2011年6月17日

范畴经济 VS. 规模经济

economies of scope --范畴经济 or 范围经济，又可叫做"外部规模经济"（External Economy of Scale）

见：互动百科 和 wiki-MBA

定义：因同时生产(经营)几种相关的产品或服务而引起的经济效益提高。 透过营运范畴的扩大，两个以上的事业单位共同分担研发、营销、生产等成本，而享有的经济效益，使总成本下降。

 

单一厂商同时生产两项以上物品和服务的成本比分别由专业厂商生产的成本更低廉导致厂商生产出现范畴经济的原因，可能是来自多元化的经营策略、营运范畴的扩大、资源的分享、投入要素的共同、统一管理的效率、财务会计的优势，导致生产成本降低的效果规模经济是相对于专业化而言，范畴经济则是相对于多元化而言，两者并没有直接的关联

范畴经济也就是多样化经济，即企业在生产不同的产品时，若出现成本递减的现象，则就可称之为范畴经济。

 

(1)    当q1，q2代表不同产量，C(q1+ q2) < C(q1) + C(q2)表示联合生产的总成本小于分别生产的成本总和，亦即存在「规模经济」。

(2)    当q1，q2代表不同产品，C(q1+ q2) < C(q1) + C(q2)表示不同产品"一起"生产的总成本低于分别生产的成本总和，亦即存在「范畴经济」。

发帖者 时间：

2011年6月16日

51 key economics concepts

The National Council on Economic Education (NCEE) has compiled a list of the 51 key economics concepts common to all U.S. State requirements for high school classes in economics. 


Fundamental Economics

Macroeconomics

Microeconomics

International Economics

Personal Finance Economics

Source： http://www.econlib.org/library/Topics/HighSchool/HighSchoolTopics.html
发帖者 时间：

2011年6月14日

Hospitalist

Robert M. Wachter 1996年他第一个在NEJM上的一篇文章coined这个名词 hospitalist -- 这近20年在美国迅速发展的医疗科系（Hospital Medicine）从业人士名称。Hospital Medicine 和 Hospitalist几乎是密不可分的，同时这两者也是我最关注的health workforce development的组成部分。

-----Wikipeida的释义：

Hospital medicine in the United States is the discipline concerned with the medical care of acutely ill hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists; this type of medical practice has extended beyond the US into Canada. The practical effect of the hospitalist is to act as transition coordinator and case manager, due to the tremendous growth in medical knowledge and resultant number of medical specialists.

The term hospitalist was first coined by Robert Wachter and Lee Goldman in a 1996 New England Journal of Medicine article. Hospitalist activities may include patient care, teaching, research, and leadership related to hospital care. Hospital medicine, like emergency medicine, is a specialty organized around a site of care (the hospital), rather than an organ (like cardiology), a disease (like oncology), or a patient's age (like pediatrics).

--------Wikipeida的历史说明：

Hospital medicine is a relatively new phenomenon in American medicine. Almost unheard of a generation ago, this type of practice arose from three powerful shifts in medical practice:

  • Nearly all states, as well as the national residency accreditation organizations, the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA), have established limitations on house staff duty hours, the number of hours that interns and residents can work. This effectively reduces by 10-25% the amount of inpatient coverage provided per[citation needed]. Many hospitalists are coming to perform the same tasks formerly performed by residents; although this is usually referred to as a House Officer rather than a Hospitalist[citation needed]. The fundamental difference between a Hospitalist and a House Officer is that the Hospitalist is the Attending Physician of a patient while that patient is hospitalized. The House Officer admits the patient for another Attending Physician and cares for that patient until the Attending Physician can see the patient.
  • Most primary care physicians are experiencing a shrinking role in hospital care. Many primary care physicians find they can generate more revenue in the office during the hour or more they would have spent on inpatient rounds, including traveling to and from the hospital[citation needed].

Hospitalists represent one of the most rapidly growing forms of medical practice in the US. Currently a large proportion of hospitalists are recently-graduated residents, who continue familiar duties for a few years. As residency programs are encouraged to limit inpatient duty hours and provide more outpatient education, this pattern may shift. If this specialty evolves as emergency and intensive care medicine did, it will become a formal specialty with its own residencies and board certification within a decade or two. A few distinct residency and fellowship training programs are currently operating at major universities[citation needed].

In addition to patient care duties, hospitalists are often involved in developing and managing aspects of hospital operations such as inpatient flow and quality assurance. The formation of hospitalist training tracks in residency programs has been driven in part by the need to educate future hospitalists about business and operational aspects of medicine, as these topics are not covered in traditional residencies[citation needed].

发帖者 时间：

2011年6月12日

医疗纠纷[zt]

周老师关于医疗纠纷的思考--"医纠诉讼"如果做一个专有名词，一个专门课题，起码有两方面的意见（赞成和反对），两方面意见对"医纠诉讼"的positive和negative效果的看法截然不同，且效果之间存在cost-effectiveness的tradeoff，所以到底要赞同还是控制"医纠诉讼"，必须有实证依据加以支持，所以我们经济学家需要上场啦。

-------摘录：

对于医疗纠纷诉讼，有正反两面很极端的意见。赞成的一方认为透过此机制可以使被伤害的一方获得应有的补偿，达成社会正义；有人认为这样可以遏止不当的医疗行为；有人则认为这是保障医疗质量不可缺少的一项机制。反对的一方认为医疗纠纷的诉讼会造成许多副作用，这些副作用可能会超过它所带来前述的好处。这些副作用包括防卫性医疗(医疗人员为了保护自己，使用更多的检验或检查)导致医疗的浪费及对病人潜在的伤害，高额的医疗诉讼费、赔偿金以及医疗纠纷保险费导致医疗成本的增加，高风险科别的医师退出服务造成病人找不到相关医师诊疗，医病关系的破坏，以及双方所付出时间、精神压力与金钱等庞大的社会成本等。

尽管每位医师都有可能碰到医疗纠纷或诉讼，不过研究指出医疗案件发生在某些特定医师的机率比其它医师高很多，但这不表示这些医师的医疗质量比其它的医师差，其它研究发现，有专科证照的医师比没有专科证照的医师(美国的专科医师不一定要有专科证照)容易发生医疗纠纷，比较常被病人抱怨的医师发生医疗纠纷的机率也会比较高。(这是很耐人寻味的现象，意谓医疗纠纷的发生可能与医师的技术较没有关系，而与其医病关系特质有密切关系，我直觉上会同意这个论点，也许可以拿医院的医纠与抱怨的案件出来做回归分析)。不过研究发现，医疗纠纷的发生率与医师所就读的医学院排名无关，也与医师是美国人还是外国人、单独开业或与其它医师一起执业都无关。

至于医疗纠纷的诉讼对不当的医疗行为是否真有遏止的效果，目前的研究发现并没有明显的作用，主要原因是真正因为过失而致伤害的病人提出告诉的比例很低，最后获得赔偿的比例更低，因此医师所承担的风险事实上不大；另一个原因是医师大多有购买医疗纠纷保险，这些保险大多以科别风险订定各科医师的保费，而不是用个别医师过去的医疗纠纷理赔记录计算每位医师应缴的保费，这就更降低了医师要额外谨慎诊疗的诱因。

对于防卫性医疗与医疗诉讼有多少关连，以及其程度的大小，经济学家曾做过一些探讨。有的学者针对美国不同州的情形加以研究，发现防卫性医疗程度与该州病人的诉讼倾向没有相关性。有一份研究发现若某一州的法律对医师产生的医疗纠纷压力较大，该州的防卫性医疗程度也较高，但是医疗的结果都差不多。
发帖者 时间：
订阅： 博文 (Atom)