‘A Theory of the Allocation of Time’ Turns Fifty: Its Impact on the Field of Health Economics

The year 2015 is the 50th anniversary of the publication of ‘A Theory of the Allocation of Time,’ by Gary S. Becker in the 1965 volume of The Economic Journal. To mark that occasion, this editorial focuses on the importance of that paper in the history and evolution of the field of health economics. Copyright © 2015 John Wiley & Sons, Ltd.     

基于分级诊疗的广西卫生人力资源配置分析

目的:从推进实施分级诊疗的视角,对比分析广西的医院和基层医疗卫生机构卫生人力资源配置状况与存在问题,并有针对性地提出政策建议。方法:对广西相关年份的医院及基层医疗卫生机构的卫生人力资源配置状况进行分析和讨论。结果:广西医院及基层医疗卫生机构卫生人力资源均呈增长趋势,但医院与基层医疗机构之间在人员数量、学历及职称构成等人员质量方面仍有较大差距,优势资源仍有向医院汇集的态势。结论:广西的卫生人力资源配置与分级诊疗的需要仍不相适应,建议政府加大基层卫生人力供给、改革基层医务人员薪酬制度、加快推进医联体改革,引导卫生人力资源向基层流动。     

上海市儿科床位资源配置利用现况与思考简

目的：掌握上海市儿科床位资源配置与利用现状,剖析存在的问题及原因,提出对策和建议。方法：采用问卷调查的方法,对2011年初上海所有设住院床位的医疗机构进行调查,对其中在2008—2010年间实际开放儿科床位的医疗机构,对其儿科床位的配置和利用情况进行调查分析。结果：上海实际开设儿科床位的医疗机构数有所减少,2010年为70家;全市儿科床位主要集中在儿童专科医院,占全市儿科床位总数的近50％,三级综合医院的儿科实际开放床位数逐年减少;约50％的儿科床位分布在中心城区;儿童专科医院的儿科床位使用率较高,3年累计值达到101．17％,而民营医疗机构的儿科床位利用率仅为29．43％。结论：三级综合医院实际开放儿科床位的数量呈萎缩态势,近郊区儿科床位配置总量显不足,儿童专科医院的床位利用效率趋于饱和,民营医疗机构儿科床位闲置状况严重;建议制定儿科医疗服务体系建设发展规划。加大对儿科住院医疗服务体系的投入,构筑分工合作的儿科诊疗格局,大力培育儿科专业人才队伍。     

对农村养老护理保健卫生资源配置问题的思考简

目的：了解与提出深化医改形势下人口老龄化的现状及养老护理保健卫生资源配置的问题,为做好老年人养老护理保健工作提供政策依据。方法：主要用调查法和观察法等描述性研究的方法进行综合描述。结论：提出加强农村养老护理保健机构建设、培养农村养老护理保健机构人才等建议。     

试论大型公立医院内部资源配置的优化

当前我国大型公立医院内部资源配置模式存在的弊端主要表现为存在趋利性和粗放性,不适应外部政策导向和自身发展需求。优化内部资源配置是优化运行机制的基础,针对大型公立医院内部资源配置存在的问题,结合其资源的特点,从创新发展战略、创新体制机制、加强知识资源管理和对资源科学利用方式探索等方面对优化大型公立医院内部资源配置的相关路径进行探讨,并提出相关政策建议。     

军队医院床位资源配置优化模型构建

目的 探索军队医院临床科室床位资源配置方法.方法 提取医院各临床科室展开床位数和一定期间的每日收治军、地人员数,应用优化模型对医院床位配置进行优化.结果 构建一套军队医院实用的优化床位资源配置的数学模型.结论 通过优化模型法在医院床位配置中的应用研究,为医院做好资源合理分配,履行好军人就医保障任务,提供有效方法.     

为军服务“约束锥”DEA模型在医疗资源配置中的应用

目的结合军队中心医院宗旨与任务,不断改进和提升医院＂为军服务＂质量。方法运用普通DEA评价方法与带有＂为军服务＂约束锥的DEA方法分别计算8所军队中心医院医疗资源配置效率,并对结果进行比对。结果和结论在原有的DEA模型中加了体现军事效益偏好的约束锥。使得计算结果中原来一些的DEA有效单元变成非有效,说明一些医院在为兵服务上还做得不足,可以在相应投入产出上作出调整,提高＂为军服务＂效率。     

Bayesian inference for multivariate meta‐analysis Box–Cox transformation models for individual patient data with applications to evaluation of cholesterol‐lowering drugs

In this paper, we propose a class of Box–Cox transformation regression models with multidimensional random effects for analyzing multivariate responses for individual patient data in meta‐analysis. Our modeling formulation uses a multivariate normal response meta‐analysis model with multivariate random effects, in which each response is allowed to have its own Box–Cox transformation. Prior distributions are specified for the Box–Cox transformation parameters as well as the regression coefficients in this complex model, and the deviance information criterion is used to select the best transformation model. Because the model is quite complex, we develop a novel Monte Carlo Markov chain sampling scheme to sample from the joint posterior of the parameters. This model is motivated by a very rich dataset comprising 26 clinical trials involving cholesterol‐lowering drugs where the goal is to jointly model the three‐dimensional response consisting of low density lipoprotein cholesterol (LDL‐C), high density lipoprotein cholesterol (HDL‐C), and triglycerides (TG) (LDL‐C, HDL‐C, TG). Because the joint distribution of (LDL‐C, HDL‐C, TG) is not multivariate normal and in fact quite skewed, a Box–Cox transformation is needed to achieve normality. In the clinical literature, these three variables are usually analyzed univariately; however, a multivariate approach would be more appropriate because these variables are correlated with each other. We carry out a detailed analysis of these data by using the proposed methodology. Copyright © 2013 John Wiley & Sons, Ltd.     

Attitudes Toward the Global Allocation of Chinese COVID-19 Vaccines: Cross-sectional Online Survey of Adults Living in China

BackgroundCOVID-19 vaccines are in short supply worldwide. China was among the first countries to pledge supplies of the COVID-19 vaccine as a global public product, and to date, the country has provided more than 600 million vaccines to more than 200 countries and regions with low COVID-19 vaccination rates. Understanding the public’s attitude in China toward the global distribution of COVID-19 vaccines could inform global and national decisions, policies, and debates.ObjectiveThe aim of this study was to determine the attitudes of adults living in China regarding the global allocation of COVID-19 vaccines developed in China and how these attitudes vary across provinces and by sociodemographic characteristics.MethodsWe conducted a cross-sectional online survey among adults registered with the survey company KuRunData. The survey asked participants 31 questions about their attitudes regarding the global allocation of COVID-19 vaccines developed in China. We disaggregated responses by province and sociodemographic characteristics. All analyses used survey sampling weights.ResultsA total of 10,000 participants completed the questionnaire. Participants generally favored providing COVID-19 vaccines to foreign countries before fulfilling domestic needs (75.6%, 95% CI 74.6%-76.5%). Women (3778/4921, 76.8%; odds ratio 1.18, 95% CI 1.07-1.32; P=.002) and those living in rural areas (3123/4065, 76.8%; odds ratio 1.13, 95% CI 1.01-1.27; P=.03) were especially likely to hold this opinion. Most respondents preferred providing financial support through international platforms rather than directly offering support to individual countries (72.1%, 95% CI 71%-73.1%), while for vaccine products they preferred direct provision to relevant countries instead of via a delivery platform such as COVAX (77.3%, 95% CI 76.3%-78.2%).ConclusionsAmong our survey sample, we found that adults are generally supportive of the international distribution of COVID-19 vaccines, which may encourage policy makers to support and implement the distribution of COVID-19 vaccines developed in China worldwide. Conducting similar surveys in other countries could help align policy makers’ actions on COVID-19 vaccine distribution with the preferences of their constituencies.     

分级诊疗视域下广东省基层卫生资源配置效率分析

目的 通过对2013-2018年广东省基层医疗机构及2018年各地级市乡镇卫生院的卫生资源配置效率的评估,为广东省基层医疗机构优化资源配置,及各地级市合理推进分级诊疗制度提供参考.方法 采用Malmquist模型测算2013-2018年广东省基层医疗卫生资源整体配置效率;利用CRS-CCR和VRS-BCC模型评估各地级...