In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focu...In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focused on the implications of public health plans such as Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance as well as out-of-pocket ratios on patient treatment plans regarding whether they pursue surgical interventions or therapeutic treatments such as chemotherapy.While Wu et al put forth potential explanations for why patients with the UEBMI plan surprisingly had a 23.30%increased risk of oesophageal cancer-specific death,more analysis is needed to alleviate cancer burden within this group.Although it is likely that patients covered by Urban Resident Basic Medical Insurance and higher out-ofpocket ratios have stronger self-recovery awareness,more work must be done to improve outcomes for people with the UEBMI plan while simultaneously implementing international and domestic initiatives to better emphasize cancer prevention and early detection.Lastly,future research must explore the relationship between Serious Illness Medical Insurance as well as the New Rural Cooperative Medical System on the mortality rate of oesophageal cancer patients in rural China,where disease burden is significantly higher than urban areas.By unifying these public health insurance schemes,officials can significantly alleviate economic burden of treatment and better prognosis for patients with oesophageal cancer.展开更多
With the rapid development of China's insurance market,the high-quality development of the insurance market is faced with many different challenges and various problems.This paper aims to deeply analyze the actual...With the rapid development of China's insurance market,the high-quality development of the insurance market is faced with many different challenges and various problems.This paper aims to deeply analyze the actual problems in China's insurance market and put forward supporting countermeasures.First,by understanding the background of highquality insurance development,we can explain the research significance of this paper in combination with the existing national policies.Secondly,by summarizing the current situation of high-quality insurance development,the paper puts forward the shortage of insurance talents in the expansion of insurance scale,the continuous improvement of insurance density and depth,and the growth of insurance compensation in the development of high-quality insurance.Finally,from the perspective of differentiated customized insurance products,training professionals,and providing financial subsidies,we will put forward the corresponding suggestions for the problem and look forward to the future development prospects.展开更多
This article investigates the development process and current status of policy-based agricultural insurance in Chongqing.Based on recent data-including premium income,compensation amounts,the number of insured househo...This article investigates the development process and current status of policy-based agricultural insurance in Chongqing.Based on recent data-including premium income,compensation amounts,the number of insured households,and insurance penetration,the article analyzes the primary challenges faced in the system's operation and proposes recommendations from two dimensions:institutional optimization and practical interventions.These recommendations include establishing a differentiated participation incentive mechanism,optimizing the composition of insurance products,enhancing risk diversification and reinsurance systems,creating an agricultural disaster risk reserve fund,developing a dynamic fiscal subsidy distribution mechanism based on risk and performance,improving information-sharing platforms,strengthening the rural grassroots power grid infrastructure,and accelerating the adoption of modern technologies in underwriting and claims settlement processes.The findings suggest that the coordinated advancement of institutional optimization and technological empowerment can substantially enhance the inclusiveness,sustainability,and operational efficiency of policy-based agricultural insurance in Chongqing,thereby providing substantial support for agricultural modernization and the Rural Revitalization Strategy.展开更多
BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal ...BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.展开更多
The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of heal...The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of health insurance on treatment availability and patient outcomes,demonstrating that the type of insurance can affect the financial burden on patients.This study investigates the effects of different types of health care coverage,namely Urban Employee Basic Medical Insurance vs Urban-Rural Resident Basic Medical Insurance,and the personal spending ratio on treatment decisions and survival outcomes.The database used is derived from esophageal tumor patient continuation from Chongqing University Hospital in China.A total of 2543 patients were included in the study,allowing for the formation of research cohorts.Patient information included demographic characteristics.The study followed various processes to maintain consistency,including data sources,inclusion and exclusion criteria,follow-up duration,health insurance,and statistical analysis.The average age at diagnosis ranged from 57-74 years,and predominantly included men,married people,and those of Han ethnic background,comprising 2088 and 2519 individuals,respectively.Upon controlling for age,sex,relationship status,country of origin,pathological evaluation,tumor stage,and biochemical indicators,individuals who had Urban Employee Basic Medical Insurance exhibited a higher propensity to opt for radiotherapy,chemotherapy,immunotherapy,and targeted therapy compared to those covered by the Urban-Rural Resident Basic Medical Insurance.During the follow-up phase of the study,a total of 1438 deaths were documented,with 1106 ascribed to esophageal cancer.Additionally,individuals with Urban-Rural Resident Basic Medical Insurance had a significantly elevated risk of esophageal cancer,particularly mortality,compared to those without Urban-Rural Resident Basic Medical Insurance.展开更多
BACKGROUND Private insurance coverage is associated with higher rates of living donor kidney transplantation(LDKT)but whether this is attributable to confounding is not known.AIM To study the association between incre...BACKGROUND Private insurance coverage is associated with higher rates of living donor kidney transplantation(LDKT)but whether this is attributable to confounding is not known.AIM To study the association between increased access to private health insurance and LDKT.METHODS Retrospective cohort study using United States transplant registry data.We identified incident candidates aged 22-29 years who were waitlisted for a kidneyonly transplant from 2005-2014,excluding prior transplant recipients and those with missing data.We calculated the hazard of LDKT after waitlisting for those with private insurance vs other insurance pre-Affordable Care Act(ACA)vs post-ACA,using death and delisting as competing events,for candidates affected by the policy change(age 22-25 years)vs those who were not(age 26-29 years).RESULTS A total of 13817 candidates were included,of whom 46%were age 22-25 years and 54%were age 26-29 years.Among candidates aged 22-25 years at listing,those listed post-ACA were more likely to have private insurance compared to those listed pre-ACA(42%vs 35%),but there was no difference in private insurance coverage between eras among candidates aged 26-29 years at listing.In adjusted competing risk regression,privately insured patients age 22-25 years were less likely to receive a LDKT post-ACA compared to pre-ACA[hazard ratio(HR)=0.88,95%CI:0.78-1.00],as were those aged 22-25 years old with other insurance types(HR=0.80,95%CI:0.69-0.92).These associations were not seen among candidates age 26-29 years.CONCLUSION Candidates age 22-25 years were likelier to have private insurance post-ACA,without an increased rate in LDKT.Demonstrations of associations between insurance and LDKT are likely attributable to residual confounding.展开更多
Agricultural insurance plays a key role in promoting the coordinated development of green agriculture and farmers’income growth,which is crucial for China’s high-quality agricultural development.Using the coupling c...Agricultural insurance plays a key role in promoting the coordinated development of green agriculture and farmers’income growth,which is crucial for China’s high-quality agricultural development.Using the coupling coordination degree model,this study empirically demonstrates that the development of agricultural insurance significantly promotes the coordinated development of green agriculture and farmers’income growth once a certain threshold is exceeded.This effect is more pronounced in the major grain-producing regions and the central provinces.Expanding the scale of agricultural production and increasing investment in agricultural technology are the key mechanisms through which agricultural insurance supports the dual goals of green agriculture and income growth in China.In conclusion,this study proposes several policy recommendations,which include increasing investment in agricultural insurance infrastructure,strengthening the policy guidance for agricultural insurance,and designing differentiated agricultural insurance policies.展开更多
China’s healthcare system faces increasing challenges,including surging medical costs,resource allocation imbalances favoring large hospitals,and ineffective referral mechanisms.The lack of a unified strategy integra...China’s healthcare system faces increasing challenges,including surging medical costs,resource allocation imbalances favoring large hospitals,and ineffective referral mechanisms.The lack of a unified strategy integrating standardized coverage with personalized payment compounds these issues.To this end,this study proposes a risk-sharing reform strategy that combines equal coverage for the same disease(ECSD)with an individualized out-of-pocket(I-OOP)model.Specifically,the study employs a Markov model to capture patient transitions across health states and care levels.The findings show that ECSD and I-OOP enhance equity by standardizing disease coverage while tailoring costs to patient income and facility type.This approach alleviates demand on high-tier hospitals,promoting primary care utilization and enabling balanced resource distribution.The study’s findings provide a reference for policymakers and healthcare administrators by presenting a scalable framework that is aligned with China’s development goals with the aim of fostering an efficient,sustainable healthcare system that is adaptable to regional needs.展开更多
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 t...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.展开更多
Objective Antiretroviral drugs covered by medical insurance have been gradually used by people living with human immunodeficiency virus(PLWH)in recent years in China.This study aimed to analyze their willingness to pa...Objective Antiretroviral drugs covered by medical insurance have been gradually used by people living with human immunodeficiency virus(PLWH)in recent years in China.This study aimed to analyze their willingness to pay(WTP)for antiretroviral drugs.Methods A mixed-methods study design involving a cross-sectional survey and in-depth interviews was conducted.A cross-sectional survey was performed to collect data on the general characteristics,economic status,antiretroviral therapy(ART)status,and WTP of PLWH in 18 Chinese cities from August 2022 to February 2023.Multivariate logistic regression was used to analyze the factors associated with WTP.Representatives of PLWH were interviewed via in-depth interviews,and the data were thematically analyzed.Results Among the 941 PLWH,271(28.80%)were willing to pay for antiretroviral drugs covered by medical insurance.For basic medical insurance for urban and rural residents,PLWH with the following characteristics were more willing to pay:an educational level of senior high school or technical secondary school,having an undergraduate degree or higher,frequently working away from their hometowns,and homosexual transmission.Off-farm workers and recipients of government medical aid were more unwilling to pay.For basic medical insurance for urban employees,PLWH with the following characteristics were more willing to pay:frequently working away from their hometowns;homosexual transmission;personal annual income≥100,000 CNY;and adverse events of antiretroviral drugs.The main reasons for PLWH’s WTP for antiretroviral drugs covered by medical insurance were that the drugs had fewer adverse events and were easier to administer.The main reasons for PLWH’s unwillingness to pay were financial difficulties and privacy concerns.Conclusion Nearly one-third of PLWH are willing to pay for antiretroviral drugs covered by medical insurance.In the future,PLWH with a high WTP can be guided to use these drugs.展开更多
The paper presents an innovative approach towards agricultural insurance underwriting and risk pricing through the development of an Extreme Machine Learning (ELM) Actuarial Intelligent Model. This model integrates di...The paper presents an innovative approach towards agricultural insurance underwriting and risk pricing through the development of an Extreme Machine Learning (ELM) Actuarial Intelligent Model. This model integrates diverse datasets, including climate change scenarios, crop types, farm sizes, and various risk factors, to automate underwriting decisions and estimate loss reserves in agricultural insurance. The study conducts extensive exploratory data analysis, model building, feature engineering, and validation to demonstrate the effectiveness of the proposed approach. Additionally, the paper discusses the application of robust tests, stress tests, and scenario tests to assess the model’s resilience and adaptability to changing market conditions. Overall, the research contributes to advancing actuarial science in agricultural insurance by leveraging advanced machine learning techniques for enhanced risk management and decision-making.展开更多
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 fo...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.展开更多
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 busine...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.展开更多
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...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.展开更多
With the rise of new business forms,the traditional industrial-era model of binding social insurance to labor relations is facing unprecedented challenges.In the context of these new business forms,whether the protect...With the rise of new business forms,the traditional industrial-era model of binding social insurance to labor relations is facing unprecedented challenges.In the context of these new business forms,whether the protection of workers’social insurance rights and interests can be“decoupled from labor relations”has become a hotly debated topic in academia,with“the ability to establish labor relations”emerging as a key variable influencing government departments’policy choices on classified social insurance coverage.Based on this,the paper constructs a theoretical model of the correlation between social insurance and labor relations to analyze cases concerning the protection of social insurance rights and interests of workers in new business forms.It examines the advantages and disadvantages of binding social insurance to labor relations and suggests promoting social insurance policy innovation by transcending labor relations.The paper advocates abandoning the path dependency that starts with labor relations and clarifying the theoretical basis that workers’access to social insurance rights should be based on labor rather than employment.To adapt to the profit model of new business forms,it proposes establishing a rule of“proportional responsibility for commissions,”where the social insurance contribution base is determined by the proportion and amount of corporate commissions.By reasonably setting rates,it will protect the healthy development of new business forms in a balanced manner.In this way,enterprises can share social insurance responsibilities according to unified rules without worrying about being classified as having a labor relationship,which helps fully protect workers’social insurance rights and interests and promotes fair competition and healthy development among enterprises.展开更多
One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in med...One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in medicine, pharmaceutical trends, and political factors are only a few of the many factors that cause annual fluctuations in healthcare costs. This paper describes how a system may analyse a person’s medical history to display their insurance plans and make predictions about their health insurance premiums. The performance of four ML models—XGBoost, Lasso, KNN, and Ridge—is evaluated using R2-score and RMSE. The analysis of medical health insurance cost prediction using Lasso regression, Ridge regression, and K-Nearest Neighbours (KNN), and XGBoost (XGB) highlights notable differences in performance. KNN has the lowest R2-score of 55.21 and an RMSE of 4431.1, indicating limited predictive ability. Ridge Regression improves on this by an R2-score of 78.38 but has a higher RMSE of 4652.06. Lasso Regression slightly edges out Ridge with an R2-score of 79.78, yet it suffers from an advanced RMSE of 5671.6. In contrast, XGBoost excels with the highest R2-score of 86.81 and the lowermost RMSE of 4450.4, demonstrating superior predictive accuracy and making it the most effective model for this task. The best method for accurately predicting health insurance premiums was XGBoost Regression. The findings beneficial for policymakers, insurers, and healthcare providers as they can use this information to allocate resources more efficiently and enhance cost-effectiveness in the healthcare industry.展开更多
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 i...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.展开更多
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 ...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.展开更多
文摘In this article,we comment on the work put forth by Wu et al regarding the investigation of oesophageal cancer-specific mortality for a cohort of patients from Chongqing University Cancer Hospital.We specifically focused on the implications of public health plans such as Urban Employee Basic Medical Insurance(UEBMI)and Urban Resident Basic Medical Insurance as well as out-of-pocket ratios on patient treatment plans regarding whether they pursue surgical interventions or therapeutic treatments such as chemotherapy.While Wu et al put forth potential explanations for why patients with the UEBMI plan surprisingly had a 23.30%increased risk of oesophageal cancer-specific death,more analysis is needed to alleviate cancer burden within this group.Although it is likely that patients covered by Urban Resident Basic Medical Insurance and higher out-ofpocket ratios have stronger self-recovery awareness,more work must be done to improve outcomes for people with the UEBMI plan while simultaneously implementing international and domestic initiatives to better emphasize cancer prevention and early detection.Lastly,future research must explore the relationship between Serious Illness Medical Insurance as well as the New Rural Cooperative Medical System on the mortality rate of oesophageal cancer patients in rural China,where disease burden is significantly higher than urban areas.By unifying these public health insurance schemes,officials can significantly alleviate economic burden of treatment and better prognosis for patients with oesophageal cancer.
文摘With the rapid development of China's insurance market,the high-quality development of the insurance market is faced with many different challenges and various problems.This paper aims to deeply analyze the actual problems in China's insurance market and put forward supporting countermeasures.First,by understanding the background of highquality insurance development,we can explain the research significance of this paper in combination with the existing national policies.Secondly,by summarizing the current situation of high-quality insurance development,the paper puts forward the shortage of insurance talents in the expansion of insurance scale,the continuous improvement of insurance density and depth,and the growth of insurance compensation in the development of high-quality insurance.Finally,from the perspective of differentiated customized insurance products,training professionals,and providing financial subsidies,we will put forward the corresponding suggestions for the problem and look forward to the future development prospects.
基金Supported by Chongqing Social Science Planning Project(Doctoral Project)"Research Support on the Impact of Policy-based Agricultural Insurance on the Production Behavior of Chinese Farmers"(2020BS39).
文摘This article investigates the development process and current status of policy-based agricultural insurance in Chongqing.Based on recent data-including premium income,compensation amounts,the number of insured households,and insurance penetration,the article analyzes the primary challenges faced in the system's operation and proposes recommendations from two dimensions:institutional optimization and practical interventions.These recommendations include establishing a differentiated participation incentive mechanism,optimizing the composition of insurance products,enhancing risk diversification and reinsurance systems,creating an agricultural disaster risk reserve fund,developing a dynamic fiscal subsidy distribution mechanism based on risk and performance,improving information-sharing platforms,strengthening the rural grassroots power grid infrastructure,and accelerating the adoption of modern technologies in underwriting and claims settlement processes.The findings suggest that the coordinated advancement of institutional optimization and technological empowerment can substantially enhance the inclusiveness,sustainability,and operational efficiency of policy-based agricultural insurance in Chongqing,thereby providing substantial support for agricultural modernization and the Rural Revitalization Strategy.
基金Supported by the Chongqing Science and Health Joint Medical Research Project,No.2024MSXM065.
文摘BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.
文摘The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of health insurance on treatment availability and patient outcomes,demonstrating that the type of insurance can affect the financial burden on patients.This study investigates the effects of different types of health care coverage,namely Urban Employee Basic Medical Insurance vs Urban-Rural Resident Basic Medical Insurance,and the personal spending ratio on treatment decisions and survival outcomes.The database used is derived from esophageal tumor patient continuation from Chongqing University Hospital in China.A total of 2543 patients were included in the study,allowing for the formation of research cohorts.Patient information included demographic characteristics.The study followed various processes to maintain consistency,including data sources,inclusion and exclusion criteria,follow-up duration,health insurance,and statistical analysis.The average age at diagnosis ranged from 57-74 years,and predominantly included men,married people,and those of Han ethnic background,comprising 2088 and 2519 individuals,respectively.Upon controlling for age,sex,relationship status,country of origin,pathological evaluation,tumor stage,and biochemical indicators,individuals who had Urban Employee Basic Medical Insurance exhibited a higher propensity to opt for radiotherapy,chemotherapy,immunotherapy,and targeted therapy compared to those covered by the Urban-Rural Resident Basic Medical Insurance.During the follow-up phase of the study,a total of 1438 deaths were documented,with 1106 ascribed to esophageal cancer.Additionally,individuals with Urban-Rural Resident Basic Medical Insurance had a significantly elevated risk of esophageal cancer,particularly mortality,compared to those without Urban-Rural Resident Basic Medical Insurance.
基金Supported by National Institute of Diabetes and Digestive and Kidney Diseases,United States,No.K23DK133729。
文摘BACKGROUND Private insurance coverage is associated with higher rates of living donor kidney transplantation(LDKT)but whether this is attributable to confounding is not known.AIM To study the association between increased access to private health insurance and LDKT.METHODS Retrospective cohort study using United States transplant registry data.We identified incident candidates aged 22-29 years who were waitlisted for a kidneyonly transplant from 2005-2014,excluding prior transplant recipients and those with missing data.We calculated the hazard of LDKT after waitlisting for those with private insurance vs other insurance pre-Affordable Care Act(ACA)vs post-ACA,using death and delisting as competing events,for candidates affected by the policy change(age 22-25 years)vs those who were not(age 26-29 years).RESULTS A total of 13817 candidates were included,of whom 46%were age 22-25 years and 54%were age 26-29 years.Among candidates aged 22-25 years at listing,those listed post-ACA were more likely to have private insurance compared to those listed pre-ACA(42%vs 35%),but there was no difference in private insurance coverage between eras among candidates aged 26-29 years at listing.In adjusted competing risk regression,privately insured patients age 22-25 years were less likely to receive a LDKT post-ACA compared to pre-ACA[hazard ratio(HR)=0.88,95%CI:0.78-1.00],as were those aged 22-25 years old with other insurance types(HR=0.80,95%CI:0.69-0.92).These associations were not seen among candidates age 26-29 years.CONCLUSION Candidates age 22-25 years were likelier to have private insurance post-ACA,without an increased rate in LDKT.Demonstrations of associations between insurance and LDKT are likely attributable to residual confounding.
基金This paper presents preliminary research findings from two projects:a major project funded by the National Social Science Fund of China,titled“Changes in the Nature of Rural Poverty in China in the New Era and Research on Post-2020 Anti-Poverty Policies”(Project No:19ZDA116)Doctoral Research Project under the Special Program for Talents in Shortage Areas Serving National Needs,Nanjing University of Finance and Economics,titled“The Impact of Policy-Based Agricultural Insurance on Farmers’Income and Welfare Levels”(Project No:BSZX2021-12).
文摘Agricultural insurance plays a key role in promoting the coordinated development of green agriculture and farmers’income growth,which is crucial for China’s high-quality agricultural development.Using the coupling coordination degree model,this study empirically demonstrates that the development of agricultural insurance significantly promotes the coordinated development of green agriculture and farmers’income growth once a certain threshold is exceeded.This effect is more pronounced in the major grain-producing regions and the central provinces.Expanding the scale of agricultural production and increasing investment in agricultural technology are the key mechanisms through which agricultural insurance supports the dual goals of green agriculture and income growth in China.In conclusion,this study proposes several policy recommendations,which include increasing investment in agricultural insurance infrastructure,strengthening the policy guidance for agricultural insurance,and designing differentiated agricultural insurance policies.
基金The National Natural Science Foundation of China(No.72071042)。
文摘China’s healthcare system faces increasing challenges,including surging medical costs,resource allocation imbalances favoring large hospitals,and ineffective referral mechanisms.The lack of a unified strategy integrating standardized coverage with personalized payment compounds these issues.To this end,this study proposes a risk-sharing reform strategy that combines equal coverage for the same disease(ECSD)with an individualized out-of-pocket(I-OOP)model.Specifically,the study employs a Markov model to capture patient transitions across health states and care levels.The findings show that ECSD and I-OOP enhance equity by standardizing disease coverage while tailoring costs to patient income and facility type.This approach alleviates demand on high-tier hospitals,promoting primary care utilization and enabling balanced resource distribution.The study’s findings provide a reference for policymakers and healthcare administrators by presenting a scalable framework that is aligned with China’s development goals with the aim of fostering an efficient,sustainable healthcare system that is adaptable to regional needs.
文摘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.
基金supported by the National Natural Science Foundation of China[Grant No.72374186]。
文摘Objective Antiretroviral drugs covered by medical insurance have been gradually used by people living with human immunodeficiency virus(PLWH)in recent years in China.This study aimed to analyze their willingness to pay(WTP)for antiretroviral drugs.Methods A mixed-methods study design involving a cross-sectional survey and in-depth interviews was conducted.A cross-sectional survey was performed to collect data on the general characteristics,economic status,antiretroviral therapy(ART)status,and WTP of PLWH in 18 Chinese cities from August 2022 to February 2023.Multivariate logistic regression was used to analyze the factors associated with WTP.Representatives of PLWH were interviewed via in-depth interviews,and the data were thematically analyzed.Results Among the 941 PLWH,271(28.80%)were willing to pay for antiretroviral drugs covered by medical insurance.For basic medical insurance for urban and rural residents,PLWH with the following characteristics were more willing to pay:an educational level of senior high school or technical secondary school,having an undergraduate degree or higher,frequently working away from their hometowns,and homosexual transmission.Off-farm workers and recipients of government medical aid were more unwilling to pay.For basic medical insurance for urban employees,PLWH with the following characteristics were more willing to pay:frequently working away from their hometowns;homosexual transmission;personal annual income≥100,000 CNY;and adverse events of antiretroviral drugs.The main reasons for PLWH’s WTP for antiretroviral drugs covered by medical insurance were that the drugs had fewer adverse events and were easier to administer.The main reasons for PLWH’s unwillingness to pay were financial difficulties and privacy concerns.Conclusion Nearly one-third of PLWH are willing to pay for antiretroviral drugs covered by medical insurance.In the future,PLWH with a high WTP can be guided to use these drugs.
文摘The paper presents an innovative approach towards agricultural insurance underwriting and risk pricing through the development of an Extreme Machine Learning (ELM) Actuarial Intelligent Model. This model integrates diverse datasets, including climate change scenarios, crop types, farm sizes, and various risk factors, to automate underwriting decisions and estimate loss reserves in agricultural insurance. The study conducts extensive exploratory data analysis, model building, feature engineering, and validation to demonstrate the effectiveness of the proposed approach. Additionally, the paper discusses the application of robust tests, stress tests, and scenario tests to assess the model’s resilience and adaptability to changing market conditions. Overall, the research contributes to advancing actuarial science in agricultural insurance by leveraging advanced machine learning techniques for enhanced risk management and decision-making.
基金The authors acknowledge the financial support of the Dutch Research Council(NWO-WOTRO)(Grant No.W07.45.103.00)and the support of D.P.Hoijer Fonds,Erasmus Trustfonds,Erasmus University Rotterdam.
文摘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.
文摘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.
文摘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.
基金the Humanities and Social Sciences Planning Fund Project of the Ministry of Education:“Research on the Transfer and Institutional Coordination Mechanism of Social Insurance Relations for Retired Military Personnel”(Project Approval Number 18YJAZH122)the Shandong Workers’Movement Insti-tute’s project“Case Study on Protection of Rights and Interests of Workers in New Business Forms Based on Grounded Theory”(Project Approval Number SDGY2023-12).
文摘With the rise of new business forms,the traditional industrial-era model of binding social insurance to labor relations is facing unprecedented challenges.In the context of these new business forms,whether the protection of workers’social insurance rights and interests can be“decoupled from labor relations”has become a hotly debated topic in academia,with“the ability to establish labor relations”emerging as a key variable influencing government departments’policy choices on classified social insurance coverage.Based on this,the paper constructs a theoretical model of the correlation between social insurance and labor relations to analyze cases concerning the protection of social insurance rights and interests of workers in new business forms.It examines the advantages and disadvantages of binding social insurance to labor relations and suggests promoting social insurance policy innovation by transcending labor relations.The paper advocates abandoning the path dependency that starts with labor relations and clarifying the theoretical basis that workers’access to social insurance rights should be based on labor rather than employment.To adapt to the profit model of new business forms,it proposes establishing a rule of“proportional responsibility for commissions,”where the social insurance contribution base is determined by the proportion and amount of corporate commissions.By reasonably setting rates,it will protect the healthy development of new business forms in a balanced manner.In this way,enterprises can share social insurance responsibilities according to unified rules without worrying about being classified as having a labor relationship,which helps fully protect workers’social insurance rights and interests and promotes fair competition and healthy development among enterprises.
文摘One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in medicine, pharmaceutical trends, and political factors are only a few of the many factors that cause annual fluctuations in healthcare costs. This paper describes how a system may analyse a person’s medical history to display their insurance plans and make predictions about their health insurance premiums. The performance of four ML models—XGBoost, Lasso, KNN, and Ridge—is evaluated using R2-score and RMSE. The analysis of medical health insurance cost prediction using Lasso regression, Ridge regression, and K-Nearest Neighbours (KNN), and XGBoost (XGB) highlights notable differences in performance. KNN has the lowest R2-score of 55.21 and an RMSE of 4431.1, indicating limited predictive ability. Ridge Regression improves on this by an R2-score of 78.38 but has a higher RMSE of 4652.06. Lasso Regression slightly edges out Ridge with an R2-score of 79.78, yet it suffers from an advanced RMSE of 5671.6. In contrast, XGBoost excels with the highest R2-score of 86.81 and the lowermost RMSE of 4450.4, demonstrating superior predictive accuracy and making it the most effective model for this task. The best method for accurately predicting health insurance premiums was XGBoost Regression. The findings beneficial for policymakers, insurers, and healthcare providers as they can use this information to allocate resources more efficiently and enhance cost-effectiveness in the healthcare industry.
文摘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.
文摘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.
