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1.
PLoS One ; 19(5): e0300775, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38753653

RESUMO

This paper investigates the impact of digital inclusive financial development on local government expenditure incentives at the income level. It does so by constructing a multi-level government Dynamic Stochastic General Equilibrium (DSGE) model that incorporates the financial sector. By employing empirical methods that involve uncertainty shocks and counterfactual simulations, the research yields several key findings. Firstly, the development of digital inclusive finance contributes to breaking down the urban-rural dual financial structure, thus facilitating balanced economic development within regions. Secondly, it reduces the proportion of financially excluded areas, accelerates fiscal decentralization, leading to an increase in local government fiscal revenue, and, consequently, an expansion of local fiscal expenditures. Thirdly, at a certain stage of digital inclusive finance development, it tends to crowd out residents' investment and consumption. Therefore, the decentralization of fiscal power and the expansion of local government expenditure at this stage may paradoxically inhibit regional economic growth. The study's conclusions validate the significant impact of digital inclusive finance on local government incentives at the income level.


Assuntos
Desenvolvimento Econômico , Governo Local , China , Humanos , Financiamento Governamental/tendências , Modelos Econômicos , Renda
3.
BMC Prim Care ; 25(1): 142, 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38678172

RESUMO

PURPOSE: Annually, the French Ministry of Health funds clinical research projects based on a national call for projects. Since 2013, the Ministry has prioritized funding of primary care. Projects selected for funding are made public without distinguishing the specific area of research. The objective of this study was to identify and describe the evolution of the primary care research projects funded by the Ministry of Health between 2013 and 2019. METHOD: We reviewed all of the 1796 medical research projects funded between 2013 and 2019 and categorized projects as primary care projects by using a list of specific keywords. This list was established through two approaches: (1) selected by an expert committee, the RECaP primary care working group, and (2) using an automated textual analysis of published articles in the field. The keywords were used to screen the titles of the medical research projects funded. The abstracts (at www. CLINICALTRIALS: gov ) or details (from project leaders) were then analyzed by two independent reviewers to determine true primary care projects. RESULTS: Finally, 49 primary care projects were identified, representing 2.7% of all medical research projects funded, without any significant change over the period. These projects were predominantly interventional (69%), with a median number of patients expected per project of 902. CONCLUSION: Despite the prioritization of primary care research in 2013 by the French ministry of health, the number and proportion of projects funded remains low, with no significant change over the years. TRIAL REGISTRATION: Not applicable.


Assuntos
Pesquisa Biomédica , Financiamento Governamental , Atenção Primária à Saúde , França , Atenção Primária à Saúde/economia , Atenção Primária à Saúde/organização & administração , Humanos , Pesquisa Biomédica/economia , Financiamento Governamental/economia , Financiamento Governamental/tendências
5.
Biol Futur ; 72(2): 129-138, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34554467

RESUMO

In 2019, the record for the most expensive drug was broken at US$2.1 million per patient. The high costs of new drugs are justified by the pharmaceutical industry as the expense required for maintaining research and development (R&D) pipelines. However, this does not take into account that globally the public pays for between one to two-thirds of upfront R&D costs through taxpayers or charitable donations. Governments are effectively paying twice for medicines; first through R&D, and then paying the high prices upon approval. High drug prices distort research priorities, emphasising financial gains and not health gains. In this manuscript, issues surrounding the current patent-based drug development model, public funding of research and pharmaceutical lobbying will be addressed. Finally, innovations in drug development to improve public health needs and guaranteeing medication access to patients will be explored.


Assuntos
Custos de Medicamentos/normas , Desenvolvimento de Medicamentos/métodos , Financiamento Governamental/economia , Custos de Medicamentos/tendências , Desenvolvimento de Medicamentos/economia , Indústria Farmacêutica/economia , Financiamento Governamental/tendências , Humanos
7.
PLoS One ; 16(4): e0250130, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33861771

RESUMO

The sustainable development of pension systems has been investigated from a financial perspective worldwide. However, the pension adequacy and its effect on the sustainability of a national pension system are still understudied. Using actual replacement rate and modified living standards replacement rate, this study empirically evaluates whether China's New Rural Pension Scheme (NRPS) grants enough livelihood protection for the rural residents in the Northwestern China. The results show that the NRPS fails to meet the basic needs of the elderly people (i.e., age of sixty years or older) or the middle-aged people (forty-five to fifty-nine years old), while it only provides limited protection for the young people (sixteen to forty-four years old). These findings suggest that the current NRPS benefits are very low in the Northwestern China and policy reforms should be further implemented to improve the sustainable development of the New Rural Pension Scheme.


Assuntos
Financiamento Governamental/estatística & dados numéricos , Pensões/estatística & dados numéricos , Desenvolvimento Sustentável/economia , China , Financiamento Governamental/métodos , Financiamento Governamental/tendências , Programas Governamentais/métodos , Humanos , Estudos Longitudinais , Qualidade de Vida/legislação & jurisprudência , Aposentadoria , População Rural , Fatores Socioeconômicos , Desenvolvimento Sustentável/legislação & jurisprudência , Desenvolvimento Sustentável/tendências
8.
PLoS One ; 16(4): e0250129, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33848302

RESUMO

This study develops a novel framework of heterogeneous producer attitudes towards risk to analyze different, stated and revealed, roles of crop insurance premium subsidies and underlying policy objectives of the government. The analysis reveals a strong connection and a complementarity between the roles of premium subsidies in increasing producer participation in crop insurance, inducing a desired separating equilibrium in the presence of asymmetric information, and transferring income to agricultural producers participating in the program. Developing an alternative design of premium subsidies that can achieve the stated government objective of increased producer participation and induce any desired separating equilibrium at significantly reduced costs, our study rejects the idea that the income redistribution taking place under the current policy design is necessary for increasing producer participation in crop insurance. Indeed, the current policy design reveals that premium subsidies are either a means of income redistribution or a policy failure.


Assuntos
Produtos Agrícolas/economia , Seguro/economia , Seguro/tendências , Agricultura/economia , Custos e Análise de Custo , Financiamento Governamental/economia , Financiamento Governamental/tendências , Humanos , Renda , Cobertura do Seguro/economia , Estados Unidos
9.
J Urol ; 206(2): 427-433, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33780282

RESUMO

PURPOSE: We explored the patterns and distribution of National Institutes of Health grant funding for urological research in the United States. MATERIALS AND METHODS: The National Institutes of Health RePORTER database was queried for all grants awarded to urology departments between 2010 and 2019. Information regarding the value of the grant, funded institution, successful publication of the research, and the category of urological subspecialty were collected. Data on principal investigators were extracted from publicly available information. RESULTS: There were 509 grants awarded to Urology between 2010 and 2019 for a total value of $640,873,867, and a median per-project value of $675,484 (IQR 344,170-1,369,385). Over the study period, total funding decreased by 15.6% and was lower compared to other surgical subspecialties. Most grants were awarded by the National Cancer Institute and National Institute of Diabetes and Digestive and Kidney Diseases (85%) to Western or North Central institutions (52.5%), and had principal investigators specialized in urologic oncology (56.4%), followed by general urologists (21.5%). Female principal investigators led 21.6% of Urology grants and were more likely PhD basic scientists than males (64.4% vs 38.2%, p=0.001). In total, 10,404 publications linked to the 509 grants were produced, of which 28.5% were published in journals with an impact factor ≥10. CONCLUSIONS: Urology is underrepresented in National Institutes of Health grant funding compared to other surgical fields. During the past decade there was a further decrease in the total budget of National Institutes of Health grants to Urology.


Assuntos
Financiamento Governamental/tendências , Departamentos Hospitalares , National Institutes of Health (U.S.) , Apoio à Pesquisa como Assunto/tendências , Urologia , Bases de Dados Factuais , Financiamento Governamental/estatística & dados numéricos , Humanos , Patentes como Assunto/estatística & dados numéricos , Editoração/estatística & dados numéricos , Apoio à Pesquisa como Assunto/estatística & dados numéricos , Distribuição por Sexo , Estados Unidos
13.
Int J Equity Health ; 19(1): 219, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33302978

RESUMO

BACKGROUND: As a key part of the new round of health reform, the zero-markup drug policy (ZMDP) removed the profit margins of drug sales at public health care facilities, and had some effects to the operation of these institutions. This study aims to assess whether the ZMDP has different impacts between county general and traditional Chinese medicine (TCM) hospitals. METHODS: We obtained longitudinal data from all county general and TCM hospitals of Shandong province in 2007-2017. We used difference-in-difference (DID) method to identify the overall and dynamic effects of the ZMDP. RESULTS: On average, after the implementation of the ZMDP, the share of revenue from medicine sales reduced by 16.47 and 10.42%, the revenue from medicine sales reduced by 24.04 and 11.58%, in county general and TCM hospitals, respectively. The gross revenue reduced by 5.07% in county general hospitals. The number of annual outpatient visits reduced by 11.22% in county TCM hospitals. Government subsidies increased by 199.22 and 89.3% in county general and TCM hospitals, respectively. The ZMDP reform was not significantly associated with the revenue and expenditure surplus, the number of annual outpatient visits and the number of annual inpatient visits in county general hospitals, the gross revenue, the revenue and expenditure surplus and the number of annual inpatient visits in county TCM hospitals. In terms of dynamic effects, the share of revenue from medicine sales, revenue from medicine sales, and gross revenue decreased by 20.20, 32.58 and 6.08% respectively, and up to 28.53, 63.89 and 17.94% after adoption, while government subsidies increased by around 170 to 200% in county general hospitals. The number of annual outpatient visits decreased by 9.70% and up to 18.84% in county TCM hospitals. CONCLUSION: The ZMDP achieved its some initial goals of removing the profits from western medicines in county hospitals' revenue without disrupting the normal operation, and had different impacts between county general and TCM hospitals. Meanwhile, some unintended consequences were also recognized through the analysis, such as the decline of the utilization of the TCM.


Assuntos
Custos de Medicamentos/tendências , Política de Saúde , Hospitais de Condado/economia , Medicina Tradicional Chinesa/economia , China , Controle de Custos , Financiamento Governamental/tendências , Hospitais de Condado/estatística & dados numéricos , Humanos , Estudos Longitudinais , Medicina Tradicional Chinesa/estatística & dados numéricos
14.
Adv Chronic Kidney Dis ; 27(4): 305-311.e1, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33131643

RESUMO

The focus of this article is to review the available funding opportunities for the nephrology workforce at all career levels and review the current challenges involved in the career of a physician-scientist. While the scarcity of nephrology fellows for training programs is a continuing challenge, increased funding for the National Institutes of Health is encouraging particularly for early career investigators. In addition to National Institutes of Health funding, other funding sources are also discussed as they provide much needed bridge funding during key transition periods for young careers. Recent initiatives such as the Advancing American Kidney Health, KidneyX, and National Institute of Diabetes and Digestive and Kidney Diseases' Kidney Precision Medicine Project offer new research opportunities for bringing much needed innovation to improve lives of people with kidney diseases. The time is now for us to seize the opportunity and ensure that a strong workforce will be able to take advantage of these potential game changers for nephrology.


Assuntos
Pesquisa Biomédica/economia , Pesquisa Biomédica/tendências , Financiamento Governamental/tendências , Nefropatias , National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)/economia , Nefrologia , Fundações/economia , Mão de Obra em Saúde , Humanos , Nefropatias/diagnóstico , Nefropatias/terapia , Empresa de Pequeno Porte/economia , Sociedades Médicas/economia , Estados Unidos , United States Department of Veterans Affairs/economia
18.
PLoS One ; 15(6): e0233367, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32480400

RESUMO

Total NIH funding dollars have increased from 2009-2018. We questioned whether this growth has occurred proportionately around the country and throughout allopathic medical schools. Therefore, we compared the trend in NIH grant funding from 2009 to 2018 for United States allopathic medical schools among historically top-funded schools, private and public schools, and by region of the country. Changes in both unadjusted and real funding dollars over time revealed a significant difference. Region was the only significant factor for mean percent change in funding from 2009-2018, with the Western region showing a 33.79% increase in purchasing power. The Northeastern region showed a -6.64% decrease in purchasing power while the Central and Southern regions reported changes of 2.46% and -6.08%, respectively. The mean percent increases were more proportional and nonsignificant in the public vs. private institutions comparison, at -3.41% and 4.75%, respectively. Likewise, the top-funded institutions vs. other institutions comparisons demonstrated modest, nonsignificant differences. However, although the relative changes might be proportional, the absolute increases evidence a pattern of growing cumulative advantage that favor the highest-funded institutions and private institutions. The potential consequences of this disproportionate increase include health science education, biomedical research, and patient access disparities in large parts of the country. The NIH and the scientific community should explore potential solutions in its funding models.


Assuntos
Financiamento Governamental/tendências , National Institutes of Health (U.S.)/tendências , Faculdades de Medicina/economia , Pesquisa Biomédica/economia , Financiamento Governamental/história , Organização do Financiamento/tendências , História do Século XXI , Humanos , National Institutes of Health (U.S.)/economia , National Institutes of Health (U.S.)/história , Estados Unidos
19.
BMC Public Health ; 20(1): 643, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32389120

RESUMO

BACKGROUND: Implementation of food taxes or subsidies may promote healthier and a more sustainable diet in a society. This study estimates the effects of a tax (15% or 30%) on meat and a subsidy (10%) on fruit and vegetables (F&V) consumption in the Netherlands using a social cost-benefit analysis with a 30-year time horizon. METHODS: Calculations with the representative Dutch National Food Consumption Survey (2012-2014) served as the reference. Price elasticities were applied to calculate changes in consumption and consumer surplus. Future food consumption and health effects were estimated using the DYNAMO-HIA model and environmental impacts were estimated using Life Cycle Analysis. The time horizon of all calculations is 30 year. All effects were monetarized and discounted to 2018 euros. RESULTS: Over 30-years, a 15% or 30% meat tax or 10% F&V subsidy could result in reduced healthcare costs, increased quality of life, and higher productivity levels. Benefits to the environment of a meat tax are an estimated €3400 million or €6300 million in the 15% or 30% scenario respectively, whereas the increased F&V consumption could result in €100 million costs for the environment. While consumers benefit from a subsidy, a consumer surplus of €10,000 million, the tax scenarios demonstrate large experienced costs of respectively €21,000 and €41,000 million. Overall, a 15% or 30% price increase in meat could lead to a net benefit for society between €3100-7400 million or €4100-12,300 million over 30 years respectively. A 10% F&V subsidy could lead to a net benefit to society of €1800-3300 million. Sensitivity analyses did not change the main findings. CONCLUSIONS: The studied meat taxes and F&V subsidy showed net total welfare benefits for the Dutch society over a 30-year time horizon.


Assuntos
Dieta Saudável/economia , Dieta Saudável/estatística & dados numéricos , Frutas/economia , Carne/economia , Impostos/economia , Impostos/tendências , Verduras/economia , Análise Custo-Benefício/estatística & dados numéricos , Análise Custo-Benefício/tendências , Financiamento Governamental/economia , Financiamento Governamental/estatística & dados numéricos , Financiamento Governamental/tendências , Previsões , Humanos , Países Baixos , Impostos/estatística & dados numéricos
20.
Healthc Q ; 23(1): 10-12, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32249733

RESUMO

Public drug program spending accounts for 43.1% of prescribed drug spending in Canada. This report provides an in-depth look at public drug program spending in Canada, using the Canadian Institute for Health Information's (CIHI) National Prescription Drug Utilization Information System. Public drug program spending does not include spending on drugs dispensed in hospitals or on those funded through cancer agencies and other special programs.


Assuntos
Custos de Medicamentos/estatística & dados numéricos , Financiamento Governamental/estatística & dados numéricos , Medicamentos sob Prescrição/economia , Canadá , Financiamento Governamental/tendências , Gastos em Saúde/estatística & dados numéricos , Humanos , Medicamentos sob Prescrição/classificação
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