Towards an Integrated Healthcare System: Evolutionary Game Analysis on Competition and Cooperation Between Urban and Rural Medical Institutions in China.

Background: The game of interest is the root cause of the non-cooperative competition between urban and rural medical and health institutions. The study investigates competition and cooperation among urban and rural medical institutions using the evolutionary game analysis. Methods: With the evolutionary game model, analysis of the stable evolutionary strategies between the urban and rural medical and health facilities is carried out. A numerical simulation is performed to demonstrate the influence of various values. Results: The result shows that the cooperation mechanism between urban and rural medical Institutions is relevant to the efficiency of rural medical institutions, government supervision, reward, and punishment mechanism. Conclusions: Suggestions for utilizing the government's macro regulation and control capabilities, resolving conflicts of interest between urban and rural medical and health institutions is recommended. In addition, the study again advocates mobilizing the internal power of medical institutions' cooperation to promote collaboration between urban and rural medical and health institutions.

Effects of Personal Ability and Social Welfare on the Health of Rural-to-Urban Elderly Migrants: An Empirical Analysis from Jiangsu Province, China.

This study aims to discuss the relationship between personal endowment and social welfare on the health status of the rural-to-urban elderly migrants. It constructed the theoretical framework of the health vulnerability of rural-to-urban elderly migrants. The health status of rural-to-urban elderly migrants was divided into three dimensions: physical health, mental health, and social adaptation. A total of 658 rural-to-urban elderly migrants in 12 cities of Jiangsu province were selected as samples for empirical test and analyzed the influence of individual endowments and social welfare on the health status of rural-to-urban elderly migrants and their differences. The result shows that personal ability affects the social adaptation ability of rural-to-urban elderly migrants, and social welfare has a significant influence on the physical and mental health of rural-to-urban elderly migrants. Lacking the learning ability of rural-to-urban elderly migrants in sample areas is the main factor that leads to their low social adaptation ability and the unequal social welfare and public services restricting the physiological and mental health status of rural-to-urban elderly migrants.

A Comparative Analysis of Impact of Universal Two-Child Policy on Maternity Insurance Fund in Jiangsu Province and Guangxi Zhuang AR.

The maternity insurance fund in some provinces in China has accumulated unprecedented deficit levels. This imminent depletion can cause a catastrophic health crisis for maternal health. This study analyzed the post-policy impact of key factors on maternity insurance income inflow and outflow in Jiangsu Province and Guangxi Zhuang Autonomous Region (AR). We applied Pasera's ARLD model and VECM Granger Causality Test to establish long- and short-term impact of selected factors that determines the income and expenditure of the maternity insurance fund in the two regions based on data from 2011 to 2019. Our results show that the addition of new births due to the universal two-child policy has increased the per capita utilization of the maternity insurance fund in both areas. We further observed that the impact of the maternity insurance contribution rate to the maternity insurance fund decays with time giving a long-run limited impact in both provinces. Thus the positive impact is stronger in the short term, but in the long term, its influence or contribution to stability of the funds reduces. The positive impact of interest from investment in the maternity insurance fund is however insignificant in both provinces, giving a major cause for concern on its role in maternity insurance fund income generation. In the short term, the contribution rate of the maternity insurance fund must be adjusted upward or the payment base expanded to receive additional contribution from all employees to avoid complete depletion of the fund. In the long term, we recommend the need to replenish the maternity insurance funds through proper investment options for the funds. We further recommend the need to look for other sources of funding social interventions based on existing practices in other countries.

Beyond COVID-19 Pandemic: An Integrative Review of Global Health Crisis Influencing the Evolution and Practice of Corporate Social Responsibility.

Background: Global health crisis continues to drive the dynamics of corporate social responsibility (CSR) across industries with self-perpetuating momentum. From a historical point of view, more than a century of immense corporate fecundity has formed the ecological conditions and shaped current understanding of the effect of public health on CSR. This study sought to examine the extent to which companies are able to balance their business interest with social interest through health-related CSR and how knowledge of them can help explain the potential impact of COVID-19. Method: This study employs a narrative review of current literature; however, the integrative strategy was combined with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist to rigorously select the necessary articles for proper integrative synthesis. Results: We note that in the pursuit of their social responsibility, corporate enterprises struggle to balance the interest of society and their own interest. Genuine CSR activities such as donations are often undermined by unbridled and excessive desire to draw society on themselves to reap economic benefits are largely dominated by the need to advance. There are signals that enterprises might see COVID-19-related CSR as an entry door to increase corporate influence thereby commercializing the pandemic. Conclusions: The impact of COVID-19 on CSR is epochal. There is a moral obligation for enterprises to reform current risk assessments and collaborate more deeply with state agencies to invest in the health and safety inspections at the world place. CSR strategies must be proactive to endure other unknown pandemics with equal capacity to disrupt business operations. Companies must create innovative and regular activities to educate its stakeholders to become more committed to safeguarding future enterprise-based defense mechanism needed to diagnose, protect, treat, and rehabilitate victims and those threatened by pandemics and other emergencies that affect the stability of an organization to reduce its cost and protect revenue.

An empirical study on the determinants of health care expenses in emerging economies.

BACKGROUND: Emerging countries continue to suffer gravely from insufficient healthcare funding, which adversely affects access to quality healthcare and ultimately the health status of citizens. By using panel data from the World Development Indicators, the study examined the determinants of health care expenditure among twenty-two (22) emerging countries from the year 2000 to 2018. METHODS: The study employed cross-section dependence and homogeneity tests to confirm cross-sectional dependence and to deal with homogeneity issues. The Quantile regression technique is employed to test for the relationship between private and public health care expenses and its determinants. The Pooled mean group causality test is used to examine the causal connections among the variables. RESULTS: The outcome of the quantile regression test revealed that economic growth and aging population could induce healthcare costs in emerging countries. However, the impact of industrialization, agricultural activities, and technological advancement on health expenses are found to be noticeably heterogeneous at the various quantile levels. Unidirectional causality was found between industrialization and public health expenses; whereas two-way causal influence was reveled amongst public health expenditure and GDP per capita; public health expenditure and agricultural activities. CONCLUSION: It is therefore suggested that effective and integrated strategies should be considered by industries and agricultural sectors to help reduce preventable diseases that will ultimately reduce healthcare costs among the emerging countries.

Reconstructing family doctors' psychological well-being and motivation for effective performance in China: the intervening role of psychological capital.

BACKGROUND: Family practice and family doctors are critical part of China's primary healthcare delivery in a constantly evolving society. As the first point of contact with the medical system, family practices require physically and psychologically sound and a well-motivated family doctors at all times. This is because an error can lead to loss of lives as gatekeepers of the medical system. Our study explored the extent to which positive psychological capital promotes higher performance among family doctors. METHODS: A questionnaire was used to collect data from family doctors in Shanghai, Nanjing, and Beijing. We applied a structural equation analysis to analyze the causal relationship among the variables. RESULTS: We found out that psychological well-being and job involvement significantly influences the performance of family doctors in China. The study also noted that psychological capital moderates the relationship between psychological well-being attainment, job involvement, and performance. CONCLUSIONS: Studies have shown that these pressures affect their well-being considerably. For this reason, a healthcare professional who experiences positive emotions affects the total behavior which culminates into performance.

Evaluation of Green Procurement Practices Among Mining Companies' Hospitals in Ghana: A Qualitative Analysis.

This study focuses on the evaluation of the green procurement practices among 7 mining hospitals in Ghana via qualitative analysis techniques. Thus, in this study, based on a 5-year case study, the practices of procurement officers in 7 hospitals belonging to mining companies in Ghana are explored. Within this period, interviews were conducted with key persons with recognizable responsibilities within the supply chain and procurement setup of the facilities. Details of their procurement practices, procedures, and policies were analyzed. A qualitative approach to organizational learning and practice is used to appreciate the existence of these differences observed and also to give a meaning to new perspectives on the challenges in establishing green procurement in the 7 mining companies' hospitals. The results of the analysis demonstrated that adjustments in the buyers' practices are not as much dependent on whether they understand, for instance, policies, tools, and procedures, but rather a matter of whether the buyers actually put their knowledge into practice.

"Assessment of the social influence and facilitating conditions that support nurses' adoption of hospital electronic information management systems (HEIMS) in Ghana using the unified theory of acceptance and use of technology (UTAUT) model".

BACKGROUND: Hospital electronic information management systems (HEIMS) are widely used in Ghana, and hence its performance must be carefully assessed. Nurses as clinical health personnel are the largest cluster of hospital staff and are the pillar of healthcare delivery. Therefore, they play a crucial role in the adoption and assessment of HEIMSs in Ghana. This report sought to assess the "Social Influence" (SI) and "Facilitating Conditions" (FC) that support Nurses' Acceptance of HEIMS in Ghana using the "Unified Theory of Acceptance and Use of Technology" (UTAUT) model. METHODS: This study applied a non-experimental survey design. An electronic platform questionnaire on smartphones was used to collect data on 660 nurses. Statistically, AMOS Structural Equation Modelling (SEM) version 22.0 was employed to examine the research model. RESULTS: "Behavioral Intention" (BI) to HEIMS use was significantly predicted by SI and FC (p < 0.001). Notably, both SI and FC had an influence on nurses' use behavior (UB) with behavioral intention (BI) as the mediator, which explains a total of 42.1% variance in the intention of nurses to use HEIMS. Likewise, UB of HEIMS was also significantly predicted by SI (R2 = 43.2) and BI (R2 = 0.39.6) with both constructs explaining a total of 51.7% of the variance in nurses' acceptance to use HEIMS. CONCLUSION: Nurses' adoption of HEIMS in terms of the UB was influenced by SI and BI, whiles SI and FC had the strongest influence on BI (serving as mediator) of UB to adopt and use HEIMS among the nurses in Ghanaian hospitals.

Complementarity of Clinician Judgment and Evidence Based Models in Medical Decision Making: Antecedents, Prospects, and Challenges.

Early accounts of the development of modern medicine suggest that the clinical skills, scientific competence, and doctors' judgment were the main impetus for treatment decision, diagnosis, prognosis, therapy assessment, and medical progress. Yet, clinician judgment has its own critics and is sometimes harshly described as notoriously fallacious and an irrational and unfathomable black box with little transparency. With the rise of contemporary medical research, the reputation of clinician judgment has undergone significant reformation in the last century as its fallacious aspects are increasingly emphasized relative to the evidence based options. Within the last decade, however, medical forecasting literature has seen tremendous change and new understanding is emerging on best ways of sharing medical information to complement the evidence based medicine practices. This review revisits and highlights the core debate on clinical judgments and its interrelations with evidence based medicine. It outlines the key empirical results of clinician judgments relative to evidence based models and identifies its key strengths and prospects, the key limitations and conditions for the effective use of clinician judgment, and the extent to which it can be optimized and professionalized for medical use.

Forecasting optimal solar energy supply in Jiangsu Province (China): a systematic approach using hybrid of weather and energy forecast models.

The idea of aggregating information is clearly recognizable in the daily lives of all entities whether as individuals or as a group, since time immemorial corporate organizations, governments, and individuals as economic agents aggregate information to formulate decisions. Energy planning represents an investment-decision problem where information needs to be aggregated from credible sources to predict both demand and supply of energy. To do this there are varying methods ranging from the use of portfolio theory to managing risk and maximizing portfolio performance under a variety of unpredictable economic outcomes. The future demand for energy and need to use solar energy in order to avoid future energy crisis in Jiangsu province in China require energy planners in the province to abandon their reliance on traditional, "least-cost," and stand-alone technology cost estimates and instead evaluate conventional and renewable energy supply on the basis of a hybrid of optimization models in order to ensure effective and reliable supply. Our task in this research is to propose measures towards addressing optimal solar energy forecasting by employing a systematic optimization approach based on a hybrid of weather and energy forecast models. After giving an overview of the sustainable energy issues in China, we have reviewed and classified the various models that existing studies have used to predict the influences of the weather influences and the output of solar energy production units. Further, we evaluate the performance of an exemplary ensemble model which combines the forecast output of two popular statistical prediction methods using a dynamic weighting factor.