此,基于生态系统服务功能供给的空间差异,可以将当前相互重叠、缺乏体系的自然保护地划分为国家公园、自然保护区、自然公园、自然保护小区等四种类型,搭建"1部基础法律+4部类型化条例(或法律)"的自然保护地法律体系,并可以通过体系化公法、私法制度工具强化自然保护地的有效治理.     

高校哲学社会科学研究评价的本质要求及其制度建设

建设具有中国特色、中国风格、中国气派的哲学社会科学,一直是我国哲学社会科学繁荣发展的根本目的.提升高校哲学社会科学繁荣发展水平,离不开科学有效的哲学社会科学研究评价.坚持党的领导、"二为"方向和"双百"方针是哲学社会科学繁荣发展的根本保障,坚持"质量为本"和"创新至上"是哲学社会科学繁荣发展的必然要求,坚持科学权威和公开透明是哲学社会科学研究评价的现实需要.结合当前高校哲学社会科学研究评价中"量化评价下数量与质量的关系论辩","学术评价与科研管理评价的边界异化"和"学术权力和行政权力的制度规制"三大问题聚讼,文章建议通过强化学术成果质量保障机制、优化学术共同体工作机制、构建学术争鸣长效机制和完善学术成果转化应用机制等制度建设,推动构建科学权威、公开透明的哲学社会科学研究评价体系,以期进一步改善新时代高校哲学社会科学研究评价工作.     

随机需求环境下联产品系统价格与产量决策研究

基于固定比例生产技术和多产品随机需求的情形,研究了联产品制造商的两阶段产量和价格联合优化模型。通过反向倒推的优化求解,得到了联产品制造商的最优产量和价格决策以及变化规律。同时研究了需求服从均匀分布时,需求波动对均衡的影响。研究结果表明,在订货成本较低和一种产品的需求波动性较大时,当另外一种产品的波动增大,则该产品的最优订货量增大,同时价格下降。借助数值仿真,分析了价格敏感度和产出比例对最优决策和利润的影响。结果表明,在给定一种产品的价格敏感度时,另外一种的价格敏感度越大,那么该产品的价格就越低,制造商的订货量就下降。当一种产品的产出比例固定时,另一种产品的产出比例上升时,则该产品的价格下降,制造商的订货量下降,总利润上升。     

Mentorship experiences during registrar training: reflections of Black African specialists in the Western Cape

In order to meet the significant staffing challenges to health care provision in South Africa, the need to support the training and retention of Black medical specialists has been identified. This small qualitative study aimed to explore experiences of mentorship among a group of Black medical specialists in hopes of understanding the value and potential challenges that these relationships raise. Ten Black medical specialists were interviewed about their experiences of being mentored during their registrar training. The interview data was analysed using discourse analysis, and the results comprise of three main themes, namely: Difficulty accessing mentorship, a lack of Black and/or female role models and finally, experiences of feeling excluded from soft networks. The experiences explored in this study indicate the need for open dialogue within the mentorship dyad regarding certain taken-for-granted assumptions surrounding race, so as to aid the provision of more effective and satisfying mentorship outcomes.     

农户地权诉求视角下农地制度的创新

目前我国农户的地权诉求已经发生了很大的变化，即由地权稳定、自主经营向农地资源的优化配置和高效利用转化。这一变化的内在动力是农户急切希望改变承包地过于细碎化以及改善农业生产经营基本条件。考察我国农地制度的发展史可以发现，我国农地制度变迁的基本逻辑就是农户的地权诉求决定农地制度的发展方向，这一点在当下一些地方的农地制度创新试验和经验中再次得到证明。今后我国农地制度创新必须遵循这一逻辑，根据我国农户地权诉求的变化，实施农户自愿前提下的承包地连片重划,争取国家对承包地重划制度的支持,强化农民集体民主决策制度,地方政府也要给予必要的支持。     

人工智能背景下医疗法律责任的现实困境与完善路径

医疗人工智能利用深度学习和计算机算法等现代化技术，实现辅助诊疗、医学影像、药物发掘、健康诊疗等功能，是人工智能应用最具前景的领域之一。随着人工智能技术发展，具备自主思维和决策能力的智能机器人医生等人工智能将对现有的医疗法律责任制度带来颠覆性影响。在人工智能背景下，医疗人工智能是否具有独立法律主体地位、传统的医疗过错责任归责能否适用、因果关系如何认定等成为现代民事法律责任制度的严峻挑战，也成为实践中的必答之问。因此，在借鉴欧美人工智能领域的探索经验的基础上，在当前阶段通过修正和完善我国民事法律责任制度，提出针对不同的人工智能侵权情形适用差别化归责原则，并尝试建立人工智能强制保险或储备金制度，设置人工智能监管机构及行业标准，以实现既保障患者合法公平权益，又鼓励人工智能技术有效发展之间的平衡。     

丹巴土司制度发展历史考证

丹巴位于“藏彝走廊”的核心区域，其对汉藏民族关系、中央政权与边疆地区的稳定均具有重要影响。自忽必烈时期开始丹巴即开始实行土司制度直至新中国成立，研究丹巴的土司制度发展历史对梳理“藏彝走廊”民族关系及社会发展历史具有重要作用。本文对丹巴土司制度的发展历史进行了考证，并对其境内的四个土司的管辖范围、权力地位进行了梳理，以期对该地区历史发展研究提供一些参考与借鉴。     

Responsibilisation,social work and inclusive social security in Finland

ABSTRACT

In this article responsibilisation in social work is studied by analysing two Finnish state-level policy documents (called final report and research report) which concern a current activation initiative called inclusive social security (ISS). It is asked how social workers and clients are constructed as responsible subjects in these documents. Responsibilisation refers to the advanced liberal mode of governmentality, which aims to strengthen citizens’ abilities to self-governance through various techniques that include the intertwined elements of surveillance and empowerment. It is demonstrated that the policy documents construct the social workers’ and the clients’ responsibilities partly in different ways. The final report leads activation to be based on shared responsibility and social work to be more community-based, whereas the research report strengthens more individual-based responsibility of clients and social workers. For the clients, the interpretation of ISS based on shared responsibility would probably be less stigmatising and paternalistic than the one based on individual responsibilities, i.e. approaching long-term unemployed citizens as being personally ‘at risk’ and thus a justified target group of individualised techniques for activation. For social workers and clients, future activation appears to be a wide mix of different techniques, moral expectations and possible ways of being a responsible subject.     

China’s Choice of Analytical Models for Its Anti-Monopoly Law

Modern analytical models for anti-monopoly laws are a core element of the application of those laws. Since the Anti-Monopoly Law of the People’s Republic of China was promulgated in 2008, law enforcement and judicial authorities have applied different analytical models, leading to divergent legal and regulatory outcomes as similar cases receive different verdicts. To select a suitable analytical model for China’s Anti-Monopoly Law, we need to consider the possible contribution of both economic analysis and legal formalism and to learn from the mature systems and experience of foreign countries. It is also necessary to take into account such binding constraints as the current composition of China’s anti-monopoly legal system, the ability of implementing agencies and the supply of economic analysis, in order to ensure complementarity between the analytical model chosen and the complexity of economic analysis and between the professionalism of implementing agencies and the cost of compliance for participants in economic activities. In terms of institutional design, the models should provide a considered explanation of the legislative aims of the law’s provisions. It is necessary, therefore, to establish a processing model of behavioral classification that is based on China’s national conditions, applies analytical models using normative comprehensive analysis, makes use of the distribution rule of burden of proof, improves supporting systems related to analytical models and enhances the ability of public authorities to implement the law.