RESUMO
Grid-side energy storage has become a crucial part of contemporary power systems as a result of the rapid expansion of renewable energy sources and the rising demand for grid stability. This study aims to investigate the rationality of incorporating grid-side energy storage costs into transmission and distribution (T&D) tariffs, evaluating this approach using economic externality theory. We first develop a comprehensive benefit evaluation framework based on economic externality theory considering system stability, renewable energy integration, end-user, and environmental impacts. Then, using the CPLEX solver, an operating model of grid-side energy storage is constructed with the goal of reducing substation load variations. Through a case study, it is found that grid-side energy storage has significant positive externality benefits, validating the rationale for including grid-side energy storage costs in T&D tariffs. Sensitivity analysis suggests that with cost reduction and market development, the proportion of grid-side energy storage included in the T&D tariff should gradually recede. As a result, this study offers important information about whether it is reasonable to include grid-side energy storage costs in T&D tariffs in China.
RESUMO
The availability and affordability of medicines remain major health challenges around the world. In March 2019, the Chinese government introduced a pilot National Centralized Drug Procurement (NCDP) program in order to reduce drug prices and improve the affordability of effective and safe medicines. This study aimed to assess the impact of NCDP policy on health expenditures of cancer patients. Using inpatient discharge records from a large hospital in the pilot city, we performed a difference-in-differences design to estimate the change in health expenditures before and after the policy. We found that the implementation of NCDP was associated with a significant decrease in total expenditures (14.13%) and drug expenditures (20.75%) per inpatient admission. There were also significant reductions in non-drug-related expenditures, including a 7.65% decrease in health service expenditures, a 38.28% decrease in diagnosis expenditures, and a 25.31% decrease in consumable material expenditures per inpatient admission. However, the NCDP implementation was associated with a 107.97% increase in the traditional Chinese medicine expenditures. Overall, the study provided evidence that the NCDP policy has achieved its goals of high-quality and affordable healthcare. The drug expenditures of lung cancer patients revealed a continuous decline, and the policy may have spillover effects on other healthcare expenditures. Further studies are needed to evaluate the long-term effects of NCDP on policy-related expenditures and health outcomes.
Assuntos
Gastos em Saúde , Neoplasias Pulmonares , Custos de Medicamentos , Humanos , Pacientes Internados , Centros de Atenção TerciáriaRESUMO
BACKGROUND: A reasonable allocation of health resources is often characterized by equity and high efficiency. This study aims to evaluate the equity and efficiency of maternal and child health (MCH) resources allocation in Hunan Province, China. METHODS: Data related to MCH resources and services was obtained from the Hunan maternal and child health information reporting and management system. The Gini coefficient and data envelopment analysis (DEA) were employed to evaluate the equity and efficiency of MCH resources allocation, respectively. RESULTS: The MCH resources allocation in terms of demographic dimension were in a preferred equity status with the Gini values all less than 0.3, and the Gini values for each MCH resources' allocation in terms of the geographical dimension ranged from 0.1298 to 0.4256, with the highest values in the number of midwives and medical equipment (≥ CNY 10,000), which exceeds 0.4, indicating an alert of inequity. More than 40% regions in Hunan were found to be relatively inefficient with decreased return to scale in the allocation of MCH resources, indicating those inefficient regions were using more inputs than needed to obtain the current output levels. CONCLUSIONS: The equity of MCH resources by population size is superior by geographic area and the disproportionate distribution of the number of medical equipment (≥ CNY 10,000) and midwives between different regions was the main source of inequity. Policy-makers need to consider the geographical accessibility of health resources among different regions to ensure people in different regions could get access to available health services. More than 40% of regions in Hunan were found to be inefficient, with using more health resources than needed to produce the current amount of health services. Further investigations on factors affecting the efficiency of MCH resources allocation is still needed to guide regional health plans-making and resource allocation.