Objective:Aiming at the problems of clinical pathway optimization and medical cost control for stroke patients,this study proposes a clinical pathway discrimination model based on the XGBoost integrated learning algor...Objective:Aiming at the problems of clinical pathway optimization and medical cost control for stroke patients,this study proposes a clinical pathway discrimination model based on the XGBoost integrated learning algorithm.Combined with the multi-objective programming(MOP)method,this study explores its application value under the Diagnosis-Intervention Packet(DIP)payment model.Methods:The data of stroke patients(ICD codes I60-I63)from 2018 to 2024 were obtained through the medical record statistical management system of medical institutions in Guangdong Province.Efficiency indicators(average length of hospital stay),health economics indicators(total cost),effectiveness indicators(mortality rate),and specific indicators(NIHSS score)were extracted.The XGBoost algorithm was used to construct the clinical pathway discrimination model,and the hyperparameters were optimized through grid search.Based on the DIP payment rules,the prediction results of the model were used as inputs to establish a dynamic programming model,aiming to minimize costs and maximize curative effects to obtain the optimal clinical pathway plan.Results:The goodness-of-fit(R 2)of the XGBoost model on the test set reached 0.768,which was significantly better than that of the random forest(0.691)and the BP neural network(0.343).The total cost of the clinical pathway optimized by the dynamic programming model decreased by 12.7%(95%CI:10.2-15.1%),the average length of hospital stay was shortened by 1.8 days,and the NIHSS improvement rate increased by 8.3%.Conclusion:The integrated model proposed in this study has high accuracy and robustness in clinical pathway discrimination.Combined with the MOP method,it can provide a scientific basis for the optimization of medical resources under the DIP model,helping medical institutions achieve the dual goals of precise cost control and curative effect improvement.展开更多
The use of electronic currency for transactions,denoting a cashless paradigm,has become increasingly common.However,this financial innovation is not prevalent in all countries.This study aims to explain the discrepanc...The use of electronic currency for transactions,denoting a cashless paradigm,has become increasingly common.However,this financial innovation is not prevalent in all countries.This study aims to explain the discrepancies across countries,including individual and country factors.It may be superficially posited that this lag in development stems from individual or microlevel usage challenges.However,the application of the Technology Acceptance Model highlights the presence of overarching characteristics conducive to extensive adoption.Thus,an additional stratum,the multilevel perspective,needs to be examined.This analytical framework incorporates not only individual attributes but also the sociotechnical framework or mesolevel factors in which they operate.A multilevel econometric model is used.The results of these analyses show that the impact on the adoption of cashless payments extends beyond individual factors(attitude to technology use,perceived usefulness,and perceived ease of use).Our primary contribution,conceptually and empirically,is to broaden the analysis vision.A comprehensive multilevel analysis revealed that broader contextual elements,such as infrastructure and national skills,exert a significant influence on the adoption of cashless transactions.Consequently,the widespread acceptance of cashless payment methods is not only contingent on individual choices but is also a collective phenomenon in which the surrounding environment plays a crucial role as a catalyst for the end users in the cashless economy.展开更多
Facial recognition payment(FRP),a new method of contactless payment,has attracted considerable attention over the past few years.However,the research on this topic remains nascent.This study assessed the drivers of cu...Facial recognition payment(FRP),a new method of contactless payment,has attracted considerable attention over the past few years.However,the research on this topic remains nascent.This study assessed the drivers of customers’FRP continuance intention from the perspectives of coolness and inspiration.We use online survey data from 610 Chinese FRP customers as the basis for our conceptual model.The results show that the coolness factors of subculture,attractiveness,utility,and originality have positive and significant effects on customers’inspired-by states and that subculture and utility also promote inspired-to.Inspired-by is positively associated with inspiredto,which in turn enhances customers’FRP continuance intention.Furthermore,the relationship between inspired-to and FRP continuance intention is negatively moderated by financial risk.In addition to contributing to the literature on FRP,coolness,and customer inspiration,this study offers several suggestions for implementing and developing FRP systems.展开更多
Money is how we pay for things that we need.People pay for things in cash,which is the main form for a long time.Nowadays,there are more ways to pay than ever,including mobile payment or e-payments.Cash comes in the f...Money is how we pay for things that we need.People pay for things in cash,which is the main form for a long time.Nowadays,there are more ways to pay than ever,including mobile payment or e-payments.Cash comes in the form of banknotes and coins;e-payments make people buy things through a phone and watch.So,which way of buying things is better?展开更多
Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clin...Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clinical data from patients who received treatment in the Department of Orthopedics and the Department of Acupuncture and Moxibustion at our hospital from January 1,2023,to December 31,2023.The study compared the costs of medications,examinations,treatments,laboratory tests,nursing and other expenses,and total treatment costs between the two departments.It analyzed the cost structure of the two departments and proposed further improvement suggestions.Results:The study results indicated that the total costs in the Department of Acupuncture and Moxibustion were significantly higher than those in the Department of Orthopedics.Among medication costs,the total medication costs in the Department of Orthopedics were higher than those in the Department of Acupuncture and Moxibustion,with costs for Western medicine,proprietary Chinese medicine,and herbal medicine all being higher(p<0.05).Regarding examination costs,consultation fees in the Department of Orthopedics were lower than those in the Department of Acupuncture and Moxibustion,while examination costs were higher(p<0.05).In terms of treatment costs,orthopedic treatment and surgical fees were higher than those in the Department of Acupuncture and Moxibustion(p<0.05).For laboratory test costs,orthopedic laboratory fees were significantly higher than those in the Department of Acupuncture and Moxibustion(p<0.05).Among nursing and other expenses,orthopedic blood transfusion,bed fees,and other expenses were higher than those in the Department of Acupuncture and Moxibustion,while nursing fees were lower(p<0.05).Conclusion:Treatment fees in the Department of Acupuncture and Moxibustion are the core and account for a relatively high proportion of the total costs.The benefits generated by the Department of Orthopedics are primarily derived from medication,examination,and laboratory fees,aligning with the characteristics of combining diagnosis,medication,and surgical intervention in orthopedic treatment.Consultation fees,nursing fees,and bed fees in the Department of Acupuncture and Moxibustion are higher than those in the Department of Orthopedics,indicating a longer treatment cycle in acupuncture,which warrants clinical attention.展开更多
Mangrove ecosystems support biodiversity,protect coastal areas,and provide sustainable livelihoods.However,they face significant threats from deforestation and unsustainable land use practices.This study examines the ...Mangrove ecosystems support biodiversity,protect coastal areas,and provide sustainable livelihoods.However,they face significant threats from deforestation and unsustainable land use practices.This study examines the viability of the payments for ecosystem services(PES)programs in promoting sustainable mangrove tourism in Tongke-Tongke Village,Sinjai District,South SulawesiProvince,Indonesia.We collected data through household surveys,semi-structured stakeholder interviews,and tourist questionnaires to evaluate the economic value of mangrove tourism and tourists’willingness to pay(WTP)for conservation.Analytical methods included quantitative descriptive analysis,thematic analysis,travel cost analysis,and contingent valuationmethod.The results indicatedstrong community support,with 70.00% of respondents acknowledging sustainable mangrove tourism’s economic,environmental,and cultural benefits.Economic estimates revealedthat mangrove tourism generated 943.00 USD/(hm^(2)·a),while tourists’WTP for conservation rangedfrom 0.21 to 0.56 USD/(person×month),contributing approximately 11.39 USD/(hm^(2)·a).Despite challenges such as inadequate infrastructure,socioeconomic disparities,and land privatization,this study advocates for integrating the PES programs,enhancing governance frameworks,and fostering local community engagement to ensure equitable benefit distribution and maximize the potential of mangrove tourism.These strategies aim to bolster conservation efforts,improve local livelihoods,and strengthen the resilience of mangroveecosystems.展开更多
This study investigates how financial literacy and behavioral traits affect the adoption of electronic payment(ePayment)services in Japan.We construct a financial literacy index using a representative sample of 25,000...This study investigates how financial literacy and behavioral traits affect the adoption of electronic payment(ePayment)services in Japan.We construct a financial literacy index using a representative sample of 25,000 individuals from the Bank of Japan’s 2019 Financial Literacy Survey.We then analyze the relationship between this index and the extensive and intensive usage of two types of payment services:electronic money(e-money)and mobile payment apps.Using an instrumental variable approach,we find that higher financial literacy is positively associated with a higher likelihood of adopting ePayment services.The empirical results suggest that individuals with higher financial literacy use payment services more frequently.We also find that risk-averse people are less likely to adopt and use ePayment services,whereas people with herd behavior tend to adopt and use ePayment services more.Our empirical results also suggest that the effects of financial literacy on the adoption and use of ePayment differ among people with different behavioral traits.展开更多
This study utilizes a time-precedence network technique to construct two models of multi-mode resource constrained project scheduling problem with discounted cash flows （MRCPSPDCF）, individually including the progre...This study utilizes a time-precedence network technique to construct two models of multi-mode resource constrained project scheduling problem with discounted cash flows （MRCPSPDCF）, individually including the progress payment （PP） and the payment at an equal time interval （ETI）. The objective of each model is to maximize the net present value （NPV） for all cash flows in the project, subject to the related operational constraints. The models are characterized as NP-hard. A heuristic algorithm, coupled with two upper bound solutions, is proposed to efficiently solve the models and evaluate the heuristic algorithm performance which was not performed in past studies. The results show that the performance of proposed models and heuristic algorithm is good.展开更多
The goal of this paper is to spot out factors affecting the intention to use mobile payment service plan in Vietnam.This study attempts to analyze the impact of various variables extracted from mobility,convenience,co...The goal of this paper is to spot out factors affecting the intention to use mobile payment service plan in Vietnam.This study attempts to analyze the impact of various variables extracted from mobility,convenience,compatibility,M-payment knowledge,ease to use,usefulness,risk,,trust,and safe to use on intention to use mobile payment.Quantitative questionnaire is used to measure responses of participants.The statistical analysis method employed in this study is to apply Structural Equation Modeling to test all hypotheses.The results indicate that the strong predictors of the intention to use M-payment are perceived ease of use and perceived usefulness.All respondents show that they do not care about risk when they have intention to use mobile payment services.Convenience of mobility,compatibility,and mobile payment knowledge have impacts on ease to use and usefulness.Among of them,compatibility has the most significant impact o11 ease to use and usefulness in the opinion of those surveyed.Specially,it proved that trust of safe to use has no significant impact on usefulness,but instead has direct impact on intension to use mobile payment services.The outcomes of this research have important connotations for the improvement and development of mobile payment services in Vietnam.Therefore,at the end of this paper,some suggestions based on research results are given for the future development of mobile payment service business in Vietnam.展开更多
Mobile medical service has become an indispensable method for the hospitals to improve service quality, while mobile payment has provided an effective solution for solving the problems of long queuing, long examinatio...Mobile medical service has become an indispensable method for the hospitals to improve service quality, while mobile payment has provided an effective solution for solving the problems of long queuing, long examination time, long waiting before being hospitalized and short time of diagnosis and treatment of the traditional outpatient services. With the increasing diversification of payment methods, it is necessary for the hospitals to establish a unified payment platform in order to support different business scenarios according to needs and standardize the interfaces of various developers and manufacturers. In addition, it will help the Financial Department timely identify the problems in the tons of transaction data and better serve the goals of the hospitals to streamline the procedures of medical services and achieve concentrated information management.展开更多
Payment for ecosystem services （PES） has attracted considerable attention as an economic incentive for promoting natural resource management recently. As emphasis has been placed on using the incentive-based mechani...Payment for ecosystem services （PES） has attracted considerable attention as an economic incentive for promoting natural resource management recently. As emphasis has been placed on using the incentive-based mechanism by the central government, rapid progress on PES research and practice has been achieved. However PES still faces many difficulties. A key issue is the lack of a fully-fledged theory and method to clearly define the design scope, accounting and feasibility of PES criteria. An improved watershed criteria model was developed in light of research on PES practices in China, investigations on the water source area for the Middle Route Project of South-to-North Water Diversion and ecosystem services outflows theory. The basic principle of assessment is the direct and opportunity cost for ecological conservation and environmental protection in the water source area deduct nationally-financed PES and internal effect. Then the scope and the criteria methods were determined, and internal effect was put forward to define benefits brought from water source area. Finally, Shiyan City, which is the main water source area for the Project of Water Diversion, was analyzed by this model and its payment was calculated. The results showed that： （1） during 2003–2050, the total direct cost and opportunity cost would reach up to 262.70 billion and 256.33 billion Chinese Yuan （CNY, 2000 constant prices）, i.e., 50.61% and 49.38% of total cost, respectively; （2） Shiyan City would gain 0.23, 0.06 and 0.03 CNY/m3 in 2014–2020, 2021–2030, and 2031–2050, respectively.展开更多
This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their percep...This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their perceptions of mobile payment.The findings indicate that perceived usefulness and perceived ease of use have significant effects on users'attitude.Furthermore,network externality is also an important factor influencing the adoption.But customers have weak perceptions of the risks of M-payment.The results may provide further insights into mobile payment strategies.展开更多
Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on ...Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.展开更多
Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further contro...Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.展开更多
In this paper, we propose a trusted mobile payment environment （TMPE） based on trusted computing and virtualization technology. There are a normal operating system （OS） and a trusted OS （TOS） in TMPE. We store t...In this paper, we propose a trusted mobile payment environment （TMPE） based on trusted computing and virtualization technology. There are a normal operating system （OS） and a trusted OS （TOS） in TMPE. We store the image of TOS in a memory card to hinder tampering. The integrity of TOS is protected by means of a trusted platform module （TPM）. TOS can only be updated through a trusted third party. In addition, virtualization technology is applied to isolate TOS from normal OS. Users complete ordinary affairs in normal OS and security-sensitive affairs in TOS. TMPE can offer users a highly protected environment for mobile payment. Moreover, TMPE has good compatibility in different hardware architectures of mobile platforms. As the evaluation shows, TMPE satisfies the requirement of mobile payment well.展开更多
In this paper,a Markov-dependent risk model with a threshold strategy is considered. The expected discounted dividend payments satisfy some integro-differential equations. The analytical solutions to these systems are...In this paper,a Markov-dependent risk model with a threshold strategy is considered. The expected discounted dividend payments satisfy some integro-differential equations. The analytical solutions to these systems are given. Finally,some numerical exam-ples in some special cases are provided.展开更多
In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance syst...In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease （COPD）, a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before （n=1569） and after the integrated case payment reform （n=4764） were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment （including price-cap case payment and fixed-reimbursement case payment） and clinical pathway （including clinical pathway A, clinical pathway B and clinical pathway C）. Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment （β=2382.988, P〈0.001） and fixed-reimbursement case payment β=2613.564, P〈0.001）, and clinical pathway C （β=1996.467, P〈0.001） were risk factors of per capita total medical expenses. Clinical pathway A （β=-1443.409, P〈0.001） and clinical pathway B （β=-1583.791, P〈0.001） were protective factors. The interactive effects of case payment with hospital level （β=0.710, P〈0.001） lowered the readmission rate within 30 days. Meanwhile, clinical pathways A （β=18.949, P〈0.001）, B （β=-19.752, P〈0.001） and C （β=-1.882, P〈0.1） were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.展开更多
Payments for Ecosystem Services(PES)have been studied extensively over the past decade as an important policy tool for coordinating ecological protection and regional socioeconomic development.One of the greatest chal...Payments for Ecosystem Services(PES)have been studied extensively over the past decade as an important policy tool for coordinating ecological protection and regional socioeconomic development.One of the greatest challenges of PES implementation is to understand where to pay,i.e.,spatial targeting,which can directly impact PES effectiveness and efficiency.In this study,we conducted a systematic review of spatial targeting methods based on literature analysis using Citespace.Firstly,peer-reviewed articles related to spatial targeting of PES were selected from the Web of Science database based on keywords.Cases applying PES spatial targeting methods were then chosen and analyzed after all articles were read.In total,70%of the chosen cases focused on improving the compensation efficiency of biodiversity or another single environmental objective,whereas the remaining cases focused on coordinating trade-offs between equity and efficiency or multiple environmental objectives.The main PES spatial targeting approaches included cost-benefit analysis,multi-objective optimization,data envelope analysis and other methods aimed at specific issues.Of these,cost-benefit analysis has been most widely applied at different scales,including county,regional and watershed scales.Significant differences among the different PES spatial targeting methods were found,including in PES spatial targeting dimensions,efficiency optimization approaches and method application conditions.The practice of PES spatial targeting requires the selection of appropriate methods based on contextual biophysical and socioeconomic conditions as well as relevant environmental issues.The combined application of PES spatial targeting methods,compensation willingness of stakeholders and dynamic implementation of PES spatial targeting should be considered in future research.展开更多
Mobile wallet is a very convenient means of mobile payment to allow the clients to conduct the payment via their mobile devices. To reduce the computation burden of resources-constraint mobile devices, a few mobile wa...Mobile wallet is a very convenient means of mobile payment to allow the clients to conduct the payment via their mobile devices. To reduce the computation burden of resources-constraint mobile devices, a few mobile wallet protocols with outsourced verification in cloud computing were proposed. But in some of the protocols, there exist the risk of a colluding attack of the customer and the untrusted cloud server. In this paper, we propose an improved protocol, in which the payment information is protected by Hash function and random number. The malicious customer and cloud server cannot change the payment information to conduct a collusion forgery attack to defraud the merchant. The security analysis indicates that the proposed improved protocol can enhance the security in terms of correctness, unforgeability and traceability without increasing the computational burden.展开更多
Market based initiatives for management of degrading ecosystems and their services have received the added attention as one of the innovative responses in the reent years. Those initiatives such as direct and indirect...Market based initiatives for management of degrading ecosystems and their services have received the added attention as one of the innovative responses in the reent years. Those initiatives such as direct and indirect payment for ecosystem services like premium for rain forest honey, payment by the people at the lower reach to those at the upper reach for the watershed services etc. have drawn the attention of the decision makers as they have proved to be far more cost effective.This paper wynthesizes the key messages from some of the paper are carbon, watershed services and biodiversity, We find that while credible valuation of ecosystem services for all services remain a critical concern behind setting up the payment mechanism, absent of necessary institutional framework may seriously undermine this innovative response for management of ecosystems. In the paper, necessary institutional mechanisms enabling the market for those services have been sketched out, Key messages from those cases have been synthesized.展开更多
基金Guangdong Medical Science and Technology Research Fund,Research on the Construction of a Clinical Path Discrimination Model for Stroke Patients Based on the XGBoost Integrated Learning Algorithm and Its Application in MOP under the DIP Payment Model,(Project No.:B2023177)Guangdong Health Economics Association,Research on the Prediction of Hospitalization Costs of Stroke Patients under the DRG/DIP Reform Based on Machine Learning Algorithms,(Project No.:2022-WJMF-13)。
文摘Objective:Aiming at the problems of clinical pathway optimization and medical cost control for stroke patients,this study proposes a clinical pathway discrimination model based on the XGBoost integrated learning algorithm.Combined with the multi-objective programming(MOP)method,this study explores its application value under the Diagnosis-Intervention Packet(DIP)payment model.Methods:The data of stroke patients(ICD codes I60-I63)from 2018 to 2024 were obtained through the medical record statistical management system of medical institutions in Guangdong Province.Efficiency indicators(average length of hospital stay),health economics indicators(total cost),effectiveness indicators(mortality rate),and specific indicators(NIHSS score)were extracted.The XGBoost algorithm was used to construct the clinical pathway discrimination model,and the hyperparameters were optimized through grid search.Based on the DIP payment rules,the prediction results of the model were used as inputs to establish a dynamic programming model,aiming to minimize costs and maximize curative effects to obtain the optimal clinical pathway plan.Results:The goodness-of-fit(R 2)of the XGBoost model on the test set reached 0.768,which was significantly better than that of the random forest(0.691)and the BP neural network(0.343).The total cost of the clinical pathway optimized by the dynamic programming model decreased by 12.7%(95%CI:10.2-15.1%),the average length of hospital stay was shortened by 1.8 days,and the NIHSS improvement rate increased by 8.3%.Conclusion:The integrated model proposed in this study has high accuracy and robustness in clinical pathway discrimination.Combined with the MOP method,it can provide a scientific basis for the optimization of medical resources under the DIP model,helping medical institutions achieve the dual goals of precise cost control and curative effect improvement.
基金Euskal Herriko Unibertsitatea(UPV/EHU)ECRI Ethics in Finance&Social Value GIU22/003Fundacion Emilio Soldevilla para la Investigacion y el Desarrollo en Economia de la Empresa(FESIDE)BOPV2020.
文摘The use of electronic currency for transactions,denoting a cashless paradigm,has become increasingly common.However,this financial innovation is not prevalent in all countries.This study aims to explain the discrepancies across countries,including individual and country factors.It may be superficially posited that this lag in development stems from individual or microlevel usage challenges.However,the application of the Technology Acceptance Model highlights the presence of overarching characteristics conducive to extensive adoption.Thus,an additional stratum,the multilevel perspective,needs to be examined.This analytical framework incorporates not only individual attributes but also the sociotechnical framework or mesolevel factors in which they operate.A multilevel econometric model is used.The results of these analyses show that the impact on the adoption of cashless payments extends beyond individual factors(attitude to technology use,perceived usefulness,and perceived ease of use).Our primary contribution,conceptually and empirically,is to broaden the analysis vision.A comprehensive multilevel analysis revealed that broader contextual elements,such as infrastructure and national skills,exert a significant influence on the adoption of cashless transactions.Consequently,the widespread acceptance of cashless payment methods is not only contingent on individual choices but is also a collective phenomenon in which the surrounding environment plays a crucial role as a catalyst for the end users in the cashless economy.
基金This study was supported by the National Natural Science Foundation of China(72202185,72302145)the Postdoctoral Science Foundation of China(2023M742232)the Innovation Research 2035 Pilot Plan of Southwest University(SWUPilotPlan026).
文摘Facial recognition payment(FRP),a new method of contactless payment,has attracted considerable attention over the past few years.However,the research on this topic remains nascent.This study assessed the drivers of customers’FRP continuance intention from the perspectives of coolness and inspiration.We use online survey data from 610 Chinese FRP customers as the basis for our conceptual model.The results show that the coolness factors of subculture,attractiveness,utility,and originality have positive and significant effects on customers’inspired-by states and that subculture and utility also promote inspired-to.Inspired-by is positively associated with inspiredto,which in turn enhances customers’FRP continuance intention.Furthermore,the relationship between inspired-to and FRP continuance intention is negatively moderated by financial risk.In addition to contributing to the literature on FRP,coolness,and customer inspiration,this study offers several suggestions for implementing and developing FRP systems.
文摘Money is how we pay for things that we need.People pay for things in cash,which is the main form for a long time.Nowadays,there are more ways to pay than ever,including mobile payment or e-payments.Cash comes in the form of banknotes and coins;e-payments make people buy things through a phone and watch.So,which way of buying things is better?
文摘Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clinical data from patients who received treatment in the Department of Orthopedics and the Department of Acupuncture and Moxibustion at our hospital from January 1,2023,to December 31,2023.The study compared the costs of medications,examinations,treatments,laboratory tests,nursing and other expenses,and total treatment costs between the two departments.It analyzed the cost structure of the two departments and proposed further improvement suggestions.Results:The study results indicated that the total costs in the Department of Acupuncture and Moxibustion were significantly higher than those in the Department of Orthopedics.Among medication costs,the total medication costs in the Department of Orthopedics were higher than those in the Department of Acupuncture and Moxibustion,with costs for Western medicine,proprietary Chinese medicine,and herbal medicine all being higher(p<0.05).Regarding examination costs,consultation fees in the Department of Orthopedics were lower than those in the Department of Acupuncture and Moxibustion,while examination costs were higher(p<0.05).In terms of treatment costs,orthopedic treatment and surgical fees were higher than those in the Department of Acupuncture and Moxibustion(p<0.05).For laboratory test costs,orthopedic laboratory fees were significantly higher than those in the Department of Acupuncture and Moxibustion(p<0.05).Among nursing and other expenses,orthopedic blood transfusion,bed fees,and other expenses were higher than those in the Department of Acupuncture and Moxibustion,while nursing fees were lower(p<0.05).Conclusion:Treatment fees in the Department of Acupuncture and Moxibustion are the core and account for a relatively high proportion of the total costs.The benefits generated by the Department of Orthopedics are primarily derived from medication,examination,and laboratory fees,aligning with the characteristics of combining diagnosis,medication,and surgical intervention in orthopedic treatment.Consultation fees,nursing fees,and bed fees in the Department of Acupuncture and Moxibustion are higher than those in the Department of Orthopedics,indicating a longer treatment cycle in acupuncture,which warrants clinical attention.
基金the State University of Makassar for their financial backing of this study(SP DIPA-023.17.2.677523/2021 Revision 01).
文摘Mangrove ecosystems support biodiversity,protect coastal areas,and provide sustainable livelihoods.However,they face significant threats from deforestation and unsustainable land use practices.This study examines the viability of the payments for ecosystem services(PES)programs in promoting sustainable mangrove tourism in Tongke-Tongke Village,Sinjai District,South SulawesiProvince,Indonesia.We collected data through household surveys,semi-structured stakeholder interviews,and tourist questionnaires to evaluate the economic value of mangrove tourism and tourists’willingness to pay(WTP)for conservation.Analytical methods included quantitative descriptive analysis,thematic analysis,travel cost analysis,and contingent valuationmethod.The results indicatedstrong community support,with 70.00% of respondents acknowledging sustainable mangrove tourism’s economic,environmental,and cultural benefits.Economic estimates revealedthat mangrove tourism generated 943.00 USD/(hm^(2)·a),while tourists’WTP for conservation rangedfrom 0.21 to 0.56 USD/(person×month),contributing approximately 11.39 USD/(hm^(2)·a).Despite challenges such as inadequate infrastructure,socioeconomic disparities,and land privatization,this study advocates for integrating the PES programs,enhancing governance frameworks,and fostering local community engagement to ensure equitable benefit distribution and maximize the potential of mangrove tourism.These strategies aim to bolster conservation efforts,improve local livelihoods,and strengthen the resilience of mangroveecosystems.
基金National Foundation for Science and Technology Development(No.502.01-2020.308).
文摘This study investigates how financial literacy and behavioral traits affect the adoption of electronic payment(ePayment)services in Japan.We construct a financial literacy index using a representative sample of 25,000 individuals from the Bank of Japan’s 2019 Financial Literacy Survey.We then analyze the relationship between this index and the extensive and intensive usage of two types of payment services:electronic money(e-money)and mobile payment apps.Using an instrumental variable approach,we find that higher financial literacy is positively associated with a higher likelihood of adopting ePayment services.The empirical results suggest that individuals with higher financial literacy use payment services more frequently.We also find that risk-averse people are less likely to adopt and use ePayment services,whereas people with herd behavior tend to adopt and use ePayment services more.Our empirical results also suggest that the effects of financial literacy on the adoption and use of ePayment differ among people with different behavioral traits.
文摘This study utilizes a time-precedence network technique to construct two models of multi-mode resource constrained project scheduling problem with discounted cash flows （MRCPSPDCF）, individually including the progress payment （PP） and the payment at an equal time interval （ETI）. The objective of each model is to maximize the net present value （NPV） for all cash flows in the project, subject to the related operational constraints. The models are characterized as NP-hard. A heuristic algorithm, coupled with two upper bound solutions, is proposed to efficiently solve the models and evaluate the heuristic algorithm performance which was not performed in past studies. The results show that the performance of proposed models and heuristic algorithm is good.
文摘The goal of this paper is to spot out factors affecting the intention to use mobile payment service plan in Vietnam.This study attempts to analyze the impact of various variables extracted from mobility,convenience,compatibility,M-payment knowledge,ease to use,usefulness,risk,,trust,and safe to use on intention to use mobile payment.Quantitative questionnaire is used to measure responses of participants.The statistical analysis method employed in this study is to apply Structural Equation Modeling to test all hypotheses.The results indicate that the strong predictors of the intention to use M-payment are perceived ease of use and perceived usefulness.All respondents show that they do not care about risk when they have intention to use mobile payment services.Convenience of mobility,compatibility,and mobile payment knowledge have impacts on ease to use and usefulness.Among of them,compatibility has the most significant impact o11 ease to use and usefulness in the opinion of those surveyed.Specially,it proved that trust of safe to use has no significant impact on usefulness,but instead has direct impact on intension to use mobile payment services.The outcomes of this research have important connotations for the improvement and development of mobile payment services in Vietnam.Therefore,at the end of this paper,some suggestions based on research results are given for the future development of mobile payment service business in Vietnam.
文摘Mobile medical service has become an indispensable method for the hospitals to improve service quality, while mobile payment has provided an effective solution for solving the problems of long queuing, long examination time, long waiting before being hospitalized and short time of diagnosis and treatment of the traditional outpatient services. With the increasing diversification of payment methods, it is necessary for the hospitals to establish a unified payment platform in order to support different business scenarios according to needs and standardize the interfaces of various developers and manufacturers. In addition, it will help the Financial Department timely identify the problems in the tons of transaction data and better serve the goals of the hospitals to streamline the procedures of medical services and achieve concentrated information management.
基金This study was supported by the National Natural Science Foundation of China (No. 70703034)State Key Laboratory of Urban and Regional Ecology (No.SKLURE 2008-1-02)the National Major Program on Pollution Control and Management of Water Body(No. 2009ZX07318-006)
文摘Payment for ecosystem services （PES） has attracted considerable attention as an economic incentive for promoting natural resource management recently. As emphasis has been placed on using the incentive-based mechanism by the central government, rapid progress on PES research and practice has been achieved. However PES still faces many difficulties. A key issue is the lack of a fully-fledged theory and method to clearly define the design scope, accounting and feasibility of PES criteria. An improved watershed criteria model was developed in light of research on PES practices in China, investigations on the water source area for the Middle Route Project of South-to-North Water Diversion and ecosystem services outflows theory. The basic principle of assessment is the direct and opportunity cost for ecological conservation and environmental protection in the water source area deduct nationally-financed PES and internal effect. Then the scope and the criteria methods were determined, and internal effect was put forward to define benefits brought from water source area. Finally, Shiyan City, which is the main water source area for the Project of Water Diversion, was analyzed by this model and its payment was calculated. The results showed that： （1） during 2003–2050, the total direct cost and opportunity cost would reach up to 262.70 billion and 256.33 billion Chinese Yuan （CNY, 2000 constant prices）, i.e., 50.61% and 49.38% of total cost, respectively; （2） Shiyan City would gain 0.23, 0.06 and 0.03 CNY/m3 in 2014–2020, 2021–2030, and 2031–2050, respectively.
基金supported by China Fundamental Research Funds for the Central Universities under Grant No.BUPT2011RC1005
文摘This study uses TAM to examine the factors that influence the adoption of mobile payment in China.The proposed model is empirically evaluated based on TAM by using data collected from 370 users concerning their perceptions of mobile payment.The findings indicate that perceived usefulness and perceived ease of use have significant effects on users'attitude.Furthermore,network externality is also an important factor influencing the adoption.But customers have weak perceptions of the risks of M-payment.The results may provide further insights into mobile payment strategies.
文摘Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.
基金supported by National Natural Science Foundation of China (No. 71403189)
文摘Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.
基金Supported by the National Basic Research Program of China(973 Program)(2014CB340600)the National Natural Science Foundation of China(61173138,61103628,61103220)the Intel Collaborative Research Project
文摘In this paper, we propose a trusted mobile payment environment （TMPE） based on trusted computing and virtualization technology. There are a normal operating system （OS） and a trusted OS （TOS） in TMPE. We store the image of TOS in a memory card to hinder tampering. The integrity of TOS is protected by means of a trusted platform module （TPM）. TOS can only be updated through a trusted third party. In addition, virtualization technology is applied to isolate TOS from normal OS. Users complete ordinary affairs in normal OS and security-sensitive affairs in TOS. TMPE can offer users a highly protected environment for mobile payment. Moreover, TMPE has good compatibility in different hardware architectures of mobile platforms. As the evaluation shows, TMPE satisfies the requirement of mobile payment well.
基金Supported by the Science and Technology Foundation of Hubei Province (D20092207)the Hubei Normal University Post-Graduate Foundation (2010C17)
文摘In this paper,a Markov-dependent risk model with a threshold strategy is considered. The expected discounted dividend payments satisfy some integro-differential equations. The analytical solutions to these systems are given. Finally,some numerical exam-ples in some special cases are provided.
基金This project was supported by grants from the National Natural Science Foundation of China （No.71373091, No. 71603132） and by the Humanities and Social Sciences Research Program of the Ministry of Education of China （No. 16YJA840013）.
文摘In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease （COPD）, a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before （n=1569） and after the integrated case payment reform （n=4764） were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment （including price-cap case payment and fixed-reimbursement case payment） and clinical pathway （including clinical pathway A, clinical pathway B and clinical pathway C）. Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment （β=2382.988, P〈0.001） and fixed-reimbursement case payment β=2613.564, P〈0.001）, and clinical pathway C （β=1996.467, P〈0.001） were risk factors of per capita total medical expenses. Clinical pathway A （β=-1443.409, P〈0.001） and clinical pathway B （β=-1583.791, P〈0.001） were protective factors. The interactive effects of case payment with hospital level （β=0.710, P〈0.001） lowered the readmission rate within 30 days. Meanwhile, clinical pathways A （β=18.949, P〈0.001）, B （β=-19.752, P〈0.001） and C （β=-1.882, P〈0.1） were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.
基金supported by the Second Tibetan Plateau Scientific Expedition and Research(STEP)program(Grant No.2019QZKK0307)the China National Social Science Funding of Major Projects(Grant No.18VSJ100)National Natural Science Foundation of China(Grant No.41925005).
文摘Payments for Ecosystem Services(PES)have been studied extensively over the past decade as an important policy tool for coordinating ecological protection and regional socioeconomic development.One of the greatest challenges of PES implementation is to understand where to pay,i.e.,spatial targeting,which can directly impact PES effectiveness and efficiency.In this study,we conducted a systematic review of spatial targeting methods based on literature analysis using Citespace.Firstly,peer-reviewed articles related to spatial targeting of PES were selected from the Web of Science database based on keywords.Cases applying PES spatial targeting methods were then chosen and analyzed after all articles were read.In total,70%of the chosen cases focused on improving the compensation efficiency of biodiversity or another single environmental objective,whereas the remaining cases focused on coordinating trade-offs between equity and efficiency or multiple environmental objectives.The main PES spatial targeting approaches included cost-benefit analysis,multi-objective optimization,data envelope analysis and other methods aimed at specific issues.Of these,cost-benefit analysis has been most widely applied at different scales,including county,regional and watershed scales.Significant differences among the different PES spatial targeting methods were found,including in PES spatial targeting dimensions,efficiency optimization approaches and method application conditions.The practice of PES spatial targeting requires the selection of appropriate methods based on contextual biophysical and socioeconomic conditions as well as relevant environmental issues.The combined application of PES spatial targeting methods,compensation willingness of stakeholders and dynamic implementation of PES spatial targeting should be considered in future research.
基金Supported by the Applied Basic and Advanced Technology Research Programs of Tianjin(15JCYBJC15900)
文摘Mobile wallet is a very convenient means of mobile payment to allow the clients to conduct the payment via their mobile devices. To reduce the computation burden of resources-constraint mobile devices, a few mobile wallet protocols with outsourced verification in cloud computing were proposed. But in some of the protocols, there exist the risk of a colluding attack of the customer and the untrusted cloud server. In this paper, we propose an improved protocol, in which the payment information is protected by Hash function and random number. The malicious customer and cloud server cannot change the payment information to conduct a collusion forgery attack to defraud the merchant. The security analysis indicates that the proposed improved protocol can enhance the security in terms of correctness, unforgeability and traceability without increasing the computational burden.
文摘Market based initiatives for management of degrading ecosystems and their services have received the added attention as one of the innovative responses in the reent years. Those initiatives such as direct and indirect payment for ecosystem services like premium for rain forest honey, payment by the people at the lower reach to those at the upper reach for the watershed services etc. have drawn the attention of the decision makers as they have proved to be far more cost effective.This paper wynthesizes the key messages from some of the paper are carbon, watershed services and biodiversity, We find that while credible valuation of ecosystem services for all services remain a critical concern behind setting up the payment mechanism, absent of necessary institutional framework may seriously undermine this innovative response for management of ecosystems. In the paper, necessary institutional mechanisms enabling the market for those services have been sketched out, Key messages from those cases have been synthesized.
