Hasil untuk "Insurance"

James M. Bourey

In order to avoid unnecessary costs when you seek health care services, it’s important to be familiar with your health insurance policy. Read your health insurance policy carefully so that you know what your plan covers and does not cover, and which doctors, hospitals, and pharmacies are in your insurance plan’s network. If you are enrolled in U-M’s International Student/Scholar Health Insurance Plan (Blue Care Network), visit the U-M International Center's Health Insurance [1] section for more information. Review the Benefits and Wellness section of the U-M Human Resources website if you are enrolled in GradCare [2] or in one of U-M’s faculty/staff health insurance plans [3]. If you have a different insurance plan, consult that plan’s website.

David Lefutso, Abiodun A. Ogundeji, Gideon Danso-Abbeam et al.

Flood risk in South Africa remains a problem due to climate change, rapid urbanisation and persistent disparities in the region and low-income urban households are disproportionately impacted because of poor access to affordable flood insurance. This paper constructs the Integrated Market Flood Risk Insurance Framework (IMFRIF) based on a qualitative, desk-based research design consisting of contextual policy analysis, systematic literature review and analytical synthesis through systems thinking. The policy and document analysis reviewed the legislation on national disaster management, insurance and industry reports to determine institutional and market limitations on the provision of flood insurance. A PRISMA-ScR systematic literature review filtered 312 records on Scopus, Web of Science, and Google Scholar, which led to the identification of 47 peer-reviewed articles and 15 policy and comparative case studies. Thematic analysis led to the identification of six prevailing clusters of barriers based on the influence on insurance uptake, which included affordability and product design, trust and risk perception, data and risk assessment gaps, regulatory capacity, multi-stakeholder coordination, and community engagement. The results of these studies were used to design the IMFRIF, a system incorporating 9 major stakeholder groups and 5 interdependent system components into a single market-based design. The framework provides a systematic foundation to the resolution of systemic exclusion of flood insurance, but specifically acknowledges the implementation limitations regarding data availability, regulation capacity, fiscal sustainability and communal level of trust. The IMFRIF is placed as a progressive and responsive system that offers a point of future empirical confirmation and policy implementation to promote inclusive disaster risk financing in South Africa and comparable low- and middle-income contexts.

Yimer Seid Yimer, Ahmed Ali Ahmed, Adamu Addissie et al.

Abstract Background It’s crucial for individuals with diabetes to practice effective self-management to reach their treatment goals and to prevent complications. Aim This study aimed to explore needs and challenges in diabetes self-management for patients with type 2 diabetes (T2D) and healthcare providers in Addis Ababa, Ethiopia, between February and April 2023. Methods This study employed a mixed method approach, with an exploratory qualitative study, including in-depth interviews with 22 patients with diabetes and key informant interviews with 25 healthcare providers. Additionally, we conducted a quantitative assessment of 26 primary health care facilities to understand facility-related factors that impact diabetes self-management practices. Thematic analysis was performed using a deductive coding approach following the socioecological model, with the help of Open Code software. Findings This study revealed that poor diabetes self-management practices are a major risk factor for blood glucose control among patients with type 2 diabetes. Patients struggled with misconceptions, low health literacy, dietary preferences, a lack of glucometers, financial constraints, age-related issues, and comorbidities. Healthcare system factors included insufficient trained staff, the absence of health insurance coverage, inadequate diabetes education, the scarcity of educational resources, and limited access to affordable diagnostic facilities. At the community level, a lack of social support, self-stigma, religious fasting practices, and restricted access to diverse food options were prominent obstacles. Patients expressed preferences for accessible educational materials such as pamphlets, mobile messages, and localized TV programs. Healthcare providers emphasized the necessity for culturally appropriate guidelines tailored to local contexts, emphasizing patient understanding and personalized care. Conclusions This study found that inadequate diabetes self-management practices are the risk behaviours for poor blood glucose control in patients with T2D and these issues are associated with challenges at the patient, organizational, and community levels. This study highlights the need for tailored diabetes self-management programs in Ethiopian primary healthcare, considering local contexts, diabetes health literacy, participant demographics, and evolving patient needs.

Martha Burla, Brocha Z Stern, Andrew BL Berry et al.

Abstract BackgroundProviding patients with information about their health and treatment options is important to ensure care that best reflects patient needs, values, and preferences. Patient-reported outcomes (PROs), measures of health status, are regularly collected in clinical contexts and scores can be returned to patients in personalized decision aids. One example of a PRO-based decision aid is the Arthritis care through Shared Knowledge (ASK) report, which shares individual PRO data on knee and hip arthritis–related pain and functional limitations with patients. However, given that the use of such data in clinical consultations is unfamiliar to many patients, support may be required to ensure this information is understood and used as intended. ObjectiveThis paper describes ASK coaching, an online 1-hour group session designed to ensure patients understood the ASK report, including their PRO scores, and how to use the information in conversations with their clinicians. We present (1) quantitative evaluation results associated with attendance and self-assessment of learning and (2) qualitative evaluation results on motivation to attend, acceptability of the session format, and achievement of session goals. MethodsThe session was designed and refined collaboratively with clinical experts and patient advisers. Patients in one arm of a pragmatic cluster-randomized trial evaluating the ASK report were invited to attend this session. To understand the profile of attendees (N=438) sociodemographic and clinical data were compared with all participants invited to coaching (N=1545) and a patient-reported assessment of self-efficacy was collected on a subset (N=692). In addition, a postsession survey was used to self-assess learning. Qualitative data were synthesized from semistructured postcoaching interviews, paired pre- and postcoaching interviews, and free-text responses to a postsession survey. A qualitative descriptive approach was used for analysis. ResultsCompared with nonattendees, patients reporting higher education, greater health literacy, Medicare insurance, and lower self-efficacy for managing treatments were more likely to attend ASK coaching when invited. Participants’ self-assessment of learning showed an improved understanding of current and projected osteoarthritis symptoms and where to find additional information. Qualitatively, patients reported attending coaching to gain information that could benefit their treatment or aid in research. The online group format was generally described as acceptable, and the session goals related to understanding the report and preparing for future conversations with clinicians were met. Suggestions for improvement, such as providing more opportunities for within-group interaction, were also provided. ConclusionsOur results highlight the value of coaching as an intervention to help patients understand and use novel health information, including PRO data, in conversations with clinicians. Given that it was well-liked by patients, promoting a greater understanding of the PRO-based ASK report, and increased feelings of preparedness for clinical consultation, coaching appears to be a promising intervention to support patients in understanding and using their personal health data.

Stephen Cusack

Large variations of European storm activity at decadal and longer timescales have been found to be driven by major tropical volcanic eruptions, internal climate variability and anthropogenic aerosols (AA). The insurance industry have the ability to align with these slow fluctuations in windstorm risk, yet have not done so, due to uncertainty in how the climate diagnostics used by researchers relate to insured losses. A key aim of this study was to link past research findings to insurance applications by measuring the impacts of AA on European property damage. This was done by extracting the winds from a set of climate model experiments on AA forcing and converting them into European storm losses using an established technique. The multimodel mean result indicates AA boosted insured windstorm losses by 45% in the late 20th century relative to preindustrial times, though model changes range from zero to a doubling of losses and suggest large uncertainty in the size of the strengthening. Further analysis of individual model simulations suggested both AA and internal climate variability explain about half of the amplitude of the last peak, implying a significant role for volcanic eruptions. Looking ahead, we cannot be sure of the timing of the next peak since it may require at least one major volcanic eruption, but climate models provide encouraging signs that recent cuts in AA emissions from North America and Europe will act to reduce its severity.

Volodymyr Koval, Lesia Skurinevska, Denys Mykhailovskyi

Мета роботи: розроблення методики оцінювання ефективності та результативності програми розвитку Збройних Сил України. Метод дослідження: програмно-цільовий метод оцінки програм, метод аналізу ієрархій, аналітичний метод, шкала бажаності Харінгтона. Результати дослідження: розроблена методика враховує різну пріоритетність часткових показників оцінювання ефективності та результативності заходів програми розвитку, ієрархічну залежність та множину складових стратегічних цілей, підцілей (завдань) та заходів, їх рівноважливість під час реалізації програми розвитку та дозволяє отримати кількісну та якісну оцінку ефективності та результативності реалізації програми розвитку. Тип статті: теоретична.

Kiran Sohail Azeemi, Shifa Salman Habib, Waqas Hameed et al.

Objective:This study aims to assess perceived quality of care among users of hospitals empanelled under SCP Programme, KP. Methods: The assumed satisfaction level was 80% among SCP users, and 10%-point lower satisfaction among SCP nonusers. With a design effect of 1.5, 95% confidence level, and 80% power, the estimated total sample size was 972 patients, with equal group sizes of SCP users and SCP non-users. However, a total of 1,006 patients were included in the study, of which 517 were SCP users and 489 were non-SCP users. Total samples were distributed across 38 facilities in KP, proportional to average monthly admissions at each sampled facility. The data collection tool included 18 indicators of perceived quality of care, spread across 6 domains. Results:The overall satisfaction level with the quality of care among SCP users was found higher, 81%, relative to non-users, 79% (p<0.001). Disaggregated analysis across the study domains showed that the SCP non-users expressed higher perception about quality of hospital infrastructure and amenities relative to SCP users, whereas SCP users reported higher satisfaction with promptness of service, healthcare provider conduct, healthcare provider communication and quality of health service delivery. Only 326 (63%) users and 299 (61%) non-users were satisfied with healthcare provider communication. A total of 344 (67%) SCP users reported that Sehat Card Desk Representative gave them complete information about benefits and services under the programme. Conclusions: The SCP users reported high perceived quality of care. Further in-depth qualitative assessment is recommended to explain these findings. Keywords: Social health insurance, Quality of care, Sehat Card Plus Programme, Patient satisfaction, Khyber Pakhtunkhwa

Mona Ibrahim Abouzeid, Mohamed Gamal Elsehrawy, Maha Mahmoud Saadoon et al.

Background: Intravenous complications, especially pediatric IV infiltration, are common in pediatric departments because such complications occur more frequently in children than in adults. Aim: To investigate the pediatric nurses’ performance enhancement regarding the management of Pediatric IV infiltration. Subjects and Method: A quasi-experimental study was conducted. The study was carried out at Pediatric and Neonatal Intensive Care Units in Port Said Universal Health Insurance Hospitals. Data was collected from 50 pediatric nurses by using the Pediatric Nurses’ Knowledge Assessment Questionnaire and an observational checklist schedule for nurses’ practice before and after the implementation of an educational program regarding intravenous infiltration management. Results: No statistically significant relationship between pediatric nurses’ knowledge before and after the program, while a statistically significant relation was evidenced between their practice before and after the program. Conclusion: the educational program was effective for pediatric nurses’ performance by increasing their knowledge and improving their practice, with only a statistically significant difference between nurses’ practice before and after the program. Recommendations: The educational program should be periodically conducted for pediatric nurses to enhance their performance to achieve high-quality nursing care for pediatric patients.

Andreas Pinter, Ahmed M. Soliman, Karina C. Manz et al.

Abstract Background Biologics are therapeutic options for the management of moderate−severe plaque psoriasis. Some patients need to switch biologic treatment to achieve satisfactory outcomes, which might have a considerable economic impact. Objectives We assessed the characteristics and switch rates of patients with plaque psoriasis initiating biologic treatment and compared healthcare resource utilization (HCRU) and associated costs for switching and non‐switching. Methods This study was a retrospective claims‐based analysis comprising a 182‐day baseline period to identify patient characteristics and a 365‐day follow‐up to assess switch rates, HCRU and associated costs. Data covering claims activity from 2016 to 2021 in a representative sample of four million individuals with statutory insurance in Germany was used. Results We identified 2565 patients with psoriasis initiating biologic treatment with anti‐IL‐17 (n = 1037), anti‐IL‐23 (n = 704), anti‐TNF‐α (n = 583) and anti‐IL‐12/23 (n = 241) agents. A total of 9.2% of patients switched therapy to another biologic during follow‐up, ranging from 4.9% (secukinumab) to 16.5% (etanercept). The probability of treatment switching was significantly lower in patients treated with risankizumab (p < 0.05) than in patients treated with other biologics except guselkumab (p = 0.14). HCRU and associated costs during the follow‐up were generally higher with a therapy switch (all‐cause: 32,263 ± 15,381€) than without (25,041 ± 12,090€). This applied to direct costs (outpatient services, hospitalization, drug treatment) and indirect costs (sickness benefits). Drug treatment accounted for the largest share of costs. Conclusions Treatment switching is frequent in patients with moderate−severe plaque psoriasis initiating biologic therapy and is associated with increased HCRU and associated costs. As the probability that a switch occurs within 365 days after treatment initiation widely differs between biologic agents, further research is warranted to determine the underlying reasons for switching to help establish clinically and economically sound therapy sequences.

Claudia M. Peixoto, Diego Marcondes, Mariana P. Melo et al.

The rise in healthcare costs has led to the adoption of cost-sharing devices in health plans. This article explores this discussion by simulating Health Savings Accounts (HSAs) to cover medical and hospital expenses, supported by catastrophic insurance. Simulating 10 million lives, we evaluate the utilization of catastrophic insurance and the balances of HSAs at the end of working life. To estimate annual expenditures, a Markov Chains approach - distinct from the usual ones - was used based on recent past expenditures, age range, and gender. The results suggest that HSAs do not create inequalities, offering a viable method to sustain private healthcare financing for the elderly.

Ziyue Shi, David Landriault, Fangda Liu

In the literature, insurance and reinsurance pricing is typically determined by a premium principle, characterized by a risk measure that reflects the policy seller's risk attitude. Building on the work of Meyers (1980) and Chen et al. (2016), we propose a new performance-based variable premium scheme for reinsurance policies, where the premium depends on both the distribution of the ceded loss and the actual realized loss. Under this scheme, the insurer and the reinsurer face a random premium at the beginning of the policy period. Based on the realized loss, the premium is adjusted into either a ''reward'' or ''penalty'' scenario, resulting in a discount or surcharge at the end of the policy period. We characterize the optimal reinsurance policy from the insurer's perspective under this new variable premium scheme. In addition, we formulate a Bowley optimization problem between the insurer and the monopoly reinsurer. Numerical examples demonstrate that, compared to the expected-value premium principle, the reinsurer prefers the variable premium scheme as it reduces the reinsurer's total risk exposure.

Aleksandar Arandjelović, Julia Eisenberg

We consider an insurance company which faces financial risk in the form of insurance claims and market-dependent surplus fluctuations. The company aims to simultaneously control its terminal wealth (e.g. at the end of an accounting period) and the ruin probability in a finite time interval by purchasing reinsurance. The target functional is given by the expected utility of terminal wealth perturbed by a modified Gerber-Shiu penalty function. We solve the problem of finding the optimal reinsurance strategy and the corresponding maximal target functional via neural networks. The procedure is illustrated by a numerical example, where the surplus process is given by a Cramér-Lundberg model perturbed by a mean-reverting Ornstein-Uhlenbeck process.

Emel Savku

We develop an approach for two-player constraint zero-sum and nonzero-sum stochastic differential games, which are modeled by Markov regime-switching jump-diffusion processes. We provide the relations between a usual stochastic optimal control setting and a Lagrangian method. In this context, we prove corresponding theorems for two different types of constraints, which lead us to find real-valued and stochastic Lagrange multipliers, respectively. Then, we illustrate our results for a nonzero-sum game problem with the stochastic maximum principle technique. Our application is an example of cooperation between a bank and an insurance company, which is a popular, well-known business agreement type called Bancassurance.

Alli Noah Gbenga, Afolabi Mutiu Adeniyi

An annuity is a way of transferring longevity risk from an individual to an insurance company, which can pool risk among many individuals and achieve greater diversification of risk than can be accomplished by any individual. Annuity premiums build capital for insurance companies and encourage technical innovation and progress, while the benefits paid to annuitants are beneficial to them in the and, in turn, helps with the economies of large-scale production and increases specialization, which helps to accelerate labour profuctivity and increase GDP. This paper examines the impact of annuities on economic development in Nigeria. Annuities provide longevity risk protection and retirement income security. The study aims to determine the impact of annuity premiums paid by workers and annuity benefits paid to retirees on Nigeria's economic development, as measured by real GDP. An ex-post facto research design is adopted using secondary data from 2014-2020. Two hypotheses are tested using regression analysis. The first hypothesis postulates that annuity premiums do not have significant impact on economic development. The second hypothesis postulates that there is no significant effect of annuity benefits on economic development. The results reject both null hypotheses at the 5 % significance level. Annuity premiums positively and significantly (p = 0.013) affect economic development. This occurs as premiums create capital formation for insurance firms to make productivity-enhancing investments. However, annuity benefits negatively and significantly (p = 0.0027) affect development, likely indicating funds withdrawn from the economy. Recommendations include the establishing structures to develop annuity products and markets to address the problems of the decumulation phase. In addition, it is advisable to increase investment in annuity premiums and to monitor the payout ratio of annuities. The empirical analysis provides useful insights, but future research should explore long-term macroeconomic effects.

Yuriy Veklenko, Mykola Dorofeev, Tetiana Fitsailo et al.

Мета роботи: впровадження методики  оцінки балістичних характеристик (випробувань, дослідних стрільб) мінометних пострілів іноземного виробництва для складання скорочених тимчасових таблиць стрільби для мінометів різних виробників за результатами дослідних стрільб на артилерійській директрисі. Метод дослідження: системного аналізу, математичної статистики. Результати дослідження: за результати проведених практичних стрільб по методиці щодо визначення оцінювання балістичних характеристик мінометних пострілів на створеній балістичній трасі були отримані точні, розгорнуті дані які наведені вище за допомогою яких було здійснено розрахунок таблиць стрільби. Теоретична цінність дослідження: обумовлена тим, що створення сучасних артилерійських систем (засобів) вогневого ураження, розробка удосконалення (модернізація) існуючих боєприпасів, складання відповідних таблиць стрільби потребує практичного проведення стрільб, методика яких описана в даній статті. Тип статті: науково-практична.

Shenglan Ma, Junlin Huang

The coupling coordination mechanism between economic resilience and high-quality economic development is clarified not only to improve the capacity of economies to withstand external shocks but also to boost the level of sustainable economic development. However, economic resilience and economic quality research are still in their infancy. This study constructs an economic resilience indicator system based on the data of 28 prefecture-level cities in the urban agglomeration in the middle reaches of the Yangtze River (UAMRYR) from 2010-2019. The entropy approach was then coupled with the coupling coordination model to determine the level of coupling coordination between the two. Finally, the geographical detector was employed to reveal the coupling coordination process and driving elements. This study demonstrates that: (1) The economic resilience and high-quality economic development of the UAMRYR are on the rise; (2) The coupling coordination degree between economic resilience and high-quality economic development is improving, with the average value increasing from 0.33 in 2010 to 0.46 in 2019, exhibiting a Core-Periphery spatial distribution pattern with Wuhan, Changsha, and Nanchang as the core; (3) The economic resilience resistance subsystem plays a substantial role in the driving influence of the coupling coordination degree, where the total retail sales of consumer goods indicator have an explanatory power of 0.8 or higher for coupled coordination. Innovation and inclusiveness thoroughly drive the coupling coordination degree among the five subsystems of high-quality economic development, where the q-value of the number of urban basic endowment insurance participants index is at least 0.9. Additionally, the interplay of the components demonstrates a complementary enhancement impact and a two-factor enhancement effect; (4) Economic resilience and high-quality economic development are complementary and provide a powerful incentive for the sustainable development of urban economic systems to achieve higher quality, more efficient, more egalitarian, and more sustainable economic development. Overall, this study improves the analysis of mechanism between economic resilience and high-quality economic development, and it provides more targeted guidance for economic development in the UARMRYR.

David R. Baños, Salvador Ortiz-Latorre, Oriol Zamora Font

The main purpose of the paper is to derive Thiele's differential equation for unit-linked policies in the Heston-Hawkes stochastic volatility model introduced in arXiv:2210.15343. This model is an extension of the well-known Heston model that incorporates the volatility clustering feature by adding a compound Hawkes process in the volatility. Since the model is arbitrage-free, pricing unit-linked policies via the equivalence principle under a risk neutral probability measure is possible. Studying the moments of the variance and certain stochastic exponentials, a suitable family of risk neutral probability measures is found. The established and practical method to compute reserves in life insurance is by solving Thiele's equation, which is crucial to guarantee the solvency of the insurance company.

Levon Barseghyan, Francesca Molinari

We provide sufficient conditions for semi-nonparametric point identification of a mixture model of decision making under risk, when agents make choices in multiple lines of insurance coverage (contexts) by purchasing a bundle. As a first departure from the related literature, the model allows for two preference types. In the first one, agents behave according to standard expected utility theory with CARA Bernoulli utility function, with an agent-specific coefficient of absolute risk aversion whose distribution is left completely unspecified. In the other, agents behave according to the dual theory of choice under risk(Yaari, 1987) combined with a one-parameter family distortion function, where the parameter is agent-specific and is drawn from a distribution that is left completely unspecified. Within each preference type, the model allows for unobserved heterogeneity in consideration sets, where the latter form at the bundle level -- a second departure from the related literature. Our point identification result rests on observing sufficient variation in covariates across contexts, without requiring any independent variation across alternatives within a single context. We estimate the model on data on households' deductible choices in two lines of property insurance, and use the results to assess the welfare implications of a hypothetical market intervention where the two lines of insurance are combined into a single one. We study the role of limited consideration in mediating the welfare effects of such intervention.

Wei Tian

Policy evaluation in empirical microeconomics has been focusing on estimating the average treatment effect and more recently the heterogeneous treatment effects, often relying on the unconfoundedness assumption. We propose a method based on the interactive fixed effects model to estimate treatment effects at the individual level, which allows both the treatment assignment and the potential outcomes to be correlated with the unobserved individual characteristics. This method is suitable for panel datasets where multiple related outcomes are observed for a large number of individuals over a small number of time periods. Monte Carlo simulations show that our method outperforms related methods. To illustrate our method, we provide an example of estimating the effect of health insurance coverage on individual usage of hospital emergency departments using the Oregon Health Insurance Experiment data.