Research on the economic effects of housing support expenditures under the perspective of consumption heterogeneity: Evidence from China.

What kind of impact does the government's housing support expenditure have on residents' consumption? This is a topic that deserves in-depth study and is of practical significance. This study constructs provincial equilibrium panel data based on China's guaranteed housing construction and financial expenditures on housing support data from 1999-2009 and 2000-2021. It applies the systematic GMM method to estimate the impact of government housing support expenditures on residents' consumption. The study found that whatever form of expenditure on housing support contributed to the total consumption of urban residents, while the impact on the consumption structure had different results. Based on the divisions of consumption structure, the results of the increase in government housing support expenditure on the consumption structure of urban residents are different. An examination of different forms of housing support reveals that the predominantly secure form of housing construction has a positive effect on all consumption structure divisions. Whereas the predominantly monetary subsidy form has a significant positive relationship with housing, necessity, and durability consumption expenditures, it has a weak or even negative relationship with non-housing, non-necessity, and non-durability consumption expenditures. The research in this paper makes up for the lack of current literature examining the economic effects of housing support from the perspective of consumption structure and provides a theoretical basis and policy reference for constructing a multi-level gradient housing support system.

Accumulation of production capital and income growth of Chinese farmers in the post-poverty alleviation era: A study based on a two-way fixed effects model with CFPS data.

Agricultural mechanization is a crucial indicator of modernization in agriculture. It improves productivity and underpins the evolution of a modern state. This study scrutinizes the enduring effects of government subsidies on farm machinery acquisition, income growth, and capital accumulation in rural households. It is based on policies about targeted poverty alleviation and rural revitalization. Research findings indicate that government subsidies have significantly increased the per capita net income of rural households. However, in the post-poverty alleviation era, for households that already possess agricultural machinery, the benefits brought by government subsidies in the early stages of the policy cycle tend to diminish over time. From 2016 to 2020, government subsidies continued to enhance the value of agricultural machinery in rural households. Their impact on ownership rates first slightly declined and then increased again. The promotional effect in 2020 was not significantly better than in 2016. When China is fighting against poverty, it is essential to encourage rural households to use their income and government subsidies to accumulate production capital. A long-term mechanism has been established to protect the achievements of poverty alleviation, promote agricultural mechanization and rural modernization, and support rural revitalization.

Experiences of central child health services teams regarding a special governmental investment in child health services.

BACKGROUND: Historically marked by a high infant mortality rate, Sweden's healthcare reforms have successively led to a robust, decentralized universal child health system covering over 97% of the population 0-5 years. However, inequities in health have become an increasing problem and the public health law explicitly states that health inequities should be reduced, resulting in various government initiatives. This study examines the experiences of Central Child Health Services (CCHS) teams during the implementation of the Child Health Services Accessibility Agreement between the State and the regions starting in 2017. The agreement aimed to enhance child health service accessibility, especially in socio-economically disadvantaged areas, but broadly stated guidelines and the short-term nature of funding have raised questions about its effectiveness. The aim of this study was to understand the experiences of CCHC teams in implementing the Child Health Services Accessibility Agreement, focusing on investment decisions, implementation efforts, as well as facilitators and barriers to using the funds effectively. METHODS: CCHC teams were purposefully sampled and invited via email for interviews, with follow-ups for non-respondents. Conducted from January to October 2023, the interviews were held digitally and recorded with individuals familiar with the agreement's implementation within these teams. Both authors analyzed the transcripts thematically, applying Braun and Clarke's framework. Participants represented a cross-section of Sweden's varied healthcare regions. RESULTS: Three main themes emerged from the thematic analysis: "Easy come, easy go," highlighting funding uncertainties; "What are we supposed to do?" expressing dilemmas over project prioritization and partner collaboration; and "Building castles on sand," focusing on the challenges of staff retention and foundational program stability. Respective subthemes addressed issues like fund allocation timing, strategic decision-making, and the practical difficulties of implementing extended home visiting programs, particularly in collaboration with social services. CONCLUSIONS: This study uncovered the challenges faced in implementing the Child Health Services Accessibility Agreement across different regions in Sweden. These obstacles underline the need for precise guidelines regarding the use of funds, stable financing for long-term project sustainability, and strong foundational support to ensure effective interprofessional collaboration and infrastructure development for equitable service delivery in child health services.

Federal Funding for Expensive Drugs for Rare Diseases: How Do We Pick and Choose?

The number of expensive drugs for rare diseases (EDRDs) approved by Health Canada and their contribution to healthcare costs have been rapidly increasing. The federal government has announced a three-year funding commitment of $1.4 billion for EDRDs, but principles need to be developed for how that funding will be allocated, especially in cases where insufficient data are available to guide decision making. Here, we review the role of evidence quality in making choices and draw on the experience from other countries to put forward five principles about how the money should be spent.

Commentary: Which Principles Should Apply for a National Strategy on Rare Diseases?

Lexchin and Sirrs (2024) proposed five relevant principles to guide the use of federal funding for expensive drugs for rare diseases, including funding of outcomes-based risk-sharing agreements (OBRSAs) and proactive commitment and participation in the generation of high-quality evidence in a transparent way. This rejoinder, however, questions whether the federal funding should be used only to buy new drugs or whether it could be used to develop new drugs as well. It also examines what OBRSAs would require in terms of institutional capacities to allow the collection of real-world evidence.

Public funding for private for-profit centres and access to cataract surgery by patient socioeconomic status: an Ontario population-based study.

BACKGROUND: Public funding of cataract surgery provided in private, for-profit surgical centres increased to help mitigate surgical backlogs during the COVID-19 pandemic in Ontario, Canada. We sought to compare the socioeconomic status of patients who underwent cataract surgery in not-for-profit public hospitals with those who underwent this surgery in private for-profit surgical centres and to evaluate whether differences in access by socioeconomic status decreased after the infusion of public funding for private, for-profit centres. METHODS: We conducted a population-based study of all cataract operations in Ontario, Canada, between January 2017 and March 2022. We analyzed differences in socioeconomic status among patients who accessed surgery at not-for-profit public hospitals versus those who accessed it at private for-profit surgical centres before and during the period of expanded public funding for private for-profit centres. RESULTS: Overall, 935 729 cataract surgeries occurred during the study period. Within private for-profit surgical centres, the rate of cataract surgeries rose 22.0% during the funding change period for patients in the highest socioeconomic status quintile, whereas, for patients in the lowest socioeconomic status quintile, the rate fell 8.5%. In contrast, within public hospitals, the rate of surgery decreased similarly among patients of all quintiles of socioeconomic status. During the funding change period, 92 809 fewer cataract operations were performed than expected. This trend was associated with socioeconomic status, particularly within private for-profit surgical centres, where patients with the highest socioeconomic status were the only group to have an increase in cataract operations. INTERPRETATION: After increased public funding for private, for-profit surgical centres, patient socioeconomic status was associated with access to cataract surgery in these centres, but not in public hospitals. Addressing the factors underlying this incongruity is vital to ensure access to surgery and maintain public confidence in the cataract surgery system.

Government funded suicide prevention in Australia - an environmental scan.

BACKGROUND: Suicide is a worldwide public health problem. In response to this problem, Australia was one of the first countries to develop national suicide prevention policy. Guided by the National Suicide Prevention Office (NSPO), which was established in 2021, suicide prevention in Australia is in a period of reform. The NSPO is driving a nationally consistent and integrated approach to suicide prevention including leading the development of a new National Suicide Prevention Strategy. This article summarises findings from an environmental scan of government-led suicide prevention in Australia, conducted as an input for the development of the new Strategy. METHODS: The scan was conducted from August 2022 to January 2023. We searched relevant government websites and Google to identify policy documents and programs and services. We undertook a desktop review of documents and programs/services using coding templates developed to address the objectives of the scan. Qualitative information was extracted in a systematic manner using these templates. RESULTS: Australia's suicide prevention efforts are significant as demonstrated by activities ranging from policy documents intended to guide and plan activity, the National Mental Health and Suicide Prevention Agreement committing the Federal Government and jurisdictions to work together, and the availability of national, state, local area based, and digital services and programs. Suicide prevention approaches in Australia are mostly selective or indicated. There is less emphasis on universal approaches, wellbeing promotion, strengthening protective factors and mitigating the impact of known drivers of distress. In addition, there is limited evidence to demonstrate a whole-of-government or whole-of-system approach is operating in Australia. Findings should be interpreted in the context that suicide prevention in Australia is currently in a period of transition. CONCLUSIONS: Current government emphasis on and investment in suicide prevention activity, together with strong commitment to lived experience and cross sectorial collaboration, are substantial and appropriate. There are also many opportunities to further progress cross-portfolio and cross-jurisdiction suicide prevention and response efforts. This requires urgently adopting a shared understanding of suicide, which includes the diverse drivers of suicidal distress, and improving protective factors and social wellbeing.

COVID-19 Federal Funding To Health Centers: Tracking Distribution, Locations, And Patient Characteristics.

In 2020 and 2021, health centers received federal funding to support their COVID-19 pandemic response, yet little is known about how the funds were distributed. This study identified ten sources of funding distributed to 1,352 centers, ranging from $19 to $1.22 billion per center. When we examined patient and organizational characteristics by quartiles of funding per patient, health centers in the highest-funded quartile (quartile 4) were more likely rural and in the South; employed lower percentages of physicians; and had the highest percentages of sicker, uninsured, and unhoused patients. Centers in the lowest-funded quartile (quartile 1) were more likely urban, employed lower percentages of nurse practitioners, and had the highest percentages of Medicaid enrollees. With the end of pandemic-related funding in 2023, combined with Medicaid unwinding concerns, targeted investment is needed to mitigate a financial cliff and help maintain health centers' capacity to provide high-quality services to those most in need.

Evaluation of public private partnerships in highways.

This paper reviews and evaluates four U.S. P3 toll highways, identifying their performance and common challenges. Contrary to the conventional wisdom that federal and state governments should fund highways, this paper argues that users should bear the cost for both efficiency and equity considerations. The shift from government investment and operation of highways to Public-Private Partnerships (P3) was driven by the lack of public funding, more productive competitive business practices, and the government's desire for upfront payments to fund other unrelated public projects. However, these justifiable public benefits were accompanied by significant problems. Highways were often leased for 35 to 75 years, depending on the total equity and loans of the private partner and various risk factors.

Can revenue collection for public funding in health care be progressive? An assessment of 29 Countries.

Most research on health care equity focuses on accessing services, with less attention given to how revenue is collected to pay for a country's health care bill. This article examines the progressivity of revenue collection among publicly funded sources: income taxes, social insurance (often in the form of payroll) taxes, and consumption taxes (e.g., value-added taxes). We develop methodology to derive a qualitative index that rates each of 29 high-income countries as to its progressivity or regressivity for each of the three sources of revenue. A variety of data sources are employed, some from secondary data sources and other from country representatives of the Health Systems and Policy Monitor of the European Observatory on Health Systems and Policies. We found that countries with more progressive income tax systems used more income-based tax brackets and had larger differences in marginal tax rates between the brackets. The more progressive social insurance revenue collection systems did not have an upper income cap and exempted poorer persons or reduced their contributions. The only pattern regarding consumption taxes was that countries that exhibited the fewest overall income inequalities tended to have least regressive consumption tax policies. The article also provides several examples from the sample of countries on ways to make public revenue financing of health care more progressive.

Unlocking SME growth: Analyzing the government subsidies' impact on financing in China.

Small and medium-sized enterprises (SMEs) were an important part of China's economy, but they faced challenges to growth due to financing difficulties. Government subsidies are considered as a potential way to address this problem. This study aims to assess the effectiveness of the Chinese government's subsidy program aimed at improving the accessibility of financing for SMEs. We analyze a comprehensive dataset of Chinese firms' subsidy programs from 2011 to 2020. We classify subsidies into unconditional and conditional categories and use fixed-effects regression models to control for the effects of time and between-group variation to more accurately assess the effectiveness of government subsidies. In addition, we use a PSM-DID model to reduce the effect of selectivity bias to more accurately estimate the causal effect of subsidies on financing strategies. We also use a mediated effects model to help understand the mechanisms by which different types of subsidies affect financing strategies. The results show that government subsidies can significantly improve SMEs' financing ability, but different types of subsidies produce subtle differences. Conditional subsidies support debt financing mainly through incentives, while unconditional subsidies help SMEs improve their equity financing ability through information effects. Furthermore, we find that over-reliance on a single subsidy type may reduce its effectiveness, suggesting a complex relationship between government intervention and SME financing. Thus, well-designed policies are crucial for promoting SMEs and fostering economic growth.

Association of Federal COVID-19 Funding Distributions With Workforce and Capacity in Health Centers.

Using novel national data, we examined the association between 2020 federal COVID-related funding targeted to health centers (i.e., H8 funding) and health center workforce and operational capacity measures that may be important for preserving patient access to care and staff safety. We assigned health centers to quartiles based on federal funding distribution per patient and used adjusted linear probability models to estimate differences in workforce and operational capacity outcomes across quartiles from April 2020 to June 2022. We found a nearly 6-fold difference in 2020 H8 funding per patient when comparing health centers in the lowest versus highest quartiles. Despite this difference, health centers' outcomes improved similarly across quartiles over time, with the lowest-funded health centers having the greatest staffing and service capacity challenges. Our findings suggest that COVID-related health center funding may have contributed to stabilization of health centers' workforce and operations. Amid concerns about staff turnover, sustained investments targeted to supporting workforce retention at health centers can help to ensure ongoing delivery of critical services.

U.S. agency funding for climate and health research falls short.

Interdisciplinary teams struggle to find a home in siloed federal grant-funding system.

The oral health care system in Libya: a case study.

BACKGROUND: This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups. METHODS: A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study's aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents. RESULTS: The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults. CONCLUSION: The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.

The effect of ending public funding for abortion: evidence from West Virginia.

OBJECTIVES: This study aimed to evaluate the immediate impact of West Virginia's 2018 policy change prohibiting state Medicaid funds from covering abortions on the state's abortion rate. STUDY DESIGN: We use the synthetic control method with a weighted combination of control states to estimate West Virginia's counterfactual abortion rate without the policy change. METHODS: We obtained abortion data from the Centers for Disease Control and Prevention. We used a synthetic control approach to construct a weighted average of control states that resembled West Virginia in various pre-policy characteristics. We then compared the actual abortion rate in West Virginia after the policy change with the estimated counterfactual rate based on the control states. RESULTS: We found that the abortion rate per 1000 women of reproductive age in West Virginia was approximately 1.3 abortions lower in 2019 compared to the estimated counterfactual rate in the absence of the policy change (3.8 vs. 5.1). CONCLUSIONS: Our findings suggest that West Virginia's policy change prohibiting Medicaid-funded abortions in 2018 may have led to a reduction in the state's abortion rate in 2019.

Prevalence of faculty mentoring programs in anesthesiology and medical schools in the US and their association with federal research funding.

BACKGROUND: While mentoring programs have demonstrated success for faculty development, reported rates of formal mentoring programs vary for specific programs as well as academic medical institutions overall. The aim of this paper was to evaluate the overall prevalence of faculty mentoring programs and faculty development offices in anesthesiology departments and at academic medical schools and assess the association between those with mentoring programs and faculty development support and NIH funding. METHODS: This study used publicly available data from program and institutional websites to record the presence of faculty mentoring programs and faculty development offices in anesthesiology departments as well as both formal and informal mentoring activities and whether there were offices and deans specifically related to faculty development at the institutional level. Data on NIH funding of anesthesiology departments were recorded from the Blue Ridge Institute for Medical Research rankings of medical schools and their departments. Cramer's V was used to evaluate the association between NIH funding and the presence of mentoring programs offered by the department and/or institution. Logistic regression was used to evaluate the association between total NIH funding of ranked programs (categorized as above or below median of funding) and presence of mentoring programs. RESULTS: The study included 164 US anesthesiology programs, of which 33% had NIH funding. Only 10% of anesthesiology programs had faculty mentoring programs and 29% had offices or leadership positions related to faculty development. At the institutional level, 59% had formal mentoring programs, 73% offered informal mentoring activities, and 77% had offices or deans related to faculty development. Seventy-four percent (74%) of anesthesiology departments offering mentoring resources had NIH funding, compared to only 26% of departments without such resources. For anesthesiology departments with NIH funding, departments in the upper median of funded programs were much more likely to have departmental mentoring resources (OR = 1.429.08; 95% CI: 1.721.03-1.9748.99). Departmental NIH funding was not significantly associated with institutional level presence of formal mentoring programs (OR = 0.91; 95% CI: 0.0.23-3.65). CONCLUSIONS: Our findings suggest an association between the presence of faculty mentoring programs and faculty development support with departmental NIH funding, with the amount of funding associated primarily with department-specific mentoring and faculty development initiatives. Our findings support efforts to create formal mentoring programs and establish offices and other support systems for faculty development and suggest, at least in terms of academic productivity, that efforts should be more focused on department-specific initiatives.

Effectiveness of public health spending: Investigating the moderating role of governance using partial least squares structural equation modelling (PLS-SEM).

BACKGROUND: The link between public health spending (PHS) and population health outcomes (PHO) has been extensively studied. However, in sub-Saharan Africa (SSA), the moderating effects of governance in this relationship are little known. Furthermore, studies have focused on mortality as the main health outcome. This study contributes to this literature by investigating the moderating role of governance in the relationship by simultaneously assessing three dimensions of governance (corruption control, government effectiveness and voice accountability) using disability-adjusted life years (DALYs) as a measure of outcomes. METHODS: The study applies the two-stage moderation approach using partial least squares structural equation modelling (PLS-SEM) to panel data from 43 SSA nations from 2013 to 2019. The study also uses domestic general government health expenditure (DGGHE) as an independent variable and disability-adjusted life years (DALY) as the dependent variable in this relationship. RESULTS: The analysis reveals that DGGHE affects DALY negatively and that governance improves the effect of DGGHE on DALY, with bigger improvements among countries with worse governance. CONCLUSION: These findings provide evidence that good governance is crucial to the effectiveness of PHS in SSA nations. Sub-Saharan Africa (SSA) countries should improve governance to improve population health.