Hasil untuk "Insurance"

Charles A. Wilson

K. Moene, M. Wallerstein

María Soledad Martínez Pería, S. Schmukler

D. Acemoglu, Daron Acemoglu, D. Acemoglu et al.

Albina de Fátima Fanni Santos, Carolina Dutra Degli Esposti, Ana Paula Santana Coelho Almeida

Objective: To identify the factors associated with the resolution of endodontic treatments in Brazilian municipalities with Brazilian Dental Specialty Centers (CEO). Material and Methods: Ecological study with 684 municipalities participating in the second cycle of the National Program for Improving Access and Quality of Specialty Dental Centers (PMAQ‑CEO) in 2018. Data were obtained from the health information systems of the Brazilian Unified Health System (SUS), the PMAQ-CEO, and additional sources. The dependent variable, resolution, was the ratio of completed endodontic treatments to endodontic access procedures. For the bivariate analysis, Pearson's chi-square test was applied, considering contextual and health system-related municipal factors as independent variables. These included the Municipal Human Development Index (MHDI), resident population size, national macro-region, dental insurance coverage, oral health team coverage, number of dentists affiliated with the SUS, coverage of initial dental consultations, existence of an Urgent Care Center, number of CEO, and PMAQ-CEO certification. Multivariate analysis was performed using ordinal logistic regression, adopting a two-level hierarchical model. Results: The median of the dependent variable was 0.33; that is, for every 10 teeth opened for pain relief due to deep dental caries, approximately 3 teeth had completed endodontic treatment. The adjusted analysis showed greater chance of resolution in municipalities with the following characteristics: Northeastern region (OR=1.9; 1.1-3.4); medium population size (OR=2.0; 104-2.9); second HDI-M quartile (OR=2.5; 1.6-4.0); lower dental plan coverage (OR=2.4; 1.5-4.0); classified as good, very good or excellent in the PMAQ-CEO certification (OR=1.4; 1.1-1.9). Conclusion: There was low resolution in endodontic treatments performed in SUS. Municipalities of both small and large sizes demonstrate greater fragility in care continuity, as reflected in a low proportion of completed endodontic treatments within the SUS.

Zirui Guo, Mingchen Yang, Hao Sun

Migrant workers in China often experience employment instability due to limited labor protection and restricted access to formal institutions, which undermines both job security and social integration. Although trade unions are expected to support workers’ employment, their role remains debated in the Chinese context. Using pooled data from the China General Social Survey (2010–2021), this study examines the effect of union participation on migrant workers’ employment by applying a treatment effect model. The results indicate that union membership is significantly associated with a higher likelihood of non-agricultural employment. Mechanism analyses suggest that unions improve employment outcomes by enhancing labor rights protection, promoting formal contracts, and expanding social insurance coverage, thereby reducing perceived employment uncertainty and strengthening labor market attachment. These findings suggest that union participation is associated with improved employment outcomes, potentially through institutional and psychological pathways. However, it is important to acknowledge that unions may also serve as markers of pre-existing formalized employment environments.

Simon D. Lindner, Herbert Oberacher, Karin Weyermair et al.

Wastewater-based epidemiology offers a comprehensive yet cost-effective way to monitor pathogen circulation. However, it is not entirely clear how wastewater signals can be reliably mapped to case numbers and therefore to incidence. Here, we aim to estimate the number of total SARS-CoV-2 infections including reported and unreported cases in Austria by analysing two different longitudinal wastewater datasets covering 113 wastewater treatment plants from October 2021 to October 2022. These plants cover most of the Austrian population, which had one of the highest per capita testing rates during the Coronavirus Disease 2019 (COVID-19) pandemic. We empirically find that the relationship between reported COVID-19 cases and viral load in wastewater is significantly influenced by the number of tests performed. Based on this observation, we developed a method for estimating total cases by scaling reported cases by test activity and accounting for periods when different viral variants were dominant. We find that the ratio of estimated total to reported cases increased substantially over time, from a value around 1.49 at the peak of the BA.2 wave to a value of 5.48 at the peak of the BA.5 wave, and validate these results in two datasets. Our results also suggest that there was less shedding per case in periods where BA.5 was dominant than in periods where BA.1 and BA.2 were dominant, which in turn showed less shedding than in periods dominated by the Delta variant. The results of this study provide critical insight into the potential of wastewater measurements to provide a more accurate assessment of the dynamics of infectious disease transmission.

Kathiresan Jeyashree, Jeromie W. V. Thangaraj, Devika Shanmugasundaram et al.

Abstract Background Tuberculosis (TB) poses a significant social and economic burden to households of persons with TB (PwTB). Despite free diagnosis and care under the National TB Elimination Programme (NTEP), individuals often experience significant out-of-pocket expenditure and lost productivity, causing financial catastrophe. We estimated the costs incurred by the PwTB during TB care and identified the factors associated with the costs. Methods In our cross-sectional study, we used multi-stage sampling to select PwTB notified under the NTEP, whose treatment outcome was declared between May 2022 and February 2023. Total patient costs were measured through direct medical, non-medical and indirect costs. Catastrophic costs were defined as expenditure on TB care > 20% of the annual household income. We determined the factors influencing the total cost of TB care using median regression. We plotted concentration curves to depict the equity in distribution of catastrophic costs across income quintiles. We used a cluster-adjusted, generalized model to determine the factors associated with catastrophic costs. Results The mean (SD) age of the 1407 PwTB interviewed was 40.8 (16.8) years. Among them, 865 (61.5%) were male, and 786 (55.9%) were economically active. Thirty-four (2.4%) had Drug Resistant TB (DRTB), and 258 (18.3%) had been hospitalized for TB. The median (Interquartile range [IQR] and 95% confidence interval [CI]) of total costs of TB care was US$386.1 (130.8, 876.9). Direct costs accounted for 34% of the total costs, with a median of US$78.4 (43.3, 153.6), while indirect costs had a median of US$279.8 (18.9,699.4). PwTB < 60 years of age (US$446.1; 370.4, 521.8), without health insurance (US$464.2; 386.7, 541.6), and those hospitalized(US$900.4; 700.2, 1100.6) for TB experienced higher median costs. Catastrophic costs, experienced by 45% of PwTB, followed a pro-poor distribution. Hospitalized PwTB (adjusted prevalence ratio [aPR] = 1.9; 1.6, 2.2) and those notified from the private sector (aPR = 1.4; 1.1, 1.8) were more likely to incur catastrophic costs. Conclusions PwTB in India incur high costs mainly due to lost productivity and hospitalization. Nearly half of them experience catastrophic costs, especially those from poorer economic quintiles. Enabling early notification of TB, expanding the coverage of health insurance schemes to include PwTB, and implementing TB sensitive strategies to address social determinants of TB may significantly reduce catastrophic costs incurred by PwTB.

D. Anginer, A. Demirguc-Kunt, Min Zhu

Deposit insurance is widely offered in a number of countries as part of a financial system safety net to promote stability. An unintended consequence of deposit insurance is the reduction in the incentive of depositors to monitor banks which lead to excessive risk-taking. We examine the relation between deposit insurance and bank risk and systemic fragility in the years leading up to and during the recent financial crisis. We find that generous financial safety nets increase bank risk and systemic fragility in the years leading up to the global financial crisis. However, during the crisis, bank risk is lower and systemic stability is greater in countries with deposit insurance coverage. Our findings suggest that the “moral hazard effect” of deposit insurance dominates in good times while the “stabilization effect” of deposit insurance dominates in turbulent times. The overall effect of deposit insurance over the full sample we study remains negative since the destabilizing effect during normal times is greater in magnitude compared to the stabilizing effect during global turbulence. In addition, we find that good bank supervision can alleviate the unintended consequences of deposit insurance on bank systemic risk during good times, suggesting that fostering the appropriate incentive framework is very important for ensuring systemic stability.

Maalila Malambo

Purpose: This study investigates the factors contributing to the low uptake of Insurance Institute of South Africa (IISA) membership among insurance professionals in Botswana. The goal is to comprehend this phenomenon and provide insights into improving membership rates. Design / Methodology / Approach: A questionnaire-based survey targeting insurance professionals, students, and lecturers was employed. This approach aimed to gather comprehensive perspectives on membership uptake and related factors. The survey identified primary influences on low membership uptake, including lack of awareness, high fees, perceived limited value, and inadequate networking opportunities. The study explored the importance of membership, benefits, barriers, and suggestions for boosting participation. Findings: The study reveals crucial factors contributing to low IISA membership rates. Challenges include insufficient awareness of benefits, high fees deterring potential members, perceived value gaps, and limited networking prospects. These insights provide a holistic understanding of obstacles faced by insurance professionals in joining IISA. The research underscores the significance of professional organization membership for networking, skill enhancement, and career growth. However, financial, and perceptual barriers hinder potential members from joining.

Eugene Han, Kyung-Do Han, Yong-ho Lee et al.

Background This study investigated the changes of fatty liver disease prevalence in general Korean population. Methods This study analyzed data from the Korean National Health Insurance Service from 2009 to 2017 that included individuals aged 20 years or older who had undergone a medical health examination. Fatty liver disease was assessed using the fatty liver index (FLI). The disease severity was defined by FLI cutoff, ≥30 as moderate, and ≥60 as severe fatty liver disease. Results The prevalence of Korean adults aged 20 years or over with fatty liver disease (FLI ≥60) increased from 13.3% in 2009 to 15.5% in 2017 (P for trend <0.001). The increase in fatty liver disease prevalence was prominent in men (from 20.5% to 24.2%) and the young age (20 to 39 years) group (from 12.8% to 16.4%) (P for interaction <0.001). The prevalence of fatty liver disease was the highest in type 2 diabetes mellitus (T2DM, 29.6%) population compared to that of prediabetes or normoglycemia (10.0% and 21.8%) in 2017. The prevalence of fatty liver disease had statistically increased in individuals with T2DM and prediabetes (P for trend <0.001). Its prevalence increased more steeply in the young-aged population with T2DM, from 42.2% in 2009 to 60.1% in 2017. When applying a lower FLI cutoff (≥30) similar results were observed. Conclusion The prevalence of fatty liver disease in the Korean population has increased. Individuals who are young, male, and have T2DM are vulnerable to fatty liver disease.

Saeed Sazzad Jeris, Shahriar Frances, Mst Taskia Akter et al.

Economic Policy Uncertainty (EPU) is the level of uncertainty or unpredictability arising from government policy on topics such as taxes, trade, monetary policy, and regulation. Exploring the relationship between EPU and insurance premiums can provide insights into broader economic trends and policy decisions. EPU is often driven by political and economic events, and understanding its impact on insurance premiums can provide valuable information about how policy decisions and other external factors can affect the insurance industry and the broader economy. To understand the impact of EPU, this research examines the nexus between EPU and insurance premiums across 22 countries from 1996 to 2020. By applying panel cointegration tests, and the PMG-ARDL regression, it is found a periodical (both short-term and long-term) influence of EPU on insurance premiums. Additionally, it is revealed that EPU has a longer-term consequence on insurance premiums than it does in the short run. Also, EPU has a greater role in life insurance than non-life insurance. The results are consistent when robustness techniques (FMOLS and DOLS) are applied. The findings of the article have major implications for the government, policymakers, insurance authorities, and other relevant stakeholders.

Amal Yassin Almajali, S. Alamro, Yahya Zakarea Al-Soub

Ilana Azulay Chertok, Rada Artzi-Medvedik, Maryse Arendt et al.

Abstract Background Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic. Methods A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with maternal report of exclusive breastfeeding at the time of discharge. Results There were 26,709 participating mothers from 17 European Region countries who were included in the analysis. Among the mothers, 72.4% (n = 19,350) exclusively breastfed and 27.6% (n = 7,359) did not exclusively breastfeed at discharge. There was an overall decline in exclusive breastfeeding rates over time (p = 0.015) with a significantly lower rate following the publication of the WHO breastfeeding guidelines on 23 June 2020 (AOR 0.88; 95% CI 0.82, 0.94). Factors significantly associated with exclusive breastfeeding outcomes in the logistic regression analysis included maternal age, parity, education, health insurance, mode of birth, inadequate breastfeeding support, lack of early breastfeeding initiation, lack of full rooming-in, birth attendant, perceived healthcare professionalism and attention, facility room cleanliness, timing of birth, and location of birth. Conclusions Results from the study indicate the decline in exclusive breastfeeding rates in the WHO European Region during the COVID-19 pandemic. Using the socio-ecological model to identify factors associated with breastfeeding outcomes facilitates an integrated and holistic approach to address breastfeeding needs among women across the region. These findings demonstrate the need to augment breastfeeding support and to protect exclusive breastfeeding among mother-infant dyads, in an effort to reverse the declining exclusive breastfeeding rates. The study highlights the need to educate mothers and their families about the importance of exclusive breastfeeding, reduce maternal-infant separation, increase professional breastfeeding support, and follow evidence-based practice guidelines to promote breastfeeding in a comprehensive and multi-level manner. Trial registration number Clinical Trials NCT04847336.

L. Dun, G. Yuan

The digitalization of the economy provides additional opportunities for businesses to ensure their competitiveness, increase of the production of goods, works, services, and their export. However, in this case, risks and threats arise for other parameters of macroeconomic equilibrium, in particular, for the labor market. Thus, digitalization not only creates risks for jobs, as the replacement of human labor with capital within Industry 4.0 ensures the competitiveness of businesses but also forces workers to accept significantly worse working conditions. In 2021 in our study we noted the risks and threats to the labor market due to digitalization. In this article, we will describe possible solutions that can be implemented by state in the regulation of the labor market at the present stage of economic development and digitalization. The purpose of the article is to create an opportunity to establish a state digital platform on labor contracts as a basis for solving the following cases: compliance with the rules for drawing up labor contracts and fulfilling their conditions; compliance of online platforms with working hours; activation of the trade union movement, suppression of violations of the rights to meetings of trade unions on Internet platforms; establishment of the minimum wage and provision of guarantees for its payment to employees of Internet platforms; extension of the social security system to workers employed on Internet platforms (health, social and pension insurance, vacation pay). As a result, the research substantiates a necessity of creating the model of the state digital platform on labor contracts.

Hiromu Sugiyama, Mitsuko Shiroyama, Ikuyo Yamamoto et al.

Using data from 2018–2019 health insurance claims, we estimated the average annual incidence of anisakiasis in Japan to be 19,737 cases. Molecular identification of larvae revealed that most (88.4%) patients were infected with the species Anisakis simplex sensu stricto. Further insights into the pathogenesis of various anisakiasis forms are needed.

Kelly N. B. Palmer PhD, MHS, CCRP, Abidemi Okechukwu MBBS, MPH, Namoonga M. Mantina MSPH et al.

Lay health workers (LHWs) have been effective in delivering health promotion to underserved, vulnerable populations. Hair stylists are well positioned to serve as LHWs in addressing health disparities among Black women in the U.S. The purpose of this qualitative study was to explore the extent to which hair stylists influence their Black female clients and clients’ preferences for their stylist’s role in salon-based health promotion programming. Eight virtual platform focus groups were conducted with Black women (n = 39) who receive hair care services from a licensed hair stylist across the U.S. Most participants had a college degree (89.8%), health insurance (92.3%), a primary care provider (89.7%), and the majority had at least one chronic disease (56.4%). Participants reported higher potential for influence related to level of trust in the stylists and for stylists they find relatable and credible. Trust, relatability, and credibility were further determined by racial and gender congruence. Client interviewees felt stylists should model healthy behaviors and reported they may not be receptive to stylist-delivered health promotion out of the context of a hair-health connection. In this sample of well-educated clients, there was an expressed preference for stylists to provide referral to healthcare professionals or solicit experts for health topics out of the scope of haircare rather than guide the health promotion efforts themselves. Findings from this study can inform future development of acceptable salon-based, stylist-led health promotion programs that partner stylists with health experts to deliver health promotion.

Woo Sang Jung, Kwon-Duk Seo, Sang Hyun Suh

Purpose The purpose of this study was to evaluate trends in medical costs and prognosis in acute ischemic stroke (AIS) patients in Korea from 2008 to 2017 using medical claims data. Materials and Methods All data for the past decade was collected from a big data hub provided by the Health Insurance Review & Assessment Service. Using several Korean Standard Classification of Disease codes, we estimated the number of patients, the costs of medical insurance, and prognosis according to the treatment with or without endovascular thrombectomy (EVT) among in-patients with AIS. Results Since 2014, when EVT was covered by insurance, the number of patients who underwent EVT for AIS has increased significantly. Also, in the past decade, the medical costs following inpatient care for AIS with EVT have increased gradually, and the overall medical costs for the first year post-stroke have also increased. The prognosis of AIS patients with EVT was different according to the time of treatment. Annual trends for both mortality and cerebral hemorrhage after treatment of AIS with EVT have gradually decreased. Conclusion In this study, we found that both inpatient medical costs and 1-year cumulative medical costs have gradually increased, and the prognosis has gradually improved in patients receiving EVT treatment among AIS patients.

George Loewenstein, Joelle Y Friedman, Barbara McGill et al.

A. Mobarak, M. Rosenzweig