Evaluation and Influencing Factor Analysis of Sustainable Green Transformation Efficiency of Resource-Based Cities in Western China in the Post-COVID-19 Era

Business Model Innovation Paths of Manufacturing Oriented towards Green Development in Digital Economy

China's manufacturing industry has been confronted with the issue of extensive development with high input, high consumption, and high emissions for a long time, and its green development is the key to reaching carbon neutrality in China. Under the digital economy, business model innovation is the fundamental means of the green development of manufacturing enterprises. Four representative listed companies in China's manufacturing were selected as typical cases for the case study. Through open, axial, and selective coding that is based on proceduralized grounded theory, this study profoundly explores business model innovation paths of the manufacturing industry oriented towards green development in the digital economy following the research logic of "green development orientation-business model innovation process-business model innovation result". Moreover, this study further compares the differences among paths and discusses each path's effectiveness and applicable conditions. Results show that: (1) Four green business model innovation paths are revealed based on the four green development orientations: efficiency-oriented path, value-oriented path, user-oriented path, and ecology-oriented path. (2) Different enterprises pursue distinct business model innovation paths. The scientific premise for enterprises to opt for the optimal innovation path is the matching of upgrading demands, existing conditions, and path characteristics. Ultimately, the following policy implications are offered: First, promote the green innovation of business models in the manufacturing industry. Second, consider enterprises' heterogeneity and implement differentiated support policies. This study can serve as theoretical support and decision-making reference for business model innovation and green development in manufacturing enterprises.

Levels, trends, and determinants of effectiveness on the hierarchical medical system in China: Data envelopment analysis and bootstrapping truncated regression analysis

Background

The hierarchical medical system (HMS) refers to the classification of treatment according to disease priorities based on severity and difficulty to promote the fairness of medical services for residents, which is regarded as the key to the success of medical reform in China.

Methods

In the past decade of "New Medical Reform," the efficiency of HMS, including secondary and tertiary hospitals and primary healthcare centers (PHCs), was measured horizontally and vertically by employing the combination of an output-oriented superefficiency slack-based model-data envelopment analysis (SE-SBM-DEA) model with the Malmquist total factor productivity index (MTFP). In the second stage, the overall technical efficiency (OTE) scores were regressed against a set of environmental characteristics and several managerial factors through bootstrapping truncated regression.

Results

On average, the OTE score in tertiary hospitals was 0.93, which was higher than that in secondary hospitals and PHCs (0.9 and 0.92, respectively). In terms of trend, the OTE of tertiary hospitals declined at first and then increased. The opposite was true of secondary hospitals, in which the APC of the OTE was 10.82 and -3.11% in early and late 2012, respectively. The PHCs generally showed a fluctuating downward trend. In the aspects of productivity, all institutions showed a downturn by an annual average rate of 2.73, 0.51, and 2.70%, respectively. There was a significant negative relationship between the ratio of outpatients to inpatients and tertiary hospitals. Additionally, the medical technical personnel per 1,000 population negatively affected PHCs. In contrast, the GDP per capita had a significantly positive effect on tertiary hospitals, and the number of beds per 1,000 population positively influenced PHCs.

Conclusion

The efficiency of medical institutions at various levels in HMS was unbalanced and took the form of an "inverted pyramid." Multilateral factors influence the efficiency of HMS, and to address it, multi-intervention packages focusing on sinking high-quality medical resources and improving healthcare capacity, and guiding hierarchical medical practice should be adopted.