scholarly journals Litigations following spinal neurosurgery in France: “out-of-court system,” therapeutic hazard, and welfare state

2020 ◽  
Vol 49 (5) ◽  
pp. E11
Author(s):  
Bertrand Debono ◽  
Carole Gerson ◽  
Thierry Houselstein ◽  
Lynda Lettat-Ouatah ◽  
Renaud Bougeard ◽  
...  
Keyword(s):  
Cauda Equina ◽  
Functional Results ◽  
Data Bank ◽  
Final Decision ◽  
Insurance Company ◽  
Court System ◽  
Solidarity Fund ◽  
Classical Procedure ◽  
Random Nature ◽  
National Solidarity

OBJECTIVESpinal surgeries carry risks of malpractice litigation due to the random nature of their functional results, which may not meet patient expectations, and the hazards associated with these complex procedures. Claims are frequent and costly. In France, since 2002, a new law, the Patients’ Rights Law of March 4, 2002, has created an alternative, out-of-court scheme, which established a simplified, rapid, free-of-charge procedure (Commission for Conciliation and Compensation [CCI]). Moreover, this law has optimized the compensation provided to patients for therapeutic hazards by use of a national solidarity fund. The authors analyzed the consequences of this alternative route in the case of claims against private neurosurgeons in France.METHODSFrom the data bank of the insurer Mutuelle d’Assurances du Corps de Santé Français (MACSF), the main insurance company for private neurosurgeons in France, the authors retrospectively analyzed 193 files covering the period 2015–2019. These computerized files comprised the anonymized medical records of the patients, the reports of the independent experts, and the final judgments of the CCI and the entities supporting the compensation, if any.RESULTSDuring the 5-year study period (2015–2019), the insurance company recorded 494 complaints involving private neurosurgeons for spinal surgery procedures, of which 126 (25.5%) were in civil court, 123 (24.9%) were under amicable procedure, and 245 (49.6%) were in the out-of-court scheme administered by the CCI. Out of these 245 cases, only 193 were closed due to delays. The conclusions of the commission were rejection/incompetence decisions in 47.2% of the cases, therapeutic hazards in 21.2%, nosocomial infections in 17.6%, and practitioner fault in 13.5%. National solidarity compensated for 48 complaints (24.8%). The final decision of the CCI is not always consistent with the conclusions of the experts mandated by it, illustrating the difficulty in defining the concept of hazards. The authors found that the therapeutic hazards retained and compensated by the national solidarity included decompensated spondylotic myelopathies (15% of the 40 cases) and cauda equina syndromes (30%). As allowed by law, 11.5% of the patients who were not satisfied triggered a classical procedure in a court.CONCLUSIONSIn the French out-of-court system, trial decisions resulting in rulings of proven medical malpractice are rare, but patients can start a new procedure in the classical courts. The therapeutic hazard remains a subtle definition, which may be problematic and require further discussion between experts and magistrates. In spite of the imperfections, this out-of-court system proposes a major evolution to move patients and medical providers from legal battles to reconciliations.

Information Technology Process Improvement Decision-Making

2012 ◽  
Vol 3 (2) ◽  
pp. 18-35
Author(s):  
Sandy A. Lamp ◽  
Kathleen M. Hargiss ◽  
Caroline Howard
Keyword(s):  
Decision Making ◽  
Process Improvement ◽  
Cost Benefit Analysis ◽  
Investment Decision ◽  
Cost Benefit ◽  
Final Decision ◽  
Insurance Company ◽  
Senior Leadership ◽  
Structured Interviews ◽  
Process Managers

This article is derived from a qualitative multicase study with two settings that explored the way decisions are made in two IT organizations regarding process improvement initiatives by using face-to-face semi-structured interviews with 20 IT process owners and managers. The two participating organizations are a healthcare insurance company and a manufacturer of electronic interconnects. The study sought to uncover (a) how IT process improvements are prioritized and how approvals are attained, (b) how senior leadership is involved in decision making, (c) how security and risk are considered, (d) if and how formal process improvement methodologies are used, (e) if and how estimated and actual cost benefit analysis are conducted associated with decisions, and (f) how alignment with organizational goals is attained. The topic of IT governance was narrowed to explore the perspective of IT process owners and process managers, and their approaches and methodologies used with IT process improvement initiatives. The study found that pre-decision stages take place in IT investment decision making, and that process owners and process managers, participants other than senior leadership, and executive level decision makers are involved in these pre-decision stages and may be involved in the final decision stages.

LEGAL REGULATION THE MECHANISM OF CONCLUDING AGREEMENTS AS A MEANS OF REACHING A COMPROMISE IN THE CRIMINAL JUSTICE OF UKRAINE: HISTORICAL ASPECT

2020 ◽  
pp. 119-129
Author(s):  
Mariia Sirotkina
Keyword(s):  
Criminal Justice ◽  
Functional Results ◽  
Legal Regulation ◽  
Practical Significance ◽  
Political Regime ◽  
Final Decision ◽  
Criminal Proceedings ◽  
Historical Aspect ◽  
Historical Periods ◽  
Comprehensive Study

Purpose. The aim of the article is to study the genesis and development of legal regulation of the mechanism of concluding agreements as a means of reaching a compromise in the criminal justice of Ukraine. Methodology. The methodology involves a comprehensive study of historical and theoretical material on this issue, as well as the formulation of relevant conclusions and recommendations. The following methods of scientific cognition were used during the research: historical, historical-legal, terminological, formal-logical, system-functional. Results. In the course of the research it was established that the domestic experience of the development of the institution of agreements in criminal proceedings originates from Russka Pravda, which enshrined the rules of simplified proceedings, and the guilty plea directly affected the final decision. An important stage in the development of legal regulation of compromise procedures was the adoption in 1864 of the Statute of Criminal Justice. According to its provisions, if the accused pleaded guilty and his confession did not cause the judge to doubt, the judge could immediately proceed to sentencing in the case, without further investigation. In the pre-revolutionary and Soviet historical periods, the nature of criminal justice was particularly strongly influenced by the political regime. In 1918-1960 there was a significant slowdown in the development of compromise criminal procedure institutions. Scientific novelty. According to the results of the study, it is established that the institution of agreements in criminal proceedings continues its formation taking into account the historical preconditions of its development. Practical significance. The results of the research and historical experience of legal regulation can be used to improve the current legislation of Ukraine, which regulates the mechanism of concluding agreements in criminal proceedings.

scholarly journals Modelling of technical reserves of an insurance company

2019 ◽  
pp. 46-51
Author(s):  
M. S. Lyzhechko ◽  
I. V. Rozora
Keyword(s):  
Insurance Industry ◽  
Stochastic Modelling ◽  
Insurance Company ◽  
Deterministic Models ◽  
Time Value Of Money ◽  
Deterministic Methods ◽  
Chain Ladder Method ◽  
Chain Ladder ◽  
Value Of Money ◽  
Random Nature

In the modern rapidly evolving society, the science and the business are facing new needs and challenges constantly. The insurance industry and its mathematical foundation, the actuarial science, are not exceptions. Currently, the greatest challenge that the insurance system has to cope with is the issue of the new international financial standard that affects the calculation of reserves among other things. So far, insurers have mainly used common classical deterministic methods. However, the new standard emphasizes the necessity of the realistic prognosis that is best achieved with stochastic modelling tools since deterministic models do not represent the uncertainty and the random nature of future possible losses. This article considers the advantage of using stochastic modelling for reserve calculation in comparison to the deterministic approach. The article consists of five sections. In the first section, we briefly present the technique that lies in the basis of technical reserves calculation. The second section is devoted to such deterministic methods of reserve calculation as the Bornhuetter-Ferguson method and the chain-ladder method. In the third section, we consider modifications of two stochastic models – the Mack method and the bootstrapping technique. The fourth section considers the adjustment of reserves for the time value of money and inflation. In the fifth section, the results of modelling in the programming language R are presented.

scholarly journals Marketing Research of the Medical Institution in the System of Voluntary Medical Insurance for Making Managerial Decisions

2018 ◽  
pp. 164-171
Author(s):  
A. B. Tsvetkova ◽  
R. Kh. Yunisov
Keyword(s):  
Marketing Research ◽  
Medical Insurance ◽  
Medical Institution ◽  
Final Decision ◽  
Insurance Company ◽  
Process Data ◽  
Managerial Decisions ◽  
System Data ◽  
Marketing Information ◽  
Competitive Products

The segment of voluntary medical insurance is a promising type of insurance. This situation encourages insurers to develop advanced competitive products with continuously upgrading level of service. It is very important to pay special attention to legal and medical and economic protection of the ensured. It is clear that the insurance company needs data of marketing research for its efficient work. However, we should bear in mind that one party of the voluntary medical insurance is a medical institution, which is involved in the process and understands the importance of marketing information system data while signing the contract with the insurance company. Systematized data of the medical institution gives an opportunity to choose an optimal partner. The article using the example of NMHC named after N.I.Pirogov shows which data is analyzed by the medical institution and why and demonstrates how the mechanism of making decision about choosing the insurance company looks like. It was highlighted that using the internal information could allow the medical institution to save money and time necessary to process data and make the final decision. The authors ground recommendations for using the research in the process of signing the contract with the insurance company, a relevant model was built as an illustration.

scholarly journals FIGHT AGAINST CORRUPTION IN UKRAINE AS THE PRECONDITION FOR INTRODUCTION OF VISA-FREE REGIME WITH THE EUROPEAN UNION

2016 ◽  
pp. 74-81
Author(s):  
N. Mushak
Keyword(s):  
Action Plan ◽  
Final Decision ◽  
Court System ◽  
The European Union ◽  
National Agency ◽  
Effective Work ◽  
The Public ◽  
Four Blocks ◽  
Corruption Prevention ◽  
The Eu

Nowadays, the only unreformed component, which remains within the legal system of Ukraine is the Ukrainian court system. The main factors that affect the activity of the courts in Ukraine are both political and economic corruption. If we compare the degree of influence on the courts, we can say that the activity of the CCU mostly suffers from political corruption while the economic corruption significantly affects the activity of courts of general jurisdiction. To implement legal instruments to combat corruption in Ukraine the appropriate system of enforcement bodies has been implemented. It involves the National Anti-Corruption Bureau of Ukraine (hereinafter – NABU), Anti-corruption Prosecutor Office, the National Agency for the Corruption Prevention (hereinafter – NACP) and the Agency for Investigation / Return Assets. The article defines that unresolved problem is the launch by the National Agency for the Prevention of Corruption of the electronic declaration system to be held on 15 August 2016. The launch of e-declaration is an essential is the final commitment of Ukraine to obtain the free visa regime. The final decision on the implementation by Ukraine of the criteria of the Action Plan on Visa Liberalization was approved by the EU Commission on 18 December 2015. The document stipulates that Ukraine fulfilled all the criteria set of four blocks of APVL. Nowadays Ukraine is expecting to get the visa regime from the EU. In general, for effective implementation of anti-corruption policy in Ukraine should be introduced a systematic approach. The phenomenon of corruption is systemic, and accordingly it must be overcome only by joint efforts. It is necessary to ensure the independence of anti-corruption bodies and prevent their political dependence on the governing bodies; establish effective work of the National Agency for Corruption Prevention, the National Anti-Corruption Bureau, Anti-corruption Prosecutor's Office and the Agency for Investigation/return assets must; inform the public on their performance; and to provide penalties for officials who committed corruption offenses.

scholarly journals Senegal

2020 ◽  
Vol 20 (108) ◽  
Author(s):  
Keyword(s):  
Health System ◽  
Balance Of Payments ◽  
State Of Emergency ◽  
Travel And Tourism ◽  
Comprehensive Plan ◽  
Solidarity Fund ◽  
External Demand ◽  
Containment Measures ◽  
Vulnerable Households ◽  
National Solidarity

The COVID-19 pandemic has weakened the macroeconomic outlook for Senegal’s economy. Containment measures to avoid the propagation of the virus, lower external demand, reduced remittances, and the sudden stop of travel and tourism are having a significant impact on growth and generating an urgent budgetary and balance-of-payments (BOP) needs. The authorities have taken strong actions to address the pandemic by declaring a state of emergency, closing schools, suspending flights, banning public gatherings, and imposing a curfew. They are implementing a comprehensive plan to upgrade the health system and contain the economic impact, including by setting up a national solidarity fund and providing targeted support to vulnerable households and firms.

Tuesday Evening

PMLA ◽  
1935 ◽  
Vol 50 (4) ◽  
pp. 1357-1357
Keyword(s):  
Life Insurance ◽  
Insurance Company ◽  
Life Insurance Company ◽  
Local Committee ◽  
Tuesday Evening

On Tuesday evening the members of the Association, and attending members of their families, were entertained with a buffet supper at the Queen City Club at 7:30 p.m. at the invitation of Messrs. Joseph S. Graydon, John J. Rowe, and other Cincinnati friends of the Association. Following this supper an entertainment arranged by the Local Committee was presented in the Hall of the Western and Southern Life Insurance Company. Attendance: about 900.

Pacinioma of the cauda equina

2006 ◽  
Vol 48 (12) ◽  
pp. 994 ◽  
Author(s):  
Nika Kojc ◽  
Marjan Koršic ◽  
Mara Popovic
Keyword(s):  
Cauda Equina
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