Hasil untuk "Insurance"

J. Mossin

D. Mayers, Clifford W. Smith

Barbara J Mace

Shaun S. Wang

Tuan Chau Do, Tien Thinh Le, Nguyen Trong Hieu et al.

In this work, we investigate a modified version of the classical SIS model that incorporates hospitalization for treatment and disease-induced mortality, aiming to more accurately capture the dynamics relevant to health insurance pricing models. More precisely, we introduce a new framework, referred to as the SISHD model, which considers both hospitalized individuals and disease-induced mortality. Dynamical properties of the proposed model are thoroughly analyzed, including positivity and boundedness of the solutions, the basic reproduction number, the existence and asymptotic stability of equilibrium points. Furthermore, we utilize the proposed model in the context of health insurance pricing, where the population sizes estimated from the SISHD model are used to determine appropriate insurance costs. Finally, numerical simulations are conducted to illustrate and validate the theoretical results.

Linyan Chen, Wenting Luo, Juntong Liu et al.

ObjectiveTo investigate medical expenses and factors influencing surgical choices among lung cancer patients in a tertiary hospital in Xiamen, China, and to identify key cost differences between surgical and non-surgical approaches.MethodsIn this retrospective cross-sectional study, we analyzed 3,806 lung cancer patients treated in 2023. Data analysis was performed using SPSS 27.0, with independent-sample t-tests for cost comparisons and binary logistic regression to identify factors influencing surgical intervention.ResultsThe study analyzed 3,806 lung cancer patients (60.7% male, 51.1% aged 61–80 years), revealing significant demographic and clinical predictors of surgical intervention. Multivariate analysis identified female gender (adjusted OR = 1.989, 95%CI:1.624–2.436, p < 0.001), younger age (61–80 years: adjusted OR = 0.454, 95% CI:0.305–0.676, p = 0.001; >80 years: adjusted OR = 0.353, 95%CI: 0.161–0.774, p = 0.009), and prolonged hospitalization (adjusted OR = 106.729, 95%CI: 79.485–143.312, p < 0.001) as key determinants, while insurance type showed no association. Surgical patients incurred 8.5-fold higher median costs (¥48,610 vs. ¥5,676), with medical consumables exhibiting the most pronounced disparity (>2,000-fold difference). The predictive model demonstrated excellent discrimination (AUC = 0.904), calibration (Hosmer-Lemeshow p = 0.402), and specificity (81.6%) at a 46.75% probability threshold, with length of stay being the strongest individual predictor (univariate AIC = 2,874 vs. full model AIC = 2,802). Insurance type showed no significant association with surgical treatment in either univariate or multivariate analyses.ConclusionGender, age, and hospital stay length were major factors associated with surgical decisions in lung cancer patients, with surgery significantly increasing total medical costs. Policy improvements in the management of high-value medical consumables and insurance reimbursement are needed to reduce financial burdens and enhance surgical accessibility.

Lang Qin, Yuejin Xie, Daili Hua et al.

Extreme weather events increasingly threaten the insurance and real estate industries, creating conflicts between profitability and homeowner burdens. To address this, we propose the SSC-Insurance Model, which integrates SMOTE, SVM, and C-D-C algorithms to evaluate weather impacts on policies and investments. Our model achieves 88.3% accuracy in Zhejiang and 79.6% in Ireland, identifying a critical threshold (43% weather increase) for insurance viability. Additionally, we develop the TOA-Preservation Model using TOPSIS-ORM and AHP to prioritize building protection, with cultural value scoring highest (weight: 0.3383). Case studies on Nanxun Ancient Town show a 65.32% insurability probability and a protection score of 0.512. This work provides actionable tools for insurers, developers, and policymakers to manage climate risks sustainably.

Panupong Hansrivijit, Janinne Ortega-Montiel, Deborah J. Wexler et al.

Rationale & Objective: Tirzepatide, a dual GIP/GLP-1 receptor agonist, has been approved for type 2 diabetes (T2D) and obesity. However, the real-world utilization of tirzepatide remains unexplored, particularly in patients with chronic kidney disease (CKD), where the prevalence of T2D and obesity is high. This study aimed to describe the utilization trends of tirzepatide, glucose-lowering medications (GLMs), and anti-obesity medications (AOMs) in patients with CKD, with and without T2D. Study Design: A population-based, observational cohort study. Setting & Participants: Patients with CKD, with and without T2D, were identified from a large US health insurance claims database (from January 1, 2022 to September 30, 2023). Exposures: Tirzepatide, other GLMs, and AOMs. Outcomes: Medication utilization trends and patient characteristics. Any users were defined as those with prescription claims, and incident users as those with no previous dispensing within 365 days. Analytical Approach: Longitudinal trends were assessed by 1-month intervals from January 1, 2022 to September 30, 2023. Results: Among 455,047 patients with CKD and T2D, tirzepatide any users increased to 4.8% in September 2023, while incident users rose from 0.8% to 8.6%. Sodium glucose cotransporter-2 inhibitors remained the most initiated GLM. Tirzepatide initiators had higher rates of obesity (32.5%), and morbid obesity (44.1%) when compared with other GLMs. Among 5,978 patients with CKD without diabetes, weekly semaglutide ≤2 mg was the most initiated AOM, followed by tirzepatide. Incident users of tirzepatide rose from 0.6% in June 2022 to 23.5% in September 2023. Clinical characteristics were similar between semaglutide ≤2 mg versus tirzepatide initiators. Limitations: The study period ended before tirzepatide’s approval for weight management (November 2023). Conclusions: Our study indicates rapidly shifting trends in tirzepatide uptake among patients with CKD both with and without diabetes. The uptake of tirzepatide is expected to increase further. Future studies on the comparative effectiveness and safety of tirzepatide in patients with CKD are warranted. Plain Language Summary: Tirzepatide, a dual GIP/GLP-1 receptor agonist, has been approved for glycemic control and weight management, but its utilization in the real-world settings among patients with chronic kidney disease (CKD) is unknown, where the prevalence of type 2 diabetes and obesity is high. In this study, we examined the utilization trends of tirzepatide, other glucose-lowering medications, and anti-obesity medications (AOMs) from January 1, 2022 to September 30, 2023 using a large US health insurance database. We found that the use of tirzepatide has been rapidly rising as a GLM and AOM among patients with CKD and is expected to increase further. Future studies on the effectiveness and safety of tirzepatide against other glucose-lowering medications or AOMs in patients with CKD are needed.

Pearl A. McElfish, Aaron Caldwell, Donya Watson et al.

Objectives: This study examines prenatal care utilization differences in Arkansas. Methods: Birth records data from the National Center for Health Statistics were used. The study population consisted of singleton live births in Arkansas from 2014 to 2022. Primary outcomes included number of prenatal visits, fewer than the recommended number of prenatal visits, late prenatal care, and no prenatal care. Summary statistics were computed, and adjusted rates ratios were calculated adjusting for maternal age, maternal education, and parity for payer, race/ethnicity, and rural/urban residence. Results: Mothers with a Medicaid-covered birth had 0.90 times fewer prenatal care visits and were 1.26 times more likely to have fewer than the recommended number of visits, 1.60 times more likely to initiate prenatal care late, and 1.46 times more likely to have reported no prenatal visits at all. Number of prenatal care visits was lower for all racial/ethnic groups relative to white mothers and for mothers living in rural areas. The largest differences were for Native Hawaiian and Pacific Islander (NHPI) mothers, who reported almost half the number of visits (ARR = 0.67, 95 % CI [0.64, 0.70]). Having no prenatal care was more prevalent among NHPI (ARR = 3.68, 95 % CI [2.66, 5.10]) and Black (ARR = 1.47, 95 % CI [1.34, 1.61]) mothers. Racially/ethnically minoritized groups were more likely to have late prenatal care and fewer than the recommended number of prenatal visits, with the greatest difference for NHPI. Conclusions: Findings document disparities in prenatal care utilization related to payer, race/ethnicity, and rural/urban residence.

Tao Li, Linlin Wang

IntroductionAs China confronts rapid population ageing and rising demand for older people’s care, the establishment of a comprehensive long-term care insurance system has become an important institutional innovation. This study explores whether and how the implementation of the long-term care insurance pilot policy affects urban household consumption, a key component of domestic demand.MethodsThis study employs a Difference-in-Differences approach based on panel data from 232 prefecture-level and above cities in China between 2011 and 2018 to identify the causal effect of the long-term care insurance pilot. The analysis further investigates the underlying mechanisms, including the expansion of public healthcare services, the enhancement of urban innovation capacity, and the improvement of wage levels. It also examines heterogeneity across different city types and spatial spillover effects.ResultsEmpirical evidence suggests that the implementation of the long-term care insurance pilot has a statistically significant positive impact on urban residents’ consumption, increasing it by 7.35 per cent, equivalent to approximately 206.14 yuan. This effect is primarily driven by the reduction in informal care burdens, the rise in labour market participation, improved accessibility of medical services, and the enhanced application of technology in the care industry. The impact is more pronounced in cities with net population inflows and broader pilot coverage. Specifically, the introduction of the long-term care insurance raises urban residents’ consumption by 8.22 per cent and 8.44 per cent in these cities, corresponding to 240.82 yuan and 236.68 yuan respectively, whereas such effects are not evident in cities with population outflows or narrower pilot coverage. Furthermore, the policy exhibits a notable spatial spillover effect, increasing the consumption levels of neighbouring non-pilot cities by up to 9.86 per cent, approximately 275.16 yuan.DiscussionThese findings highlight the economic significance of long-term care system reform. Beyond meeting the care needs of an ageing population, the long-term care insurance pilot serves as a policy tool to stimulate consumption, promote employment, and narrow regional disparities. The spatial spillover effects suggest that scaling up the program may generate broader regional benefits, providing valuable insights for the further development of China’s care system and social security reform.

Blaise R. Boles, Matthew J. Thoendel, Pradeep K. Singh

David Card, Carlos Dobkin, Nicole Maestas

M. Halpern, E. Ward, A. Pavluck et al.

Roba Bairakdar, Debbie Dupuis, Melina Mailhot

Insurance risk arising from catastrophes such as earthquakes a component of the Minimum Capital Test for federally regulated property and casualty insurance companies. Analyzing earthquake insurance risk requires well-fitted spatio-temporal point process models. Given the spatial heterogeneity of earthquakes, the ability to assess whether the fits are adequate in certain locations is crucial in obtaining usable models. Accordingly, we extend the use of Voronoi residuals to calculate deviance Voronoi residuals. We also create a simulation-based approach, in which losses and insurance claim payments are calculated by relying on earthquake hazard maps of Canada. As an alternative to the current guidelines of OSFI, a formula to calculate the country-wide minimum capital test is proposed based on the correlation between the provinces. Finally, an interactive web application is provided which allows the user to simulate earthquake damage and the resulting financial losses and insurance claims, at a chosen epicenter location.

Alice Saebom Kwak, Cheonkam Jeong, Ji Weon Lim et al.

This paper introduces a Korean legal judgment prediction (LJP) dataset for insurance disputes. Successful LJP models on insurance disputes can benefit insurance companies and their customers. It can save both sides' time and money by allowing them to predict how the result would come out if they proceed to the dispute mediation process. As is often the case with low-resource languages, there is a limitation on the amount of data available for this specific task. To mitigate this issue, we investigate how one can achieve a good performance despite the limitation in data. In our experiment, we demonstrate that Sentence Transformer Fine-tuning (SetFit, Tunstall et al., 2022) is a good alternative to standard fine-tuning when training data are limited. The models fine-tuned with the SetFit approach on our data show similar performance to the Korean LJP benchmark models (Hwang et al., 2022) despite the much smaller data size.

Dragan M. Vučković

Raketa AIM-174, nova varijanta rakete SM-6; Ruski raketni sistem Rubež-M

Ezzat A. Ismail, Shaimaa A. Shehata, Ahmed M. Fouad et al.

Abstract Background The usage and implementation of telemedicine by urologists to diagnose, treat, mentor, and prevent diseases have grown worldwide. Numerous clinical, legal, and ethical issues are addressed by this practice. This is a cross-sectional study based on an anonymous online questionnaire, aimed to assess the current urologists’ knowledge and attitude towards telemedicine use in Egypt. A total of 108 Egyptian urologists filled out the questionnaire which included sociodemographic data, urologist knowledge, attitude regarding telemedicine, and common concerns and barriers. Results Out of the total sample, 75.9% of participants did not use telemedicine modalities until COVID-19 pandemic. Nearly 66.7% of participants did not receive formal medicolegal training on using telemedicine. About 62% of participants used personal accounts on social media, and 73.1% of teleconsultations were to assess radiological and laboratory data. Several concerns were highlighted such as possible malpractice risks (79.6%), defamation (72.2%), and keeping patient records (71.3%). Urologists raised many considerable barriers regarding telemedicine, such as lack of patient technology skills (84.3%), absence of regulations or laws (76.9%), insurance reimbursement (57.4%), and lack of administrative support (53.7%). Most of the participants have a positive impression of the advantages of tele-urology. There was a statistically significant difference between the number of cases seen per week and positive total attitude score. Conclusions Although most participants practiced telemedicine, many obstacles were highlighted through the study. Ignoring legal, ethical, personal, and patient issues may also jeopardize the future of telemedicine. Well-established health policies, formal education, and the implementation of regulated laws of telemedicine are fundamental.

I GUSTI AYU VIDYARA VRAJESHVARI, I NYOMAN WIDANA, NI KETUT TARI TASTRAWATI

Education insurance is an insurance product that provides financial protection for the continuity of a child's education. It offers certainty in funding a child's education. This research utilizes secondary data from the Mortality Table Indonesia IV 2019 and illustration data from an educational insurance policy offered by an insurance company. The data analysis method involves the use of Python programming language, and the steps include determining the Mortality Table for joint life insurance, creating a model to calculate the annual premium and policy value based on the contract specified in the policy, developing software to calculate the premium and policy value using the generated model, and determining the premium and policy value using the software. The aim of this research is to determine  the effect of changes in interest rate on the volicy value. Based on the case study and using the developed software, it is found that the premium price and policy value of education insurance will change when the interest rates change. The premium price will decrease, and the policy value will be smaller when the interest rates increase.

Constance Bordet, Mahmoud Zureik, Yoann Zelmat et al.

Introduction: Previous studies have identified an interaction between protein kinase inhibitors (PKIs) and proton pump inhibitors (PPIs) in patients with lung cancer. This type of interaction may reduce the efficacy of PKIs. However, the effect of PKI-PPI interaction on patient mortality remains controversial. This study set out to determine the impact of PKI-PPI interaction on overall survival for lung cancer patients. Materials and methods: This study was conducted using data from the French National Health Care Database from January 1, 2011 to December 31, 2021. We identified patients with: (i) an age equal to or greater than 18 years; (ii) lung cancer; and (iii) at least one reimbursement for one of the following drugs: erlotinib, gefitinib, afatinib and osimertinib. Patients were followed-up between the first date of PKI reimbursement and either December 31, 2021 or if they died, the date on which death occurred. The cumulative exposure to PPI duration during PKI treatment was calculated as the ratio between the number of concomitant exposure days to PKI and PPI and the number of exposure days to PKI. A survival analysis using a Cox proportional hazards model was then performed to assess the risk of death following exposure to a PKI-PPI interaction. Results: 34,048 patients received at least one reimbursement for PKIs of interest in our study: 26,133 (76.8 %) were exposed to erlotinib; 3,142 (9.2 %) to gefitinib; 1,417 (4.2 %) to afatinib; and 3,356 (9.9 %) to osimertinib. Patients with concomitant exposure to PKI-PPI interaction during 20 % or more of the PKI treatment period demonstrated an increased risk of death (HR, 1.60 [95 % CI, 1.57–1.64]) compared to other patients. When this cut-off varied from 10 % to 80 %, the estimated HR ranged from 1.46 [95 % CI, 1.43–1.50] to 2.19 [95 % CI, 2.12–2.25]. Discussion/Conclusion: In our study, an elevated risk of death was observed in patients exposed to PKI-PPI interaction. Finally, we were able to identify a dose-dependent effect for this interaction. This deleterious effect of osimertinib and PPI was revealed for the first time in real life conditions.

Eduardo Cavallo, E. Borensztein, Patricio Valenzuela

Natural disasters are an important source of vulnerability in the Caribbean region. Despite being one of the more disaster-prone areas of the world, it has the lowest levels of insurance coverage. This paper examines the vulnerability of Belizes public finance to the occurrence of hurricanes and the potential impact of insurance instruments in reducing that vulnerability. The paper finds that catastrophic risk insurance significantly improves Belizes debt sustainability. In addition, the methodology employed makes it possible to estimate the appropriate level of insurance, which for the case of Belize is a maximum coverage of US$120 million per year. International organizations can play a role in assisting countries to overcome distortions in insurance markets, as well as in helping to relax internal political resistance to the purchase of insurance policies.