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Background Medical costs have been rising rapidly in recent years, and China is controlling medical costs from the perspective of health insurance payments. Objectives To explore the impact of the capitation prepayment method on medical expenses and health service utilization of coronary heart disease (CHD) patients, which provides a scientific basis for further improvement of the payment approach. Methods The diagnosis records of visits for CHD in the database from 2014 to 2016 (April to December each year) were selected, and two townships were randomly selected as the pilot and control groups. Propensity score matching (PSM) and difference-in-difference (DID) model were used to assess changes in outpatient and inpatient expenses and health service utilization among CHD patients after the implementation of the capitation prepayment policy. Results There were eventually 3,900 outpatients and 664 inpatients enrolled in this study after PSM. The DID model showed that in the first year of implementing the reform, total outpatient expenses decreased by CNY 13.953, drug expenses decreased by CNY 11.289, as well as Medicare payments decreased by CNY 8.707 in the pilot group compared to the control group. In the second year of implementing the reform, compared with the control group, the pilot group had a reduction of CNY 3.123 in other expenses, and a reduction of CNY 6.841 in Medicare payments. There was no significant change in inpatient expenses in the pilot group compared to the control group, but there was an increase of 0.829 visits to rural medical institutions, and an increase of 0.750 visits within the county for inpatients. Conclusions The capitation prepayment method has been effective in controlling the outpatient expenses of CHD patients, as well as improving the medical service capacity of medical institutions within the Medical Community, and increasing the rate of inside county visits for inpatients.

The Sourcebook introduces a framework for social analysis in Poverty and Social Impact Analysis along with a set of practical tools that address the institutional, political, and social dimensions of policy design and implementation and how these impact poverty and distributional equity. It is designed for country practitioners working in policy analysis in a range of areas, including macroeconomic, sectoral, and public sector policy.

This IEG evaluation, requested by the World Bank’s Board of Executive Directors, represents the first independent evaluation of the PSIA experience. The evaluation finds that:. • The PSIA approach has appropriately emphasized the importance of assessing the distributional impact of policy actions, understanding institutional and political constraints to development, and building domestic ownership for reforms. • PSIAs have not always explicitly stated their operational objectives (i.e., informing country policies, informing Bank operations, and/or contributing to country capacity). • PSIAs have had limited ownership by Bank staff and managers and have often not been effectively integrated into country assistance programs. • Quality assurance and Monitoring and Evaluation of the overall effectiveness of PSIAs have been weak. The evaluation recommends that the World Bank:. • Ensure that Bank staff understand what the PSIA approach is and when to use it. • Clarify the operational objectives of each PSIA and tailor the approach and timeline to those objectives. • Improve integration of the PSIA into the Bank’s country assistance program by requiring that all earmarked funding for PSIAs be matched by a substantial contribution from the country unit budgets. • Strengthen PSIA effectiveness through enhanced quality assurance.

This article provides a thorough analysis of John Dewey and his theory experimentalism. John Dewey was a leader in education and philosophy of his time. Still today his ideologies have a place in educational curriculums across the globe. John Dewey believed that students learn from human experiences. Furthermore, Dewey believed that student experiences shape the future decisions that a learner engages in. Although Dewey’s work faced scrutiny, Dewey’s thoughts are still relevant in education reform today. This article resurfaces the need for whole child research considerations and inclusive learner experiences like Dewey’s work many years ago when making educational decision and building curriculum that meet the needs of individuals to promote a positive global change.

As both a regulator and an academic, Fred Kahn argued that end-use electricity consumers should face prices that reflect the time-varying marginal costs of generating electricity. This has been very slow to happen in the US, even in light of recent technological advances that have lowered costs and improved functionality for meters and automated demand response technologies. We describe these recent developments and discuss the remaining barriers to the proliferation of time-varying electricity pricing.

Health care is widely considered to be an important determinant of health. The health care systems of Western Europe have recently experienced significant reforms, under pressure from economic globalization. Similarly, in Eastern Europe, health care reforms have been undertaken in response to the demands of the new market economy. Both of these changes may influence equality in health outcomes. This article aims to identify the mechanisms through which health care may affect inequalities. The authors conducted a literature review of the effects on health inequalities of European health care reforms. Particular reference was paid to interventions in the fields of financing and pooling, allocation, purchasing, and provision of services. The majority of studies were from Western Europe, and the outcomes most often examined were access to services or income distribution. Overall, the quality of research was poor, confirming the need to develop an appropriate impact assessment methodology. Few studies were related to pooling, allocation, or purchasing. For financing and purchasing, the studies showed that publicly funded universal health care reduces the impact of ill health on income distribution, while insurance systems can increase inequalities in access to care. Out-of-pocket payments increase inequalities in access to care and contribute to impoverishment. Decentralizing health services can lead to geographic inequalities in health care access. Nationalized, publicly funded health care systems are most effective at reducing inequalities in access and reducing the effects on health of income distribution.

Purpose - To prepare Hong Kong students to face a rapidly changing twenty-first century, the Hong Kong Government implemented a major curriculum reform entitled Learning to Learn - The Way Forward in Curriculum Development. This reform has shaped the direction of Hong Kong's school education since 2001. The purpose of this paper is to examine the impact of the reform from the perspectives of the major stakeholders, namely principals, teachers, and students.Design methodology approach - The paper was written based on the data obtained from a large-scale study that covered over 250 primary and secondary schools, or about 20 per cent of the total population in Hong Kong. Both qualitative (focus group interviews) and quantitative methods (questionnaire survey) were employed in the study.Findings - The findings indicated that moderate progress has been made in students' overall performance in generic skills, positive values and attitudes, language proficiency, and over the key learning areas. On the other hand, the progress made in secondary schools was perceived to be less than that made in primary schools. The views of frontline teachers could also be different from senior teachers and principals as to the degree of achievement. There also existed a gap as the progress reported for critical thinking and self learning abilities might be less favourable when compared to those reported for IT, reading habits and healthy lifestyle.Originality value - The original findings and policy suggestions of the paper are of reference value to curriculum policy planners, researchers and educators.

The current distribution of power markets around intermediate structures between full integration and unbundling suggests that there has not been a linear path to reform in practice. Instead, many developing countries may retain intermediate structures in the foreseeable future. This possibility exposes a large gap in understanding about power market structures, since most theoretical work has focused on the two extreme structures and there is limited evidence on the impact of unbundling for developing countries.The study reports the evidence from statistical analysis and a representative sample of twenty case studies selected based on the initial conditions, such as income and power system size. It proposes a novel analytical approach to model market structure, together with ownership and regulation, controlling for several variables, as a key determinant of performance across several indicators, including access, operational and financial performance and environmental sustainability. The results of the analysis provide the following conclusions for policy guidance on power market restructuring for developing countries:• There seems to be credible empirical basis for selecting a threshold power system size and per capita income level below which unbundling of the power supply chain is not expected to be worthwhile. Indeed a dichotomy emerges between high income countries characterized by a large system size for which unbundling and other reforms are significantly linked to better performance and low income countries characterized by small system power size for which there is no strong evidence that unbundling and other reforms delivered improvements in performance.• Unbundling deliver consistently superior results across the board of performance indicators when used as an entry point to implement broader reforms, particularly introducing a sound regulatory framework, reducing the degree of concentration of the generation and distribution segments of the market by attracting additional number of both public and private players and encouraging private sector participation. • Partial forms of vertical unbundling do not appear to drive improvements, probably because the owner was able to continue exercising control over the affairs of the sector and hinder the development of competitive pressure within the power market.

Among Alfred E. “Fred” Kahn's many accomplishments, none is better remembered than his pivotal role in deregulation of the US airline industry. Kahn's commitment to marry core microeconomic principles with institutional analysis, willingness as Chairman of the Civil Aeronautics Board to step outside the “regulation as usual box,” and appealing wit made him the face of the Airline Deregulation Act of 1978, one of the great microeconomic policy triumphs. Lessons drawn from Kahn's work and the airline deregulation experience remain instructive for current academic research and regulatory policy design across broad sectors of the economy.

Alfred Kahn was a major force behind regulatory reform that initially benefited air travelers and subsequently consumers in other industries by placing greater reliance on markets than on regulators to allocate resources. Kahn also believed that effective governance was important for deregulation's success. In this paper, I argue that such governance has not occurred in practice and that problems that persist in partially deregulated industries are more likely to be solved by full deregulation and, if necessary, privatization than by government intervention.