Search Results (63)

In this paper, we utilize the 2019/20 Uganda National Household Survey data to answer three related questions: (i) To what extent did out-of-pocket payments (OOPs) for health care services exceed the threshold for household financial catastrophe amidst COVID-19? (ii) What is the impoverishing effect of OOPs for health care services on household welfare? (iii) What are the socioeconomic and demographic determinants of OOPs for health care services in Uganda? Leveraging three health expenditure thresholds (10%, 25%, and 40%), we run a Tobit model for “left-censored” health expenditures and quantile regressions, and we find that among households which incur any form of health care expense, 37.7%, 33.6%, and 28.7% spend more than 10%, 25%, and 40% of their non-food expenditures on health care, respectively. Their average OOP budget share exceeds the respective thresholds by 82.9, 78.0, and 75.8 percentage points. While, on average, household expenditures on medicine increased amidst the COVID-19 pandemic, expenditures on consultations, transport, traditional doctors’ medicines, and other unbroken hospital charges were reduced during the same period. We find that the comparatively low incidence and intensity of catastrophic health expenditures (CHEs) in the pandemic period was not necessarily due to low household health spending, but due to foregone and substituted care. Precisely, considering the entire weighted sample, about 22% of Ugandans did not seek medical care during the pandemic due to a lack of funds, compared to 18.6% in the pre-pandemic period. More Ugandans substituted medical care from health facilities with herbs and home remedies. We further find that a 10% increase in OOPs reduces household food consumption expenditures by 2.6%. This modality of health care financing, where households incur CHEs, keeps people in chronic poverty. Full article

Buy Now, Pay Later (BNPL) is a rapidly growing fintech tool, which is particularly popular among young consumers, with the potential to support more sustainable retail consumption. While firms increasingly adopt BNPL, its impact on time-inconsistent consumers remains underexplored. We address this gap using two game-theoretic models: one with traditional payment and one with BNPL. In both models, time-inconsistent consumers decide whether to purchase and then whether to return a product after learning about their fitness. In the traditional model, greater time inconsistency reduces optimal price, demand, and profit. In contrast, these outcomes remain unaffected by time inconsistency under BNPL. Comparing the equilibrium results of the two models, we find that the firm always benefits more from offering BNPL than traditional payment when consumers are time-inconsistent. By deferring payment, BNPL increases consumers’ present willingness to buy, enabling firms to charge higher prices without reducing demand, and thereby achieve higher profits. Although BNPL can improve firm revenue and overall welfare, it may reduce consumer surplus by encouraging over-consumption. We also consider the presence of the BNPL provider and default of payments to make our results more robust. These findings highlight the need for caution and potential regulation to protect consumers with self-control problems. Full article

As the “carbon neutrality” strategy is implemented, green technology R&D, a core competitive strength for sustainable enterprise development, is an essential pathway for China’s transformation and green growth. Green technology, a breakthrough over traditional production technologies, involves lengthy and costly R&D processes with high risks typically beyond the reach of a single enterprise. It requires the heterogeneous functions of enterprises, universities, and research institutions to complement each other’s advantages and establish an “industry–university–research” collaborative innovation alliance for green technologies. This paper constructs differential game models for non-cooperative and cooperative green technology R&D involving a green manufacturer and a research institution. We solve and compare the profits for both parties under these scenarios, apply a time-consistent payment distribution mechanism to allocate cooperative profits, and ensure that neither party deviates from the optimal cooperative trajectory over a prolonged period, achieving Pareto improvement and enhancing social welfare. Full article

Assessments of farmer satisfaction can be a crucial tool for effectively implementing an appropriate ecological compensation policy. This study evaluates the effectiveness of an ecological compensation policy for crop rotation in China’s black soil regions from the perspective of farmer satisfaction. Specifically, utilizing an improved entropy TOPSIS, logistic regression, and the obstacle degree model, this empirical study analyzes the performance of the ecological compensation policy for crop rotation in black soil regions and identifies barriers in Heilongjiang Province. The findings indicate that gender significantly and positively affects outcomes at the 10% level, while age has a notable influence at the 5% level. Additionally, the family labor force and the quality of cultivated land, both significant at the 5% level with negative coefficients, suggest a diminished likelihood of farmers participating in these ecological compensation projects. The family’s source of income, significantly influential at the 1% level, also indicates a lower propensity among farmers to engage. Performance analysis reveals that the values for variables of satisfaction with the project’s publicity (A1), satisfaction with the protection of farmers’ rights and interest (A3), overall satisfaction with the effectiveness of the project (B1), satisfaction with ecological compensation methods (B3), and satisfaction with household income after the implementation of the project (C1) are above the average. In contrast, values for variables of satisfaction with the supervision and management (A2), satisfaction with the payment of ecological compensation funds (A4), satisfaction level with black soil rotation ecological compensation standards (B2), satisfaction with the welfare level of family life after the implementation of the project (C2), and satisfaction with farmers’ proactive participation in the project (D1) fall below the average of 3.03. Therefore, this study provides a comprehensive framework for assessing the effectiveness of the ecological compensation policy for crop rotation in China’s black soil regions and offers recommendations for enhancing its performance. Full article

Working at construction sites can harm individuals’ health and well-being. However, stakeholders often focus on improving health while discounting well-being. Establishing a better workplace environment can improve workplace well-being. Therefore, this study aims to investigate the factors influencing workplace well-being in infrastructure construction projects. To achieve this aim, the study objectives are to (1) identify the critical factors influencing workplace well-being in infrastructure construction projects; (2) develop an interrelationship model between underlying constructs of the factors; and (3) assess the influence of the underlying constructs on workplace well-being in infrastructure construction projects. First, a list of factors influencing workplace well-being was established using data from a systematic literature review and semi-structured interviews. Then, a survey was developed using the list of factors and distributed to infrastructure construction practitioners. In total, 124 responses were retrieved and analyzed using normalized mean analysis, exploratory factor analysis (EFA) and partial least square structural equation modeling (PLS-SEM). The analyses reveal that the critical factors include workload, salary package, the timeline of salary payment, working hours, planning of the project, insurance for construction workers, workers’ welfare and project progress. Furthermore, the underlying constructs are physical factors and psychosocial factors. Finally, both physical and psychosocial factors are found to significantly influence workplace well-being in infrastructure construction projects. Focusing solely on physical factors may not sufficiently enhance workplace well-being in construction projects, as there are also non-visible factors, such as psychosocial factors. Thus, exploring the interplay between visible and non-visible factors and their influence on workplace well-being in construction projects is crucial. Nevertheless, the findings have several limitations, including using data from a single country and non-hands-on construction practitioners, as well as the underlying constructs being derived solely using statistical methods. Still, the study is original in its focus on modeling the relationship between the factors influencing workplace well-being within the context of infrastructure construction projects. In other words, this study differs from prior research by specifically modeling the factors that influence well-being in infrastructure construction projects. Full article

Background: This study aims to examine the impact of different healthcare payment systems, specifically salary and fee-for-service (FFS) models, on service provision, patient welfare, and quality of care. The influence of payment models on healthcare delivery and patient outcomes, as well as how these models affect doctors’ decision-making based on patients’ insurance coverage, is not well understood. Methods: A medically framed real-effort task experiment was conducted. This study compared two payment systems: salary and FFS models. Key outcomes measured included the level of service provision, patient welfare, and quality of care. The analysis focused on how financial incentives and patient insurance coverage influenced healthcare decisions. Results: This study found overtreatment in FFS models and undertreatment in salary-based models. Healthcare decisions are significantly influenced by financial incentives and patient needs. Specifically, in FFS models, decisions are driven by self-interest, while in salary models, they are guided by patient needs. Within the FFS model, insurance coverage affects doctors’ decisions and patients’ benefits. Insured patients often receive unnecessary or incorrect procedures, indicating a supply-side moral hazard. Conclusions: Financial incentives and patient insurance coverage significantly influence healthcare decisions, with FFS models promoting self-interested decision-making and salary models focusing more on patient needs. This study contributes to the literature on supply-side moral hazard to health economics studies that use laboratory experiments to model medical decision-making. Full article

Since the 1990s, the Philippines has established numerous protected areas aimed at preserving regions with distinct biological and ecological characteristics. However, transitioning towards a more comprehensive approach to managing these protected areas, one that effectively conserves biodiversity while also supporting the welfare of local communities, remains a formidable task. Understanding the sources of the goods and services upon which communities rely, whether directly or indirectly, and their perceptions of ecosystem services (ESs) is a crucial aspect that can inform decision-making for both protected area managers and policymakers. This research specifically examines the mapping of landscape values as perceived by local communities within Malampaya Sound Protected Landscape and Seascape (MSPLS) in the Philippines. Using survey questionnaires administered to 114 randomly selected participants, the study identifies the ESs within MSPLS and maps the associated landscape values. The respondents were tasked with assigning values to the ESs using a typology of 14 landscape values, and their willingness to pay (WTP) to enhance the ESs within MSPLS was also investigated. Analysis of socio-demographic data, the identified ESs, and the perceived landscape values was conducted to uncover significant relationships between the variables. Our findings reveal that the respondents prioritize provisioning services, particularly fisheries, agriculture, and agroforestry. Regarding landscape value preferences, economic value is most prominently perceived (37.4%), followed by subsistence value (30.8%) and life-sustaining value (6.8%). This study further unveils the socio-economic factors influencing the ranking of ESs and trends in WTP for ES improvements in Malampaya. Additionally, a potential payment for ecosystem services scheme in MSPLS is estimated at PHP 532,000, approximately USD 10,600. Full article

Non-grain agricultural land use (NGALU) could be an alternative to payments for ecosystem services (PES) to achieve ecosystem benefits, given their joint contribution to forest transition. Unraveling the correlation between PES and NGALU can enhance cost-effective decisions. While farmland abandonment and non-grain cash crops (NGCCs) plantation are two main manifestations of NGALU, previous studies have primarily assessed the effects of PES on farmland abandonment. Little is known about the effects of PES on NGCC planting. This study evaluated the effects of China’s two nationwide PES programs (i.e., the Grain to Green Program, GTGP, and the Ecological Welfare Forest Program, EWFP) on NGALU in the Black River Basin of Shaanxi province. The study found a wide adoption of NGALU, with 52% of households adopting NGALU. The total area of NGALU is more than half of the afforested area through the GTGP. A quarter of the NGALU area is abandoned farmland, while the remaining NGALU area is planted with NGCCs. The two PES programs did not have effects on NGCC planting, but reduced farmland abandonment. Engagement in labor migration and local non-farm employment increased NGALU, while livestock breeding and farmland area reduced NGALU. Furthermore, the large area and unfavorable geographical conditions of farmland parcels promoted NGALU. These results highlight the important implications of leveraging NGALU to boost ecological gains from conservation investments. Full article

It is crucial to ensure healthy diets are affordable in low socioeconomic groups, such as welfare-dependent households, who experience higher rates of diet-related disease than others. This study assessed the cost of habitual (unhealthy) and recommended (healthy) diets in six welfare-dependent and six other, comparable Australian households, using either popular branded products or the cheapest available alternatives. It also assessed diet affordability in welfare-dependent households, before and after modest increases in government welfare payments introduced in early September 2023. Results confirmed that recommended diets were less expensive than habitual diets in all households unless the cheapest available products were included. This strategy reduced habitual diet costs by 35–37% and recommended diet costs by 30–32%. The lower cost differential could aid perceptions that healthy foods are more expensive than unhealthy foods. In April 2023, 23–37% of the income of welfare-dependent households with children was required to purchase recommended diets; this reduced only to 20–35% in September 2023. Hence, the increases in welfare payments were insufficient to meaningfully improve the affordability of healthy diets in the most vulnerable Australians. In the current cost-of-living crisis, there is an urgent need for more welfare support to help purchase healthy diets. Monitoring of diet cost and affordability is also required. Full article

The Saihanba Forest Farm, a leading planted forest farm, is one of the essential ecosystem service providers for the Beijing–Tianjin–Hebei region in China. Its efforts in afforestation and landscape restoration have been recognized with the award of the Champions of the Earth from the United Nations. However, the Saihanba Forest Farm is facing the challenges of less income resulting from less commercial cutting since it has to prioritize providing ecosystem services such as water conservation, wind prevention, sand fixation, and so on, instead of timber. It is crucial to understand providers’ attitudes toward ecosystem service provision and willingness to accept payment, as it might affect the quantity and quality of ecosystem service provision in the future. In this study, the contingent valuation method was applied to measure the willingness to accept payment for the economic losses incurred due to providing ecosystem services by cutting less wood. A questionnaire survey was conducted among the staff of the Saihanba Forest Farm. A double-hurdle regression model was used to analyze the influencing factors of the willingness to accept payment, with the validation via a Tobit model. The results showed that the Saihanba Forest Farm was willing to accept a payment of CNY 9800.84 (USD 1407.24) per hectare per year for providing ecosystem services to enhance social welfare. The factors, including basic sociodemographic characteristics, attitudes toward conservation activities, and awareness on the concept of payment for ecosystem services, significantly influenced their willingness to accept payment. Full article

The contractual relationship between the processing firm and the broiler smallholder presents incessant conflicts of interest and inequality due to technical and economic discrepancies, leading to an undervaluation of the producers’ remuneration. This study aims to deepen the discussion on searching for a more balanced monetary exchange between processing firms and broiler smallholders based on scientific aspects. For this, the emergy theory and its concepts are used while considering a representative broiler production system at Concórdia, Brazil. The results indicate the importance of including cultural information in the emergy-based model calculation, which achieved the highest emergy contribution (~63%; transformity = 1.73 $\times {10}^8$ sej/J) for the broiler smallholder. On the other hand, the cultural information was not sufficient to increase the sustainability of the broiler production system. The results show an imbalance in the monetary exchange between the processing firm and broiler smallholder from both perspectives (the economic and emergy-based ones), which indicates higher values (USD 0.32/broiler and EmUSD 1.62/broiler) than the practiced payment value of USD 0.24/broiler. Evaluating the “(eco)cost” from an emergy-based accounting perspective recognizes that production depends not only on tangible physical resources but also on knowledge, skills and information (“iceberg of value” thinking). Policy and decision makers must therefore consider the promotion of public policies that subside initiatives, including social and environmental welfare programs. Full article

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent inflammation in the airways, resulting in narrowing and obstruction of the air passages. The development of COPD is primarily attributed to long-term exposure to irritants, such as cigarette smoke and environmental pollutants. Among individuals hospitalized for exacerbations of COPD, approximately one in five is readmitted within 30 days of discharge or encounters immediate post-discharge complications, highlighting a lack of adequate preparedness for self-management. To address this inadequate preparedness, transitional care services (TCS) have emerged as a promising approach. Therefore, this study primarily aims to present a detailed protocol for a multi-site, single-blind, randomized, controlled trial (RCT) aimed at enhancing self-management competency and overall quality of life for patients with COPD through the provision of TCS, facilitated by a proficient Clinical Research Coordinator. The RCT intervention commenced in September 2022 and is set to conclude in December 2024, with a total of 362 COPD patients anticipated to be enrolled in the study. The intervention program encompasses various components, including an initial assessment during hospitalization, comprehensive self-management education, facilitation of social welfare connections, post-discharge home visits, and regular telephone monitoring. Furthermore, follow-up evaluations are conducted at both one month and three months after discharge to assess the effectiveness of the intervention in terms of preventing re-hospitalization, reducing acute exacerbations, and enhancing disease awareness among participants. The results of this study are expected to provide a basis for the development of TCS fee payment policies for future health insurance. Full article

In recent years, eco-efficiency assessment has proven to be an effective tool to reduce the environmental damages of agricultural activities while preserving their economic sustainability. Hence, this paper aims to assess the eco-efficiency of a sample of 148 beef cattle farms operating in the extensive livestock system of Central Italy. The analysis is based on Farm Accountancy Data Network (FADN) economic data in the year 2020 and includes, as environmental pressures, farm expenditure for the use of fuels, electricity and heating, and fertilizers. A two-stage approach was implemented: in the first stage, an input-oriented DEA model including slack variables was used to quantify farm eco-efficiency scores and determine the polluting inputs’ abatement potentials. In the second stage, the influence of possible influencing factors on eco-efficiency scores was tested using a regression model for truncated data. The analyzed farms were found to be highly eco-inefficient, as they could abate their environmental pressures, on average, in a range from 56% to 60% while keeping the value of their global production constant. Fertilizers and fuel consumption were identified as the least efficiently operating inputs, with potential reductions in terms of the related expenditures fluctuating between 9% and 42%. Farms showing a high-intensity livestock system, a low labor intensity, and a larger farm area were recognized as the most eco-efficient. Environmental and animal welfare subsidies were found to not affect eco-efficiency, while a negative influence was estimated for a single farm payment, which does not seem to be an incentive mechanism for farms to operate efficiently. Full article

The world is experiencing population ageing, which will extend to the future across the world. The ageing population is sure to impact a country’s welfare policy and economy. Macau is a special administrative region (SAR) of China with a long-life expectancy and a decreasing reproduction rate, making the population ageing particularly obvious. This study adopts a mixed methods approach to analyze the relationship between the ageing population, pension recipients, and pension payments to suggest the pension system and welfare leaking strategies of Macau SAR. The Granger causality test and focus group were conducted to test and discuss the ageing population, pension recipients, and pension payments. Results show that the ageing population positively affects pension payments. The ageing recipients are not corresponding to the ageing population and payments show welfare leakage. Suggestions are offered accordingly for a welfare policy to offer remedy strategies and reform the pension system. Full article

Food prices have escalated due to impacts of the COVID-19 pandemic on global food systems, and other regional shocks and stressors including climate change and war. Few studies have applied a health lens to identify the most affected foods. This study aimed to assess costs and affordability of habitual (unhealthy) diets and recommended (healthy, equitable and more sustainable) diets and their components in Greater Brisbane, Queensland, Australia from 2019 to 2022 using the Healthy Diets Australian Standardised Affordability and Pricing protocol. Affordability was determined for reference households at three levels of income: median, minimum wage, and welfare-dependent. The recommended diet cost increased 17.9%; mostly in the last year when the prices of healthy foods, such as fruit, vegetables and legumes, healthy fats/oils, grains, and meats/alternatives, increased by 12.8%. In contrast, the cost of the unhealthy foods and drinks in the habitual diet ‘only’ increased 9.0% from 2019 to 2022, and 7.0% from 2021 to 2022. An exception was the cost of unhealthy take-away foods which increased by 14.7% over 2019–2022. With government COVID-19-related payments, for the first time recommended diets were affordable for all and food security and diets improved in 2020. However, the special payments were withdrawn in 2021, and recommended diets became 11.5% less affordable. Permanently increasing welfare support and providing an adequate minimum wage, while keeping basic, healthy foods GST-free and increasing GST to 20% on unhealthy foods, would improve food security and diet-related health inequities. Development of a Consumer Price Index specifically for healthy food would help highlight health risks during economic downturns. Full article