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1.
BMC Public Health ; 22(1): 914, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534861

RESUMO

BACKGROUND: The Chinese government launched health care reforms in 2009 and introduced a national list of essential public health services (EPHS) as an integral part of the plan to deliver health care for all. EPHS was also built into the national plan to promote the equalisation of public services across the country. A national standard was set for financial input to EPHS. As the services are co-funded by the central and local governments, a robust intergovernmental fiscal system is essential to guarantee that the hundreds of thousands of service providers have adequate financing to meet the service commitment. METHODS: We examined the flow of funds through China's complex intergovernmental fiscal system to see whether the promise of equal funding for EPHS was implemented, and how the costs were distributed across levels of government. Information was collated from funding documents issued by all levels of governments involved, for a sample that includes the central government, 12 provincial governments, eight prefectural governments and 11 county-level governments. For each level of government, we examined: (i) when and how much funding they disbursed or received from higher levels; (ii) when and how much matching funds were made; and (iii) the allocation rules adopted. RESULTS: Overall, we found the central government met its commitments for the program on time and in full, and good compliance from local governments in passing through funding from higher levels and as well as meeting their own financial responsibilities. However, we also found the following problems: (i) the involvement of so many levels of government resulted in delays in the disbursement of funds; (ii) the use of outdated population data in calculating required funding resulted in some under-allocation; and (iii) localities that needed funding the most were not well targeted by the distribution of funds. CONCLUSION: This study traces how the 2018 subsidy for EPHS was disbursed from the central government to service providers, focusing on the roles played by intermediate levels of subnational governments-provinces, prefectures and counties. In this way, it identifies gaps in the current intergovernmental financing of EPHS and points to areas for further improvement.


Assuntos
Reforma dos Serviços de Saúde , Governo Local , China/epidemiologia , Atenção à Saúde , Financiamento Governamental , Serviços de Saúde , Humanos
2.
PLoS One ; 17(4): e0266413, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35363807

RESUMO

This paper explored how the government provides low-carbon subsidies for the manufacturers, retailers, and consumers in a secondary supply chain under cap-and-trade scheme. We calculated the best prices, emissions reductions, and the demands for common and low-carbon products when subsidizing each of the abovementioned market players. In particular, a comparative analysis of their equilibrium outcomes was made thereafter. The MATLAB simulation found that the optimal emissions reductions under the three subsidy modes were even and positively correlated to low-carbon subsidies, which, however, negatively correlated to the prices of both product types. Higher subsidies drove up demand for low-carbon products and dragged down that for common goods. But the prices of these products maintained the highest levels when consumers were subsidized; demand for common products was greater when subsidies went to retailers than to manufacturers or consumers, consequently generating the largest emissions and highest profits. When the subsidies were greater than [Formula: see text], all three subsidy modes saw a drop in total carbon emissions. That being so, the government should offer proper subsidies before seeing energy-saving progress.


Assuntos
Financiamento Governamental , Governo , Carbono , Comércio , Custos e Análise de Custo
4.
Artigo em Inglês | MEDLINE | ID: mdl-35457518

RESUMO

Carbon emission reduction has been a consensus goal for most countries to achieve environmental sustainability. The use of carbon emission trading policies has been generally considered by the governments. Remanufacturing, as an effective way to reduce carbon emission, is incorporated together with the tool of carbon emission policy to construct a low-carbon supply chain in this paper. We analyze the carbon emission reduction and profit maximization problem among enterprises of original equipment manufacturers (OEMs) and their outsourcing remanufacturers, integrating the impact of the carbon emission constraint policy and the carbon market. Considering consumer preferences on low-carbon products and recycling rates of waste products, we construct a Stackelberg game model (dominated by the OEM) and analyze the impact of a carbon emission constraint policy on sales price, volume, carbon emission, and revenue of new and remanufactured products in the supply chain system. The results suggest that the upper bound set by the government on carbon emission for enterprises positively affects sales volume of new products and negatively affects sales prices of both products. Moreover, the discount rate of carbon emission constraint negatively affects sales volume of new products and positively affects sales prices of both products. Notably, the carbon emission constraint policy has impacts on the production decisions of both manufacturers on an economic scale. When the upper bound of carbon emission is equal to a certain threshold, the OEM could obtain the greatest revenue. The results provide a new perspective for the government to attain the goal of carbon emission reduction and not sacrifice economic growth. Managers in outsourcing remanufacturers and OEMs could also be implicated from our results to collaborate in allocating remanufacturing orders to achieve win-win opportunities between them.


Assuntos
Comportamento do Consumidor , Serviços Terceirizados , Carbono , Comércio , Financiamento Governamental , Políticas
8.
Artigo em Inglês | MEDLINE | ID: mdl-35329274

RESUMO

To facilitate the green transformation of enterprises and realize low-carbon development, governments have adopted the policies of carbon emission constraint and carbon trade to promote enterprises' low-carbon production. Although the two policies aim to reduce carbon emissions, they have different effects on enterprises' production. Meanwhile, the development of remanufacturing caters to the low-carbon economy. Therefore, this article establishes the game models between an original equipment manufacturer (OEM) and a remanufacturer under carbon-emission-constraint and carbon-trade policies, analyzing the production decisions of enterprises under different policies to compare the influence of the two policies on outsourcing remanufacturing. The main conclusions of the article are as follows: (1) Both carbon-emission-constraint and carbon-trade policies increase the unit retail price of remanufactured and new products, reducing the new products sales volume. However, the sales volume of remanufactured products only decreases if the discount rate is less than the rate of carbon emissions of the two products. (2) The upper limit of carbon emissions can affect the unit outsourcing cost. The unit cost of outsourcing under the carbon-emission-constraint policy is only higher when the upper limit of carbon emissions is less than a certain threshold, and the discount rate is larger than the proportion of carbon emissions for both products; otherwise, the unit outsourcing cost under the carbon-trade policy is higher. (3) Both policies lessen the total environmental implication. When the upper limit of carbon emissions is less than a particular threshold, the environmental effect of the two manufacturers under the carbon-emission-constraint policy is smaller; otherwise, the environmental impact is smaller under the carbon-trade policy.


Assuntos
Serviços Terceirizados , Carbono , Comércio , Financiamento Governamental , Políticas
12.
PLoS One ; 17(2): e0262655, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35143496

RESUMO

This paper studies the pharmaceutical production supply chain system composed of upstream and downstream pharmaceutical enterprises, and explores the impact of government subsidy strategies on the new drug research and development (R&D) decision variables and profits of pharmaceutical enterprises as well as social welfare, when considering both the horizontal spillover effects within the industry and the vertical spillover effects between industries. Comparing and analyzing the impact of these strategies including non-government subsidy strategy, pharmaceutical enterprise innovation input subsidy strategy, pharmaceutical enterprise innovative product subsidy strategy, patient price subsidy strategy, and patient medical insurance subsidy strategy. By establishing a four-stage Cournot duopoly model incorporating spillover effects, the equilibrium solutions are obtained by backward induction, and the impact of spillover effects on decision variables is investigated accordingly. Studies have shown that: (a) Government subsidy strategies can promote pharmaceutical enterprises' R&D investment and have a positive incentive effect on the pharmaceutical enterprises' profits and social welfare. (b) The patient medical insurance subsidy strategy is the optimal subsidy strategy, which can generate higher profits for pharmaceutical enterprises and higher social welfare.


Assuntos
Financiamento Governamental , Pesquisa/economia , Indústria Farmacêutica/economia , Modelos Teóricos , Preparações Farmacêuticas/provisão & distribuição , Seguridade Social
14.
Artigo em Inglês | MEDLINE | ID: mdl-35206425

RESUMO

To reduce energy consumption and environmental pollution in the construction industry, many countries have focused on the development of green housing (GH), which is a type of green building for residential use. In China, the local governments have introduced various incentive policies to encourage the development of GH; however, its scale is still small and unevenly distributed. This implies a necessity to optimize the policies that apply to the GH incentive. To promote GH diffusion, we built an evolutionary game model on a complex network to analyze the impacts of government policies on GH pricing and demand and the profits of real estate enterprises developing GH. By implementing simulations, we further explored the incentive effect and operational mechanism of the government policies. The results show that the subsidy policy, the preferential policy for GH, and the restriction policy for ordinary housing can effectively promote the diffusion of GH to 0.6752, 0.506, and 0.5137 respectively. Meanwhile, the incentive effect of the enterprise subsidy policy and GH preferential policy gradually decreases with the increase in policy strength. In terms of the demand side, the consumer subsidy policy could promote GH diffusion to 0.7097. If the subsidy is below 120 CNY/m2, the effect of the consumer subsidy policy is less powerful than that of the enterprises subsidy policy; conversely, the former is slightly more effective than the latter. The outcome of the study has managerial implications on governmental decision-making, especially on the strategy design of incentive policies for GH.


Assuntos
Indústria da Construção , Habitação , China , Custos e Análise de Custo , Financiamento Governamental , Governo , Governo Local , Políticas
15.
PLoS One ; 17(1): e0263018, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35100316

RESUMO

Private enterprises play an increasingly important role in China. They can improve the total-factor productivity (TFP) and help transform and upgrade industrial structures. This study uses data for private listed manufacturing companies from 2009 to 2017 to examine the effects of different types of subsidies on TFP. We also analyze the heterogeneity and specific mechanism of subsidy effects. We find that R&D subsidies and production subsidies positively affect private enterprises' TFP. Moreover, R&D subsidies and production subsidies lagged by one period can also significantly increase private enterprises' TFP. In terms of industry, R&D subsidies have more obvious effects on technology-intensive industries, while production subsidies have more significant effects on labor-intensive and capital-intensive industries. In terms of scale, R&D subsidies' effects on the TFP of medium-sized enterprises are the largest, while production subsidies have the greatest effect on small enterprises' TFP. Government subsidies increase private enterprises' TFP through two mechanisms: improving technological innovation capability and alleviating financing constraints. Our results suggest that governments should formulate different subsidy policies according to industry and enterprise scale.


Assuntos
Financiamento Governamental , Indústrias , Políticas , Setor Privado , China , Comércio/economia , Comércio/legislação & jurisprudência , Financiamento Governamental/economia , Financiamento Governamental/legislação & jurisprudência , Governo , Indústrias/economia , Indústrias/legislação & jurisprudência
17.
JAMA Netw Open ; 5(1): e2144742, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-35072720

RESUMO

Importance: Despite the rapid growth of interest and diversity in applications of artificial intelligence (AI) to biomedical research, there are limited objective ways to characterize the potential for use of AI in clinical practice. Objective: To examine what types of medical AI have the greatest estimated translational impact (ie, ability to lead to development that has measurable value for human health) potential. Design, Setting, and Participants: In this cohort study, research grants related to AI awarded between January 1, 1985, and December 31, 2020, were identified from a National Institutes of Health (NIH) award database. The text content for each award was entered into a Natural Language Processing (NLP) clustering algorithm. An NIH database was also used to extract citation data, including the number of citations and approximate potential to translate (APT) score for published articles associated with the granted awards to create proxies for translatability. Exposures: Unsupervised assignment of AI-related research awards to application topics using NLP. Main Outcomes and Measures: Annualized citations per $1 million funding (ACOF) and average APT score for award-associated articles, grouped by application topic. The APT score is a machine-learning based metric created by the NIH Office of Portfolio Analysis that quantifies the likelihood of future citation by a clinical article. Results: A total of 16 629 NIH awards related to AI were included in the analysis, and 75 applications of AI were identified. Total annual funding for AI grew from $17.4 million in 1985 to $1.43 billion in 2020. By average APT, interpersonal communication technologies (0.488; 95% CI, 0.472-0.504) and population genetics (0.463; 95% CI, 0.453-0.472) had the highest translatability; environmental health (ACOF, 1038) and applications focused on the electronic health record (ACOF, 489) also had high translatability. The category of applications related to biochemical analysis was found to have low translatability by both metrics (average APT, 0.393; 95% CI, 0.388-0.398; ACOF, 246). Conclusions and Relevance: Based on this study's findings, data on grants from the NIH can apparently be used to identify and characterize medical applications of AI to understand changes in academic productivity, funding support, and potential for translational impact. This method may be extended to characterize other research domains.


Assuntos
Inteligência Artificial/economia , Distinções e Prêmios , Pesquisa Biomédica/economia , National Institutes of Health (U.S.)/economia , Estudos de Coortes , Financiamento Governamental , Organização do Financiamento , Humanos , Apoio à Pesquisa como Assunto/economia , Estados Unidos
18.
JNCI Cancer Spectr ; 6(1)2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35005429

RESUMO

Background: Dissemination and implementation (D&I) research is a key factor in the uptake and use of evidence-based cancer control interventions. National Cancer Institute (NCI)-designated cancer centers are ideal settings in which to further D&I knowledge. The purpose of this study was to summarize the characteristics of NCI-funded D&I science grants in the nation's cancer centers to understand the nature, extent, and opportunity for this key type of translational work. Methods: We used the National Institutes of Health Research Portfolio Online Reporting Tool to identify active NCI-funded grants in D&I science at NCI clinical cancer centers (n = 13) and comprehensive cancer centers (n = 51) as well as their academic affiliates. Active projects were eligible for inclusion if they 1) were awarded directly to an NCI cancer center or an academic or research affiliate, and 2) identified D&I content in the abstract. Portfolio data were collected in February 2021. Results: We identified 104 active NCI-funded D&I research or training grants across the 64 cancer centers; 57.8% of cancer centers had at least 1 NCI-funded D&I grant. Most awards (71.1%) were for research grants. Training grants constituted 29.1% of D&I-focused grants. Overall, 50.0% of grants (n = 52) concentrated on specific cancers. Almost two-thirds of grants (n = 68, 65.4%) had a stated health equity focus. Conclusions: More than one-half of NCI-designated cancer centers have active funding in D&I science, reflecting a substantial investment by NCI. There remains considerable room for further development, which would further support NCI's translational mission.


Assuntos
Institutos de Câncer/estatística & dados numéricos , Financiamento Governamental/estatística & dados numéricos , Ciência da Implementação , National Cancer Institute (U.S.) , Neoplasias , /estatística & dados numéricos , Humanos , Neoplasias/prevenção & controle , Estados Unidos
19.
J Trauma Acute Care Surg ; 92(2): e25-e27, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35081099

RESUMO

ABSTRACT: In recent years, calls to address gun violence through public health approaches have increased. However, securing funding for health-based community violence intervention models has remained a challenge. New actions suggest that this may be shifting. Upon taking office, the Biden administration announced a series of funding opportunities for these programs, which ranged from competitive grant programs to a proposed 8-year, $5 billion plan. Less publicized, but just as important, is the administration's announcement that Medicaid can be used to reimburse this work, specifically noting the eligibility of hospital-based violence intervention and prevention programs. For these programs, this creates a predictable and reliable funding source that has not existed to date. This integration of violence prevention programming in the traditional health care and financing systems represents a critical inflection point in the United States' shifting response to community violence. However, the decision to use this optional benefit lies with each state. States should strongly consider harnessing Medicaid as a wise investment to address the United States' gun violence epidemic. LEVEL OF EVIDENCE: Economic and value-based evaluation, level IV.


Assuntos
Financiamento Governamental , Violência com Arma de Fogo/prevenção & controle , Medicaid/economia , Humanos , Política , Governo Estadual , Estados Unidos
20.
Environ Sci Pollut Res Int ; 29(23): 34776-34797, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35041171

RESUMO

During 2013-2017, the new energy industry in China experienced prosperous growth with the financing support of the government. To evaluate the real performance of this industry and the government subsidy effect during this period, this paper measures both the original and adjusted industry efficiencies and investigates the non-linear impact of the government subsidy. Applying a four-stage data envelopment analysis (DEA) method to a sample of listed companies during 2013-2017, we find that: (1) China's new energy industry obtains relatively a high efficiency while showing a noticeable decline after a rising trend; (2) the industry efficiency presents a downward adjustment after eliminating the environmental factors; (3) a single threshold of government subsidy is identified, indicating a shackle after a short-term positive impact; (4) the positive mediating effect of cash flow and R&D investments are identified; and whereas the management self-interest presents a negative mediating effect, (5) the regional and ownership endogeneity of the government subsidy effect are recognized.


Assuntos
Eficiência , Indústrias , China , Financiamento Governamental , Governo , Investimentos em Saúde
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