Hasil untuk "Insurance"

P. Embrechts, R. Frey, H. Furrer

Tsung-Mei Cheng

H. Kazianga, C. Udry

A. Demirguc-Kunt, H. Huizinga

Kofi Effah, Ethel Tekpor, Joseph Emmanuel Amuah et al.

Abstract Background Cervical cancer (CC) screening uptake remains low primarily owing to the absence of organized screening and lack of insurance coverage. Members of the Ghana National Association of Teachers (GNAT) contribute monthly to an insurance scheme which covers cancer (including CC) treatment but not cervical precancer screening/treatment. We conducted this study to examine health beliefs shaping cervical screening uptake among educators and to understand how the scheme could scale cervical precancer screening and treatment services for beneficiaries across the country. Methods From February − July 2022, we performed cervical precancer screening with concurrent hr-HPV DNA testing and visual inspection with acetic acid (VIA) for 102 teachers in 3 districts in the Volta Region. From April − May 2024, we conducted a cross-sectional study among 498 female subscribers of the GNAT insurance scheme in the same districts using non-probability snowball sampling. Data on utilization of cervical cancer screening services and risk factors were collected using a self-administered questionnaire. Health beliefs and situational factors associated with screening uptake among school teachers were assessed. Results Although all 498 female school teachers were enrolled in the cancer insurance scheme, cervical cancer screening uptake was reported by 116 (23.9%). Utilization of cervical cancer screening services was 25.3% among married women and 34.4% among women who reported limited access to screening. In the final adjusted logistic regression model, perceived barriers to screening (aOR, 0.55; 95% CI, 0.42 − 0.72) and being divorced/widowed (aOR, 2.11; 95% CI, 1.10–4.03 vs. married/cohabitating) were independently associated with cervical precancer screening uptake. The hr-HPV prevalence and VIA ‘positivity’ rate were 17.3% (95% CI, 9.9–24.8) and 1.0% (95% CI, 0.0–5.5), respectively. Conclusions Cervical precancer screening utilization among female teachers enrolled in the GNAT cancer insurance scheme was sub-optimal owing to barriers related to low awareness, limited access, and social factors. The cancer insurance scheme represents a golden opportunity to overcome the identified barriers and improve HPV screening access and outcomes in addition to increasing access to cervical cancer treatment and should be explored.

Zhangwei Zheng, Mohd Hafizuddin Syah Bangaan Abdullah, Hafizah Omar Zaki et al.

Abstract Background Health insurance plays a vital role in reducing healthcare costs and promoting equitable access to medical services. However, coverage gaps persist in many regions, impeding progress toward universal health coverage as outlined in the UN Sustainable Development Goals. This study aims to comprehensively review recent research on health insurance purchasing, focusing on patterns, trends, methodologies, and key thematic areas. Methods A combination of bibliometric analysis and systematic review was employed to analyze health insurance purchasing literature. The Theory-Context-Methodology (TCM) framework guided the systematic review, with performance analysis conducted to evaluate publication trends and contribution patterns. Bibliographic coupling and co-occurrence analysis were used to identify the major themes and frontier topics. Results The study examined diverse theoretical perspectives and methodological approaches, with a focus on developed and emerging markets. The performance analysis revealed a steady increase in publications, with the United States and China emerging as leading contributors. Quantitative methods dominated in developed markets, while qualitative approaches were more prevalent in emerging markets. Key research themes included policy reforms and consumer behavior, with frontier topics such as cultural and financial factors and urban–rural insurance integration gaining prominence. Conclusions This study enhances the understanding of global health insurance purchasing research, particularly highlighting the need for further exploration in emerging markets. The findings provide valuable insights for future research, especially regarding evolving insurance systems and their impact on healthcare access and equity.

Ian C. Smith, Yasmin Abusetah, Homira Osman et al.

Abstract Introduction Neuromuscular diseases (NMDs) are rare multisystem, genetic or acquired disorders causing weakness and/or sensory loss. It is essential for governments, insurance providers, and broader society to have a better understanding of the burden of illness of NMDs. Our goal is to assess the social and economic burden of Canadians living with NMDs, encompassing schooling and education achievement, health-related quality-of-life, and labour force participation and productivity. Methods and analysis We will conduct a national, cross-sectional survey of individuals living with a NMD and their caregivers who are members of Muscular Dystrophy Canada and/or are patients within our national network of neuromuscular clinics. Surveys can be completed online or via telephone. The specific sub-sections of the questionnaire will differ based on respondent’s profile, whether they are 1) a minor living with a NMD, 2) an adult living with a NMD, 3) an adult who is a caregiver for someone living with a NMD, or 4) an adult who both lives with a NMD and is a caregiver for someone with a NMD. We will use descriptive statistics to describe distributions and ranges of the social and economic measures. Pearson correlations for continuous data and Spearman rho for rank data will be used to detect the strength of association of socio-demographic factors, disease characteristics, and social and economic impacts of NMDs. Ethics and dissemination The study protocol has been approved by the Ottawa Health Science Network Research Ethics Board (Protocol ID # 20210601-01H). This study will provide the overall impact of NMD on costs and health-related quality of life, disseminated via a series of manuscripts which will include both between- and within-NMD/NMD subtype comparisons. The data obtained will guide governmental policy development and inform patient organisation programs to deliver more effective supports to individuals and families affected by NMDs.

Dayea Kim, Jaewoo Cha

Background Angina, a major manifestation of ischaemic heart disease, affects 3–7% of adults and is a leading cause of cardiovascular morbidity. As an ambulatory care-sensitive condition, its outcomes can be improved through proactive outpatient management. However, the real-world impact of continuity of care (COC) and medication adherence, measured by the medication possession ratio (MPR)—on angina complications in South Korea remains poorly understood.Objective This study evaluated the effectiveness of COC and MPR in patients with angina using comprehensive national data and examined the outcomes at the hospital level.Methods This retrospective cohort study used data from the National Health Insurance Service of Korea between 2002 and 2019. We identified 11 127 patients aged >30 years newly diagnosed with angina, applying strict exclusion criteria to ensure cohort validity. COC was categorised as high (COC index=1.0) or low (<1.0), and MPR was classified as excellent (≥80%), good (60%–79%) or poor (<60%). Complications, defined as the onset of coronary artery disease (International Classification of Diseases, 10th Revision: I20–I25), were analysed using Kaplan-Meier survival curves and Cox proportional hazards models, adjusting for key sociodemographic and clinical covariates.Results Among the study cohort (mean age 63.4 years; 54.3% female), 64.2% had low COC. While patients with low COC had a 20% higher risk of complications compared with those with high COC (HR: 1.20; 95% CI: 0.87 to 1.65; p=0.266), this was not statistically significant. Similarly, patients with poor MPR had a modestly elevated but non-significant risk (HR: 0.96; 95% CI: 0.67 to 1.36). Subgroup analysis revealed significantly elevated complication risk in patients ≥80 years with low COC (HR: 2.00; 95% CI: 1.67 to 2.32; p=0.04). The lowest complication rates were observed in patients receiving care from clinics with high COC and excellent MPR.Conclusions Higher levels of COC and MPR were associated with reduced angina-related complications, underscoring their importance in chronic disease management. However, the inconsistent statistical significance suggests disease-specific strategies may be needed to optimise continuity and adherence interventions. These findings have implications for refining ambulatory care models and enhancing chronic disease policies within Korea’s single-payer system.

Thomas Gyima-Adu, Godwin Gidisu

Ghana records a low penetration of 1.05% compared to some of its African counterparts. For example South Africa, which has an insurance penetration rate of 17%, followed by Namibia which records 6.3%. This means, there is more room for improvement. More upsetting, with Ghana hovering around the 1% as at 2018, the rate works out to the small amount of Gross Domestic Product. This research seeks to model and forecast insurance penetration rate in Ghana using the Autoregressive Integrated Moving Average technique. The result indicates that ARIMA (3,1,0) is the appropriate model for insurance penetration in Ghana. Also, results from the forecast could serve as an advisory or the need to re-strategize as a country. Therefore, determining the future pattern of insurance penetration will lead to the remedies that will increase the number of insured in the future.

Markus Johannes Maier, Matthias Scherer

Payments in parametric insurance solutions are linked to an index and thus decoupled from policyholders' true losses. While this principle has appealing operational benefits compared to traditional indemnity coverage, i.e. is very efficient and cost effective, a downside is the discrepancy between payouts and actual damage, called basis risk. We show that in an asymmetrically weighted mean square error framework, the basis risk-minimizing payment schemes for pure parametric and parametric index insurance contracts can be expressed as conditional expectiles of policyholders' true loss given a compensation-triggering incident. We provide connections to stochastic orderings and demonstrate that regression approaches allow easy implementation in practice. Our results are visualized in parametric coverage for cyber risks and agricultural insurance.

T. Beck, Ian Webb

Life insurance has become an increasingly important part of the financial sector over the past 40 years, providing a range of financial services for consumers and becoming a major source of investment in the capital market. But what drives the large variation in life insurance consumption across countries remains unclear. Using a panel with data aggregated at different frequencies for 68 economies in 1961-2000, this article finds that economic indicators such as inflation, income per capita, and banking sector development and religious and institutional indicators are the most robust predictors of the use of life insurance. Education, life expectancy, the young dependency ratio, and the size of the social security system appear to have no robust association with life insurance consumption. The results highlight the importance of price stability and banking sector development in fully realizing the savings and investment functions of life insurance in an economy.

Gilbert Exaud Mushi, Aaron Andrew Mwakifwamba, Pierre-Yves Burgi et al.

Digital technologies are promising tools for sustainable agriculture; however, the cutting-edge digital solutions in agriculture are impractical for smallholder farmers in developing countries. Smallholder farmers need access to credit and insurance services, quality farm inputs, advisory services, subsidies, and market services to be able participate in sustainable agriculture. This paper is part of an extensive study conducted using the design science research (DSR) methodology. As part of our previous research, we conducted a thorough survey of the various stakeholders in Tanzania to assess their needs. Thereafter, we designed a conceptual digital framework called Farmers’ Digital Information System (FDIS), which provides all the necessary services to smallholder farmers and other stakeholders and addresses the identified needs. This paper presents a technical implementation of FDIS that aims to deliver essential services to smallholder farmers for sustainable agriculture within a comprehensive single mobile application. We used Android Studio Iguana and a Flutter framework to develop four service modules that include farmer and farm data, advisory services, and financial and marketing services as part of the FDIS platform. The system reflects the services offered in a real-world environment, as farmers can directly request advice from experts, apply for credit services from financial institutions, and market farm products to meet potential customers. It solves problems of access to farm advisory services and credit services for farm investment and helps farmers to find reliable markets for their products without going through intermediaries (middlemen). The completion of the FDIS development presented here will be followed by a test of the platform with real users for evaluation and improvement. Future research will focus on the scalability of FDIS for different regions, the embedding of more advanced technologies, and the adaptability of FDIS to different agricultural ecosystems. The FDIS solution has the potential to improve sustainable farming and empower smallholder farmers in Tanzania and beyond.

Rogelio A. Coronado, Jacquelyn S. Pennings, Hiral Master et al.

OBJECTIVES/GOALS: To examine the individual and combined association between preoperative sleep disturbance (SD) and depression and 12-month disability, back pain, and leg pain after lumbar spine surgery (LSS). METHODS/STUDY POPULATION: We analyzed prospectively collected multi-center registry data from 700 patients undergoing LSS (mean age=60.9 years, 37% female, 89% white). Preoperative SD and depression were assessed with PROMIS measures. Established thresholds defined patients with moderate/severe symptoms. Disability (Oswestry Disability Index) and back and leg pain (Numeric Rating Scales) were assessed preoperatively and at 12 months. We conducted separate regressions to examine the influence of SD and depression on each outcome. Regressions examined each factor with and without accounting for the other and in combination as a 4-level variable. Covariates included age, sex, race, education, insurance, body mass index, smoking status, preoperative opioid use, fusion status, revision status, and preoperative outcome score. RESULTS/ANTICIPATED RESULTS: One hundred thirteen (17%) patients reported moderate/severe SD alone, 70 (10%) reported moderate/severe depression alone, and 57 (8%) reported both moderate/severe SD and depression. In independent models, preoperative SD and depression were significantly associated with 12-month outcomes (all p’s<0.05). After accounting for depression, preoperative SD was only associated with disability, while preoperative depression adjusting for SD remained associated with all outcomes (all p’s<0.05). Patients reporting both moderate/severe SD and moderate/severe depression had 12.6 points higher disability (95%CI=7.4 to 17.8) and 1.5 points higher back (95%CI=0.8 to 2.3) and leg pain (95%CI=0.7 to 2.3) compared to patients with no/mild SD and no/mild depression. DISCUSSION/SIGNIFICANCE: Preoperative SD and depression are independent predictors of 12-month disability and pain when considered in isolation. The combination of SD and depression impacts postoperative outcomes considerably. The high-risk group of patients with moderate/severe SD and depression could benefit from targeted treatment strategies.

David Beauchemin, Zachary Gagnon, Ricahrd Khoury

Large Language Models (LLMs) perform outstandingly in various downstream tasks, and the use of the Retrieval-Augmented Generation (RAG) architecture has been shown to improve performance for legal question answering (Nuruzzaman and Hussain, 2020; Louis et al., 2024). However, there are limited applications in insurance questions-answering, a specific type of legal document. This paper introduces two corpora: the Quebec Automobile Insurance Expertise Reference Corpus and a set of 82 Expert Answers to Layperson Automobile Insurance Questions. Our study leverages both corpora to automatically and manually assess a GPT4-o, a state-of-the-art LLM, to answer Quebec automobile insurance questions. Our results demonstrate that, on average, using our expertise reference corpus generates better responses on both automatic and manual evaluation metrics. However, they also highlight that LLM QA is unreliable enough for mass utilization in critical areas. Indeed, our results show that between 5% to 13% of answered questions include a false statement that could lead to customer misunderstanding.

Gaurab Aryal, Isabelle Perrigne, Quang Vuong et al.

In this paper, we address the identification and estimation of insurance models where insurees have private information about their risk and risk aversion. The model includes random damages and allows for several claims, while insurers choose from a finite number of coverages. We show that the joint distribution of risk and risk aversion is nonparametrically identified despite bunching due to multidimensional types and a finite number of coverages. Our identification strategy exploits the observed number of claims as well as an exclusion restriction, and a full support assumption. Furthermore, our results apply to any form of competition. We propose a novel estimation procedure combining nonparametric estimators and GMM estimation that we illustrate in a Monte Carlo study.

Amy N. Finkelstein, K. Mcgarry

O. Mahul, Charles Stutley

Governments in developing countries have been increasingly involved in the support of commercial agricultural (crop and livestock) insurance programs in recent years. A striking example is China, where, with support (and premium subsidies) from the central and provincial governments, the agricultural insurance market grew dramatically to become the second largest market in the world (after the United States) in 2008. In India and Mexico, weather-based crop insurance has been developed on a large scale to protect farmers against the vagaries of the weather. Many other countries have investigated the feasibility of agricultural insurance, and some have implemented pilot programs. This book aims to inform and update public and private decision makers involved in promoting agricultural insurance about recent developments in agriculture insurance. The literature is heavily biased toward the practice and experience of a few very large public-private programs in Northern America and Europe, which are driven by large public financial subsidies. This book provides decision makers with a framework for developing agricultural insurance. It is based on an analytical review of the rationale for public intervention in agricultural insurance and a detailed comparative analysis of crop and livestock insurance programs provided with and without government support in more than 65 developed and developing countries. The comparative analysis is based on a survey conducted by the World Bank's agricultural insurance team in 2008. Drawing on the survey results, the book identifies some key roles governments can play to support the development of sustainable, affordable, and cost-effective agricultural insurance programs.

Amy N. Finkelstein, L. Einav, M. Cullen

Berna Doğan Başar, İbrahim Halil Ekşi, Emrah Doğan

In this study, the socioeconomic factors determining the insurance inclusion variable, constructed using principal component analysis, were tested using the Parks-Kmenta estimator and quantile regression for the E7 countries. In this context, the data used in the study were obtained between 2004 and 2017, depending on the accessibility of the variables. The empirical results show that while inclusion in the insurance sector is positively influenced by macroeconomic factors such as economic growth, sustainable development, urbanization, and public expenditure variables, it is negatively affected by risk components such as global uncertainty and political risk. Thus, the results suggest that socioeconomic factors significantly influence involvement in the insurance sector. In addition, thanks to financial inclusion, the revival of E7 countries will be ensured, and the growth of the economies of these countries will accelerate.

Leonard Mushunje, David Edmund Allen

We studied the behavior and variation of utility between the two conflicting players in a closed Nash-equilibrium loop. Our modeling approach also captured the nexus between optimal premium strategizing and firm performance using the Lotka-Volterra completion model. Our model robustly modeled the two main cases, insurer-insurer and insurer-policyholder, which we accompanied by numerical examples of premium movements and their relationship to the market equilibrium point. We found that insurers with high claim exposures tend to set high premiums. The other competitors either set a competitive premium or adopt the fixed premium charge to remain in the game; otherwise, they will operate below the optimal point. We also noted an inverse link between trading premiums and claims in general insurance games due to self-interest and utility indifferences. We concluded that while an insurer aims to charge high premiums to enjoy more, policyholders are willing to avoid these charges by paying less.