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.     

经济赋能与社区融合—以一个西部地区的反贫困实践为例

文章基于陕西省白水县的农村反贫困实践探索,从发展性社会工作视角探讨经济赋能与社区融合干预对于残疾人脱贫发展的意义。 这一反贫困实践案例显示,贫困者的生计发展嵌入在其家庭及社区的关系性脉络中,依托于残疾人互助合作社的社区融合介入,有助于残疾人的经济与社会的双重赋能,提升残疾人生计发展的内生动力。 同时,本地社会组织在残疾人反贫困中发挥关键作用,社会组织的能动性发展促进了多主体合作参与的贫困治理,也带动了社会工作专业理念和方法在反贫困实践中的运用。     

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.     

Improved Transferability of Data‐Driven Damage Models Through Sample Selection Bias Correction

Damage models for natural hazards are used for decision making on reducing and transferring risk. The damage estimates from these models depend on many variables and their complex sometimes nonlinear relationships with the damage. In recent years, data‐driven modeling techniques have been used to capture those relationships. The available data to build such models are often limited. Therefore, in practice it is usually necessary to transfer models to a different context. In this article, we show that this implies the samples used to build the model are often not fully representative for the situation where they need to be applied on, which leads to a “sample selection bias.” In this article, we enhance data‐driven damage models by applying methods, not previously applied to damage modeling, to correct for this bias before the machine learning (ML) models are trained. We demonstrate this with case studies on flooding in Europe, and typhoon wind damage in the Philippines. Two sample selection bias correction methods from the ML literature are applied and one of these methods is also adjusted to our problem. These three methods are combined with stochastic generation of synthetic damage data. We demonstrate that for both case studies, the sample selection bias correction techniques reduce model errors, especially for the mean bias error this reduction can be larger than 30%. The novel combination with stochastic data generation seems to enhance these techniques. This shows that sample selection bias correction methods are beneficial for damage model transfer.     

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。     

Women’s mobility and ‘transport-related social exclusion’ in Bishkek

This paper analyses gendered mobilities in Bishkek in the space of the most popular form of public transport: the minibus, or ‘marshrutka’. As the means by which women often access various important sites of daily life, the marshrutka itself is a site of negotiation and interaction. Utilizing theories of mobility and empirical data, we argue that marshrutkas are spaces that can give rise to two dichotomous conditions: positive marshrutka experiences may increase the social mobility of female passengers and subsequently increase social empowerment and influence, while negative ones can provide the grounds for social exclusion and gender inequality.     

Cooperative innovation through a talent management pool: A qualitative study on coopetition in healthcare

In recent years, the Dutch healthcare sector has been confronted with increased competition. Not only are financial resources scarce, Dutch hospitals also need to compete with other hospitals in the same geographic area to attract and retain talented employees due to considerable labour shortages. However, four hospitals operating in the same region are cooperating to cope with these shortages by developing a joint Talent Management Pool. ‘Coopetiton’ is a concept used for simultaneous cooperation and competition. In this paper, a case study is performed in order to enhance our understanding of coopetition. Among other things, the findings suggest that perceptions of organizational actors on competition differ and might hinder cooperative innovation with competitors, while perceived shared problems and resource constraints stimulate coopetition. We reflect on the current coopetition literature in light of the research findings, which have implications for future research on this topic.     

Efficacy Foundations for Risk Communication: How People Think About Reducing the Risks of Climate Change

Believing action to reduce the risks of climate change is both possible (self‐efficacy) and effective (response efficacy) is essential to motivate and sustain risk mitigation efforts, according to current risk communication theory. Although the public recognizes the dangers of climate change, and is deluged with lists of possible mitigative actions, little is known about public efficacy beliefs in the context of climate change. Prior efficacy studies rely on conflicting constructs and measures of efficacy, and links between efficacy and risk management actions are muddled. As a result, much remains to learn about how laypersons think about the ease and effectiveness of potential mitigative actions. To bring clarity and inform risk communication and management efforts, we investigate how people think about efficacy in the context of climate change risk management by analyzing unprompted and prompted beliefs from two national surveys (N = 405, N = 1,820). In general, respondents distinguish little between effective and ineffective climate strategies. While many respondents appreciate that reducing fossil fuel use is an effective risk mitigation strategy, overall assessments reflect persistent misconceptions about climate change causes, and uncertainties about the effectiveness of risk mitigation strategies. Our findings suggest targeting climate change risk communication and management strategies to (1) address gaps in people's existing mental models of climate action, (2) leverage existing public understanding of both potentially effective mitigation strategies and the collective action dilemma at the heart of climate change action, and (3) take into account ideologically driven reactions to behavior change and government action framed as climate action.     

Capturing the broader picture of value co-creation management

The interactional, interdependent, and dynamic nature of value co-creation has made value management in business relationships a particularly challenging issue for both academicians and practitioners. In addition, studies on this topic have mostly focused on managing value co-creation in isolation from the wider relational context without completely capturing the influence of other value processes on value co-creation. This paper examines the broader picture of value co-creation management by providing a model based on interlinked value processes, namely, value communication, value appropriation, value measurement, and value representation. We adopted a qualitative approach based on 86 interviews with managers of both customer and supplier companies, which operated in different industries. Results showed that the management of value co-creation implies considering complex patterns of interconnections with other value processes. In particular, the study will shed light on the centrality of value appropriation to co-create value and on the importance of value representation to coordinate ideas and enable future co-creation opportunities.     

中国员工企业伦理态度调查及分析

随着中国市场经济的发展,各种企业丑闻的频发引起业界广泛关注,公司治理越来越受到重视。已有的研究表明,员工企业伦理态度关乎员工承诺度和企业竞争力。本文依据个人层次研究理论,采用实证分析方法,选择国内6家企业的员工为调研对象,沿用国外企业伦理个体层次研究中广泛使用的量表"Attitude Towards Business Ethics Questionnaire"(ATBEQ)即企业伦理态度量表,考察当代中国企业员工对企业伦理态度的看法;另外,也分析了不同的工作年限,性别,学历,户口等因素下的企业员工伦理态度差异。调查结果显示:中国员工的企业伦理观存在困惑;大部分中国员工有企业利益相关者意识;教育对企业员工伦理态度存在显著影响。