Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

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.

Telematics as a Transformative Agent for the Zimbabwean Auto Insurance Ecosystem

Zimbabwe has witnessed the evolution of Information Communication Technology (ICT). The vehicle population soared to above 1.2 million hence rendering the Transport and Insurance domains complex. Therefore, there is a need to look at ways that can augment conventional Vehicular Management Information Systems (VMIS) in transforming business processes through Telematics. This paper aims to contextualise the role that telematics can play in transforming the Insurance Ecosystem in Zimbabwe. The main objective was to investigate the integration of Usage-Based Insurance (UBI) with vehicle tracking solutions provided by technology companies like Econet Wireless in Zimbabwe, aiming to align customer billing with individual risk profiles and enhance the synergy between technology and insurance service providers in the motor insurance ecosystem. A triangulation through structured interviews, questionnaires, and literature review, supported by Information Systems Analysis and Design techniques was conducted. The study adopted a case study approach, qualitatively analyzing the complexities of the Telematics insurance ecosystem in Zimbabwe, informed by the TOGAF framework. A case-study approach was applied to derive themes whilst applying within and cross-case analysis. Data was collected using questionnaires, and interviews. The findings of the research clearly show the importance of Telematics in modern-day insurance and the positive relationship between technology and insurance business performance. The study, therefore revealed how UBI can incentivize positive driver behavior, potentially reducing insurance premiums for safe drivers and lowering the incidence of claims against insurance companies. Future work can be done on studying the role of Telematics in combating highway crime and corruption.

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])。

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.

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.

LISA与INSURE对NRDS早产患儿脑氧代谢、氧合及临床预后的影响

目的探究低侵入性肺表面活性物质给药(LISA)与气管插管-注入肺表面活性物质-拔管(INSURE)对新生儿呼吸窘迫综合征(NRDS)早产儿患脑氧代谢、氧合及临床预后的影响。方法选择2020年1月—2021年12月本院新生儿科收治的124例NRDS早产患儿,分为对照组60例和观察组64例。对照组患儿常规给予INSURE技术治疗,观察组患儿给予LISA技术治疗,分析两组患儿治疗情况、脑氧代谢、全身氧代谢及临床预后。结果观察组患儿插管用时、无创呼吸支持时间短于对照组,72 h内机械通气率低于对照组,差异有统计学意义(P<0.05),而肺表面活性物质二次给药率与对照组比较差异无统计学意义(P>0.05);随着时间推移,两组患儿脑氧饱和度(ScO_(2))水平均先升后降,但观察组用药期间、用药后5 min的ScO_(2)水平低于对照组,差异均有统计学意义(P<0.05);两组患儿治疗前、治疗24 h后的血pH值比较差异均无统计学意义(P>0.05),治疗24 h后的血氧分压(PaO_(2))、氧合指数较治疗前提高,血二氧化碳分压(PaCO_(2))水平降低,且均以观察组更明显,差异均有统计学意义(P<0.05);观察组患儿心动过缓、插管所致损伤的不良反应发生率和颅内出血、支气管肺发育不良的并发症发生率低于对照组,住院时间短于对照组,差异有统计学意义(P<0.05),两组死亡率和其余不良反应、并发症发生率比较差异无统计学意义(P>0.05)。结论相比于INSURE技术,LISA技术治疗对NRDS早产儿脑氧代谢、氧合状况影响更小,更有利于减少患儿机械通气率、不良反应和并发症发生率,改善患儿临床预后。

Empirical study on optimal reinsurance for crop insurance in China from an insurer's perspective

This study investigates the optimal reinsurance for crop insurance in China in an insurer＇s perspective using the data from Inner Mongolia, Jilin, and Liaoning, China. On the basis of the loss ratio distributions modeled by An Hua Crop Risk Evaluation System, we use the empirical model developed by Tan and Weng（2014） to study the optimal reinsurance design for crop insurance in China. We find that, when the primary insurer＇s loss function, the principle of the reinsurance premium calculation, and the risk measure are given, the level of risk tolerance of the primary insurer, the safety loading coefficient of the reinsurer, and the constraint on reinsurance premium budget affect the optimal reinsurance design. When a strict constraint on reinsurance premium budget is implemented, which often occurs in reality, the limited stop loss reinsurance is optimal, consistent with the common practice in reality. This study provides suggestions for decision making regarding the crop reinsurance in China. It also provides empirical evidence for the literature on optimal reinsurance from the insurance market of China. This evidence undoubtedly has an important practical significance for the development of China＇s crop insurance.

On the Role of Consumer Preferences in the Coordination among Health Insurers under Regulated Competition

This paper addresses the coordination problem of price and quality setting insurers, arising on the health insurance market under regulated competition, as introduced, for instance, in the Netherlands in 2006. We use an experimental study to gain novel insights on the impact of the uncertainty about consumer preferences on the coordination problem. This fundamental uncertainty implies uncertainty about the identity of the payoff dominant equilibrium, while the risk dominant equilibrium is independent of the state of the world. The experimental results show that insurers are more likely to coordinate on the payoff dominant equilibrium under incomplete information. When insurers face not only strategic but also fundamental uncertainty in the coordination problem, they delay the response to the risk dominant strategy, and persist longer in trying to coordinate on the payoff dominant equilibrium. For the market we study, this implies that the co-ordination under incomplete information will result in consumers paying higher prices, in contrast to the original objectives of the regulated competition.

Possibilities and Contradictions of Nanotechnology Applications in Preventive Activities Insurer

One effective and proven tool for managing risk is insurance. At the same time, insurers, reinsurers, insurance, and reinsurance brokers in search of the relevant value of their services in the eyes of insured and long-term benefits are increasingly paying attention to the possibilities of nanotechnology. On one hand, insurers see unlimited possibilities of nanotechnology in preventive and repressive activity in relation to losses. The obstacle in this case, for high-tech companies, is stiff competition from companies which are not innovation leaders, but with the necessary influence and power at the international and national market. On the other hand, understanding the reasons for the application of nanotechnology in the conflict prevention activities of the insurer allows him to develop and implement a more flexible strategy for sustainable development of the business.

China’s Aging Population Brings Opportunities for Insurers

The rapidly aging population in China is a great challenge for the country’s development and social security system, while it presents opportunities for insurance companies,according to a recent report by The Boston Consulting Group (BCG) and Swiss Re.

Study of Volatility Stochastic Processes in the Context of Solvency Forecasting for Sri Lankan Life Insurers

The main business of Life Insurers is Long Term contractual obligations with a typical lifetime of 20 - 40 years. Therefore, the Solvency metric is defined by the adequacy of capital to service the cash flow requirements arising from the said obligations. The main component inducing volatility in Capital is market sensitive Assets, such as Bonds and Equity. Bond and Equity prices in Sri Lanka are highly sensitive to macro-economic elements such as investor sentiment, political stability, policy environment, economic growth, fiscal stimulus, utility environment and in the case of Equity, societal sentiment on certain companies and industries. Therefore, if an entity is to accurately forecast the impact on solvency through asset valuation, the impact of macro-economic variables on asset pricing must be modelled mathematically. This paper explores mathematical, actuarial and statistical concepts such as Brownian motion, Markov Processes, Derivation and Integration as well as Probability theorems such as the Probability Density Function in determining the optimum mathematical model which depicts the accurate relationship between macro-economic variables and asset pricing.

Disparities between Explanatory Models of Health Clients, Healthcare Providers and Health Insurer

We present qualitative data from a study in Ghana （2011）, where the National Health Insurance Scheme （NHIS） was introduced to improve access to health care. In 2011 membership enrolment and retention in the scheme was stalling. To obtain better insights into socio-cultural factors that influence utilization of healthcare services and the NHIS this study compared Explanatory Models of healthcare clients with those of primary healthcare providers and the NHIS regarding illness, the need for, the quality of, and the control over heaithcare and health insurance services. We found critical disparities in socio-cultural beliefs and perceptions of healthcare and health insurance between these three stakeholder groups, such as the clients＇ holistic view on illness versus healthcare providers＇ bio-medical view; the clients＇ inter-relational focus in perceiving quality of services versus the providers＇ medical technical focus. These differences are leading to misconceptions, blame practice, poor services, non-adherence and low trust. The findings increase our understanding of clients＇ behavior and that of their service providers. We conclude with key messages for policy leaders and operational managers that can guide them in improving services and facilitating client trust and interest to participate in health insurance and utilize healthcare services.

China Approves Four New foreign Insurers

Four more foreign insurance companieshave been given approval to open branchesor set up joint ventures in China by theInsurance Regulatory Commission.They

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.