新型农村合作医疗参合农民满意度影响因素辨析及其政策优化:一个基于L市的案例分析

参合农民的满意度是评价新农合基金绩效的重要指标。对L市2015年592位参合农民的样本数据进行分析,发现就医过程对参合农民满意度影响最为显著,其中,农民满意度与新农合定点医疗机构的医疗水平和综合费用有很强的相关度;新农合基金管理水平对参合农民满意度有较为显著的影响,制度设计对参合农民满意度影响最小。因此,为优化新农合基金政策绩效、提升参合农民满意度水平,应构建高质量医疗服务供给机制、强化农民主动参与机制、推进新农合政府管理机构能力建设以及对新农合基金绩效开展持续评价。     

家庭医生签约服务下社区居民就医选择的相关因素研究

为了解南京市浦口区居民就医选择现状,分析影响就医选择的相关因素,以浦口区11个社区卫生服务中心为调查地点,普查与等容抽样相结合方式纳入调查对象2 301人。问卷调查收集其人口学特征、就医选择以及医疗相关行为等信息;多因素Logistic回归分析浦口区居民就医选择的相关影响因素。结果显示,调查对象中1 883人（81.9%）表示可以接受以家庭医生为核心的基层首诊,1 525人（66.3%）选择首先去基层医疗机构就诊。Logistic回归分析结果显示,到最近医疗机构所需时间、年龄、慢性病、是否签约家庭医生是居民接受以家庭医生为核心的基层首诊的相关因素;影响居民就医选择的相关因素则包括到最近医疗机构所需时间、年龄、文化程度、家庭人均月收入、是否签约家庭医生。浦口区居民选择基层医疗机构首诊的构成比相对较高;签约家庭医生有助于促进社区居民对基层首诊的选择与接受度;60岁及以上老年人与慢病患者对基层首诊的需求度更高,提示签约家庭医生的推广工作应重点关注这两类人群。     

南京市公立医院医务人员薪酬水平及满意度研究

通过对965名公立医院医务人员进行自填式问卷调查,探讨南京市公立医院薪酬水平及其满意度情况,为南京市公立医院薪酬制度改革提供科学依据。结果显示,医务人员年均工资为（8.86±4.48）万元,存在岗位差异和医院等级差异;员工期望年均总工资为现有年均工资的2倍左右,社会平均工资的2倍或3倍;薪酬水平总体满意度得分为（3.06±0.89）分,处于一般水平,3个维度满意度按得分高低排序依次为：内部公平性、个人公平性和外部公平性;多元线性回归分析结果显示,年龄、婚姻状况、职称、岗位类别和医院等级对薪酬水平满意度的影响有统计学意义（P＜0.05）。公立医院薪酬制度改革应努力提高薪酬水平,合理拉开不同岗位间工资差距,并注重发挥非经济性报酬的作用,以期有效促进公立医院健康、持续发展。     

浙沪传染病信息有效利用程度比较及对传染病防控影响研究

系统收集涉及浙沪两地公开发布的传染病信息利用的文献及信息报告,量化计算有效利用程度;运用 Spearman 相关、线性回归分析传染病信息有效利用程度与甲、乙类传染病发病率之间的关系。结果显示,浙江省传染病信息有效利用程度从 2000 年的0.3%上升到 2017 年的 9.8%,上海市从 2000 年的2.9%上升到 2017 年的17.5%;浙沪两地的及时程度与甲、乙类传染病发病率呈显著负相关（P < 0.01）,对传染病发病的解释程度分别为 47.2%和79.2%。浙沪两地传染病信息有效利用的程度有差异,浙江省的利用程度较低,说明有效利用疾病监测信息是做好传染病防制工作的前提;两地仍要加强传染病信息的有效利用;该方法用于量化一个国家（或地区）传染病信息有效利用程度是科学可行的,可推广应用于其他公共卫生领域或地区。     

N市老年人家庭医生签约服务知晓与利用情况调查分析

采用自制问卷,对N市2017年4月新签约居民进行电话调查,以有效应答样本中9 362例老年人为研究对象,分析N市主城区与非主城区老年人对家庭医生签约服务的知晓与利用情况差异。结果显示,在控制其他人口学因素不变的情况下,非主城区老年人签约知晓率是主城区的1.467倍,服务内容了解率是主城区的1.717倍,人均服务利用项目比主城区多0.630项,差异均有统计学意义。主城区与非主城区老年人对家庭医生签约服务的知晓与利用情况存在差异,如何发挥好家庭医生服务的作用应在实践中进一步探索。     

Ridge Estimation to the Restricted Linear Model

This article is concerned with the problem of multicollinearity in a linear model with linear restrictions. After introducing a spheral restricted condition, a new restricted ridge estimation method is proposed by minimizing the sum of squared residuals. The property of the new estimator in its superiority over the ordinary restricted least squares estimation is then theoretically analyzed. Furthermore, a sufficient and necessary condition for selecting the ridge parameter k is obtained. To simplify the selection of the ridge parameter, a sufficient condition is also given. Finally, a numerical example demonstrates the merit of the new method in the aspect of solving the multicollinearity over the ordinary restricted least squares estimation.     

The Research on Two Kinds of Restricted Biased Estimators Based on Mean Squared Error Matrix

Sakall?oglu et al. (2001 Sakall?oglu , Kaç?ranlar , Akdeniz ( 2001 ). Mean squared error comparisons of some biased estimators . Commun. Statist. Theor. Meth. 30 : 347 – 361 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) dealt with the comparisons among the ridge estimator, Liu estimator, and iteration estimator. Akdeniz and Erol (2003 Akdeniz , F. , Erol , H. ( 2003 ). Mean squared error matrix comparisons of some biased estimators in linear regression . Commun. Statist. Theor. Meth. 32 : 2389 – 2413 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) have compared the (almost unbiased) generalized ridge regression estimator with the (almost unbiased) generalized Liu estimator in the matrix mean squared error sense. In this article, we study the ridge estimator and Liu estimator with respect to linear equality restriction, and establish some sufficient conditions for the superiority of the restricted ridge estimator over the restricted Liu estimator and the superiority of the restricted Liu estimator over the restricted ridge estimator under mean squared error matrix, respectively. Furthermore, we give a numerical example.     

Some New Results on Likelihood Ratio Orderings for Spacings of Heterogeneous Exponential Random Variables

Let X ₁, X ₂,…, X _n be independent exponential random variables with X _i having failure rate λ _i for i = 1,…, n. Denote by D _i:n  = X _i:n  ? X _i?1:n the ith spacing of the order statistics X _1:n  ≤ X _2:n  ≤ ··· ≤ X _n:n , i = 1,…, n, where X _0:n ≡ 0. It is shown that if λ _n+1 ≤ [≥] λ _k for k = 1,…, n then D _n:n  ≤ _lr D _n+1:n+1 and D _1:n  ≤ _lr D _2:n+1 [D _2:n+1 ≤ _lr D _2:n ], and that if λ _i  + λ _j  ≥ λ _k for all distinct i,j, and k then D _n?1:n  ≤ _lr D _n:n and D _n:n+1 ≤ _lr D _n:n , where ≤ _lr denotes the likelihood ratio order. We also prove that D _1:n  ≤ _lr D _2:n for n ≥ 2 and D _2:3 ≤ _lr D _3:3 for all λ _i 's.     

More on the Preliminary Test Estimator in Almost Unbiased Liu Regression

This article is concerned with the parameter estimation in linear regression model when it is suspected that the regression coefficients are the subspace of the equality restrictions. The objective of this article is to introduce the preliminary test almost unbiased Liu estimators (PTAULE) based on the Wald (W), the likelihood ratio (LR), and the Lagrangian multiplier (LM) tests and compare the proposed estimators in the sense of the quadratic bias and mean square error (MSE) criterion.     

A Quality Control Approach of PVC Gloves Based on the Integration of SPC and EPC

Parameters in the production process of PVC gloves, such as production cycle, oven temperature, temperature, and viscosity of feed liquids are critical to the final quality of gloves. The dosing of feed liquids and plasticization of gloves are all controlled manually, and the viscosities of feed liquids and average oven temperature cannot be exactly regulated; those result in the degradation of final products and unreliability of the process. This article conducted studies on reliability enhancement of glove quality—an integrated control policy based on SPC and EPC was raised to minimize the process fluctuation, stabilize the output quality, and finally improve the process reliability. Using SPC method to eliminate the assignable factors in the process, when the process is under control, the EPC method was applied to make the process parameters closer to the target values which were decided through an inverse model of the process. The theory and methods were verified in the case study of PVC production control.