A Dynamic DEA Analysis of Health Output Efficiencies of Cities and Counties in Taiwan.

This research utilizes the dynamic slack-based measure (DSBM) model to evaluate health output efficiencies in Taiwan's administrative districts from 2014 to 2018. To measure health output efficiency, it adopts four input variables, one output variable, and one carry-over (exercise expenditure). This paper includes both public goods in totals and private goods per capita as the inputs of health output. Empirical results indicate that health output efficiencies in the south and east areas relatively lower. Lastly, the overall efficiency of urban areas may not be better than that in non-urban areas.

[Effect of Tongdu Tiaoshen acupuncture on serum GABA and CORT levels in patients with chronic insomnia].

OBJECTIVE: To observe the clinical effect of Tongdu Tiaoshen acupuncture on chronic insomnia, and explore its possible mechanism. METHODS: A total of 60 patients with chronic insomnia were randomly divided into an observation group (30 cases) and a control group (30 cases, 1 case dropped off ). The observation group was treated with Tongdu Tiaoshen acupuncture at Baihui (GV 20), Yintang (GV 29), Shenting (GV 24), etc. once every other day, 3 times a week. The control group was treated with estazolam tablets (1 mg) orally before going to bed every night. The treatments of both groups were required 4 weeks. The Pittsburgh sleep quality index (PSQI) scores, serum gamma-aminobutyric acid (GABA) and cortisol (CORT) levels were observed before and after treatment in the two groups, and the clinical effect was compared. RESULTS: After treatment, the sleep quality, day dysfunction scores of PSQI in the observation group and the falling asleep time, sleep time, sleep efficiency, sleep disturbance scores and total scores of PSQI in the two groups were lower than before treatment (P<0.01, P<0.05). After treatment, the daytime dysfunction score of PSQI in the observation group was lower than that in the control group (P<0.05). After treatment, the serum GABA levels in the two groups were higher than before treatment (P<0.05), and the serum CORT levels were lower than before treatment (P<0.01). The total effective rate was 90% (27/30) in the observation group and 93.1% (27/29) in the control group, the difference was not statistically significant (P>0.05). CONCLUSION: Tongdu Tiaoshen acupuncture has the same effect as western medication estazolam tablets in the treatment of patients with chronic insomnia, and has little effect on daytime dysfunction. The mechanism may be related to the increase of serum GABA level and the inhibition of the hyperactivation of hypothalamus-pituitary-adrenal (HPA) axis.

Degrees of Shortage and Uncovered Ratios for Long-Term Care in Taiwan's Regions: Evidence from Dynamic DEA.

The government is facing the country's aging population and low birth rate have led to a severe shortage of its healthcare workforce in Taiwan after 2003. In order to explore the status of the country's degree of long-term care shortage and uncovered ratio, this research uses the Push-Pull-Mooring (PPM) theory to explain long-term care efficiency during 2010-2019 in each city and county. We collect longitudinal-sectional data for 2010-2019 from the Ministry of Health and Welfare's Department of Statistics for 22 administrative regions in Taiwan in each year and employ dynamic data envelopment analysis (DEA) to evaluate the overall technical efficiency and the disaggregate output insufficiency to explain the research results. The main findings are as follows: (1) Cities near the capital Taipei have the highest degree of shortages in long-term caregivers and high uncovered ratios of people who need long-term care. (2) Presently, there is no demand to increase the number of long-term care institutions in Taiwan. (3) The government should introduce new long-term care certificates through national examinations in order to develop a stronger professional workforce in this field.

Projecting the Target Quantity of Medical Staff in Taiwan's Administrative Regions by the Theory of Carrying Capacity.

As physicians and nurses are the main medical staff in any healthcare system, an appropriate medical workforce distribution is crucial for an aging society. This study thus applies the theory of carrying capacity and the given demand side to explore the carrying capacity, carrying efficiency, and potential adjustment ratio of medical staff in Taiwan's administrative regions by using the data envelopment analysis (DEA) approach in which a lower carrying efficiency implies a higher shortage ratio. The main findings are as follows. (i) The carrying efficiency of Taiwan's medical staff is weakening year by year, while the carrying efficiency of the country's nurses is lower than that of physicians. (ii) The outlying islands of Taiwan have a more serious shortage of physicians and nurses than the main island. (iii) The central government should encourage more physicians and nurses to work in regions with a low carrying efficiency.

[Effect of Phosphorus Addition on N2O Emissions from Rice-Rapeseed Rotation Soils].

The red soils in southern China are generally classified as phosphorus-deficient, and therefore planting crops in these regions usually requires high applications of phosphate fertilizer. However, the effect of phosphorus addition on N2O emissions in rice-rapeseed rotation soils is not clear. We carried out an incubation experiment with the rice-rapeseed rotation soil from Qianjiang and Xianning to explore the effect of different concentrations of phosphorus (0, 15, and 30 mg·kg-1) and different concentrations of nitrogen (0 and 100 mg·kg-1) on N2O emission. Studies have shown that the addition of phosphorus has a significant effect on soil N2O emissions, but the pathways of impact are varied:in the case of low nitrogen soil, the addition of phosphorus promotes the fixation of nitrogen in the soil by microorganisms and thus reduces N2O emissions; in case of sufficient nitrogen content in soil, adding less phosphorus promotes the activity of nitrifies and thereby promotes the emission of N2O, while adding more phosphorus also promotes fixation by microorganisms in the soil; when there is a high content of available phosphorus in the soil, whether the nitrogen is sufficient or not, the addition of phosphorus will inhibit the emission of N2O.

Environment-adjusted total-factor energy efficiency of Taiwan's service sectors.

This study computes the pure technical efficiency (PTE) and energy-saving target of Taiwan's service sectors during 2001-2008 by using the input-oriented data envelopment analysis (DEA) approach with the assumption of a variable returns-to-scale (VRS) situation. This paper further investigates the effects of industry characteristics on the energy-saving target by applying the four-stage DEA proposed by Fried et al. (1999). We also calculate the pre-adjusted and environment-adjusted total-factor energy efficiency (TFEE) scores in these service sectors. There are three inputs (labor, capital stock, and energy consumption) and a single output (real GDP) in the DEA model. The most energy efficient service sector is finance, insurance and real estate, which has an average TFEE of 0.994 and an environment-adjusted TFEE (EATFEE) of 0.807. The study utilizes the panel-data, random-effects Tobit regression model with the energy-saving target (EST) as the dependent variable. Those service industries with a larger GDP output have greater excess use of energy. The capital-labor ratio has a significantly positive effect while the time trend variable has a significantly negative impact on the EST, suggesting that future new capital investment should also be accompanied with energy-saving technology in the service sectors.