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Land tenure security and land transfer markets are once again a topmost priority in the policy development agenda because of their expected outcomes in terms of equity and efficiency in the rural sector of China. The policy of rural land rights confirmation has been implemented since 2010 to enhance land tenure security and the transferability of farmland. However, only a few studies have been conducted on the effect of rural land rights confirmation on farmland transfer. Therefore, we use household-level survey data from 48 villages across Tianjin City and Shandong Province to explore whether rural land rights confirmation promotes the transfer of farmlands. Our empirical results show that rural land rights confirmation has significant and positive effects on the likelihood and amount of transfer-out land at the 5% significance level, but the effect on transfer-in farmland is insignificant. The results of the study have several policy implications. For instance, the agricultural comparative advantage should be improved through various agricultural subsidy policies. Moreover, the intermediary service network for farmland transfer should be established, and strengthening the non-farm employment skills and improving the non-agricultural employment market are necessary for the rural labour force.

BackgroundIn order to maintain high standards of healthcare, it is necessary for medical departments to provide high-quality and affordable medical services to local residents. This has been widely accepted in developed countries, while the medical treatment systems in developing countries remain to be improved. This research is based on a pilot of a hierarchical medical system in Shanghai, China, to evaluate the effects on policy of medical reform in developing countries.Methods and resultsBy means of the difference-in-differences (DID) method, the causal relationship between medical care services' improvement and hierarchical medical systems' implementation could be identified. This project also explores the differential effects of policy intervention and confirms that the pilot showed a significant improvement in medical performance in central districts while the result remains uncertain in terms of suburban districts. Furthermore, the dynamic effect of a hierarchical medical system has also been identified with the event study method, while the policy pilot only had short-term effects on local medical resources' improvement. In order to ascertain the function mechanisms of hierarchical medical systems and explain why the policy pilot only had short-term effects, this project also conducts influencing mechanism analysis with the triple-differences method (also known as difference-in-difference-in-differences or DDD method). According to the empirical results, there is no direct evidence indicating the hierarchical medical system could bring obvious benefits from the perspectives of patients and medical institutions.ConclusionsFor better implementation of hierarchical medical systems in the future, long-term supervision mechanisms should be given more attention in the enforcement process of hierarchical medical systems. At the same time, more safeguarding measures should be implemented, such as supervising the payment systems of the medical institution and conducting performance evaluation.