Nonsymmetric equal sacrifice solutions for claim problem

2002 ◽  
Vol 43 (1) ◽  
pp. 1-18 ◽  
Author(s):  
N.I. Naumova
Author(s):  
Rakhmad Hidayat ◽  
◽  
Budi Hidayat ◽  

ABSTRACT Background: Indonesia is one of the countries affected by COVID-19 pandemic. In overcoming this pandemic, the government waives the service fees for COVID-19 patients. It provides an opportunity for hospitals serving COVID-19 patients to submit claims for treatment financing to the Ministry of Health. There are technical guidelines for payment; there are still frequent problems, leading to a dispute. This is also experienced by the University of Indonesia Hospital (RSUI) as one of the COVID-19 referral hospitals. This study aimed to provide an overview of the claim problem encountered and their solution. Subjects and Method: This was a descriptive study conducted at University of Indonesia Hospital from July, 2020. The theme of this study was problem in claiming payments for COVID-19 patients. Several informants were selected for this study included: hospital claim officers, medical record units, inpatient units and registration units. The data were collected by observation, in-depth interview, disputed claim data. Results: The results of the investigation found that the problem of dispute claims for COVID-19 in RSUI was dominated by the incompleteness of filling in administrative files as evidence of service practice for patients in the field, such as incomplete ventilator usage curves (7.8%), swab results (3.9%), and rapid test (6.8%) which was not listed. Conclusion: Discipline needs to be applied in the completeness of documents, and a clear flow of patient care is required to avoid incomplete records. Keywords: dispute, claim, COVID-19, hospital, health insurance Correspondence: Rakhmad Hidayat. Pascasarjana Kajian Administrasi, Fakultas Kesehatan Masyarakat Universitas Indonesia, Pondok Cina, Kecamatan Beji, Kota Depok, Jawa Barat 12345. Email: [email protected]. Mobile: (021) 7864975 DOI: https://doi.org/10.26911/the7thicph.04.17


2020 ◽  
Author(s):  
Barry Nalebuff

The Nash axioms lead to different results depending on whether the negotiation is framed in terms of gains relative to no agreement or in terms of sacrifices relative to an ideal. We look for a solution that leads to the same result from both perspectives. To do so, we restrict the application of Nash’s IIA axiom to bargaining sets where all options are individually rational and none exceed either party’s ideal point. If we normalize the bargaining set so that the disagreement point is (0, 0) and maximal gains are (1, 1), then any perspective-invariant bargaining solution must lie between the Utilitarian solution and the maximal equal-gain (minimal equal-sacrifice) solution. We show that a modified version of Nash’s symmetry axiom leads to the Utilitarian solution and that a reciprocity axiom leads to the equal-gain (equal-sacrifice) solution, both of which are perspective invariant. This paper was accepted by Joshua Gans, Business Strategy.


2021 ◽  
Vol 14 ◽  
pp. 302-311
Author(s):  
Natalia I. Naumova ◽  

We consider generalizations of TU games with restricted cooperation in partition function form and propose their interpretation as allocation problems with several public resources. Either all resources are goods or all resources are bads. Each resource is distributed between points of its set and permissible coalitions are subsets of the union of these sets. Each permissible coalition estimates each allocation of resources by its gain/loss function, that depends only on the restriction of the allocation on that coalition. A solution concept of "fair" allocation (envy stable solution) was proposed by the author in (Naumova, 2019). This solution is a simplification of the generalized kernel of cooperative games and it generalizes the equal sacrifice solution for claim problems. An allocation belongs to this solution if there do not exist special objections at this allocation between permissible coalitions. For several classes of such problems we describe methods for computation selectors of envy stable solutions.


Author(s):  
W. Buchholz ◽  
W. F. Richter ◽  
J. Schwaiger
Keyword(s):  

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