Background In the Chinese population, the middle-aged and older adults are the two main segments that utilize a large portion of healthcare. With the fast growth of the two segments, the demands of healthcare services increases significantly. The issue related to inequality in utilization of healthcare emerges with the growth and it deserves more attention. Most existing studies discuss overall inequality. Less attention is paid to inequality among subdivisions, that is, relative inequality. This study focuses on the inequality of healthcare utilization among the homogeneous population and the inequality of the full samples in China. Methods Data were obtained from four waves of the China Health and Retirement Longitudinal Study (CHARLS): 2011, 2013, 2015 and 2018. First, the Concentration Index (CI) was used to measure the inequality of outpatient, inpatient and preventive care for the samples, and regression analysis was applied to decompose the contributing factors of inequality. Then SOM is introduced to identify homogeneous population through clustering and measure the inequality in three types of healthcare utilization among homogeneous population. Based on this, the difference between absolute inequalities and relative inequalities was discussed. Results The preventive care is shown to have the highest degree of inequality inclined to the rich and has the largest increase (CI: 0.048 in 2011 ~ 0.086 in 2018); The inequality degree in outpatient care appears to be the smallest (CI: -0.028 in 2011 ~ 0.014 in 2018). The decomposition results show that age, education, income, chronic disease and self-reported health issues help explain a large portion of inequality in outpatient and inpatient care. And the contribution of socioeconomic factors and education to the inequality of preventive care is the largest. In regards to three types of healthcare among the homogeneous population, the degree of inequality seems to be higher among group with high socioeconomic status than those with lower socioeconomic status. In particular, for the people who are in the high socioeconomic group, the degree of inequality in preventive care is consistently higher than in outpatient and inpatient care. The inequality degree of preventive care in the low socioeconomic status group varies significantly with the flexibility of their response to policies. Conclusions Key policy recommendations include establishing a health examination card and continuously improving the fit of free preventive care with the needs of the middle-aged and older adults; developing CCB activities to avoid people’s excessive utilization in the high socioeconomic status group or insufficient utilization in the low socioeconomic status group; reasonable control of reimbursement and out-of-pocket payments.
Against the backdrop of urban stock renewal, as the core area of a city rich in culture, aesthetics, and tourism resources, the assessment of landscape visual sensitivity of historic districts can provide an accurate, objective, and intuitive decision-making basis for the multi-purpose planning of districts. The main purpose of this study was to develop an assessment method based on the geographic information system (GIS) in order to make a visual sensitivity index map on a district scale. To this end, this study uses the multi-criteria evaluation (MCE) method, selects the visibility (VSv), the number of potential users (VSu), and remarkableness (VSe) as the main criteria, and constructs a comprehensive assessment model of the visual sensitivity of the historic landscape. The most well-protected Wudadao Historic District in Tianjin (Wudadao) was selected as the study area, and its visual sensitivity was assessed. The assessment results are divided into four levels: areas of high sensitivity, moderate sensitivity, low sensitivity, and very low sensitivity. Results indicate that after the optimization and improvement of the evaluation index for visual sensitivity of a large-scale forest landscape, it is feasible to evaluate the small-scale visual sensitivity of historic districts; the higher the sensitivity level, the more important it is to be protected, and the more cautious it should be in the renewal of districts; the higher the number of potential users, the higher the visual sensitivity level, and so on. Further attention needs to be paid to planning and design to improve visual quality.
After approximately 30 years of development, public-private partnership (PPP) has attracted increased attention as an alternative procurement paradigm. However, fresh research on PPP has emerged in the last decade that needs to be summarized. This study selects publications on PPP that were published in recognized journals between 2012 and 2021 from the Scopus database. In target publications, methodologies employed, contributions made, and fields applied are summarized. Social network analysis is used to summarize five core topics in PPP from a multidisciplinary perspective; they are risk management, contract management, CFFs and CSFs, economic and financial issues, and performance management. Additionally, the research limitations and future development direction of PPP are also examined. This study can shed some light on future research on PPP and can contribute to the practice of PPP.
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