Evaluating the targeting of large-scale social assistance programs is crucial for improving public administration. Traditional approaches, relying solely on quantitative proxy means testing or qualitative community inputs, have limitations in capturing complex socioeconomic realities. This paper argues for employing hybrid methods that integrate quantitative and qualitative data sources to comprehensively assess targeting accuracy. Using China's Dibao program as a case study, we demonstrate that a hybrid approach reduced inclusion errors and enhanced program understanding among beneficiaries and communities. Our findings highlight the importance of collaborative evaluation mechanics that leverage localized knowledge while guarding against elite capture.

Background/Objectives: Community health nursing (CHN) clinical experiences are essential for preparing undergraduate nursing students to deliver safe and effective home-based care; however, access to placements is often limited. Escape room simulation (ERS) has been used in nursing education, yet its feasibility in CHN remains underexplored. This exploratory study aimed to examine the feasibility of using ERS in undergraduate CHN education by evaluating students' perceived competence, confidence, and learning experiences following participation in the simulation. Methods: A quasi-experimental, single-group pre-post design was conducted with 56 undergraduate nursing students. Data were collected at three time points: prior to the simulation, immediately after, and ten weeks post-intervention. Measures included standardized assessments of CHN competence and confidence, as well as student perceptions of the simulation experience. Linear mixed-effects modeling was used to examine changes over time. Results: Significant improvements were observed in both competence (t = 6.413, p < 0.001) and confidence (t = 8.142, p < 0.001) following the simulation, with gains maintained at ten weeks. Variability in competence decreased across participants over time, while confidence gains varied individually, with larger improvements among participants with lower baseline scores. Participants reported high levels of satisfaction with the simulation despite limited prior exposure. Conclusions: ERS was associated with improvements in undergraduate nursing students' perceived competence and confidence, suggesting that it may represent a feasible and acceptable supplemental educational strategy for undergraduate CHN education. Additional research is needed to better evaluate the educational impact and underlying mechanisms of ERS in CHN education, and to support the development of evidence-based ERS approaches that enhance student preparedness for community-based nursing practice in settings where clinical placements are limited.

The rapid expansion of financial technology (fintech) is reshaping the economic geography of developing countries, yet its consequences for urban labor markets remain poorly understood. As fintech firms cluster in a handful of cities, a critical question emerges: does this spatial concentration create broad-based employment gains or deepen existing urban inequalities? This paper examines how fintech agglomeration affects urban employment using panel data on Chinese A-share listed firms across 281 cities from 2011 to 2023. Exploiting city-level variation in fintech firm density, we establish a link between fintech concentration and firm-level hiring. A one-unit increase in log fintech firms raises firm employment by 2.0 percent, operating through two channels: fintech reduces firms' external financing constraints (SA index decreases by 0.2 percent) and lowers operational risk (Z-score increases by 19.2 percent). Importantly, however, these benefits are spatially and structurally uneven—employment effects are three times larger in eastern coastal cities than in inland regions, accrue predominantly to private firms, and disproportionately favor high-skilled workers (7.3 percent for graduate-degree holders versus no significant effect for less-educated workers). These findings reveal a key tension: while fintech agglomeration addresses longstanding credit market failures, its geographic concentration reinforces rather than flattens China's urban hierarchy, with implications for spatial equity and inclusive urban development in the digital era.

Patient-centered communication (PCC) is critical to improved patient experience and outcomes. We used binary logistic regression to examine how PCC at safety-net providers was associated with patient intent to recommend the facility. We used 2021-2022 national data collected by the Health Resources and Services Administration (HRSA). Our predictors were Consumer Assessment of Healthcare Providers and Systems (CAHPS) items to measure patient assessment of provider communication. We found that patients whose providers always listened carefully and knew important information about patients' medical history had 2.34 and 1.38 times the odds of recommending the facility, respectively. The odds of recommendation increased when providers always showed respect (OR = 1.44) or spent enough time with patients (OR = 1.59). Odds were also higher if administrative staff were always helpful (OR = 2.51) or treated patients courteously and respectfully (OR = 1.42). Patient-centered communication demonstrates significant potential to improve patient experience and care quality by safety-net providers.

Abstract This paper investigates the long-term impacts of China’s nationwide public health campaigns targeting malaria, measles, and meningitis between the 1960s and 1980s. Exploiting regional variation in precampaign disease prevalence across birth cohorts, we show that these interventions generated sizable improvements in education, cognition, health, and income. As an illustrative case, individuals from high-malaria regions who were fully exposed to the eradication campaign attained about 0.5 additional years of schooling and earned over 10% higher income in adulthood, with cognitive and schooling gains explaining a substantial share of the income effects. Extending the same approach to measles and meningitis vaccination campaigns reveals comparably large benefits, with internal rates of return ranging from 21% to 34%. Together, these findings highlight the lasting socioeconomic returns to early-life health interventions and underscore the role of public health as a foundation for human capital accumulation and long-run economic growth.

This paper documents evidence of the gambler's fallacy in housing market expectations using representative microdata from China. Contrary to the extrapolative expectations typically observed in Western markets, we find that a 1 percentage point increase in experienced city-level housing prices reduces the probability of expecting future price increases by approximately 0.3 to 0.4 percentage points. This pattern is consistent with a theoretical framework integrating the gambler's fallacy with prospect theory, where expectations incorporate both a belief in price reversals and reference-dependent evaluation. Our empirical analysis confirms that risk attitudes mediate the relationship between price experiences and expectations, with asymmetric responses to perceived gains and losses relative to endogenously-determined reference points. The gambler's fallacy exhibits heterogeneity across demographic groups, being more significant among urban residents, homeowners, and the highly educated.

The gender of a child significantly influences parental actions and decision-making processes. This study uses data from four waves of the China Family Panel Studies, collected biennially from 2014 to 2020, to investigate whether a child's gender affects household housing consumption through a two-way fixed effects model. The findings suggest that families with first-born sons demonstrate greater housing consumption compared to those with first-born daughters. This effect is intensified by external factors such as competition in the marriage market and internal family factors like the son reaching legal marriage age, the child's marital status, and increasing bequest motives. The impact of gender differences on housing consumption is particularly pronounced among households with lower-middle-income, older parents, and lower education levels, and non-members of the Communist Party of China (CPC). Further analysis reveals that the gender-related differences in housing consumption are primarily addressed through increased labor supply measured by labor force participation and weekly working hours, coupled with reduced consumption and increased savings. This study's results may be influenced by the gender of subsequent children, likely underestimating the actual economic impact of the first child's gender. These findings can guide households in optimizing housing consumption and assist governments in promoting gender equality and providing more affordable housing options.

This paper examines how place-based talent policies shape innovation dynamics across Chinese cities. Drawing on municipal "Vying for Talent" initiatives (2009-2019), we analyze how these strategies reconfigure firms' innovation incentives through interactions with local institutions. Our mechanism analysis reveals that these interventions enhance corporate R&D intensity primarily by amplifying expected returns through increased direct government subsidies, and by reducing innovation costs via lower effective tax rates and the enhancement of firm-level human capital. Policy effectiveness demonstrates strong complementarity with local economic conditions, generating a "Matthew effect" whereby advantaged cities achieve greater returns. This spatial differentiation, particularly pronounced among private and high-tech firms, suggests talent policies may reinforce existing geographical hierarchies of innovation capacity.

INTRODUCTION/OBJECTIVE:Reducing inappropriate emergency room (ER) visits is a major health management objective. While Hispanic patients reportedly have the highest percentage of avoidable ER visits (4.89%), empirical research is scarce. Effective provider communication can increase appropriate ER utilization. Our objective was to examine associations between safety net primary care providers' communication with Hispanic patients and Hispanic patients' ER use. METHODS:We used 2022 Health Center Patient Survey data collected by the United States Health Resources and Services Administration. Our predictors were patient-reported provider communication and nonclinical staff evaluation items from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) instrument. Our outcome variable was patient-reported ER visits in the previous year. We used binary logistic regression to examine the association. RESULTS:Patients who had used health centers longer had significantly lower odds of ER visits (44%-46%). Patients who had initiated conversations about their health issues had 55% higher odds of ER visits. Healthier patients and women had lower odds while insured patients and those with frequent visits to health centers had higher odds of ER use. CONCLUSIONS:Primary care continuity, stable medical home, and effective interactions with providers may reduce ER use.

Partly interval-censored data, comprising exact and intervalcensored observations, are prevalent in biomedical, clinical, and epidemiological studies. This paper studies a flexible class of the semiparametric Cox-Aalen transformation models for regression analysis of such data. These models offer a versatile framework by accommodating both multiplicative and additive covariate effects and both constant and time-varying effects within a transformation, while also allowing for potentially time-dependent covariates. Moreover, this class of models includes many popular models such as the semiparametric transformation model, the Cox-Aalen model, the stratified Cox model, and the stratified proportional odds model as special cases. To facilitate efficient computation, we formulate a set of estimating equations and propose an Expectation-Solving (ES) algorithm that guarantees stability and rapid convergence. Under mild regularity assumptions, the resulting estimator is shown to be consistent and asymptotically normal. The validity of the weighted bootstrap is also established. A supremum test is proposed to test the time-varying covariate effects. Finally, the proposed method is evaluated through comprehensive simulations and applied to analyze data from a randomized HIV/AIDS trial.

We investigate how exposure to the One-Child Policy (OCP) during early adulthood affects marriage and fertility in China. Exploring fertility penalties across provinces over time and the different implementations by ethnicity, we show that the OCP significantly increases the unmarried rate among the Han ethnicity but not among the minorities. The OCP increases Han-minority marriages in regions where Han-minority couples are allowed an additional child, but the impact is smaller in other regions. Finally, the deadweight loss caused by lower fertility accounts for 10% of annual household incomes, and policy-induced fewer marriages contribute to 30% of the fertility decline.

Independent censoring is a key assumption usually made when analyzing time-to-event data. However, this assumption is difficult to assess and can be problematic, particularly in studies with disproportionate loss to follow-up due to adverse events. This paper addresses the challenges associated with dependent censoring by introducing a likelihood-based approach for analyzing bivariate survival data under dependent censoring. A flexible Joe-Hu copula is used to formulate the interdependence within the quadruple times (two events and two censoring times). The marginal distribution of each event/censoring time is modeled via the Cox proportional hazards model. Our estimator possesses consistency and desirable asymptotic properties under regularity conditions. We present results from extensive simulation studies and further illustrate our approach using prostate cancer data.

This study investigates the impact of China's 2014 Hukou reform, which significantly relaxed barriers to internal migration, on local urban residents' perceptions of unfairness. Using data from the China Family Panel Studies, we find that exposure to increased in-migration following the reform heightened locals' perceptions of unfair treatment due to wealth inequality and Hukou status. Locals also expressed less tolerance for wealth gaps and reduced materialistic wealth recognition. These shifts in social attitudes indicate that inter-group contact through migration can reshape native residents' notions of fairness and equity. Our findings suggest implementing progressive policies may become more feasible in the wake of migration reforms by altering social views. Overall, our work sheds light on the societal impacts of internal migration and Hukou policy reforms in China.

In this study, we investigate the impact of interest rate liberalization on household investment behavior in China using data from the China Household Finance Survey from 2011 to 2019. We find that financial liberalization significantly increases the likelihood of households participating in financial markets and raises their holdings of riskier assets, driven by the wealth effect. This effect is more pronounced among higher-income, higher-asset, and better-educated households, without housing mortgages, as well as urban households. Our results highlight the importance of financial liberalization policies and provide new perspectives on the “limited participation puzzle” documented in emerging economies, where relatively few households actively invest in financial assets despite high expected returns. This study underscores how interest rate deregulation incentivizes household portfolio reallocation and promotes financial inclusion across socioeconomic groups.

In this study, we examine the interplay between regional digital financial inclusion and social capital with a focus on social trust. Our empirical analysis shows that regions with enhanced digital financial services experience a significant boost in social trust. Specifically, a one standard deviation increase in regional digital financial inclusion correlates with an approximate increase of 1% in social trust among frequent Internet users compared with infrequent users. We futher find that growth in social trust is largely attributable to noneconomic factors, such as improvements in perceived fairness. Conversely, the economic factor of increased individual income exhibits limited explanatory strength in this context. These findings shed light on the dynamics of regional development and highlight critical policy considerations for fostering social capital through digital finance.

While previous studies have extensively explored the impact of housing wealth on household consumption, only a limited number have investigated the role of bequest motives. This study focuses on understanding how bequest motives influence household consumption and decisions related to the intergenerational transfer of housing assets. Using panel data from three waves of the China Family Panel Studies collected biennially from 2014 to 2018, we empirically assess the housing wealth effect (HWE) and find that bequest motives play a significant negative role in this context, producing a dampening effect on household life satisfaction. Our results also suggest that the influence of bequest motives on housing wealth is more prominent among economically disadvantaged households, households with higher levels of education, and middle-aged and older households. These findings imply that implementing inheritance taxes could facilitate the leveraging of the HWE, ultimately promoting increased household consumption.

IntroductionInconsistencies of reports contributes to the underreporting of Alzheimer’s disease (AD) on death certificates. Whether underreporting exists within South Carolina has not been studied.MethodsWe conducted a prospective, population-based study on a cohort of persons (N = 78,534) previously diagnosed with AD and died between 2014–2019. We linked vital records with the South Carolina Alzheimer’s Disease and Related Dementias Registry to investigate their cause of death and survival rates. Descriptive analyses calculated frequencies of demographic and health-related characteristics. Turnbull’s method estimated the survival probabilities for different subgroups of patients. Hazard ratios were computed from the Cox proportional hazards model, adjusting for the following confounding variables of age at diagnosis, education level, gender, and race.ResultsThe top immediate cause of death was Alzheimer’s disease among all racial groups, except for Native American/American Indian. More females (60.3%) were affected by AD compared to males (39.7%). There is a 25% probability of survival, beyond 5 years, after AD diagnosis. Black/African American AD patients have the smallest risk of all-cause mortality across all racial/ethnic groups (HR 0.87; 95% CI, 0.85–0.89). Individuals with lower education had a lower likelihood of mortality.ConclusionAlthough AD was not underreported in the state of South Carolina further research is needed to develop protocols around classification of deaths among those diagnosed with dementia and comorbidities, including cardiovascular disease, to ensure dementia is properly reported as we move to prevent and treat Alzheimer’s disease by 2025 and beyond.

Institutional theory holds that local governance is essential in shaping regional economic activity. This study evaluates whether local economic growth targets offset the detrimental effect of nationwide policy uncertainty on local business performance. Regression analyses of data from industrial firms and manually collected data on city economic growth targets in China show that higher local growth targets result in greater corporate investment, conditional on nationwide policy uncertainty, and that the impact is substantial through financial subsidies and allocating credit resources. However, local discretion in economic growth target setting might cause investment misallocation and efficiency loss.

Digital financial inclusion is essential for promoting regional development, but its impact on demographic change requires further investigation. Using data from the Chinese General Social Survey (CGSS) between 2012 and 2017, this study provides empirical evidence on how the growth of digital financial inclusion affects fertility intentions in China. The results indicate that a one percent increase in the provincial-level digital financial inclusion index is associated with a 0.136% increase in fertility intentions. These findings hold across different components of digital financial inclusion and are robust to instrumental variable approaches. Moreover, the study shows that the expansion of digital financial inclusion has a more significant effect on households in low-income groups, central and western regions of China, and women with low educational attainment. These results underscore the importance of digital financial inclusion in addressing population declines worldwide.

Ineffective primary care provider (PCP) communication may contribute to the overuse of emergency room (ER) care in the United States. We examined the relationship between PCP communication and ER visits within a Medicaid patient population using 2022 Health Center Patient Survey data collected by the US Health Resources and Services Administration (HRSA). Our sample was 1807 Medicaid patients who had used HRSA-funded health centers for at least 12 months. Our predictors were the Consumer Assessment of Healthcare Providers and Systems communication items. Our outcome was the number of ER visits (categorized into three levels) during the previous year. Using ordinal logistic regression, we found that patients whose PCPs always knew important information about their medical history and who always received helpful service from staff had 24% and 20% lower odds of using ER care, respectively. Patients who had seen their PCP for at least 5 years had 37% lower odds of using ER care. Effective PCP and staff communication and improved continuity of care can reduce unnecessary ER visits while improving quality and reducing healthcare cost.