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A sick or injured person can obtain medical care in several different places. These include provider practices such as medical offices and clinics, hospitals and nursing homes.There are about 200,000 medical offices, clinics, and other provider practices in the United States. Earlier in the 20th century most physicians were single people working in their own offices or in partnership with another doctor. Patients visited the office, received an examination or other service, and paid a fee. This traditional fee-for-service medicine has been declining. Many physicians now practice in groups where they share the same offices and equipment with other doctors. Group practices may combine primary care physicians, several kinds of specialists, laboratories, and equipment for diagnosing disease. Physicians who practice in a group reduce their own expenses and provide patients with a wider range of services.Many doctors are joining with hospitals, insurance companies, and industrial employers to provide managed care for groups of patients. These plans manage to avoid unnecessary services and reduce costs. Rather than taking a fee from each patient, managed care physicians may receive an annual salary from a fixed sum for each patient.Patients who are too sick for care in a doctor’s office go to a hospital. Hospitals offer Patients 24-hour care from a staff of health professionals. They provide services not available elsewhere, such as major surgery, child birth, and intensive care for the critically ill. Hospital care is the most expensive form of health care. Efforts to control health care costs have emphasized reducing the number of patients admitted to hospitals and their length of stay. During the 1980s and 1990s, these efforts led to the closing of more than 600 hospitals.Patients who need long-term medical care because of advanced age or chronic illness may stay in a nursing home. The United States has about 23,000 nursing homes with about 1.3 million patients. According to the passage, the followings are the methods to reduce the costs EXCEPT（）
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[听力原文]11-15Venice is a fascinating city between sea and sky. It is built on 117 islands. There aren’t any cars and buses, But it has 150 canals and 400 bridges. The narrow streets, with their historic names, are paved with stones but have no footpaths. They are lined with flower, shops and lights side by side. The squares are charming, The brick bridges are built high to; allow boats to pass tinder them.Every year thousands of tourists front the five continents visit this city. They are always amazed at the charm of her water and beautiful lights, which can make them free from all dust and cooled by the sea breezes.But because the level of the surrounding waters is constantly rising, the Venice faces a threat to its Very existence. And the Venetian love their city and want to stay there to save the Venice from the sea, Now various methods hove already been taken and a plan to protect the city is under investigation. Every year where do thousands of tourists come from to visit this city
Almost all our major problems involve human behavior, and they cannot be solved by physical and biological technology alone. What is needed is a technology of behavior, but we have been slow to develop the science from which such a technology might be drawn. 61) One difficulty is that almost all of what is called behavioral science continues to trace behavior to states of mind, feelings, traits of character, human nature, and so on. Physics and biology once followed similar practices and advanced only when they discarded them. 62) The behavioral sciences have been slow to change partly because the explanatory items often seem to be directly observed and partly because other kinds of explanations have been hard to find. The environment is obviously important, but its role has remained obscure. It does not push or pull, it selects, and this function is difficult to discover and analyze. 63) The role of natural selection in evolution was formulated only a little more than a hundred years ago, and the selective role of the environment in shaping and maintaining the behavior of the individual is only beginning to be recognized and studied. As the interaction between organism and environment has come to be understood, however, effects once assigned to states of mind, feelings, and traits are beginning to be traced to accessible conditions, and a technology of behavior may therefore become available. It will not solve our problems, however, until it replaces traditional pre-scientific views, and these are strongly entrenched. Freedom and dignity illustrate the difficulty. 64) They are the possessions of the autonomous (self-governing) man of traditional theory, and they are essential to practices in which a person is held responsible for his conduct and given credit for his achievements. A scientific analysis shifts both the responsibility and the achievement to the environment. It also raises questions concerning "values." Who will use a technology and to what ends 65) Until these issues are resolved, a technology of behavior will continue to be rejected, and with it possibly the only way to solve our problems. The role of natural selection in evolution was formulated only a little more than a hundred years ago, and the selective role of the environment in shaping and maintaining the behavior of the individual is only beginning to be recognized and studied.
某地为了了解新研制的流感气雾免疫制剂的效果，在本地随机确定5000人接种疫苗，另外5000人不接种该疫苗作为对照，经过一个流行期后，前者50人发病，后者500人发病，则 该疫苗的效果指数为
男，31岁，1年来疑被人迫害，数次出走后被家人找回。近半年来常行为诡秘，将家中闹钟、收音机等在半夜深埋在公园树林地下，对亲友冷淡，生活懒散，房间内藏有刀、棍等，体格检查无阳性发现。精神状况检查：接触被动，有自语自笑，衣着尚得体。其称“有人要谋害我”，“有人命令我要么自杀、要么逃出去”否认有病，无自知力 该患者突发症状是
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