OPTIONS-GAME ANALYSIS FOR FIRM WITH INSURED DEBT

The strategic model for insured bond of firm is a new model which is developed based on options pricing model and game theory. When firm’s bond was insured against bankruptcy, some interesting results about endogenous bankruptcy and optimal capital structure are obtained.

Can I Have My Life Insured?

A man went to an insurance(保险)office to have his life insured.The manager of the office asked him how old his parents were when they died. 'Mother had a bad heart and died at the age of thirty.Father died of tuberculosis when he was thirty- five.' 'I am very sorry,'said the manager.'We cannot insure your life as your parents were not healthy.'

How Group-Based Cardiovascular Health Education Affects Treatment Adherence and Blood Pressure Control among Insured Hypertensive Nigerians: A Pre-Test, Post-Test Study

In sub Saharan Africa (SSA), access to affordable hypertension care through health insurance is increasing. But due to poor adherence, hypertension treatment outcomes often remain poor. Patient-centered educational interventions may reverse this trend. Using a pre-test/post-test design, in this study we investigated the effects of a structured cardiovascular health education program (CHEP) on treatment adherence, blood pressure (BP) control and body mass index (BMI) among Nigerian hypertensive patients who received guideline-based care in a rural primary care facility, in the context of a community based health insurance program. Study participants included 149 insured patients with uncontrolled BP and/or poor self-reported medication adherence after 12 months of guideline-based care. All patients received three group-based educational sessions and usual primary care over 6 months. We evaluated changes in self-reported adherence to prescribed medications and behavioral advice (primary outcomes);systolic BP (SBP) and/or diastolic BP (DBP) and BMI (secondary outcomes);and beliefs about hypertension and medications (explora- tory outcomes). Outcomes were analyzed with descriptive statistics and regression analysis. 140 patients completed the study (94%). At 6 months, more participants reported high adherence to medications and behavioral advice than at baseline: respectively, 101 (72%) versus 70 (50%), (p < 0.001) and 126 (90%) versus 106 (76%), (p < 0.001). Participants with controlled BP doubled from 34 (24%) to 65 (46%), (p = 0.001). The median SBP and DBP decreased from 129.0 to 122.0 mmHg, (p = 0.002) and from 80.0 to 73.5 mmHg, (p < 0.001), respectively. BMI did not change (p = 0.444). Improved medication adherence was associated with a decrease in medication concerns (p = 0.045) and improved medication self-efficacy (p < 0.001). By positively influencing patient perceptions of medications, CHEP strengthened medication adherence and, consequently, BP reduction among insured hypertensive Nigerians. This educational approach can support cardiovascular disease prevention programs for Africa’s growing hypertensive population.

Health Services Utilization and Health Status of Insured versus Uninsured Nigerian Children with Sickle Cell Disease

Introduction: Nigeria accounts for 150,000 infants born with the Sickle Cell Disease (SCD) every year. Children with SCD are affected by the deleterious effect of user fees which reduces affordability and utilization of health services. Evidences supported that institutionalized health insurance increases intensity of utilization. Methodology: The study was conducted at AKTH, Kano, and north-western, Nigeria. The study was retrospective comparative cross-sectional study. 100 patients were enrolled, 50 for each arm. Paediatric SCD clinic outpatients’ records and a specialty designed form containing the variables of interest were used. Data were analysed using Minitab 16. Proportions, percentages, tables, charts and chi squared test were used to compare the two groups. Result: The study found no association between the two groups in the likelihood of being insured based on age (χ2 = 1.478), gender (χ2 = 0.224) and dwellings (χ2 = 0.062). On health services utilization and insurance status, the study revealed that follow up clinic visits, unscheduled clinic visits and emergency room visits were more likely among the insured group compared to the uninsured group. While the health status and insurance status of the two groups over 12 months period showed a significant association with the insured more likely to have improved health status compared to uninsured (χ2 = 28.019, p = 0.0001). Similarly, health status and health services utilization were significantly associated with insurance status (χ2 = 12.191, p = 0.002). Conclusion: The insurance status of children with SCD is associated with their health services utilization and health status. However, age, gender and dwellings were not associated with insurance status of children with SCD. Therefore, when expanding insurance coverage (NHIS) among children with SCD considerations have to be given to increase health services utilization and resultant improvement in health status as these have the potential of reducing morbidity and mortality among children with SCD.

Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia Author links open overlay panel

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Chinese herbal medicine decreases incidence of hepatocellular carcinoma in diabetes mellitus patients with regular insulin management

BACKGROUND Type 2 diabetes mellitus(DM)is an independent risk factor for hepatocellular carcinoma(HCC),while insulin is a potent mitogen.Identifying a new therapeutic modality for preventing insulin users from developing HCC is a critical goal for researchers.AIM To investigate whether regular herbal medicine use can decrease HCC risk in DM patients with regular insulin control.METHODS We used data acquired from the Taiwan,Chinaese National Health Insurance research database between 2000 and 2017.We identified patients with DM who were prescribed insulin for>3 months.The herb user group was further defined as patients prescribed herbal medication for DM for>3 months per annum during RESULTS We initially enrolled 657144 DM patients with regular insulin use from 2000 to 2017.Among these,46849 patients had used a herbal treatment for DM,and 140547 patients were included as the matched control group.The baseline variables were similar between the herb users and nonusers.DM patients with regular herb use had a 12%decreased risk of HCC compared with the control group[adjusted hazard ratio(aHR)=0.88,95%CI=0.80–0.97].The cumulative incidence of HCC in the herb users was significantly lower than that of the nonusers.Patients with a herb use of>5 years cumulatively exhibited a protective effect against development of HCC(aHR=0.82,P<0.05).Of patients who developed HCC,herb users exhibited a longer survival time than nonusers(aHR=0.78,P=0.0001).Additionally,we report the top 10 herbs and formulas in prescriptions and summarize the potential pharmacological effects of the constituents.Our analysis indicated that Astragalus propinquus(Huang Qi)plus Salvia miltiorrhiza Bunge(Dan Shen),and Astragalus propinquus(Huang Qi)plus Trichosanthes kirilowii Maxim.(Tian Hua Fen)were the most frequent combination of single herbs.Meanwhile,Ji Sheng Shen Qi Wan plus Dan Shen was the most frequent combination of herbs and formulas.CONCLUSION This large-scale retrospective cohort study reveals that herbal medicine may decrease HCC risk by 12%in DM patients with regular insulin use.

微管注入PS与INSURE技术治疗早产儿RDS的临床效果评价

目的探讨微管注入肺表面活性物质(PS)技术与气管插管-PS给药-拔管(INSURE)技术治疗≥30周早产儿呼吸窘迫综合征(RDS)的临床效果。方法选取RDS早产儿80例,按随机数表法分为观察、对照2组各40例。对照组采用INSURE技术,观察组采用微管注入(LISA)技术给与PS治疗。比较2组临床疗效、血气指标(PaO_(2)、PaCO_(2)和pH值)、脑血流动力学参数(PSV、EDV和RI)、临床相关指标和出院前病死率及并发症发生率。结果观察组患儿疗效高于对照组(P<0.05)。观察组患儿治疗后PaO_(2)、pH值均高于对照组,PaCO_(2)低于对照组(P<0.05)。2组患儿T0~T3时PSV、EDV、RI水平比较差异无统计学意义(P>0.05)。观察组患儿氧疗时间、插管用时均短于对照组(P<0.05);2组无创通气时间、住院时间及出院前病死率比较差异无统计学意义(P>0.05)。2组患儿治疗期间并发症发生率比较差异无统计学意义(P>0.05)。结论LISA和INSURE技术给予PS技术治疗早产儿RDS,可显著提高临床疗效,改善患儿血气指标。

China Continues to Be World’s Second Largest Insurance Market

Allianz Group recently released the Allianz Global Insurance Report,predicting that China will consolidate its position as the world’s second largest insurance market in the next decade.The report analyzes the business performance of the global insurance market in 2023 and forecasts the development direction and trends of the global insurance industry in the next decade.2023:A year of significant growth According to the report,in 2023,the global insurance industry grew by an impressive 7.5%,which is the fastest rate since the pre-Global Financial Crisis(GFC)era.

INSURE策略治疗早产儿呼吸窘迫综合征失败的危险因素分析

新生儿呼吸窘迫综合征(RDS)是因缺少肺泡表面活性物质(PS),导致新生儿肺发育不成熟,引起呼吸功能障碍的严重肺部疾病~([1])。该疾病多发于胎龄在34周以下的早产儿,主要症状为呼吸困难逐渐加重等,严重影响患儿生命健康,具有较高的病死率~([2])。

Automated Actuarial Data Analytics-Based Inflation Adjusted Frequency Severity Loss Reserving Model

In this paper, the Automated Actuarial Loss Reserving Model is developed and extended using machine learning. The traditional actuarial reserving techniques are no longer compatible with the increase in technological advancement currently at hand. As a result, the development of the alternative Artificial Intelligence Based Automated Actuarial Loss Reserving Methodology which captures diverse risk profiles for various policyholders through augmenting the Micro Finance services, Auto Insurance Services and Both Services lines of business on the same platform through the computation of the Comprehensive Automated Actuarial Loss Reserves (CAALR) has been implemented in this paper. The introduction of the four further types of actuarial loss reserves to those existing in the actuarial literature seems to significantly reduce lapse rates, reduce the reinsurance costs as well as expenses and outgo. As a matter of consequence, this helps to bring together a combination of new and existing policyholders in the insurance company. The frequency severity models have been extended in this paper using ten machine learning algorithms which ultimately leads to the derivation of the proposed machine learning-based actuarial loss reserving model which remarkably performed well when compared to the traditional chain ladder actuarial reserving method using simulated data.

Research on Reimbursement Management of Innovative Drugs Abroad and Its Enlightenment to China

Objective To analyze the reimbursement policies of innovative drugs in some developed countries,and to provide reference for future reimbursement management in China.Methods Literature research method was used to study the policies related to the reimbursement management of innovative drugs in Germany,France and Japan,and their successful experience was summarized.Results and Conclusion China should establish an open and transparent value evaluation standard to improve the medical insurance reimbursement management of innovative drugs.Besides,the value of innovative drugs should be taken as an important basis for reimbursement decisions,and an independent third-party value evaluation agency must be established.

Analysis of Drug Medical Insurance Access Pricing Based on the Perspective of Binary Equilibrium

Objective To study the influencing factors in the process of national medical insurance negotiation and drug pricing from the dualistic equilibrium perspective,and to provide reference for the harmonious management of drug pricing in China.Methods Through the literature analysis and policy review,the pricing subject,pricing basis and price control system in the pricing process of medical-accessed medicines were analyzed from the perspective of binary equilibrium and harmonious management.Results and Conclusion It is found that four balances in the drug pricing process,two balances in pricing basis and three balances in price control system need to be considered,respectively.Drug pricing is the key content of national medical insurance access,which is also the hotspot of the policy in the pharmaceutical fields in recent years.Drug pricing not only reflects the value of drugs,but also reflects a lot of top-level designs of binary equilibriums in medical insurance policy.While the rational design of drug pricing requires the joint efforts of the government,pharmaceutical companies and relevant experts to comprehensively consider many equilibriums,so as to improve the relevant systems.

Research on the Establishment of a Long-Term Care System for the Elderly with Alzheimer’s Disease Under the Background of Long-Term Care Insurance: A Literature Review

With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.

Optimal Insurance with Background Risk under the Ambiguity and Belief Heterogeneity Structure

In this paper, we discuss the optimal insurance in the presence of background risk while the insured is ambiguity averse and there exists belief heterogeneity between the insured and the insurer. We give the optimal insurance contract when maxing the insured’s expected utility of his/her remaining wealth under the smooth ambiguity model and the heterogeneous belief form satisfying the MHR condition. We calculate the insurance premium by using generalized Wang’s premium and also introduce a series of stochastic orders proposed by [1] to describe the relationships among the insurable risk, background risk and ambiguity parameter. We obtain the deductible insurance is the optimal insurance while they meet specific dependence structures.

A Market Model of Risk Transfer and Insurance

We introduce a model of a market where risk-averse consumers pay a fee to transfer their future losses to one or more firms.The future loss of each consumer is stochastic with a unique,known mean and variance.The law of large numbers allows the firms to know with certainty the expected aggregate loss of the consumers to whom they sell.The model could describe the behavior of agents in the market for property insurance where an insurance company sells a single type of policy to a specific group of consumers based upon the expected losses of those consumers and their willingness to pay for coverage.The model demonstrates how a single firm can choose the optimal segment of the market to which they sell a policy and how that choice might change when the distribution of consumers and their risk aversion changes.The model also demonstrates how two firms might engage in a cooperative strategy and share the market.The model shows how a firm entering the market will find it more advantageous to target a segment of the market with consumers that have a lower expected loss.

Cyberattack Ramifications, The Hidden Cost of a Security Breach

In this in-depth exploration, I delve into the complex implications and costs of cybersecurity breaches. Venturing beyond just the immediate repercussions, the research unearths both the overt and concealed long-term consequences that businesses encounter. This study integrates findings from various research, including quantitative reports, drawing upon real-world incidents faced by both small and large enterprises. This investigation emphasizes the profound intangible costs, such as trade name devaluation and potential damage to brand reputation, which can persist long after the breach. By collating insights from industry experts and a myriad of research, the study provides a comprehensive perspective on the profound, multi-dimensional impacts of cybersecurity incidents. The overarching aim is to underscore the often-underestimated scope and depth of these breaches, emphasizing the entire timeline post-incident and the urgent need for fortified preventative and reactive measures in the digital domain.

开展医疗保障经办机构飞行检查的问题及其产生因素的质性研究

目的梳理总结我国开展医疗保障(以下简称“医保”)经办机构飞行检查的问题及其产生因素,为完善我国医保基金飞行检查机制,加强对医保经办机构的监管提供建议和参考。方法于2022年7—9月,采用典型抽样法,选取4个省份的医保专家进行半结构式访谈,样本量的确定以不再出现新的信息为标准,运用colaizzi七步分析法对获取的资料进行归纳分析。结果通过对11名专家访谈资料的分析,归纳提炼开展医保经办机构飞行检查的问题,包括力度不足、队伍构成不健全、缺乏具体内容及标准等,以及导致问题产生的因素,包括选择效应、缺乏标准化做法、区域差异等。结论医保经办机构的行为及工作效率影响着医保基金安全,对其进行监管十分必要,但开展医保经办机构飞行检查的过程中存在诸多问题。建议推进制度建设,加大飞行检查力度;丰富队伍构成,提升飞行检查质量;完善指标建立,规范飞行检查内容。

我国医院远程医疗服务收费情况分析

目的分析我国医院远程医疗服务收费情况,以完善远程医疗服务收费制度,推动远程医疗规范化发展。方法2020年10—11月面向全国26个省(自治区、直辖市)组织开展线上问卷调查。选取问卷中远程医疗服务收费项目及其与医疗保险对接情况、收费标准制定、收费依据、费用支付与结算方式等内容,统计分析不同地区医院远程医疗服务收费情况。结果71.3%的医院开展了远程医疗服务收费,收费项目主要为远程会诊、远程教育、远程病理诊断、远程影像诊断和远程心电诊断。主要按照医院级别和专家职称收费,分别有59.1%的东部地区医院、69.2%的中部地区医院和68.5%的西部地区医院收费标准由行政管理部门统一制定。此外,34.6%的收费医院将远程医疗纳入医疗保险报销范畴。结论大部分医疗机构开展了远程医疗服务收费,但收费机制相对模糊,与医疗保险的对接政策也相对缺乏,应加快远程医疗服务收费政策制定,合理化远程医疗服务收费,建立健全远程医疗服务收费机制,促进远程医疗服务收费工作的规范化发展。

国家医保谈判对公立医院抗肿瘤药物采购费用、数量及结构的影响:以EGFR-TKI靶向药物为例

目的分析国家医保药品目录准入谈判(以下简称“国谈”)政策对某省公立三级医院非小细胞肺癌EGFRTKI靶向药物采购费用、数量及结构的影响,为相关政策制定提供依据。方法收集2018年1月—2020年12月某省公立三级医院EGFR-TKI靶向药物每月采购数据,利用中断时间序列模型分析采购费用、数量、药品结构及日均费用的变化趋势。结果阿法替尼、奥希替尼、吉非替尼、埃克替尼、厄洛替尼5种EGFR-TKI靶向药物总体采购量及费用以稳定为主,2018年国谈准入品种采购量及费用上升。5种EGFR-TKI靶向药物药品结构变化明显,呈即刻上升趋势;各品种日均费用出现不同程度的下降。结论国谈政策的实施增加了靶向药物的使用,国谈准入药物品种逐步进入临床,患者的用药负担进一步减轻。

普惠型商业医疗保险特定高额药品保障研究

目的研究我国普惠型商业医疗保险目前特定高额药品(以下简称“特药”)保障的范围及水平,为进一步完善普惠型商业医疗保险的保障水平提供参考。方法通过官方公众号、投保小程序收集2022年普惠型商业医疗保险的保障政策,采用政策文本分析法提取和分析参保条件、筹资标准、特药的类别及保障水平等内容。结果2022年普惠型商业医疗保险所包含特药数量的均数为28种,以肿瘤药为主。54.62%的商业医疗保险方案特药起付线设定为0,报销比例的均数为74%、中位数为80%。70.54%的商业医疗保险方案封顶线在100万元及以下。58.04%的商业医疗保险方案保障既往症人群的特药费用,但保障水平在不同程度上有所降低。结论我国普惠型商业医疗保险的特药保障有助于减轻患者的经济负担,满足患者多元化用药需求,但对既往症人群的保障水平较为有限。建议进一步优化特药保障责任,明确特药目录的遴选规则。