Governmental anti-pandemic policies,vaccination, population mobility,Twitter narratives,and the spread of COVID-19: Evidence from the European Union countries

We provide large-scale empirical evidence on the effects of multiple governmental regulatory and health policies, vaccination, population mobility, and COVID-19-related Twitter narratives on the spread of a new coronavirus infection. Using multiple-level fixed effects panel data model with weekly data for 27 European Union countries in the period of March 2020–June 2021, we show that governmental response policies were effective both in reducing the number of COVID-19 infection cases and deaths from it, particularly, in the countries with higher level of rule of law. Vaccination expectedly helped to decrease the number of virus cases. Reductions in population mobility in public places and workplaces were also powerful in fighting the pandemic. Next, we identify four core pandemic-related Twitter narratives: governmental response policies, people's sad feelings during the pandemic, vaccination, and pandemic-related international politics. We find that sad feelings’ narrative helped to combat the virus spread in EU countries. Our findings also reveal that while in countries with high rule of law international politics’ narrative helped to reduce the virus spread, in countries with low rule of law the effect was strictly the opposite. The latter finding suggests that trust in politicians played an important role in confronting the pandemic.     

普适医疗伦理问题前瞻

普适医疗是一场名副其实的基于技术引发的医疗革命。普适医疗开创了新的就医模式,拓展了人类的健康观念,促进了医患生态的和谐化,提升了医疗系统的效率,同时为有效应对现行医疗体系的重重困境指明了方向。普适医疗带来颠覆性医疗变革的同时,也将引起传统医疗伦理的冲突与流变：医疗隐私范围无限扩展、“医疗信息数字化”带来隐私泄露或被恶意利用、个体医疗隐私控制权进一步弱化、在线医疗纠纷和基于智能医疗系统的医疗事故责任难以界定、电子医疗ID引致偏见与歧视、医疗数字鸿沟和医患关系物化加剧等。有效应对和规避伦理风险,需要完善普适医疗技术设计,需要制度和伦理的协同制约,更需要培育一个德性的社会环境。     

A Paradigm Shift in Healthcare: An Open Door for Organizational Behavior Management

The United States spends more money on healthcare each year than any other country in the world (OECD, 2015). Despite high costs, the quality of healthcare is below average, resulting in a society that is far from “getting what it pays for.” High costs and poor quality have resulted in a recent paradigm shift from traditional fee-for-service systems where hospitals and providers were paid by volume of patients to value-based care, to where they are now paid by quality of care (Andel, Davidow, Hollander, & Moreno, 2012). This shift has pressured organizations to improve quality of care at a rapid pace. This paper seeks to assess how Organizational Behavior Management has helped address the quality of healthcare thus far and discuss avenues for future research and practice.     

Hiding in Plain Sight: Insights about Health-Care Trends Gained through Open Health Data

ABSTRACT

The open data movement constitutes an approach to achieving accountability for government organizations. Government agencies at the Federal and State levels have released open health data consisting of de-identified patient outcomes, costs and ratings. We applied big data analytics to understand patterns and trends in open health data. We envision the use of this data by concerned citizens to understand trends in health expenditures. We have built an open-source tool, BOAT (Big Data Open Source Analytics Tool, https://github.com/fdudatamining) to facilitate analytical exploration of open health data sets. We used BOAT to analyze data from the New York Statewide Planning and Research Cooperative System and determined that there has been a significant increase (40 percent) in the incidences of mental health issues amongst adolescents from 2009–2014. We analyzed costs for hip replacement surgery for 168,676 patients is in New York State, and showed that 88% of these patients had surgery costs of less than $30,000. This figure helps in understanding the decision by The California Public Employees’ Retirement System to cap hip replacement reimbursements at $30,000, resulting in significant savings. Our tool could enable researchers, hospitals, insurers and citizens to obtain an unbiased view on health-care expenditures, costs and emerging trends.     

当代中国农村医疗体制的变革与发展趋向

当代中国农村医疗体制在六十年中经历了翻天覆地的变化.在1978年之前,中国农村的医疗服务体系由县、乡、村三级组成,县级医疗机构属于全民所有制的事业单位,乡村医疗机构属于人民公社集体所有,它们在农村医疗服务方面发挥了积极作用.改革开放以后,传统的合作医疗被新型合作医疗所取代,即嵌合在集体主义政治经济制度中的社区微型医疗保险被政府补贴的自愿性公立医疗保险所取代.依然处在行政化制度和组织中的农村各级公立医疗机构都走上了商业化道路,但民营医疗机构在农村的发展还很不充分.由于医疗保障体系还欠发展,医保机构第三方支付对于医疗机构还缺乏制约,农村公立医疗机构的医药费用上涨幅度超过了农村居民收入的上涨幅度.针对这些问题,新一轮医疗卫生体制改革为农村医疗卫生事业的发展带来了机遇.新农合的巩固、公共财政投入向农村地区的倾斜、社会资本的进入、公立医院的法人化有助于农村医疗事业的发展,但公立医疗机构的行政化则有可能对县医院和乡镇卫生院的发展前景投下了阴影.     

Midwives’ views of traditional birth attendants within formal healthcare in Nigeria

BackgroundDiscourses around the journey to motherhood in many poorly-resourced countries, particularly in the sub-Saharan African region, with no link to death and danger are limited. The custodians of traditional practices – the traditional birth attendants – are often blamed for the high maternal deaths in this region. Conventional institutional and international thinking about traditional birth attendants is that they are dangerous and therefore should no longer be allowed to practice.AimTo explore midwives’ views of traditional birth attendants’ place within formal healthcare settings in Nigeria.MethodsHermeneutic phenomenological and poststructural feminist approaches were used. Seven midwives volunteered for semi-structured individual face to face interviews.FindingsThe responses of the midwives were diverse and conflicting. Some midwives believe that the traditional birth attendants should be banned, arguing that they are responsible for low uptake of hospital-based maternity care by women which in turn leads to an increase in maternal deaths. Contrastingly, other midwives expressed a view that the traditional birth attendants ‘cannot be phased out’ due to their valid contributions, particularly in the rural areas where access to formal maternity care is limited by intractable structural problems.ConclusionPolicy makers need to reconsider the role of traditional birth attendants. This should involve not only their integration into formal healthcare to work alongside formally trained maternity care providers, but also fostering a healthcare atmosphere where respect and recognition of each practitioner’s skill is paramount.     

基于患者两阶段医疗服务过程的病床资源优化

随着医疗需求的日益增长，供需不平衡的矛盾日益显著，病床资源短缺已经成为制约医疗服务发展的重要因素之一。针对病床资源供需失衡的问题，本文构建患者两阶段医疗服务过程的病床资源优化模型。考虑患者的医疗服务是一个两阶段串联排队过程，第一阶段是强制治疗阶段，第二阶段是康复阶段。在患者排队系统中，服务台总数固定的前提下，本文利用增补变量方法给出了该排队系统的概率等式，通过求解偏微分方程得出系统的状态概率，并推导出医院拒绝患者的概率、平均康复时间等相关指标。考虑部分患者因病床资源不足而无法入院和康复阶段患者提前出院两种风险因素，本文基于排队指标构建多病种间的病床分配模型，再利用动态规划的求解思路得到病床分配的最优解。最后，本文采用2017年卫生统计数据和模拟数据相结合进行数值分析。研究结果表明与传统单阶段模型相比，两阶段模型对不同病种间病床数差别影响显著，并且患者入院率对病床分配影响较大。进一步，基于数值结果给出了医疗管理建议和研究展望。     

孕产妇保健服务效果分析——以重庆市为例

利用统计年鉴资料,从时间纵向和区域横向上进行比较,统计指标涉及孕产妇建卡率、孕产妇系统管理率、孕产妇住院分娩率、孕产妇产前检查率、孕产妇产后访视率和孕产妇死亡率。发现自2008年以来,各类孕产妇保健指标2009年均优于2007年,处于西部地区中下水平且低于国家平均水平,与京津沪比较还有很大差距。重庆市孕产妇保健工作取得一定进展,但城乡孕产妇保健服务均等化尚未有效解决,政府仍需加大投入。此外,通过有效的宣传手段促进孕产妇保健服务意识,是保障孕产妇健康和降低孕产妇死亡率的关键。