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1.
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.  相似文献   
2.
Modelling daily multivariate pollutant data at multiple sites   总被引:7,自引:1,他引:6  
Summary. This paper considers the spatiotemporal modelling of four pollutants measured daily at eight monitoring sites in London over a 4-year period. Such multiple-pollutant data sets measured over time at multiple sites within a region of interest are typical. Here, the modelling was carried out to provide the exposure for a study investigating the health effects of air pollution. Alternative objectives include the design problem of the positioning of a new monitoring site, or for regulatory purposes to determine whether environmental standards are being met. In general, analyses are hampered by missing data due, for example, to a particular pollutant not being measured at a site, a monitor being inactive by design (e.g. a 6-day monitoring schedule) or because of an unreliable or faulty monitor. Data of this type are modelled here within a dynamic linear modelling framework, in which the dependences across time, space and pollutants are exploited. Throughout the approach is Bayesian, with implementation via Markov chain Monte Carlo sampling.  相似文献   
3.
本文简单介绍了分形理论的概念和特征,着重阐述了分形理论在图案艺术设计方面的应用和方法。研究设计了计算机辅助图案艺术设计系统的功能和构成。  相似文献   
4.
Summary.  A stochastic discrete time version of the susceptible–infected–recovered model for infectious diseases is developed. Disease is transmitted within and between communities when infected and susceptible individuals interact. Markov chain Monte Carlo methods are used to make inference about these unobserved populations and the unknown parameters of interest. The algorithm is designed specifically for modelling time series of reported measles cases although it can be adapted for other infectious diseases with permanent immunity. The application to observed measles incidence series motivates extensions to incorporate age structure as well as spatial epidemic coupling between communities.  相似文献   
5.
建立了有柔性路径的FMS动态调度问题的模型.采用离线重调度的方法,提出一种结合离线重调度两种生成调度方式的方法来阐述FMS的有柔性路径动态调度问题.最后给出了该问题的遗传算法解决方法和计算示例.  相似文献   
6.
The problem of modelling multivariate time series of vehicle counts in traffic networks is considered. It is proposed to use a model called the linear multiregression dynamic model (LMDM). The LMDM is a multivariate Bayesian dynamic model which uses any conditional independence and causal structure across the time series to break down the complex multivariate model into simpler univariate dynamic linear models. The conditional independence and causal structure in the time series can be represented by a directed acyclic graph (DAG). The DAG not only gives a useful pictorial representation of the multivariate structure, but it is also used to build the LMDM. Therefore, eliciting a DAG which gives a realistic representation of the series is a crucial part of the modelling process. A DAG is elicited for the multivariate time series of hourly vehicle counts at the junction of three major roads in the UK. A flow diagram is introduced to give a pictorial representation of the possible vehicle routes through the network. It is shown how this flow diagram, together with a map of the network, can suggest a DAG for the time series suitable for use with an LMDM.  相似文献   
7.
当语言中的一个新词诞生以后 ,只要表示与之相关的动作变化或状态的动词或形容词没有产生 ,就很可能直接用这个词来表示这种相关的动作变化或状态。因此 ,词的兼类是各种语言或方言、或各个不同时期的同一语言中常见的现象。在语言的发展史上 ,尽可能减少词的兼类现象 ,特别是通过形态变化等手段把兼类的词分化为不同的词 ,还有些词存在活用现象 ,显得很有地方特色。从此角度说 ,客家方言保留着较多的古语痕迹。  相似文献   
8.
Some statistical models defined in terms of a generating stochastic mechanism have intractable distribution theory, which renders parameter estimation difficult. However, a Monte Carlo estimate of the log-likelihood surface for such a model can be obtained via computation of nonparametric density estimates from simulated realizations of the model. Unfortunately, the bias inherent in density estimation can cause bias in the resulting log-likelihood estimate that alters the location of its maximizer. In this paper a methodology for radically reducing this bias is developed for models with an additive error component. An illustrative example involving a stochastic model of molecular fragmentation and measurement is given.  相似文献   
9.
Summary.  The association of poor education and poor health has been consistently observed in many studies and in various countries. Thus far, studies examining the mechanisms underlying this association have looked at only a limited set of potential pathways. This study simultaneously examines six distinctive pathways, which have been hypothesized to link education and health and found support from previous studies. A causal analysis of education and health was performed using structural equation models. Data were used from six phases of the National Child Development Study, which is based on following up an initial sample of 17416 children who were born in 1958. The association between education and health appears to be explained by a combination of mechanisms: adolescent health and adult health behaviours for men and women, adult social class among men and parental social class among women. We conclude that improvements in population educational attainment may not automatically lead to improvements in population health, and that health policies for improving health and reducing health inequalities need to target specific causal pathways.  相似文献   
10.
柔性嵌入是驻村干部通过沟通、对话、协商参与乡村治理的管理实践。柔性嵌入式治理并非单纯的行政制度吸纳与整合,而是包括文化嵌入、认知嵌入、关系嵌入在内的多维柔性嵌入的互动与治理的过程。从辽宁省X县的治理实践来看,驻村干部参与乡村治理仍受根深蒂固的刚性治理思维、运转不畅的民主协商机制、薄弱的乡村社会资本、匮乏的村庄公共精神等现实因素掣肘。需要从转变刚性治理观念、运用情感治理技术、完善基层协商机制、挖掘乡村内生资源、培育村庄公共精神等层面进一步激活柔性嵌入机制,持续提升驻村干部参与乡村治理效能。  相似文献   
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