Hasil untuk "Insurance"

Hanan G. Jacoby, E. Skoufias

Аndrii Bochkovskyi, Nаtalia Sapozhnikova, Valentina Purich et al.

Мета. Визначити проблеми, що зумовлюють неможливість надання ефективної медичної допомоги постраждалому від нещасних випадків на виробництві на місці виникнення інциденту та визначення напрямів щодо їх вирішення. Методи. Аналіз статистичних даних щодо кількості та динаміки випадків виникнення виробничого травматизму та нормативно-правових актів з порядку надання домедичної допомоги потерпілим, а також інших нормативно-правових документів – для визначення та актуалізації проблеми дослідження, а також визначення напрямів її вирішення. Результати. Встановлено актуальні проблеми, що унеможливлюють надання якісної та швидкої домедичної допомоги постраждалим від нещасного випадку або професійного отруєння безпосередньо на місці виникнення інциденту. Розроблено напрями їх вирішення, що передбачають впровадження обов’язкового набуття теоретичних знань та практичних навичок з надання домедичної допомоги у закладах освіти, удосконалення порядку навчання та перевірки знань з питань охорони праці в організаціях, необхідність унормування питань правового захисту особи, що надає домедичну допомогу постраждалому. Теоретична цінність. Обґрунтовано необхідність внесення змін в чинні стандарти освіти з метою забезпечення обов’язковості набуття знань та навичок з надання домедичної допомоги здобувачами освіти всіх спеціальностей, а також змін в чинне законодавство з питань правового захисту осіб, що надають домедичну допомогу потерпілим у невідкладних станах. Практична цінність. Результати проведених досліджень дозволять значно мінімізувати ризик для життя постраждалого, що знаходиться у невідкладному стані, за рахунок забезпечення можливості надання йому швидкої та якісної медичної допомоги безпосередньо на місці виникнення інциденту. Оригінальність. Розроблено напрями, реалізація яких дозволить підвищити рівень теоретичних знань та практичних навичок майбутніх фахівців та працівників з надання домедичної допомоги потерпілим та рівень правової захищеності осіб, які надають домедичну допомогу, що дозволить, в свою чергу, підвищити якість та швидкість надання домедичної допомоги безпосередньо на місці події та, відповідно, знизити ймовірність виникнення летальних випадків у постраждалого, за рахунок полегшення його стану та скорочення часу госпіталізації.

Alexandru STRATAN, Viorica LOPOTENCO, Liliana STAVER et al.

In the face of emerging challenges such as climate change, supply chain disruptions, increasing input prices, and neighbouring armed conflict, which the agricultural sector of the Republic of Moldova must address, enhancing the country's food security is a top priority. The paper examines the interconnection between the Republic of Moldova’s agri-food exports and food security insurance at the national level, to achieve a resilient agricultural sector for better future integration into the EU single market. The evidence presented in the article suggests that increasing the competitiveness of agri-food products at the international level through enhanced exports does not affect national food security, but should be observed carefully in light of significant climate changes that can cause additional issues for the sufficient supply of some basic products.

Shaokang Wang, Han Lin Shang, Leonie Tickle et al.

We introduce the function principal component regression (FPCR) forecasting method to model and forecast age-specific survival functions observed over time. The age distribution of survival functions is an example of constrained data whose values lie within a unit interval. Because of the constraint, such data do not reside in a linear vector space. A natural way to deal with such a constraint is through an invertible logit transformation that maps constrained onto unconstrained data in a linear space. With a time series of unconstrained data, we apply a functional time-series forecasting method to produce point and interval forecasts. The forecasts are then converted back to the original scale via the inverse logit transformation. Using the age- and sex-specific survival functions for Australia, we investigate the point and interval forecast accuracies for various horizons. We conclude that the functional principal component regression (FPCR) provides better forecast accuracy than the Lee–Carter (LC) method. Therefore, we apply FPCR to calculate annuity pricing and compare it with the market annuity price.

Alexandra Cathcart, Sharon M. Castellino, Heeju Sohn et al.

OBJECTIVES/GOALS: Racial/ethnic minoritized children experience poorer cancer outcomes, which may be driven by structural racism. We apply an index that combines segregation and neighborhood vulnerability to a pediatric oncology population and assesses its association with acuity of illness at initial presentation. METHODS/STUDY POPULATION: A retrospective analysis will be performed in a cohort of pediatric patients diagnosed with solid tumors at Children’s Healthcare of Atlanta (CHOA) from 2010-2018 (N=1149). The sample will be linked to a structural racism index (SRI) that has been established in our prior work. We abstract data from medical records to quantify initial acuity of illness based on the need for ICU-level resources. Differences in sociodemographic characteristics will be analyzed by the SRI, using chi-squared, Student t-tests, and ANOVA where appropriate. Logistic regression models will be used to assess the association of the SRI with acuity of illness. RESULTS/ANTICIPATED RESULTS: We anticipate that relevant sociodemographic characteristics (e.g., race/ethnicity, insurance status) differ by the SRI. The CHOA Cancer Registry includes a racially and ethnically diverse group of patients: 63% of the cohort is White, 30% is Black,10% are Other, and 15% are Hispanic/Latino. Furthermore, we anticipate that pediatric patients with solid tumors living in counties with greater levels of structural racism as measured by the SRI experience an increased acuity of illness at initial presentation. DISCUSSION/SIGNIFICANCE: By applying a novel index quantifying structural racism, we will provide new information about the structural barriers patients and families face prior to a pediatric cancer diagnosis. This work will allow us to identify areas for potential interventions in this vulnerable young patient population.

V. Bratiuk, M. Petrychko, A. Polak

The insurance market ensures the redistribution of risks in the economy, creates an environment favorable for the development of entrepreneurship, and reduces the level of risks in society. It is shown that the insurance market of Ukraine in 2022-2023, due to objective and subjective reasons (the COVID-19 pandemic, the "split" reform, and Russia's military aggression), went through the stages of crisis, adaptation, recovery, and development. The author analyzes the current state, financial indicators, and dynamics of the insurance market indicators in 2020-2023. The impact of the COVID-19 pandemic and the "split" reform on the insurance market indicators is investigated. The inexpediency of the events of the cumulative impact of several crisis factors on the insurance market, in particular the "split" reform during the COVID-19 pandemic, is shown. It is found that the number of insurers in the Ukrainian insurance market in 2020-2023 decreased from 215 to 111 companies. Note that Ukrainian insurers faced unprecedented challenges in a situation of military aggression, the main of which are the following: part of the offices of insurers operating in the east of Ukraine were damaged, destroyed or looted in the occupied territories; part of the workers suffered from shelling, joined the local territorial defense or joined the ranks of the Armed Forces of Ukraine; some of the workers have gone missing, some are in the occupied territories, have left the country, have become internally displaced persons; teams of insurers tried to organize work from bomb shelters, basements, parking lots, but they turned out to be technically unusable, without back-up power supply systems, and had no lines and means of digital communications. The author analyzes the performance of the insurance market during the military aggression in 2022-2023. It is shown that since the second quarter of 2023 there have been positive developments in terms of the resumption of insurers' activities in the main types of insurance, and there are trends in market development in terms of the number of contracts concluded and gross insurance premiums received. It was found that transport insurance (CASCO, MTPL, Green Card) and personal insurance (health, accident, life insurance) occupy the first two places in terms of insurance premiums: 36% and 27% respectively. The article performs a PEST-analysis of the problems and prospects of the insurance market development, showing that in the post-war period, a necessary condition for the development of the insurance market should be a policy of promoting and ensuring the reconstruction, development of insurers' sustainability, creation and implementation of new insurance products, and investment programs in the real sector of the economy

Maria Eugenia Fernandes Canziani, Jorge Paulo Strogoff-de-Matos, Murilo Guedes et al.

ABSTRACT Online hemodiafiltration (HDF) is a rapidly growing dialysis modality worldwide. In Brazil, the number of patients with private health insurance undergoing HDF has exceeded the number of patients on peritoneal dialysis. The achievement of a high convection volume was associated with better clinical imprand patient – reported outcomes confirming the benefits of HDF. The HDFit trial provided relevant practical information on the implementation of online HDF in dialysis centers in Brazil. This article aims to disseminate technical information to improve the quality and safety of this new dialysis modality.

Wanying Fu, Barry R. Smith, Patrick Brewer et al.

We construct a new age-specific mortality framework and implement an exemplar (DLGC) that provides an excellent fit to data from various countries and across long time periods while also providing accurate mortality forecasts by projecting parameters with ARIMA models. The model parameters have clear and reasonable interpretations that, after fitting, show stable time trends that react to major world mortality events. These trends are similar for countries with similar life-expectancies and capture mortality improvement, mortality structural change, and mortality compression over time. The parameter time plots can also be used to improve forecasting accuracy by suggesting training data periods and appropriate stochastic assumptions for parameters over time. We also give a quantitative analysis on what factors contribute to increased life expectancy and gender mortality differences during different age periods.

J. F. Lockwood, G. S. Guentchev, A. Alabaster et al.

<p>PRIMAVERA (process-based climate simulation: advances in high-resolution modelling and European climate risk assessments) was a European Union Horizon 2020 project whose primary aim was to generate advanced and well-evaluated high-resolution global climate model datasets for the benefit of governments, business and society in general. Following consultation with members of the insurance industry, we have used a PRIMAVERA multi-model ensemble to generate a European winter windstorm event set for use in insurance risk analysis, containing approximately 1300 years of windstorm data. The data are available at <a href="https://doi.org/10.5281/zenodo.6492182">https://doi.org/10.5281/zenodo.6492182</a>.</p> <p>To create the storm footprints for the event set, the storms in the PRIMAVERA models are identified through tracking. A method is developed to separate the winds from storms occurring in the domain at the same time. The wind footprints are bias corrected and converted to 3 <span class="inline-formula">s</span> gusts onto a uniform grid using quantile mapping. The distribution of the number of model storms per season as a function of estimated loss is consistent with re-analysis, as are the total losses per season, and the additional event set data greatly reduce uncertainty on return period magnitudes. The event set also reproduces the temporally clustered nature of European windstorms.</p> <p>Since the event set is generated from global climate models, it can help to quantify the non-linear relationship between large-scale climate indices such as the North Atlantic Oscillation (NAO) and windstorm damage. Although we find only a moderate positive correlation between extended winter NAO and storm damage in northern European countries (consistent with re-analysis), there is a large change in risk of extreme seasons between negative and positive NAO states. The intensities of the most severe storms in the event set are, however, sensitive to the gust conversion and bias correction method used, so care should be taken when interpreting the expected damages for very long return periods.</p>

Xue Lei and Li Yanping

Presently, the growth of residents’ consumption is slowing, which necessitates the expansion of domestic demand. Against this backdrop, research on the impact of pension insurance on the optimization of the consumption structure in rural areas not only facilitates the welfare of rural residents and improves their consumption structure but also boosts the sustainable and healthy development of the Chinese economy. This paper applies China Family Panel Studies (CFPS) micro data in 2018 and adopts Propensity Score Matching (PSM) to research the impact of China’s pension insurance system on the consumption structure in rural areas and its heterogeneity. This paper draws a conclusion at four levels. First, pension insurance effectively optimizes the consumption structure in rural areas, increases the current overall consumption level by 0.0024 percent, and objectively releases the consumption potential in rural areas. Second, participation in pension insurance enhances the overall consumption level of rural families in eastern China, central China, and northeastern China by 0.08 percent, 0.146 percent, and 0.0446 percent respectively, yet, that inhibits the overall consumption level of rural families in rural areas in western China by 0.1057 percent. Third, from eastern China to western China, with regard to pension insurance, as its impact on consumption shifts from a higher level to a lower level, its impact on the optimization of consumption structures sinks to a lower level. Fourth, in terms of major factors, age (older), matrimonial res (married), years of education (longer), health (poor), and the number of family members (small) contribute to the stronger willingness to participate in pension insurance

Richard A. Ruberto, BA, Eric A. Schweppe, BS, Rifat Ahmed, MS et al.

Background:. The coronavirus-19 (COVID-19) pandemic has prompted a shift in health-care provision toward implementation of telemedicine. This study investigated demographic information on orthopaedic telemedicine utilization at a single academic orthopaedic institution in an effort to identify factors associated with telemedicine usage. Methods:. Demographic and appointment data were collected from the electronic medical record during equivalent time periods prior to the onset of the COVID pandemic (pre-COVID) and during the COVID pandemic (peri-COVID). Multivariate analyses were performed to identify demographic and socioeconomic correlates of telemedicine utilization. Results:. There was a significant increase in telemedicine visits between the eras of study, with significant differences in telemedicine usage in association with age, sex, marital status, English as the primary language, and insurance type (p < 0.001). Multivariate analyses found American Indian/Alaska Native (adjusted odds ratio [aOR] = 0.487, p = 0.004), Black/African American (aOR = 0.622, p < 0.001), Native Hawaiian/other Pacific Islander (aOR = 0.676, p = 0.003), and Asian (aOR = 0.731, p < 0.001) race to be significantly associated with decreased telemedicine usage. Additionally, male sex (aOR = 0.878, p < 0.001) and a non-commercial insurance plan (p < 0.001) were significantly associated with decreased telemedicine usage. Conclusions:. Non-White race, non-commercial insurance plans, and male sex were associated with decreased telemedicine utilization. Further investigation is needed to characterize and better identify underlying factors contributing to disparities in telemedicine access and utilization.

Walaiporn Patcharanarumol, Viroj Tangcharoensathien, Aniqa Islam Marshall et al.

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

Dae Young Cheung, Byung Ik Jang, Sang Wook Kim et al.

The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency of its use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organs and contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopy procedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories which is feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. This guideline contains principles and instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updated knowledge about endoscopy-mediated infection and disinfection. Multiple societies and working groups participated to revise; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Association for the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nurses and Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication and established a better concordance. We still need more researches in this field and fill up the unproven area. And our guidelines will be renewed accordingly.

Maxwell Ayindenaba Dalaba, Paul Welaga, Abraham Oduro et al.

<h4>Background</h4>There is limited knowledge on cost of treating malaria in children under-five years in northern Ghana which poses a challenge in determining whether interventions such as the National Health Insurance Scheme (NHIS) and Community-based Health Planning and Services (CHPS) have reduced the economic burden of malaria to households or not. This study examined the malaria care seeking and cost of treatment in children under-five years in the Upper West Region of Ghana.<h4>Methods</h4>The study used a cross-sectional, quantitative design and data were collected between July and August 2016 in three districts in the Upper West Region of Ghana. A total of 574 women who had under-five children were interviewed. Socio-demographic characteristics of respondents, malaria seeking patterns for under-five children with malaria as well as direct medical and non-medical costs associated with treating under-five children with malaria were collected from the patient perspective. Analysis was performed using STATA 12.<h4>Results</h4>Out of 574 women visited, about 63% (360) had children who had malaria and sought treatment. Most treatment was done at formal health facilities such as the health centres (37%) and the CHPS (35%) while 3% had self-treatment at home. The main reason for choice of place of treatment outside home was nearness to home (53%). The average direct medical and non-medical costs associated with treating an under-five child with malaria were US$4.13 and US$3.04 respectively. The average cost on transportation alone was US$2.64. Overall, the average direct medical and non-medical cost associated with treating an under-five child with malaria was US$4.91(range: minimum = US$0.13 -maximum = US$46.75). Children who were enrolled into the NHIS paid an average amount of US$4.76 compared with US$5.88 for those not enrolled, though the difference was not statistically significant (p-value = 0.15).<h4>Conclusions</h4>The average cost to households in treating an under-five child with malaria was US$4.91. This amount is considerably high given the poverty level in the area. Children not insured paid a little over one US dollar for malaria treatment compared to those insured. Efforts to improve enrolment into the NHIS may be needed to reduce the cost of malaria treatment to households. Construction of more health facilities near to community members and at hard to reach areas will improve access to health care and reduce direct non-medical cost such as transportation costs.

Monika Klepacka, Paweł Bakalarski

INTRODUCTION: In Poland is equal access to the health care system, based on the insurance model. It consists of many institutions in which patients can benefit from health services. Help in pre-hospital and outpatient settings is usually performed by doctors, nurses and paramedics. The study is aimed at assessing confidence towards these selected three medical professions and indicating their the most important disadvantages and advantages. MATERIAL AND METHODS: The study was conducted among 109 randomly selected people, using the authorial questionnaire. To the statistical analysis was used Kruskal–Wallis test. All results were considered significant at p<0.05. RESULTS: The study was attended by 75 women and 34 men, the average age was 29.63 years (SD±15.62). The most people had contact with a doctor (n=109), and slightly less with a nurse (n=105) and with a paramedic (n=66). In terms of the level of social trust, paramedics was rated the highest (7.81 points, SD±1.84), and slightly below doctors (7.2 points, SD±1.89) and nurses (6.9 points; SD±2.23). The accuracy of diagnosis / therapy (43.1%, n=47) was considered the best advantage among the doctors, among nurses - good contact with the patient (57.8%, n=63), and among paramedics - manual skills (36.7%, n=40). The main disadvantages of physicians were wrong diagnosis and / or therapy (44%; n=48), among nurses - bad contact with the patient (37.6%, n=41), and among paramedics - a low level of knowledge (45%, n=49). There were no statistically significant differences between the three professional groups in terms of advantages (p = 0.957) and disadvantages (p = 0.995). CONCLUSIONS: The study showed that the greatest confidence have paramedics, then doctors and the smallest nurses. Also indicated the most important advantages and disadvantages of people performing selected medical professions.

D. Howard

Edgar Parker

After the 2008 financial collapse, Kritzman et al. 2010 introduced the now popular measure of implied systemic risk called the absorption ratio. This statistic is constructed from a fixed number of eigenvectors, and measures how closely the economy’s markets are coupled. The more closely financial markets are coupled the more susceptible they are to systemic collapse. Parker 2017 utilized information theory to develop the concept of entropic yield curve. From this equation, the implied information processing ratio or entropic efficiency of the economy can be derived. This entropic measure can also be useful in predicting economic downturns. In the current work, the relationship between these two ratios is explored.

E. Browning

D. Mayers, Clifford W. Smith

J. Outreville