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
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.
