scholarly journals Emergency care usage and longevity have opposite effects on health insurance rates

Kybernetes ◽  
2017 ◽  
Vol 46 (1) ◽  
pp. 102-113 ◽  
Author(s):  
Xavier Piulachs ◽  
Ramon Alemany ◽  
Montserrat Guillen
Keyword(s):  
Health Insurance ◽  
Emergency Care ◽  
Proportional Hazard ◽  
Joint Models ◽  
Men And Women ◽  
Content Type ◽  
Health Insurance Premiums ◽  
Insurance Rates ◽  
Log Linear ◽  
Expected Longevity

Purpose This paper aimed to study the price of health insurance for individuals aged 65 years and over. Design/methodology/approach A sample of private health policyholders in Spain is analysed. Joint models are estimated for men and women, separately. A log-linear model of the transformed cumulated number of claims associated with emergency room occupation, ambulance use and hospitalization is estimated, together with a proportional hazard survival model. Findings The association between the longitudinal process of severe medical care and the survival time process is positive and highly significant for both men and women. An increase in the price of health insurance because of the effect of a larger number of emergency care demand events is slightly offset by the decrease in expected longevity. Research limitations/implications The effect of an increase in the number of claims is small compared to the reduction in survival, so age still plays a central role in ratemaking. Practical implications High rates of health insurance for elderly insureds should be compensated with younger insureds in the portfolio. Social implications Affordable health insurance premiums for elderly people are difficult to obtain only with strict actuarial principles. Originality/value The proposed methodology allows dynamic rates to be designed, so that the price of health insurance can change as new usage information becomes available.

Sub-Ethnic and Geographic Variations in Out-of-Pocket Private Health Insurance Premiums Among Mid-Life Asians

2016 ◽  
Vol 29 (2) ◽  
pp. 222-246 ◽  
Author(s):  
Sunha Choi
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Private Insurance ◽  
State Level ◽  
Geographic Variations ◽  
Level Data ◽  
Geographic Clustering ◽  
Health Insurance Premiums ◽  
Interview Survey ◽  
Insurance Rates

Objective: This study examined out-of-pocket premium burden of mid-life Asian Americans by comparing six sub-groups of Asians after controlling for geographic clustering at the county and state levels. Method: The 2007-2011 National Health Interview Survey was linked to community-level data and analyzed for 4,628 Asians (ages 50-64), including 697 Asian Indians, 1,125 Chinese, 1,393 Filipinos, 434 Japanese, 524 Koreans, and 455 Vietnamese. Non-Hispanic Whites were included as a comparison group ( n = 48,135). Three-level multilevel modeling (state > county > individual) was conducted. Results: Koreans and Vietnamese were found as vulnerable sub-groups considering their lower private health insurance rates and higher uninsured rates. Among those with private insurance, Asians, specifically Filipinos, paid significantly less than non-Hispanic Whites. Moderate but significant variations in the county- and state-level variance in out-of-pocket premiums were found, especially among mid-life Asians. Discussion: This study demonstrates the importance of examining within-group heterogeneity and geographic variations in understanding premium burden among mid-life Asians.

Parameters of bed occupancy of intensive care units in Hungary

2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Insurance ◽  
Intensive Care Units ◽  
Emergency Care ◽  
Present Author ◽  
Bed Occupancy ◽  
National Network ◽  
Bed Capacity

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.

scholarly journals Which health-related reasons lead to prehospital emergency care and how does subjective emergency status connect to subsequent care?

2021 ◽  
Author(s):  
Silke Piedmont ◽  
Anna Katharina Reinhold ◽  
Jens-Oliver Bock ◽  
Enno Swart ◽  
Bernt-Peter Robra
Keyword(s):  
Health Insurance ◽  
Emergency Care ◽  
Third Party ◽  
Insurance Companies ◽  
Prehospital Emergency Care ◽  
Health Related ◽  
Life Threatening ◽  
Prehospital Emergency ◽  
Health Insurance Companies ◽  
Reported Data

Abstract Objectives/Background In many countries, the use of emergency medical services (EMS) increases steadily each year. At the same time, the percentage of life-threatening complaints decreases. To redesign the system, an assessment and consideration of the patients’ perspectives is helpful. Methods We conducted a paper-based survey of German EMS patients who had at least one case of prehospital emergency care in 2016. Four health insurance companies sent out the questionnaire to 1312 insured persons. We linked the self-reported data of 254 respondents to corresponding claims data provided by their health insurance companies. The analysis focuses a.) how strongly patients tend to call EMS for themselves and others given different health-related scenarios, b.) self-perceived health complaints in their own index case of prehospital emergency care and c.) subjective emergency status in combination with so-called “objective” characteristics of subsequent EMS and inpatient care. We report principal diagnoses of (1) respondents, (2) 57,240 EMS users who are not part of the survey and (3) all 20,063,689 inpatients in German hospitals. Diagnoses for group 1 and 2 only cover the inpatient stay that started on the day of the last EMS use in 2016. Results According to the survey, the threshold to call an ambulance is lower for someone else than for oneself. In 89% of all cases during their own EMS use, a third party called the ambulance. The most common, self-reported complaints were pain (38%), problems with heart and circulation (32%), and loss of consciousness (17%). The majority of respondents indicated that their EMS use was due to an emergency (89%). We could detect no or only weak associations between patients’ subjective urgency and different items for objective care. Conclusion Dispatchers can possibly optimize or reduce the disposition of EMS staff and vehicles if they spoke directly to the patients more often. Nonetheless, there is need for further research on how strongly the patients’ perceived urgency may affect the disposition, rapidness of the service and transport targets.

Labor Market Concentration and Worker Contributions to Health Insurance Premiums

2021 ◽  
pp. 107755872110129
Author(s):  
Mark K. Meiselbach ◽  
Matthew D. Eisenberg ◽  
Ge Bai ◽  
Aditi Sen ◽  
Gerard F. Anderson
Keyword(s):  
Labor Market ◽  
Health Insurance ◽  
Labor Markets ◽  
Health Plan ◽  
Fixed Effects ◽  
Health Benefits ◽  
Market Concentration ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Health Insurance Premiums

In concentrated labor markets, where workers have fewer employers to choose from, employers may exploit their monopsony power by contributing less to workers’ health benefits. This study examined if labor market concentration was associated with higher worker contributions to health plan premiums. We combined publicly available data from the Census to calculate labor market concentration and the Medical Expenditure Panel Survey Insurance/Employer Component to determine premium contributions from 2010 to 2016 for metropolitan areas. After controlling for year fixed-effects and market characteristics, we found that higher labor market concentration was associated with higher worker contributions to health plan premiums, lower take-home income, and no change in employer contributions to premiums, consistent with the hypothesis that greater labor market concentration is associated with less generous health benefits. When evaluating the effects of mergers and acquisitions on labor markets, regulatory agencies should critically assess worker contributions to health insurance premiums.

Integrating wearable technology products and big data analytics in business strategy

2019 ◽  
Vol 21 (2) ◽  
pp. 255-275 ◽  
Author(s):  
Bishwajit Nayak ◽  
Som Sekhar Bhattacharyya ◽  
Bala Krishnamoorthy
Keyword(s):  
Health Insurance ◽  
Technology Adoption ◽  
Competitive Advantage ◽  
Customer Service ◽  
Product Innovation ◽  
Dynamic Capabilities ◽  
Technology Policy ◽  
Wearable Technology ◽  
Content Type ◽  
Technology Products

Purpose This study aims to explore the impact of the adoption of wearable technology products for Indian health insurance firms. It identifies the key dynamic capabilities that health insurance firms should build to manage big data generated by wearable technology so as to attain a competitive advantage. Design/methodology/approach A qualitative exploratory study using in-depth personal interviews with 53 Indian health insurance experts was conducted with a semi-structured questionnaire. The data were coded using holistic and pattern codes and then analyzed using the content analysis technique. The findings were based on the thematic and relational intensity analysis of the codes. Findings An empirical model was established where all the propositions were strongly established except for the moderate relationship between wearable technology adoption and product innovation. The study established the nature of the interaction of variables on technology policy, organizational culture, strategic philosophy, product innovation, knowledge management and customer service quality with wearable technology adoption and also ascertained its influence on firm performance and competitive advantage. Research limitations/implications From a dynamic capabilities perspective, this study deliberates on wearable technology adoption in the health insurance context. It also explicates the relationship between the variables on technology policy, organizational culture, strategic philosophy, product innovation, knowledge management and customer service quality with wearable technology adoption on firm performance. Originality/value This study is one of the first studies to add the context of wearable technology and health insurance to the existing body of knowledge on dynamic capabilities and sustainable competitive advantage for the service sector. It would help existing and prospective players in adopting or setting up appropriate business models.

FC 068QUALITY OF LIFE OVER TIME IN OLDER MEN AND WOMEN WITH ADVANCED CKD - RESULTS FROM THE EQUAL STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Nicholas Chesnaye ◽  
Yvette Meuleman ◽  
Esther De Rooij ◽  
Friedo W Dekker ◽  
Marie Evans ◽  
...  
Keyword(s):  
Harmful Effect ◽  
Patient Characteristics ◽  
P Value ◽  
Joint Models ◽  
Cross Sectional ◽  
Linear Interaction ◽  
Men And Women ◽  
Negative Effect ◽  
The Difference ◽  
Over Time

Abstract Background and Aims Differences between the sexes are apparent in the epidemiology of CKD. Cross-sectional studies show that women consistently report a poorer health-related quality of life (QoL) than men, however, longitudinal studies are lacking. Here we investigate the sex-specific evolution of QoL over time in advanced CKD. As a secondary aim, we explore the sex-specific determinants of QoL. Method EQUAL is an observational prospective cohort study in stages 4 and 5 CKD patients ≥65 years not on dialysis with an incident estimated glomerular filtration rate (eGFR) < 20 ml/min/1.73m². Data on QoL (measured using the RAND-36), clinical and demographic patient characteristics were collected between April 2012 and September 2020. QoL trajectories were modelled by sex using linear mixed models, and joint models were applied to deal with informative censoring. We followed patients until death or dialysis initiation. Results We included 5151 QoL measurements in 1416 patients over a total of 1986 person years of follow-up. Overall, the physical component summary (PCS) declined with 2.0 (95% CI 1.4-2.6) points and the mental component summary (MCS) by 2.4 (95% CI 1.8-3.0) points per year. Although women had overall lower QoL scores, figure 1 demonstrates that PCS and MCS declined more than twice as fast in men (PCS: 2.4 per year, 95% CI 1.7 – 3.1, MCS: 2.9 per year, 95% CI 2.2 – 3.6) compared with women (PCS: 1.1 per year, 95% CI -0.2 – 2.0, MCS: 1.5 per year, 95% CI 0.5 – 2.4). We identified a non-linear interaction effect between sex and eGFR levels on QoL, demonstrating a stronger negative effect of decreased eGFR on both PCS (p=0.02) and MCS (p=0.04) in men compared with women. Subsequent adjustment for renal decline attenuated the difference in rate of QoL decline between men and women (difference after adjustment; PCS: 1.1, 95% CI -0.1 – 2.2, MCS: 1.2, 95% 0.0 – 2.3). In univariable analyses, higher serum haemoglobin was more beneficial to QoL in men compared to women (p-value for interaction; PCS: p=0.03, MCS: p=0.01). Higher serum phosphate had a strong harmful effect on both PCS and MCS in men, but not in women (PCS & MCS: p<0.001). The presence of pre-existing diabetes had a negative effect on PCS and MCS in men, but to a lesser extent in women (PCS: p=0.02, MCS: p=0.01). Conclusion Despite the higher overall QoL reported by men, both their physical and mental QoL declined approximately twice as fast compared with women. The faster decline in men was mediated in part by their lower levels of renal function, which had a stronger impact on their QoL as compared with women. Furthermore, in exploratory analyses we identified that high levels of phosphate, low levels of haemoglobin, and pre-existing diabetes were more detrimental to QoL in men than in women.

Experiences of Karen refugees with traditional and western medicine in the USA

2018 ◽  
Vol 14 (4) ◽  
pp. 387-399
Author(s):  
Natalie R. Wodniak
Keyword(s):  
New York ◽  
Health Insurance ◽  
Traditional Medicine ◽  
Traditional Practices ◽  
Content Type ◽  
Large Populations ◽  
The Usa ◽  
English Speaking ◽  
Karen Refugees ◽  
Us Cities

Purpose The purpose of this paper is to further understand the medical experiences of Karen refugees who have been resettled to the USA. It examines the use of traditional medicine throughout the transition from Burma to the USA, as well as refugees’ experiences in the American healthcare system. This study aims to identify shortcomings in refugees’ access to preferred methods of healthcare. Design/methodology/approach Interviews were conducted with 39 Karen refugees in 3 US cities with large populations of refugees from Burma – Fort Wayne, Indiana; Amarillo, Texas; and Buffalo, New York. Participants were asked questions about their healthcare experiences in Burma and the USA, their use of traditional medicine in both countries and their satisfaction with medical care in the USA. Findings Nearly all interviewees reported using traditional medicine in Burma, but only six felt able to continue to use traditional methods in the USA. Most participants had positive experiences with healthcare in America, but 15 expressed dissatisfaction with obtaining health insurance and confusion over its coverage. Findings also indicate that refugees do not feel that traditional practices are accepted in the USA. Research limitations/implications Due to the language barrier, a phone interpreter was used for non-English-speaking participants, which may have affected proper understanding or clarity of answers. Practical implications This study brings to attention the need to improve refugee healthcare by encouraging traditional practices and assisting refugees with obtaining health insurance. Originality/value This paper identifies the importance of analyzing the accessibility of various forms of healthcare, including traditional medicine, to refugees in the USA.

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