• 【在碳固定,生物多样性保护和全球REDD资金分配的公平性之间进行权衡建模。】 复制标题 收藏 收藏
    DOI:10.1073/pnas.1908683116 复制DOI
    作者列表:Palomo I,Dujardin Y,Midler E,Robin M,Sanz MJ,Pascual U
    BACKGROUND & AIMS: :The program on Reducing Emissions from Deforestation and Forest Degradation (REDD+) is one of the major attempts to tackle climate change mitigation in developing countries. REDD+ seeks to provide result-based incentives to promote emission reductions and increase carbon sinks in forest land while promoting other cobenefits, such as the conservation of biodiversity. We model different scenarios of international REDD+ funds distribution toward potential recipient countries using 2 carbon emission reduction targets (20% and 50% compared to the baseline scenario, i.e., deforestation and forest degradation without REDD+) by 2030. The model combines the prioritization of environmental outcomes in terms of carbon sequestration and biodiversity conservation and social equity, accounting for the equitable distribution of international REDD+ funds. Results highlight the synergy between carbon sequestration and biodiversity conservation under alternative fund allocation criteria, especially for scenarios of low carbon emission reduction. Trade-offs increase when distributional equity is considered as an additional criterion, especially under higher equity requirements. The analysis helps to better understand the inherent trade-offs between enhancing distributional equity and meeting environmental targets under alternative REDD+ fund allocation options.
    背景与目标: :减少森林砍伐和森林退化造成的排放计划(REDD)是解决发展中国家减缓气候变化的主要尝试之一。 REDD寻求提供基于结果的激励措施,以促进减排并增加林地的碳汇,同时促进其他协同效益,例如保护生物多样性。我们使用20个碳减排目标(与基准情景相比分别为20%和50%,即到2030年不使用REDD的森林砍伐和森林退化)来模拟向潜在接收国分配国际REDD资金的不同方案。该模型结合了环境优先级碳封存,生物多样性保护和社会公平方面的成果,说明了国际REDD资金的公平分配。结果突出显示了在替代性资金分配标准下,固碳与生物多样性保护之间的协同作用,特别是对于低碳排放的情景。当将分配权益作为附加标准时,折衷会增加,尤其是在较高的权益要求下。该分析有助于更好地了解在分配REDD资金分配方案下提高分配公平性与实现环境目标之间的内在取舍。
  • 【学术癌症中心的新组织和资金流模型。】 复制标题 收藏 收藏
    DOI:10.1097/00001888-200407000-00003 复制DOI
    作者列表:Spahlinger DA,Pai CW,Waldinger MB,Billi JE,Wicha MS
    BACKGROUND & AIMS: :The clinical impetus to develop cancer centers has been the recognition that many cancer patients require a comprehensive treatment plan coordinated across multiple specialties. Developing an effective organizational and financial structure among the multiple entities that comprise an academic cancer center has, however, been a challenge. The authors describe an effort to realize a sustainable clinical operation at the University of Michigan Comprehensive Cancer Center (UMCCC) by developing an appropriate management structure and financial model. The modified organizational structure established a clear line of administrative authority and held faculty members accountable for their effort in the UMCCC. A unified budget aligned financial incentive among all stakeholders to increase efficiency, revenue, and margin. The authors report preliminary financial evidence of the success of the new managerial structure.
    背景与目标: :发展癌症中心的临床动力已经认识到,许多癌症患者需要跨多个专业进行协调的综合治疗计划。然而,在组成学术癌症中心的多个实体之间发展有效的组织和财务结构一直是一个挑战。作者描述了通过开发适当的管理结构和财务模型来实现密歇根大学综合癌症中心(UMCCC)的可持续临床运营的努力。修改后的组织结构建立了明确的行政权限,并要求教职员工对他们在UMCCC中的工作负责。统一的预算在所有利益相关者之间调整了财务激励措施,以提高效率,收入和利润。作者报告了新管理结构成功的初步财务证据。
  • 【从民事罚款和疗养院罚款中收集和使用资金。】 复制标题 收藏 收藏
    DOI:10.1093/geront/46.6.759 复制DOI
    作者列表:Tsoukalas T,Rudder C,Mollot RJ,Shineman M,Lee HY,Harrington C
    BACKGROUND & AIMS: PURPOSE:This study examined federal and state civil money penalties and fines collected from nursing homes and how states used the collected funds. DESIGN AND METHODS:We used a telephone survey of state officials, Freedom of Information Act requests, state Web site searches, and stakeholder interviews to describe the funds collected, the availability and the use of funds, public information about penalties and fines, and the state allocation process and policies. RESULTS:In 2004, 43 states collected a total of $21 million from more than 3,000 federal and state penalties and fines. Forty-two states had $60.5 million in fund accounts from penalties and fines available in 2005, and 32 states spent $28 million on a wide range of projects. Fifteen states spent $17.9 million on survey and certification activities, 19 states spent $5.6 million on provider projects, 6 states spent $1.3 million on advocacy projects, and 12 states spent $2.7 million for other projects. Most states did not provide information to the public about issuing penalties and fines, have formal procedures to inform stakeholders and allocate funds, or involve stakeholder groups in the decision-making process. IMPLICATIONS:Funds from federal and state penalties and fines vary widely across states. These funds are a resource for improving the quality of nursing home care that needs more attention from policy makers and stakeholder groups.
    背景与目标: 目的:这项研究检查了联邦和州从养老院收取的民事罚款和罚款,以及各州如何使用收集到的资金。
    设计与方法:我们使用了对州官员的电话调查,《信息自由法》的要求,州网站的搜索以及利益相关方的访谈,以描述所收集的资金,资金的可得性和使用情况,有关罚款和罚款的公共信息以及状态分配过程和政策。
    结果:2004年,有43个州从3,000多个联邦和州罚款和罚款中获得了总计2,100万美元的收入。 2005年,有42个州的罚金和罚款有6050万美元的资金帐户,而32个州在一系列项目上的支出为2800万美元。 15个州在调查和认证活动上花费了1,790万美元,19个州在提供者项目上花费了560万美元,6个州在宣传项目上花费了130万美元,12个州在其他项目上花费了270万美元。大多数州没有向公众提供有关处罚和罚款的信息,没有正式的程序告知利益相关者和分配资金,也没有让利益相关者团体参与决策过程。
    后果:各州的联邦和州罚款及罚款资金相差很大。这些资金是用于提高家庭护理质量的资源,需要决策者和利益相关者团体的更多关注。
  • 【一个沿海漏洞框架,可在压缩时间内指导自然基础设施资金的分配。】 复制标题 收藏 收藏
    DOI:10.1007/s00267-020-01397-z 复制DOI
    作者列表:Santiago L,Barreto M,Montañez-Acuña A,Flecha T,Cabrera N,Bonano V,Marrero LB,Díaz E
    BACKGROUND & AIMS: :Hurricane Maria, a category 4 tropical cyclone, hit the US non-incorporated territory of Puerto Rico on September 20, 2017. Widespread physical and natural infrastructure damage was observed, especially in already vulnerable coastal communities. As public sector funding availability for natural infrastructure (ex. coastal ecosystems) increases, mechanisms for its efficient and equitable allocation are lacking. An accessible and replicable coastal vulnerability indicator framework is presented to assist state and federal policy makers in the allocation of funding for coastal natural infrastructure recovery. To assess funding priorization gaps and test the applicability of the proposed framework, spatial patterns in the estimated funding need identified in state-led post-Hurricane Maria assessments for natural infrastructure rehabilitation efforts were compared to physical and social coastal vulnerability estimations. Three main challenges that emerge during the implementation of a vulnerability indicator framework were considered for its design: (1) the compressed time frame in which decisions are made after an extreme weather event, (2) the availability of data to calculate indicators in a reduced time frame, and (3) the accessibility of results to a broad variety of stakeholders. We propose a vulnerability indicator framework that can become operational in a relatively short period of time, attempts to simplify data gathering efforts, and uses methods that aim to be more transparent and understandable to a broad group of stakeholders.
    背景与目标: :2017年9月20日,飓风“玛丽亚”(M飓风)袭击了美国非合并的波多黎各地区,属第4类热带气旋。人们观察到广泛的物理和自然基础设施破坏,尤其是在本来就很脆弱的沿海社区。随着公共部门对自然基础设施(例如沿海生态系统)的资金可用性的增加,缺乏对其进行有效和公平分配的机制。提出了一个可访问且可复制的沿海脆弱性指标框架,以帮助州和联邦决策者分配用于沿海自然基础设施恢复的资金。为了评估资金优先次序的差距并测试提议框架的适用性,将国家主导的飓风后玛丽亚评估中自然基础设施修复工作中确定的资金需求估算中的空间模式与自然和社会沿海脆弱性估算进行了比较。在设计脆弱性指标框架期间,考虑了三个主要挑战:(1)压缩的时间范围,在极端天气事件后做出决策;(2)数据的可用性以减少的方式计算指标时间范围;以及(3)各种利益相关者都能获得结果。我们提出了一个漏洞指示器框架,该框架可以在相对较短的时间内投入使用,试图简化数据收集工作,并使用旨在使广大利益相关者群体更加透明和易于理解的方法。
  • 【世界上十大最大的公共和慈善卫生研究资助者:他们资助什么以及如何分配他们的资金。】 复制标题 收藏 收藏
    DOI:10.1186/s12961-015-0074-z 复制DOI
    作者列表:Viergever RF,Hendriks TC
    BACKGROUND & AIMS: BACKGROUND:Little is known about who the main public and philanthropic funders of health research are globally, what they fund and how they decide what gets funded. This study aims to identify the 10 largest public and philanthropic health research funding organizations in the world, to report on what they fund, and on how they distribute their funds. METHODS:The world's key health research funding organizations were identified through a search strategy aimed at identifying different types of funding organizations. Organizations were ranked by their reported total annual health research expenditures. For the 10 largest funding organizations, data were collected on (1) funding amounts allocated towards 20 health areas, and (2) schemes employed for distributing funding (intramural/extramural, project/'people'/organizational and targeted/untargeted funding). Data collection consisted of a review of reports and websites and interviews with representatives of funding organizations. Data collection was challenging; data were often not reported or reported using different classification systems. RESULTS:Overall, 55 key health research funding organizations were identified. The 10 largest funding organizations together funded research for $37.1 billion, constituting 40% of all public and philanthropic health research spending globally. The largest funder was the United States National Institutes of Health ($26.1 billion), followed by the European Commission ($3.7 billion), and the United Kingdom Medical Research Council ($1.3 billion). The largest philanthropic funder was the Wellcome Trust ($909.1 million), the largest funder of health research through official development assistance was USAID ($186.4 million), and the largest multilateral funder was the World Health Organization ($135.0 million). Funding distribution mechanisms and funding patterns varied substantially between the 10 largest funders. CONCLUSIONS:There is a need for increased transparency about who the main funders of health research are globally, what they fund and how they decide on what gets funded, and for improving the evidence base for various funding models. Data on organizations' funding patterns and funding distribution mechanisms are often not available, and when they are, they are reported using different classification systems. To start increasing transparency in health research funding, we have established www.healthresearchfunders.org that lists health research funding organizations worldwide and their health research expenditures.
    背景与目标: 背景:鲜为人知的主要研究对象是全球的公众和慈善健康研究资助者,他们资助了什么以及如何决定要资助的内容。这项研究旨在确定全球10个最大的公共和慈善健康研究资助机构,以报告其资助资金以及分配方式。
    方法:通过旨在识别不同类型资助机构的搜索策略,确定了世界上主要的卫生研究资助机构。根据报告的年度卫生研究总支出对组织进行排名。对于10个最大的筹资组织,收集了以下数据:(1)分配给20个卫生领域的筹资额,以及(2)分配资金所采用的计划(内部/外部,项目/“人员” /组织和有针对性/无针对性的资助)。数据收集包括对报告和网站的审查以及对资助组织代表的采访。数据收集具有挑战性;经常没有报告数据或使用不同的分类系统报告数据。
    结果:总体上,确定了55个主要的卫生研究资助机构。十大最大的资助组织合计资助了371亿美元的研究,占全球所有公共和慈善健康研究支出的40%。最大的出资者是美国国立卫生研究院(261亿美元),其次是欧洲委员会(37亿美元)和英国医学研究理事会(13亿美元)。最大的慈善资金提供者是惠康信托基金(9.091亿美元),最大的通过官方发展援助进行卫生研究的资金提供者是美国国际开发署(1.864亿美元),最大的多边资金提供者是世界卫生组织(1.35亿美元)。在十个最大的供资者之间,资金分配机制和供资方式差异很大。
    结论:需要提高透明度,以确保全球卫生研究的主要资助者是谁,他们资助了什么以及他们如何决定要资助的内容以及改进各种资助模型的证据基础。通常无法获得有关组织的筹资模式和资金分配机制的数据,如果有,则使用不同的分类系统进行报告。为了开始增加卫生研究经费的透明度,我们建立了www.healthresearchfunders.org,其中列出了全球范围内的卫生研究经费组织及其卫生研究支出。
  • 【消费者对有代表性的收款人的意见,即使用残疾基金来提高对治疗的依从性。】 复制标题 收藏 收藏
    DOI:10.1176/appi.ps.56.1.45 复制DOI
    作者列表:Elbogen EB,Soriano C,Van Dorn R,Swartz MS,Swanson JW
    BACKGROUND & AIMS: OBJECTIVE:Although representative payee arrangements are common among people with psychiatric disabilities, only a small body of research has investigated how consumers feel about representative payees' use of disability funds to attempt to improve treatment adherence. METHODS:Consumers who were in treatment for a recently documented diagnosis of schizophrenia or a related disorder (N=104) were interviewed to assess their perceptions of the use of disability funds and other legal pressures to attempt to improve treatment adherence. RESULTS:Most consumers in the sample (65 percent) did not agree that withholding money was a useful method to improve treatment adherence. Multivariate analyses indicated that participants were more likely to agree that use of money as leverage was helpful if they also felt that other legal pressures were helpful for improving adherence and if they felt free to do as they wanted regarding their mental health treatment. On the other hand, participants were less likely to endorse the benefits of money used as leverage if they had at least a high school education and if they reported abusing substances in the past month. CONCLUSIONS:The results of this study point to factors that mediate the potentially negative effects of perceived coercion that are sometimes associated with representative payee arrangements. Leverage of disability funds will likely have an optimal effect if combined with efforts to enhance a sense of self-determination. Conversely, consumers with more education may be less open to this practice, possibly because of perceived stigma related to not being able to control their own finances.
    背景与目标: 目的:尽管精神病患者的代表收款人安排很普遍,但只有一小部分研究调查了消费者对代表收款人使用残疾基金来改善治疗依从性的看法。
    方法:对接受过最近诊断为精神分裂症或相关疾病诊断的治疗中的消费者(N = 104)进行了访谈,以评估他们对使用残疾基金的看法以及其他法律压力,以试图改善治疗依从性。
    结果:样本中的大多数消费者(65%)不同意预扣款是提高治疗依从性的有用方法。多变量分析表明,如果参与者还认为其他法律压力有助于改善依从性,并且愿意根据自己的意愿进行心理健康治疗,则他们更有可能同意使用金钱作为杠杆作用会有所帮助。另一方面,如果参与者至少受过高中学历,并且在过去一个月内报告滥用药物,则他们不太可能认可用作杠杆的金钱的好处。
    结论:本研究的结果指出了一些因素,这些因素介导了有时与典型的收款人安排相关的强迫感的潜在负面影响。如果与努力增强自我决定意识相结合,那么利用残疾基金将可能产生最佳效果。相反,受过更多教育的消费者可能不太愿意接受这种做法,这可能是由于与无法控制自己的财务状况有关的可耻污名。
  • 【毒品和酒精领域研究经费的分配:共识研讨会的报告。】 复制标题 收藏 收藏
    DOI:10.1080/09595239400185761 复制DOI
    作者列表:Walsh RA,Sanson-Fisher R
    BACKGROUND & AIMS: :Issues concerning the allocation of research funds in the drug and alcohol field have been widely debated. A consensus workshop involving senior researchers and policy makers was convened to examine the appropriateness of current drug and alcohol research activities in Australia. The workshop identified several major barriers restricting research developments including lack of monitoring of research efforts, limited community support, inappropriate allocations of research funds which contributed to a low level of intervention studies, the lack of application of research findings by practitioners and ethical constraints in studies involving Aboriginal populations and in multi-centre trials. Agreement was reached on 16 recommendations which could increase the amount of high quality research in Australia directed at reducing the harm associated with alcohol, tobacco and other drug use. Strategies which funding bodies could use to encourage intervention studies were identified. A proposal for the Australian Medical and Professional Society on Alcohol and other Drugs to establish a Researchers' Group to encourage implementation of the recommendations was also endorsed by workshop participants.
    背景与目标: :关于毒品和酒精领域研究经费分配的问题已经引起广泛的争论。召集了由高级研究人员和政策制定者参加的共识研讨会,以审查澳大利亚目前进行的毒品和酒精研究活动的适当性。讲习班确定了制约研究发展的几个主要障碍,包括缺乏对研究成果的监测,有限的社区支持,研究资金分配不当,这导致干预研究水平较低,从业者缺乏研究结果的应用以及研究中的伦理约束。涉及原住民和多中心试验。已就16项建议达成协议,这些建议可能会增加澳大利亚针对减少与酒精,烟草和其他毒品使用有关的危害的高质量研究的数量。确定了供资机构可以用来鼓励干预研究的策略。讲习班参加者还认可了澳大利亚医学和酒精和其他药物专业协会成立研究人员小组的建议,以鼓励执行这些建议。
  • 【艾滋病毒/艾滋病:全球趋势,全球资金和交付瓶颈。】 复制标题 收藏 收藏
    DOI:10.1186/1744-8603-1-13 复制DOI
    作者列表:Coovadia HM,Hadingham J
    BACKGROUND & AIMS: :Globalization affects all facets of human life, including health and well being. The HIV/AIDS epidemic has highlighted the global nature of human health and welfare and globalization has given rise to a trend toward finding common solutions to global health challenges. Numerous international funds have been set up in recent times to address global health challenges such as HIV. However, despite increasingly large amounts of funding for health initiatives being made available to poorer regions of the world, HIV infection rates and prevalence continue to increase world wide. As a result, the AIDS epidemic is expanding and intensifying globally. Worst affected are undoubtedly the poorer regions of the world as combinations of poverty, disease, famine, political and economic instability and weak health infrastructure exacerbate the severe and far-reaching impacts of the epidemic. One of the major reasons for the apparent ineffectiveness of global interventions is historical weaknesses in the health systems of underdeveloped countries, which contribute to bottlenecks in the distribution and utilisation of funds. Strengthening these health systems, although a vital component in addressing the global epidemic, must however be accompanied by mitigation of other determinants as well. These are intrinsically complex and include social and environmental factors, sexual behaviour, issues of human rights and biological factors, all of which contribute to HIV transmission, progression and mortality. An equally important factor is ensuring an equitable balance between prevention and treatment programmes in order to holistically address the challenges presented by the epidemic.
    背景与目标: 全球化影响着人类生活的方方面面,包括健康和福祉。艾滋病毒/艾滋病的流行突出表明了人类健康和福利的全球性,全球化引起了为全球卫生挑战寻找共同解决方案的趋势。最近已经建立了许多国际基金,以应对艾滋病等全球卫生挑战。然而,尽管世界上较贫困的地区获得了越来越多的卫生计划资金,但全世界的艾滋病毒感染率和流行率仍在继续增加。结果,艾滋病的流行在全球范围内正在扩大和加剧。毫无疑问,受害最严重的是世界上的贫困地区,因为贫困,疾病,饥荒,政治和经济不稳定以及卫生基础设施薄弱的综合因素加剧了这一流行病的严重和深远影响。全球干预措施明显无效的主要原因之一是欠发达国家卫生系统的历史薄弱环节,这造成资金分配和使用的瓶颈。加强这些卫生系统虽然是应对全球流行病的重要组成部分,但同时还必须减轻其他决定因素。这些从本质上讲是复杂的,包括社会和环境因素,性行为,人权问题和生物因素,所有这些因素都导致艾滋病毒的传播,发展和死亡。同样重要的因素是确保预防和治疗方案之间的公平平衡,以便从整体上应对这一流行病带来的挑战。
  • 【州烟草控制资金大幅减少的后果:佛罗里达,1998-2000年。】 复制标题 收藏 收藏
    DOI:10.1136/tc.2007.024331 复制DOI
    作者列表:Niederdeppe J,Farrelly MC,Hersey JC,Davis KC
    BACKGROUND & AIMS: OBJECTIVE:This study assessed whether dramatic funding reductions to the Florida Tobacco Control Program (FTCP) influenced trends in recall of the Florida "truth" anti-smoking media campaign, anti-industry attitudes and non-smoking intentions among Florida teens. METHODS:We used an interrupted time series technique to test for differences in the rates of change in Florida "truth" recall, anti-industry beliefs and non-smoking intentions before and after the FTCP budget cuts using the Florida Anti-tobacco Media Evaluation (FAME) survey, a repeated cross-sectional telephone survey of Florida teens. RESULTS:Recall of the Florida "truth" anti-smoking campaign, anti-industry attitudes, and non-smoking intentions increased dramatically between April 1998 and May 1999. Florida "truth" recall declined after FTCP budget cuts in June 1999. Anti-industry beliefs and non-smoking intentions plateaued or began to decline after the budget cuts. The launch of the national "truth" campaign in February 2000 may have offset otherwise deleterious effects of the budget cuts on anti-industry beliefs, but not smoking intentions. CONCLUSION:Reductions in tobacco control funding have immediate effects on programme exposure and cognitive precursors to smoking initiation. There is a critical need to maintain and enhance funding for state tobacco control programmes to continue nationwide progress in preventing youth from initiating cigarette smoking.
    背景与目标: 目的:本研究评估了佛罗里达烟草控制计划(FTCP)的巨额资金减少是否影响了佛罗里达青少年“真相”反吸烟媒体运动,反行业态度和非吸烟意图的召回趋势。
    方法:我们使用中断时间序列技术来测试佛罗里达州“真相”召回率变化率,反行业信念和非吸烟意图变化率的差异,方法是使用佛罗里达州反烟草媒体评估(F佛罗里达州)削减FTCP预算之前和之后( FAME)调查,这是对佛罗里达州青少年的重复横断面电话调查。
    结果:在1998年4月至1999年5月间,对佛罗里达“真相”反吸烟运动,反行业态度和非吸烟意图的召回急剧增加。在1999年6月FTCP预算削减后,佛罗里达“真相”召回率有所下降。预算削减后,信仰和非吸烟意愿趋于稳定或开始下降。 2000年2月发起的全国“真相”运动可能抵消了削减预算对反行业信念的有害影响,但对吸烟意图却没有。
    结论:减少烟草控制资金对计划暴露和开始吸烟的认知先兆有直接影响。迫切需要保持和增加对国家烟草控制计划的资金,以继续在全国范围内防止青年人开始吸烟。
  • 【以社区为基础的生态旅游是否可以很好地利用生物多样性保护资金?】 复制标题 收藏 收藏
    DOI:10.1016/j.tree.2004.03.010 复制DOI
    作者列表:Kiss A
    BACKGROUND & AIMS: :Community-based ecotourism (CBET) has become a popular tool for biodiversity conservation, based on the principle that biodiversity must pay for itself by generating economic benefits, particularly for local people. There are many examples of projects that produce revenues for local communities and improve local attitudes towards conservation, but the contribution of CBET to conservation and local economic development is limited by factors such as the small areas and few people involved, limited earnings, weak linkages between biodiversity gains and commercial success, and the competitive and specialized nature of the tourism industry. Many CBET projects cited as success stories actually involve little change in existing local land and resource-use practices, provide only a modest supplement to local livelihoods, and remain dependent on external support for long periods, if not indefinitely. Investment in CBET might be justified in cases where such small changes and benefits can yield significant conservation and social benefits, although it must still be recognized as requiring a long term funding commitment. Here, I aim to identify conditions under which CBET is, and is not, likely to be effective, efficient and sustainable compared with alternative approaches for conserving biodiversity. I also highlight the need for better data and more rigorous analysis of both conservation and economic impacts.
    背景与目标: :基于社区的生态旅游(CBET)已成为生物多样性保护的一种流行工具,其依据是生物多样性必须通过创造经济利益,特别是对当地人民的经济利益来回报自己的原则。有许多项目为当地社区创造收入并改善了当地对保护的态度的例子,但是CBET对保护和当地经济发展的贡献受到以下因素的限制:面积小,涉及的人少,收益有限,相互之间的联系薄弱生物多样性的获得和商业上的成功,以及旅游业的竞争性和专业性。许多被称为成功案例的CBET项目实际上几乎没有改变当地现有的土地和资源使用方式,仅对当地的生计提供了适度的补充,并且即使不是无限期地,也长期依赖外部支持。在这种微小的变化和收益可以带来显着的保护和社会效益的情况下,对CBET进行投资可能是合理的,尽管仍必须承认,这需要长期的资金投入。在这里,我的目的是确定与保护生物多样性的替代方法相比,CBET可能是有效,高效和可持续的条件。我还强调需要对保护和经济影响同时提供更好的数据和更严格的分析。
  • 【新成员国中的卫生与欧洲结构基金。】 复制标题 收藏 收藏
    DOI:10.1093/eurpub/ckr011 复制DOI
    作者列表:McCarthy M
    BACKGROUND & AIMS: :The structural funds are used to promote economic development as part of European Union Cohesion Policy. Previously the main beneficiary countries were in southern Europe and on the periphery. For 2007-13, the funds are being increased, and directed towards the EU's new Member States. The Commission has been working with national health ministries, and regions, to develop expertise in applications and implementation. Fields suitable in the next phase, from 2014 onwards, include social and health care for elderly people and public health research systems. Public health practitioners and academics have relevant skills and advice to provide.
    背景与目标: :作为欧盟凝聚政策的一部分,结构性资金用于促进经济发展。以前,主要的受益国是在南欧和周边地区。在2007-13年度,资金正在增加,并直接用于欧盟的新成员国。该委员会一直在与国家卫生部委和地区合作,以开发应用和实施方面的专业知识。从2014年开始,下一阶段的适用领域包括老年人的社会和医疗保健以及公共卫生研究系统。公共卫生从业人员和学者具有相关的技能和建议。
  • 【国家预算转拨给健康保险基金以实现全民健康覆盖:体制设计模式和覆盖东欧高收入国家正规部门以外人群的挑战。】 复制标题 收藏 收藏
    DOI:10.1186/s12939-016-0295-y 复制DOI
    作者列表:Vilcu I,Mathauer I
    BACKGROUND & AIMS: INTRODUCTION:Many countries from the European region, which moved from a government financed and provided health system to social health insurance, would have had the risk of moving away from universal health coverage if they had followed a "traditional" approach. The Eastern European high-income countries studied in this paper managed to avoid this potential pitfall by using state budget revenues to explicitly pay health insurance contributions on behalf of certain (vulnerable) population groups who have difficulties to pay these contributions themselves. The institutional design aspects of their government revenue transfer arrangements are analysed, as well as their impact on universal health coverage progress. METHODS:This regional study is based on literature review and review of databases for the performance assessment. The analytical framework focuses on the following institutional design features: rules on eligibility for contribution exemption, financing and pooling arrangements, and purchasing arrangements and benefit package design. RESULTS:More commonalities than differences can be identified across countries: a broad range of groups eligible for exemption from payment of health insurance contributions, full state contributions on behalf of the exempted groups, mostly mandatory participation, integrated pools for both the exempted and contributors, and relatively comprehensive benefit packages. In terms of performance, all countries have high total population coverage rates, but there are still challenges regarding financial protection and access to and utilization of health care services, especially for low income people. CONCLUSION:Overall, government revenue transfer arrangements to exempt vulnerable groups from contributions are one option to progress towards universal health coverage.
    背景与目标: 简介:许多来自欧洲地区的国家,如果从“政府”资助的医疗体系转移到社会医疗保险,则如果遵循“传统”方法,就有可能脱离全民医保。本文研究的东欧高收入国家通过使用国家预算收入来代表某些(弱势)人口群体明确支付健康保险费,从而避免了这种潜在的陷阱,这些人群本身难以支付这些费用。分析了政府收入转移安排的制度设计方面,以及它们对全民医疗覆盖进度的影响。
    方法:本区域研究基于文献综述和绩效评估数据库的综述。分析框架着重于以下机构设计特征:关于免除缴费资格的规则,筹资和集中安排,购买安排和福利包设计。
    结果:在各个国家/地区之间发现的共性比差异更大:有资格豁免医疗保险缴费的各种团体,代表被豁免团体的全额国家缴费,主要是强制性参与,被豁免者和贡献者的综合资金池,以及相对全面的福利计划。在绩效方面,所有国家的总人口覆盖率都很高,但是在财务保护以及医疗服务的获取和利用方面仍然存在挑战,特别是对于低收入人群而言。
    结论:总体而言,政府的税收转移安排使弱势群体免于缴费是实现全民健康覆盖的一种选择。
  • 【疾病基金在抑郁症中的早期发现,预防和健康促进活动。】 复制标题 收藏 收藏
    DOI:10.1055/s-0033-1349601 复制DOI
    作者列表:Thielscher C,Effinghausen M
    BACKGROUND & AIMS: OBJECTIVE:We analyzed programs managed by the ten biggest social health insurance companies in Germany that aim at early detection, prevention, and promotion of health in depression. METHODS:We conducted interviews with the responsible managers and studied relevant web sites. RESULTS:The content of these programs ranges from internet-based offers to relaxation techniques. There is very little information publicly available on the results of these programs; the same holds true for the number of participants, efficiency, and cooperation with physicians. CONCLUSION:There is a strong need to investigate results and efficiency of the programs.
    背景与目标: 目的:我们分析了德国十家最大的社会健康保险公司管理的计划,这些计划旨在及早发现,预防和促进抑郁症患者的健康。
    方法:我们对负责的经理进行了采访,并研究了相关的网站。
    结果:这些程序的内容范围从基于Internet的报价到放松技术。关于这些计划结果的公开信息很少。参与者人数,效率和与医生的合作也是如此。
    结论:迫切需要调查程序的结果和效率。
  • 【民主党人拒绝通过该法案,拒绝联邦计划生育基金会的拨款。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:2015-08-04
    来源期刊:BMJ
    DOI:10.1136/bmj.h4236 复制DOI
    作者列表:McCarthy M
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【长期平衡OASDI信托基金的选择。】 复制标题 收藏 收藏
    DOI:10.1300/J031v06n01_06 复制DOI
    作者列表:Cohen LM,Beedon LE
    BACKGROUND & AIMS: :This article explores policy alternatives that can bring Social Security (OASDI) into long-term balance. The alternatives conform to long-standing principles that benefits are: an earned right, related to pay and time in the workforce, not based primarily on need; and related to annual changes in the cost of living. Furthermore, the OASDI is self-financed, employers and employees contribute equally, and participation is compulsory. In order to maintain public support, the policy alternatives also spread the "pain" of change between workers and beneficiaries, maintain income replacement rates for low-income earners, and retain a positive correlation between taxes and benefits. The article discusses varying four policy parameters to balance the funds: the primary insurance amount, the cost-of-living adjustment; the normal retirement age; and the payroll tax rate. Only by changing several policy parameters can all the objectives be satisfied. Discussed in detail are three scenarios, each of which includes a COLA cut and a pay-as-you-go FICA tax rate.
    背景与目标: :本文探讨了可以使社会保障(OASDI)长期保持平衡的政策选择。这些备选方案符合长期的原则,即收益:与劳动者的工资和时间有关的获利权利,而不是主要基于需求;并与生活成本的年度变化有关。此外,OASDI是自负盈亏的,雇主和雇员平等出资,并且参与是强制性的。为了保持公众的支持,其他政策选择还使工人和受益人之间的变化“痛苦”蔓延,维持低收入者的收入替代率,并在税收和福利之间保持正相关。本文讨论了用于平衡资金的四个保单参数:基本保险金额,生活成本调整;正常退休年龄;和工资税率。只有改变几个政策参数,才能实现所有目标。详细讨论了三种方案,每种方案都包括削减COLA和按需付款的FICA税率。

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