病种病例分型组合的医疗产出核算方法研究

根据SNA的划分,医疗卫生服务产出属于非市场产出。目前普遍采用投入法和传统的医疗指标为基础的产出法进行核算,而采用两种方法时都存在着诸多难以避免的缺陷。文章从“病种病例分型组合”的角度出发,结合医疗卫生的特点,提出了新的核算思想。     

整体营销组合:营销组合的集成化与定制化

继4P营销组合理论产生之后,相继出现了6P、7P、11P、4C、3R、4R、4V、4S、4E等营销组合新理论。这些新理论,或期望对4P加以扩充和完善,或试图对4P进行颠覆和取代,但落实到操作层面时,不仅离不开4P,更不如4P易于撑控。为了融合各种营销组合并增强其可操作性,本文在明确各种营销组合之间的关系基础上,提出了“整体营销组合”的概念,确立了相应的模型和依据。提供了“整体营销组合”的应用思路。     

The Healthcare Systems of the USA and Canada: Forever on Divergent Paths?

Over all OECD healthcare systems, we identify increasing similarities and common trends, especially with regard to the role of the state. Yet two countries, the USA and Canada, have 'parted at the crossroads' since the 1960s and therefore are quite frequently cited as examples for the opposite trend, i.e. for divergence. According to our position, it is far from evident that this trend has still been dominant in the past 15 years. In our contribution, we show that the USA and Canada have become more similar regarding the role of the state in financing, service provision and the regulation of healthcare systems. Furthermore, the article investigates potential explanations. We find that a most influential explanatory factor is the healthcare system itself, its deficiencies and functional requirements as reflected in the specific system type. As the system types of the USA and Canada vary, so too do their adaptive responses to problem pressure. By systematically acquiring non-system-specific elements, i.e. characteristics which were originally less developed or completely absent, the systems grow more similar and therefore converge.     

Cash‐for‐care payments in Europe: Changes in resource allocation

Resource allocation has been a main policy issue in cash‐for‐care schemes (CfCs) for older people in Europe since their inception. It regards how publicly funded care benefits and services are distributed among older people. The raising pressures of an ageing population and the tensions on the financial sustainability of welfare regimes in place have further exacerbated the relevance of this topic over the recent years. Nevertheless, comparative research so far has overlooked changes in resource allocation in CfCs over time. This article contributes to fill this gap, exploring changes in resource allocation of CfCs for older people in a sample of European countries—Austria, England, France, Germany, Italy, and The Netherlands—since the early '90s (or since the introduction of the scheme). It examines three analytical dimensions: (a) The mix of public services and benefits provided to older people (CfCs, community services in kind, residential care); (b) the level of CfCs coverage; and (c) its generosity. A combined view of these dimensions leads to the discussion of two dilemmas: How to allocate the resources devoted to CfCs in the light of the trade‐off between its coverage and intensity? And, within the whole long‐term care system, how to allocate resources between CfCs and services in kind?     

国企高管团队职能背景对双重任务的偏好分析——股权混合度的调节作用

以2010—2014年沪深两市中央企业控股的上市公司为研究样本,实证揭示不同职能背景主导下的高管团队对于企业双重任务的选择偏好,并进一步考察企业股权混合程度对于高管团队与企业任务的调节效应。研究发现:生产技术型职能背景为主的高管团队与经济绩效正相关、与社会责任负相关;管理服务型职能背景为主的高管团队与经济绩效和社会责任均正相关;股权混合度会显著加强生产技术型职能背景为主的高管团队对企业任务的作用,而削弱管理服务型职能背景为主的高管团队对企业社会责任的作用,且此调节效应在商业竞争类国企中存在、在特殊功能类国企中不存在。该结论揭示了异质股东委托下的股权混合度、高管团队及企业双重任务三方综合影响机理。     

营销学理论范式变迁的追溯与展望

近年来,随着营销学作为一门独立学科的迅速发展,营销学范式的研究逐渐脱离营销学本身成为独立的研究领域,但学术界对营销学范式的理论内涵和演进阶段尚未形成共识。营销学的理论范式主要研究营销学的“理论内核”问题。基于托马斯·S·库恩的科学范式理论,营销学理论范式体系应划分为古典营销范式、管理营销及关系营销范式以及正在形成的营销新范式三个阶段。     

Bringing Together Housing and Aging Services

Aging organizations generally do not consider housing issues as an important priority. Research suggests that lack of knowledge may be a significant barrier that prevents their involvement in housing-related activities. This article reports on a study that examined the extent and level of AAAs' involvement in housing-related activities with particular attention to instances of cooperation and collaboration between AAAs and housing agencies. It employed a national survey of Area Agencies on Aging (AAAs). Further, since the lack of knowledge about housing is a barrier to involvement, the study examined the role of a housing specialist in motivating higher levels of activity. Though there is no single overall indicator of activities to do with housing, the results indicate a range of activities pursued by AAAs. The presence of a housing specialist within the AAA generally served as a catalyst, motivating higher levels of this kind of activity. The importance of housing as a component of a comprehensive long-term care continuum is also discussed.     

Does Home- and Community-Based Care Affect Nursing Home Use?

A study was conducted to assess change in numbers, expenditures, and case mix of nursing home residents as Medicaid investment in home- and community-based services (HCBS) 1915(c) waivers increased in seven states. The seven states provided Medicaid expenditure and utilization data from 2001 to 2005, including waiver and state plan utilization. The Minimum Data Set was used for nursing home residents. For three states, community assessment data were also used. In six states, the number of nursing home clients decreased as the numbers of HCBS clients grew. However, in most states, the number of additional waiver clients often greatly exceeded reductions in nursing home residents. Nursing home payments decreased moderately, but this decrease was offset by increases in HCBS waiver and state plan expenditures, leading to a net increase in long-term support services (LTSS) expenditures from 2001 to 2005. Increases in waiver expenditures outpaced increases in waiver clients, indicating expansion of services on top of expansion in clients. States that showed substantial increases in HCBS showed only modest increases in nursing home case mix. The case mix for nursing home residents was more acute than that for HCBS users. The expectation that greater HCBS use would siphon off less severe LTSS users and hence lead to a higher case mix in nursing homes was partially met. The more acute case mix in nursing homes suggests that HCBS serves some individuals who were previously cared for in nursing homes but many who were not. Efforts to promote substitution of HCBS for institutional care will require more proactive strategies such as diversion.     

“留守女童”福利供应的定量研究——基于四川省兴文县的实证调查

"留守女童"是我国工业化与城市化进程中的利益受损者,为该人群建立相对完善的福利供应体系具有较为重要的意义。目前学术界在"留守女童"福利供应体系方面的研究基本处于空白,因此本研究从多元福利的角度出发对此问题进行深入分析。研究发现,尽管"留守女童"与"留守男童"相比在福利衰减幅度上相对较小,但是其福利供应的总体水平却依然是最为有限的。同时,"留守女童"的福利供应受到父亲外出因素的深刻影响,并出现了福利主体的结构性变化。基于此,建议积极完善多元福利供应体系,努力构建"以家庭为基础、国家为主导、民间福利积极参与"的福利供应模式。