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.

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.

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.

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.

A Study Tour of Old-age Insurance Systems In Switzerland and France

A Chinese delegation of leaders from provincial and municipal departments of civil affairs and retired cadres and homes for the aged visited Switzerland and France from April 18 to 28,and attended a seminar on the old-age insurance system in Switzerland.The visit,to learn of the successful experience of developed European countries,was made at the invitation of the Swiss-Chinese Association and the China-Spain Association of International Culture and Friendship and organized by the CPAFFC.

Assessing the Impact of Health Insurance on Household Financial Protection in Togo

Context: To facilitate financial access to care for the population, health insurance mechanisms have been established, in particular the National Health Insurance Institute, which covers civil servants and their dependents. In addition, other voluntary and community mechanisms have been developed. After several years of implementation, the level of catastrophic health expenditures among insured individuals shows that there is still a considerable level of financial risk associated with health care. This study aims to assess the impact of health insurance in Togo on insured populations. Methodology: The data used in this study come from the harmonized survey on household living conditions carried out in 2018 by the National Institute of Statistics, Economic and Demographic Studies. The propensity score matching method was used according to the following steps: estimation of propensity scores, verification of the conditional independence hypothesis (balancing property) and estimation of the average treatment effect on treated. Stata V14.2 software was used. Findings: The average effect of health insurance on household financial protection is −0.012 for the nearest neighbor method, −0.013 for the matching radius method, −0.015 for the Kernel and −0.016 for the stratification method. Results showed that health insurance contributes to reducing catastrophic health expenditures, but their effect remains very limited. This could be explained by the level of care package covered and the cost covered. Conclusion: Health insurance contributes to the reduction of catastrophic health expenses for households. However, it is important to widen the range of care covered and the cost covered. In addition, measures to extend this coverage to a larger proportion of the population will make it possible to have a greater impact.

Are life insurance futures a safe haven during COVID‑19?

This study aims to examine whether life insurance futures can serve as a hedge against the COVID-19 pandemic and whether they have the characteristics of a safe haven under the impact of the health shocks of the COVID-19 pandemic.We chose three life insurance stock futures in India and one in Taiwan as samples,including the market index of the two countries and the number of confirmed COVID-19 cases as sample variables.We used the growth rate of COVID-19 cases as the threshold variable,esti-mated the asymmetric threshold vector autoregression model,and found that insur-ance futures in the regime with a significant growth rate of confirmed COVID-19 cases can hedge against COVID-19 risks;therefore,insurance futures are a safe haven for the market.We further estimated the time-varying parameter vector autoregression model,and the impulse response results showed that insurance futures are a safe haven for COVID-19 pandemic risks.

The Potential of Commercial Pension Insurance to Develop into One of the Pillars of Rural Pension Insurance:A Study from the Demand Perspective

The development of a multi-pillar pension insurance system is an effective solution for an aging society.Commercial pension insurance,as the third pillar of pension insurance,is an integral part of this system in China and can play a critical and complementary role in rural areas where support for the elderly is a more pressing concern and a second pillar of pension insurance remains absent.To this end,we first elaborate on the theoretical logic that commercial pension insurance can develop into one of the pillars of rural pension insurance.We then empirically test rural residents’willingness to participate in a commercial pension insurance plan(CPIP)in a probit model with household research data from rural areas in major labor-exporting provinces,such as Sichuan and Henan so as to explore whether commercial pension insurance has the potential to become one of the pillars of rural pension insurance.Our research findings can be synthesized in three points.First,rural residents out of agricultural production for five consecutive years are more willing to participate in a CPIP than other rural residents,indicating that progress in industrialization and urbanization can significantly boost such willingness.Second,the younger rural residents are more inclined to participate in a CPIP than the older generation.Third,income increases can significantly boost rural residents’willingness to participate in a CPIP.Thus,with progress in industrialization and urbanization and an increase in rural disposable income,commercial pension insurance has a promising potential in rural areas and can hopefully develop into one of the pillars of rural pension insurance.

Impact of Dialysis Coverage on the Provision of Universal Health Insurance in the Republic of the Congo

Introduction: The launch of health insurance in the Republic of the Congo took place against a backdrop of extremely high costs for dialysis, which was not one of the services financed within this framework. The aim of this study is to assess the impact of including dialysis in the health insurance package in Congo. Methodology: This is a descriptive cross-sectional study with an evaluative aim, analyzing the impact of dialysis on the financing capacity of health insurance and health facilities to provide this type of care. Results: The results show that including dialysis in the universal health insurance package will require an additional financial effort of 6.20% of the current total financing capacity of the care basket. Most dialysis sessions are provided by the private health sector (87.5%), whose health facilities are unevenly distributed across the country, and concentrated in the country’s two major cities. This problem is the dual consequence of the very high cost of a dialysis session (average cost 140,234,375 FCFA or 229 US Dollars) and the number of patients under care, which will increase in the absence of effective and ongoing prevention efforts against chronic diseases in general and end-stage renal failure in particular. Conclusion: Dialysis is a high-impact public health intervention. The impact of its inclusion in the universal health insurance care package is difficult to bear financially. For dialysis to be covered by universal health insurance, additional funding and improved technical facilities are needed.

Explainable AI and Interpretable Model for Insurance Premium Prediction

Traditional machine learning metrics(TMLMs)are quite useful for the current research work precision,recall,accuracy,MSE and RMSE.Not enough for a practitioner to be confident about the performance and dependability of innovative interpretable model 85%–92%.We included in the prediction process,machine learning models(MLMs)with greater than 99%accuracy with a sensitivity of 95%–98%and specifically in the database.We need to explain the model to domain specialists through the MLMs.Human-understandable explanations in addition to ML professionals must establish trust in the prediction of our model.This is achieved by creating a model-independent,locally accurate explanation set that makes it better than the primary model.As we know that human interaction with machine learning systems on this model’s interpretability is more crucial.For supporting set validations in model selection insurance premium prediction.In this study,we proposed the use of the(LIME and SHAP)approach to understand research properly and explain a model developed using random forest regression to predict insurance premiums.The SHAP algorithm’s drawback,as seen in our experiments,is its lengthy computing time—to produce the findings,it must compute every possible combination.In addition,the experiments conducted were intended to focus on the model’s interpretability and explain its ability using LIME and SHAP,not the insurance premium charge prediction.Three experiments were conducted through experiment,one was to interpret the random forest regression model using LIME techniques.In experiment 2,we used the SHAP technique to interpret the model insurance premium prediction(IPP).

Inspiration of Foreign Innovative Drug Pricing Methods and Medical Insurance Payment Standards to China

Objective To study the innovative drug pricing methods and medical insurance payment standards in foreign countries and to provide reference for China’s government.Methods The official websites were searched for information and related literature,and literature review was used.Results and Conclusion In foreign countries,the clinical value of innovative drugs and their impact on medical insurance funds were comprehensively evaluated based on factors such as quality-adjusted life years,clinical benefit,and improvement of clinical benefit.Then,the evaluation results were taken as an important basis for whether innovative drugs were admitted to the medical insurance catalog and establishing medical insurance payment standards.By using international experience for reference,innovative drug pricing methods and medical insurance payment standards for China’s national conditions can be improved by establishing a basic database of clinical value and drug economic evaluation of innovative drugs,as well as innovative drug payment models based on decision thresholds.

The Impact of Population Aging on the Expenditure of Medical Insurance Fund for Urban Workers in China

Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through analyzing the impact of the population aging,the income and accumulated balance of the medical insurance fund,and other related factors on the expenditure of the medical insurance fund,development status of the medical insurance fund for urban employees in China since 2003 was obtained.Stata 16.0 was used to perform multiple linear regression analysis on related factors to determine the correlation between population aging and the change in medical insurance expenditures.Results and Conclusion The factors that have a greater impact on the expenditure of the medical insurance fund are the amount of income from the medical insurance,followed by the number of people over the age of 65 in China and the urban retired employees participating in medical insurance.We should focus on the sustainable development of the urban employee medical insurance fund to deal with the threat of aging.

Research on Accounting Issues of the Pension Insurance Fund for Urban Employees

Pension insurance is a vital component of China's social security system,ensuring the welfare of the general publie.This study centers on the revenue and expenses of City S's urban employee basic pension insurance fund.It introduces and analyzes the fund's accounting status from four key perspectives:fund raising.expenditure,financial statement system,and accounting information disclosure.The research identifes existing problems in City S's accounting system and conducts in-depth research on these issues.Furthermore,an empirical analysis is conducted on the management of the pension insurance fund.Through this empirical study,the paper aims to offer insights and recommendations for promoting stable and healthy development measures for City S'8 urban employee basic pension insurance fund.

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。

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])。

Farmers using insurance and cooperatives to manage agricultural risks: A case study of the swine industry in China

Purchasing agricultural insurance and joining agricultural cooperatives are two prevalent instruments used by farmers in China for dealing with agricultural risks. Data from 443 swine farmers in Jiangsu and Henan provinces of China were collected. Factors affecting the farmers’ decision to purchase agricultural insurance and join agricultural cooperatives were assessed. The possibility of simultaneous use of both instruments and the potential correlation between these two decisions was considered as well. Results showed that the farmers’ decision to use agricultural insurance and cooperatives was positively correlated, indicating that farmers who purchased agricultural insurance which mainly used to mitigate production risks were more likely to join agricultural cooperatives which more used to share market risks, and vice versa. Farmers’ knowledge of swine insurance and trust in the local government positively impacted the purchase of agricultural insurance, while education, years involved in swine production and scale of swine production positively impacted farmers joining agricultural cooperatives.

Engineering models for catastrophe risk and their application to insurance

Internationally earthquake insurance,like all other insurance (fire,auto),adopted actuarial approach in the past, which is,based on historical loss experience to determine insurance rate.Due to the fact that earthquake is a rare event with severe consequence,irrational determination of premium rate and lack of understanding scale of potential loss led to many insurance companies insolvent after Northridge earthquake in 1994. Along with recent advances in earth science,computer science and engineering,computerized loss estimation methodologies based on first principles have been developed to the point that losses from destructive earthquakes can be quantified with reasonable accuracy using scientific modeling techniques. This paper intends to introduce how engineering models can assist to quantify earthquake risk and how insurance industry can use this information to manage their risk in the United States and abroad.

Farmers' Perception and Awareness and Factors Affecting Awareness of Farmers Regarding Crop Insurance as a Risk Coping Mechanism Evidence from Pakistan

This study has been conducted in three districts of Punjab Province namely, Dera Ghazi Khan, Rajan Pur and Bahawalpur of Pakistan. The study showed the results of a survey of 300 farmers which was organized to assess awareness level of farmers regarding crop insurance, factors affecting the awareness level among farmers and the perception of farmers about crop insurance. Based on exploratory research work upon the responses of farmers, the average and standard deviation were calculated. Probit model was applied to explore the factors affecting the awareness level of farmers. SPSS was used for the analysis of the collected data. The results revealed that out of 300 farmers, 184 farmers were aware with crop insurance and rests of the 116 farmers were not aware. Banks and E-media were found to be the two most important sources of the awareness for the respondent farmers. In the study area, the climatic risks were reported as the most severe risks faced by the farmers. The results also revealed the existence of negative perceptions of the farmers about crop insurance i.e. farmers perceived crop insurance as a kind of tax and they believed premium was so high that it was out of range of poor farmers and only large scale farmers could afford it. Results obtained by applying Probit model revealed that ＂education＂ and ＂previously availed agricultural credit＂ were the two most important factors which affected the awareness of the farmers regarding crop insurance.

Potato farmers’ preference for agricultural insurance in China: An investigation using the choice experimental method

Potato insurance plays an important role in transferring agricultural risks to promote the potato staple strategy. Understanding farmers’ real preferences for potato insurance attributes is important to improve the potato insurance. In this study, a choice experiment was designed with attributes such as peril, minimum compensation ratio for production loss, types of crops covered by insurance, annual premium per mu after subsidy, and complexity of claims procedures. We constructed a mixed logit model based on a questionnaire survey of 362 potato farmers’ choices of insurance attributes from 24 villages in Dingxi City of Gansu Province using random sampling. The results show that:(1) farmers prefer agricultural insurance with widely perils including output price drop and input cost risk;(2) farmers who have suffered plant disease and insect and pest damage are willing to pay a high premium for the insurance with a high compensation ratio and several types of crops covered;full-time farmers and large-scale farmers preferred insurance products with low complexity of claims procedures. Therefore, new potato insurance design could be considered specifically for different farmer groups such as those who had previous disaster experiences, and large-or small-scale farm operations.