1.Analysis on Dual-Task Incentives Contract for the Physicians in Public Hospitals/
Qiaoli WANG ; Lihong YANG ; Jun YU
Chinese Health Economics 2024;43(10):73-75,80
Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.
2.Research on the Incentive Mechanism for Doctors in Public Hospitals Based on the Perspective of Equity Preference
Jun YU ; Lihong YANG ; Qiaoli WANG
Chinese Health Economics 2024;43(10):76-80
Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.
3.Analysis on Dual-Task Incentives Contract for the Physicians in Public Hospitals/
Qiaoli WANG ; Lihong YANG ; Jun YU
Chinese Health Economics 2024;43(10):73-75,80
Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.
4.Research on the Incentive Mechanism for Doctors in Public Hospitals Based on the Perspective of Equity Preference
Jun YU ; Lihong YANG ; Qiaoli WANG
Chinese Health Economics 2024;43(10):76-80
Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.
5.A real-world study of first-line albumin-bound paclitaxel in the treatment of advanced pancreatic cancer in China
Juan DU ; Xin QIU ; Jiayao NI ; Qiaoli WANG ; Fan TONG ; Huizi SHA ; Yahui ZHU ; Liang QI ; Wei CAI ; Chao GAO ; Xiaowei WEI ; Minbin CHEN ; Zhuyin QIAN ; Maohuai CAI ; Min TAO ; Cailian WANG ; Guocan ZHENG ; Hua JIANG ; Anwei DAI ; Jun WU ; Minghong ZHAO ; Xiaoqin LI ; Bin LU ; Chunbin WANG ; Baorui LIU
Chinese Journal of Oncology 2024;46(11):1038-1048
Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P<0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.
6.Analysis on Dual-Task Incentives Contract for the Physicians in Public Hospitals/
Qiaoli WANG ; Lihong YANG ; Jun YU
Chinese Health Economics 2024;43(10):73-75,80
Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.
7.Research on the Incentive Mechanism for Doctors in Public Hospitals Based on the Perspective of Equity Preference
Jun YU ; Lihong YANG ; Qiaoli WANG
Chinese Health Economics 2024;43(10):76-80
Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.
8.Analysis on Dual-Task Incentives Contract for the Physicians in Public Hospitals/
Qiaoli WANG ; Lihong YANG ; Jun YU
Chinese Health Economics 2024;43(10):73-75,80
Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.
9.Research on the Incentive Mechanism for Doctors in Public Hospitals Based on the Perspective of Equity Preference
Jun YU ; Lihong YANG ; Qiaoli WANG
Chinese Health Economics 2024;43(10):76-80
Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.
10.Analysis on Dual-Task Incentives Contract for the Physicians in Public Hospitals/
Qiaoli WANG ; Lihong YANG ; Jun YU
Chinese Health Economics 2024;43(10):73-75,80
Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

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