Profit considerations in vaccine safety-related events in China.

Objectives: China has made remarkable achievements in the field of immunization. However, several widespread vaccine safety-related events have recently received worldwide attention and reflect flaws in vaccine management. This study aimed to summarize vaccine safety-related events between 1985 and 2018 in China and analyze the profit motives of these events.Methods. Literature and media reviews were conducted to discover vaccine safety-related events. We developed a conceptual model with profit-related variables, and using information available from each event, we identified which profit-related variable was implicated, and how it related to the pursuit of higher profits.Results: A total of 39 vaccine safety-related events were found in vaccine production, procurement, transportation, and daily management, along with adverse events following immunization (AEFIs). Overall, 90% (35/39) of the events could be classified as profit-driven. The motives of most events could be tied to one or more reasons, including decreasing costs among vaccine producers (67%, 26/39), reducing actual procurement price (67%, 26/39), and reducing costs of transportation and/or cold chain (24/39, 62%).Conclusions: In order to deal with vaccine-related challenges, a more restrictive supervision system on vaccine production and more emergency preparedness, including health and risk communication strategies, for vaccine safety should be implemented.

A Literature Survey and Experimental Evaluation of the State-of-the-Art in Uplift Modeling: A Stepping Stone Toward the Development of Prescriptive Analytics.

Prescriptive analytics extends on predictive analytics by allowing to estimate an outcome in function of control variables, allowing as such to establish the required level of control variables for realizing a desired outcome. Uplift modeling is at the heart of prescriptive analytics and aims at estimating the net difference in an outcome resulting from a specific action or treatment that is applied. In this article, a structured and detailed literature survey on uplift modeling is provided by identifying and contrasting various groups of approaches. In addition, evaluation metrics for assessing the performance of uplift models are reviewed. An experimental evaluation on four real-world data sets provides further insight into their use. Uplift random forests are found to be consistently among the best performing techniques in terms of the Qini and Gini measures, although considerable variability in performance across the various data sets of the experiments is observed. In addition, uplift models are frequently observed to be unstable and display a strong variability in terms of performance across different folds in the cross-validation experimental setup. This potentially threatens their actual use for business applications. Moreover, it is found that the available evaluation metrics do not provide an intuitively understandable indication of the actual use and performance of a model. Specifically, existing evaluation metrics do not facilitate a comparison of uplift models and predictive models and evaluate performance either at an arbitrary cutoff or over the full spectrum of potential cutoffs. In conclusion, we highlight the instability of uplift models and the need for an application-oriented approach to assess uplift models as prime topics for further research.

The Financing Difficulties and Coping Strategies for the Public Hospitals from the Perspective of Public Welfare / 中国卫生经济

The continued release of demand for medical services had stimulated the development of public hospitals.In the context of insufficient government financial subsidies and inadequate hospital funds,some public hospitals tended to seek market-oriented financing support,but the contradiction between the nonprofit nature of public hospitals and the profitability nature of capital made the process of public hospital financing into a dilemma.Through the analysis of the connotation of public welfare in public hospitals and cases of PPP projects,it found that nonprofit of public hospitals did not completely exclude the profitability of capital,the market competition mechanism that capital profit behavior relied on was a prerequisite for the realization of the public welfare nature of public hospitals.Taking the advantage of market-oriented financing methods on the basis of insisting on the public welfare of public hospitals,the following measures must be taken:firstly,adhere to the government's dominant position in the direction of public hospitals;secondly,while introducing capital,it needed to focus on the reform and innovation of operational mechanisms;thirdly,convert the dividends that belong to the government into continued investment in public hospitals to support the realization of public welfare;fourth,com bined with the local government financial resources based on differentiated financing model.

Barriers to Effective Implementation of Programs for the Prevention of Workplace Violence in Hospitals.

Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.

Financial Compensation Method, Public Hospital Operation Mechanism and Government Expenditure Estimation：Based on the Data Analysis of County-Level Public Hospitals in G Province / 中国卫生经济

To cement the 5 years’ staged achievement of new medical reform so as finally achieve the objective of medical reform, public hospital would become the aim of reform in the following stage. On one hand , canceling “using drug to supple health care” in public hospitals has came into the crucial stage; on the other hand, the government needed to increase financial input and ensure the implementation of security fund. What was the relation between these two reforms? Therefore , based on the survey of county-level public hospitals in G Province, relationship among government compensation method, hospital public profit operation mechanism and profit-driven operation mechanism were analyzed; besides, different financial insurance mode had different operation efficiency. Because the construction of hospital expense under public profit operation mechanism was more reasonable , the required government insurance fund was less, which only accounted 32.9%of the required fund under the profit-driven operation mechanism. Therefore, the policy suggestions that government need to “buy the mechanism” and “be brave to implement ‘subtraction reform’” were proposed.