scholarly journals Insurance decisions under nonperformance risk and ambiguity

Author(s):  
Timo R. Lambregts ◽  
Paul van Bruggen ◽  
Han Bleichrodt

AbstractAn important societal problem is that people underinsure against risks that are unlikely or occur in the far future, such as natural disasters and long-term care needs. One explanation is that uncertainty about the risk of non-reimbursement induces ambiguity averse and risk prudent decision makers to take out less insurance. We set up an insurance experiment to test this explanation. Consistent with the theoretical predictions, we find that the demand for insurance is lower when the nonperformance risk is ambiguous than when it is known and when decision makers are risk prudent. We cannot attribute the lower take-up of insurance to our measure of ambiguity aversion, probably because ambiguity attitudes are richer than aversion alone.

2020 ◽  
Vol 103 (12) ◽  
pp. 1315-1324

Background: Factors related to long-term care needs have been studied widely, but there is limited research about the influence of health literacy on long-term care needs among the elderly in rural communities where the social context and care environment are uniquely different. Objective: To examine factors influencing long-term care needs among Thai elderly in rural communities. Materials and Methods: The present study used the cross-sectional design. The study sample included 477 elderly persons, who were members of the communities in Nakhon Ratchasima Province. Multi-stage random sampling was used to select participants. They were interviewed using the demographic and health information questionnaire, the Thai Geriatric Depression Scale (TGDS), the health literacy scale of Thai adults and long-term care needs questionnaire. The selected factors examined as independent variables included some demographic factors, depressive symptom, and health literacy. Results: The present study results revealed significant positive relationships existing between long-term care needs with age and depressive symptom, while negative relationships between income and health literacy were reported. A hierarchical multiple regression analysis indicated that four of nine determinants of long-term care needs: age, depressive symptom, health knowledge and understanding, and ability managing their health condition significantly predicted long-term care needs at a level of 18% (R² adjusted=0.18, p<0.001). Conclusion: The present study results showed associations between personal and health literacy factors with long-term care needs. These findings prove that it is vitally important for healthcare professionals to consider the rural elderly’s mental health status and health literacy when providing care and planning treatment. Keywords: Health literacy, Long-term care needs, Rural community


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 725-725
Author(s):  
Yoko Ibuka ◽  
Yui Ohtsu

Abstract Socioeconomic status (SES) is generating considerable interest in terms of health of individuals, but how it is associated with long-term care has not been established yet. We study the relationship between SES and long-term care provision to parents among the Japanese adults using JSTAR. We use the following six measures of SES for the analysis: income, asset, expenditure, living condition, housing condition and education. We find a greater probability of care provision to parents among those in higher SES categories for some SES measures, compared to the lowest category. However, after considering the survival probability of parents, the relationship is reversed and the probability of care provision is found to be greater among lower SES individuals. The association is more pronounced among males. The association is likely to be partly mediated by care needs of parents. These results suggest a higher burden of care disproportionately falls in low SES individuals.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 111-112
Author(s):  
Rajiv Nagaich ◽  
Carol Redfield ◽  
Ben Harvill

Abstract Ten thousand turn 65 daily. Majority look forward to retiring in the beginning and then become afraid of outcomes they often hear about- dealing with institutional care, becoming a burden, or running out of money. This is not because retirees do not plan, but despite of having planned their entire life for retirement. Many employers provide financial retirement planning such as a 401K plan. Individuals have relied on employee benefit plans to ready themselves, yet few are “very confident” about it. Two-thirds of retirees say their most recent employers did “nothing” to help them transition into retirement; 16% are “not sure” what their employers did. Many may be overlooking important factors in their strategies. Among retirees who currently have a retirement strategy, 85% have factored Social Security and Medicare benefits into their strategy. Most have included on-going living expenses (79%), total savings and income needs (57%) into their plan. Fewer than half have considered other critical factors (e.g., investment returns, ongoing healthcare costs, inflation, long-term care needs, tax planning, etc.). Only 9% have contingency plans for retiring sooner than expected and/or savings shortfalls. The truth is that education offered by employers tends to be traditional planning advice, which may not be enough to address the concerns retirees will have in retirement. To this, we introduce a multi-disciplinary LifePlanning Framework which takes a wholistic, integrated approach in addressing the many complex issues of retirement found in health, housing, finance, legal, and family. Our results may impact future practice, research, and policy.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 25-25
Author(s):  
Xiao Xu ◽  
Jersey Liang ◽  
BoRin Kim ◽  
James Raymo ◽  
Mary Beth Ofstedal

Abstract Existing literature on childlessness among middle-aged and older Americans is sparse, and measuring childlessness is not straightforward for those with complex family histories. To address this knowledge gap, we examined data on 19,929 respondents age ≥50 from the 2016 Health and Retirement Study. All analyses accounted for complex sample design to generate nationally representative estimates. The proportion of respondents without children differed significantly depending on how “childless” was defined: 1) 14.9% (95% confidence interval [CI]: 13.9-15.9%) having no biological children, versus 2) 10.4% (95% CI: 9.5-11.3%) having no children/step-children that were living and in-contact. When measured based on absence of biological children, the prevalence of childlessness was higher in younger cohorts (17.7%, 13.2%, and 9.0% for age 50-64, 65-74, and ≥75 years, respectively, p&lt;0.001) and among more educated individuals (17.4%, 12.3%, and 9.6% for more than high school, high school, and less than high school education, respectively, p&lt;0.001). The prevalence of childlessness was also higher among men (16.7%) than women (13.2%) (p&lt;0.001) and among non-Hispanic whites (16.0%) than Hispanics (9.8%) (p&lt;0.001). Similar patterns, but lower prevalence, were observed when measuring childlessness based on absence of children/step-children that were living and in-contact. Although non-Hispanic whites (16.0%) were more likely than non-Hispanic blacks (13.0%) to have no biological children (p=0.007), a similar proportion of them had no children/step-children that were living and in-contact (10.8% versus 10.6%, p=0.06). Given fertility decline and growing family complexity, these findings help inform the structure of social support and long-term care needs of middle-aged and older Americans.


Author(s):  
Marsha Love ◽  
Felipe Tendick-Matesanz ◽  
Jane Thomason ◽  
Davine Carter ◽  
Myra Glassman ◽  
...  

The home care workforce, already at 2.7 million caregivers, will become the nation’s fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients’ physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.


2021 ◽  
pp. 205343452110706
Author(s):  
Brandy Shook ◽  
Cara Palusak ◽  
Susan C Davies ◽  
Jennifer P Lundine

Introduction & importance Children with traumatic brain injury (TBI) report unmet needs several years after their injury and may require long-term care. However, this chronic health condition is often only treated and monitored in the short-term. Care for young persons with TBI often relies on parents to manage their child's complex care network. Effective care coordination can close these gaps and facilitate continuity of care for children with TBI. The purpose of this scoping review was to develop a better understanding of tools that improve care coordination for Children with Special Health Care Needs (CSHCN). This, in turn, can inform care for children with TBI. Methods A scoping review was conducted following the PRISMA framework and methodology. OVID/Medline, CINAHL, PsycINFO, EMBASE, and ERIC databases were searched for articles relevant to care coordination tools used with CSHCN. Results 21 articles met the criteria for inclusion in the review, and 6 major categories of care coordination tools were identified: telehealth, online health records and tools, care plans, inpatient discharge protocols, family training, and reminders. Discussion Studies examining telehealth, online tools, care plans, and family training care coordination interventions for CSHCN have shown positive outcomes and would be relevant strategies to improve the care of children with TBI. Future prospective research should investigate these tools to explore whether they might improve communication, reduce unmet needs, increase service access, and improve long-term outcomes for children with TBI.


2012 ◽  
Vol 22 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Rumi Seko ◽  
Shuji Hashimoto ◽  
Miyuki Kawado ◽  
Yoshitaka Murakami ◽  
Masayuki Hayashi ◽  
...  

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