Actuarial Method Research Articles

Applicability of an actuarial neuropsychological method to diagnose mild cognitive impairment in a diverse sample

AbstractBackgroundThe Jak/Bondi actuarial neuropsychological method for detection of mild cognitive impairment (MCI) has been shown to identify subjects less likely to revert to normal and more likely to have Alzheimer’s Disease (AD) biomarkers compared to conventional clinical methods. Various iterations of this method have been applied to datasets of predominately White, highly‐educated participants, limiting generalizability to more diverse cohorts. This project investigated the applicability of the actuarial MCI diagnostic method to the Texas Alzheimer’s Research and Care Consortium (TARCC) cohort.MethodAll subjects from the TARCC cohort with expert consensus diagnoses of normal control (NC) and MCI at baseline (n = 1911; 65.72% female; 47.11% Hispanic; Mage = 67.49; Medu = 12.80) were re‐classified as NC or MCI using actuarial criteria of 2 impaired (>1 SD below normative mean) tests in any of 4 cognitive domains OR 1 impaired test in at least 3 cognitive domains. The clinically‐diagnosed MCI (MCIc) sample (n = 655; 58.47% female; 42.44% Hispanic; Mage = 71.34; Medu = 13.01) and the actuarially‐diagnosed MCI (MCIa) sample (n = 837; 71.21% female; 68.82% Hispanic; Mage = 66.30; Medu = 10.87) were separately submitted to cluster analysis. McNemar’s test was used to investigate frequency of APOE4 allele by diagnostic group.ResultCluster analysis of the MCIa group yielded 3 distinct clusters: a purely amnestic cluster (n = 332), a primary language‐impaired cluster (n = 381), and a multidomain/mixed cluster (n = 124). The MCIc group yielded 2 clusters: a multidomain/mixed cluster (n = 538), and a cognitively normal cluster (n = 117). The MCIc cases were significantly more likely to have APOE4 alleles (33% vs. 28% of MCIa group).ConclusionSimilar to previous research, the MCIa group fell into 3 distinct cognitively‐impaired groups. Despite 18% of MCIc participants falling in a “cognitively‐normal” cluster, MCIc subjects were more likely to have the AD biomarker APOE4. These findings warrant further investigation, particularly in relation to ethnicity, as individuals of Hispanic origin are less likely to carry APOE4 alleles, and APOE4 confers less AD risk in Hispanics compared to non‐Hispanic Whites. Future research will investigate the prognostic utility of the actuarial method for racial/ethnic minorities using cognitive and functional longitudinal data.

SEER analysis of 9-year breast cancer specific mortality (BCSM) in patients (pts) with invasive lobular breast cancer (ILC) assessed by the 21-gene Breast Recurrence Score assay.

554 Background: Linking of the results of the 21-gene Breast Recurrence Score (RS) commercial assay to SEER registries provides opportunity to assess real world prognostic performance of the assay in important subgroups of early breast cancer (BC). ILC is less common than invasive ductal carcinoma (IDC) and the performance of the RS assay in ILC is of interest. The relationship between RS results and 5-year BCSM in patients with ILC was reported based on a linkage in 2015 at this meeting in 2017. Here we present a comparison of 9-year BCSM of ILC vs IDC from a linkage update in 2019. These results will be updated further based on a new linkage of RS data to be completed in April 2023. Methods: Eligible pts had 0-3 axillary nodes at initial surgery, were hormone receptor positive and HER2-negative with a RS result, had no prior malignancy, and were diagnosed between January 2004 and December 2012. Pts with ICD-O-3 code 8520 were categorized as ILC and those with code 8500 as IDC. 9-year BCSM of both cohorts was estimated using actuarial methods. Multivariable Cox proportional hazards models characterized association between RS results and BCSM. Results: Of 89818 pts, 9835 (11.0%) had ILC and 64669 (72.0%) had IDC. Among pts with ILC, median age was 60 years; 12.5% were N1 and 28.4%, 63.7% and 7.9% were grade 1, 2 and 3. Median follow-up was 84 months. Chemotherapy (CT) use and BCSM increased with increasing RS result in both cohorts. After adjusting for age, race, tumor grade, tumor size, nodal status, and histologic subtype, the RS result was independently associated with BCSM ( p < .001) in both ILC and IDC. Conclusions: In this linked SEER analysis of pts with ILC or IDC, the RS results were prognostic for 9-year BCSM, regardless of nodal status. [Table: see text]

Dynamics of the digestive acquisition of bacterial carriage and integron presence by French preterm newborns according to maternal colonization: The DAIR3N multicentric study.

The study aimed to describe the dynamics and risk factors of Gram-negative bacteria (GNB) acquisition in preterm infants. This prospective multicenter French study included mothers hospitalized for preterm delivery and their newborns, followed until hospital discharge. Maternal feces and vaginal fluids at delivery, and neonatal feces from birth to discharge were tested for cultivable GNB, potential acquired resistance, and integrons. The primary outcome was the acquisition of GNB and integrons in neonatal feces, and their dynamics, evaluated by survival analysis using the actuarial method. Risk factors were analyzed using Cox models. Two hundred thirty-eight evaluable preterm dyads were included by five different centers over 16 months. GNB were isolated in 32.6% of vaginal samples, with 15.4% of strains producing extended-spectrum beta-lactamase (ESBL) or hyperproducing cephalosporinase (HCase), and in 96.2% of maternal feces, with 7.8% ESBL-GNB or HCase-GNB. Integrons were detected in 40.2% of feces and 10.6% of GNB strains. The mean (SD) length of stay of newborns was 39.5 (15.9) days; 4 died in the hospital. At least one infection episode occurred in 36.1% of newborns. The acquisition of GNB and integrons was progressive from birth to discharge. At discharge, half of newborns had ESBL-GNB or HCase-GNB, independently favored by a premature rupture of membranes (Hazard Ratio (HR), 3.41, 95% confidence interval (CI), 1.71; 6.81), and 25.6% had integrons (protective factor: multiple gestation, HR, 0.367, 95% CI, 0.195; 0.693). In preterm newborns, the acquisitions of GNB, including resistant ones, and integrons are progressive from birth to discharge. A premature rupture of membranes favored the colonization by ESBL-GNB or Hcase-GNB.

Patterns of care and survival forlung cancer: Results of the European population-based high-resolution study.

To investigate differences in lung cancer (LC) management and survival using data from European population cancer registries. We analysed 4,602 lung cancer cases diagnosed in 2010-2013, followed-up to 2019 in five countries. Multivariable logistic regression was used to calculate the Odds Ratio (OR) of surgery for stages I-II LC or chemo- or radiotherapy for stages III-IV LC. Relative survival (RS) was estimated by the actuarial method; Relative Excess Risk of death (RER), with 95% CI, was calculated by generalized linear models. Diagnostic work-up was extensive for 65.9% patients (range 57%, Estonia, Portugal - 85% (Belgium). Sixty-six percent of stages I-II patients underwent surgery; compared to non-operated, their adjusted OR decreased with age and was associated with main bronchus cancer (OR vs. lobes 0.25, CI, 0.08-0.82), stage II (OR vs. stage I: 0.42, CI, 0.29-0.60), comorbidity (OR vs. absent: 0.55, CI, 0.33-0.93), country (ORs: Estonia 1.82, CI, 1.28-2.60; Belgium 0.62, CI, 0.42-0.91; Portugal 0.69, CI, 0.52-0.93).Almost half of stages III-IV patients received chemo- or radiotherapy only; the adjusted OR vs. non receiving decreased with age and was associated with unspecified cancer topography or morphology. The adjusted five-year RER increased with age and stage and was lower for women (0.78, CI, 0.72-0.86), above the reference for main bronchus cancer (1.37, CI, 1.21-1.54) and unspecified morphology (1.17, CI, 1.05-1.30). Surgery carried the lowest mortality (RS 56.9; RER 0.13, CI, 0.11-0.15) with RER above the mean in Estonia (1.20, CI, 1.10-1.30), below it in Portugal (0.88, CI, 0.82-0.93) and Switzerland (0.91, CI, 0.84-0.99). Comorbidity (1.21, CI, 1.09-1.35) and not smoking (0.68, CI, 0.57-0.81) were associated with RER. The survival benefit of early diagnosis, allowing curative surgery, was evident at the population level. Screening for subjects at risk and adhesion to standard care should be incremented across the EU by funding better equipment and training health personnel.

Effectiveness and Protection Duration of Anti-COVID-19 Vaccinations among Healthcare Personnel in Cluj-Napoca, Romania.

The anti-COVID-19 vaccines, developed for use during the pandemic period, must be evaluated for effectiveness in order to coordinate the vaccination program. Therefore, this study aimed to measure the anti-COVID-19 vaccine effectiveness (VE) and duration of protection against symptomatic forms of infection among healthcare personnel who were professionally exposed to the SARS-CoV-2 virus. A prospective cohort study, which was conducted in a university hospital between January 2021 and April 2022, compared immunologically naïve and previously infected personnel who were vaccinated, revaccinated, or unvaccinated. The VE was measured based on survival rates constructed with the actuarial method, using 30 day intervals. Among the 783 subjects that were included in the study, those that were vaccinated showed a decrease in VE from 90.98% (95% confidence intervals (CI): 74.87-96.77) in the first 30 days to 69.95% (95% CI: 40.29-84.87) at 60 days after vaccination. The VE for revaccinated personnel was 93.27% (95% CI: 77.53-97.99) at 60 days and 86.54% (95% CI: 75.59-92.58) at 90 days after revaccination. For previously infected personnel, protection against reinfection was 94.03% (95% CI: 79.41-98.27) at 420 days and 82.08% (95% CI: 53.93-93.03) at 450 days after revaccination. The highest VE for preventing the symptomatic forms of COVID-19 was observed in the revaccinated, but only for a 3-month duration. Better protection against reinfection was provided by revaccination after passing through infection.

Immunohistochemical subtype and its relationship with 5-year overall survival in breast cancer patients.

Breast cancer (BC) is the malignant tumour that has been most frequently diagnosed, being the second most common cancer worldwide and the most frequent in women. To analyse the probability of 5-year overall survival according to age, stage of disease, immunohistochemical subtype, histological grade and histological type in patients with BC. Operational research that used a cohort design of patients diagnosed with BC at the SOLCA Núcleo de Loja-Ecuador Hospital from 2009 to 2015 and with follow-up until December 2019. Survival was estimated with the actuarial method and Kaplan-Meier method, and, for multivariate analysis, the proportional hazards model or Cox regression was used to estimate the adjusted Hazard Ratios (HRs). Two hundred and sixty-eight patients were studied. Mean overall survival was 4.35 years (95% confidence interval (95% CI): 40.20-4.51) and 66% survived to 5 years. The main predictors of survival were advanced stage of disease (III-IV) (HR = 7.03; 95% CI: 3.81-12.9); patients human epidermal growth factor receptor 2-neu (HER2-neu) overexpressed (HR = 2.26; 95% CI = 1.31-4.75) and triple negative (HR = 2.57; 95% CI = 1.39-4.75). The other variables were not significant. The results show a higher mortality associated with higher clinical stage, more aggressive histological grades and immunohistochemical subtype HER2-neu overexpressed and triple negative tumours.

THE LIFETIME REVISION RISK OF KNEE ARTHROPLASTY

Source of the study: University of Auckland, Auckland, New Zealand and University of Otago, Christchurch, New ZealandOutcomes following knee arthroplasty are typically defined as implant survivorship at defined timepoints, or revision incidence over time. These estimates are difficult to conceptualise, and lack context for younger patients with more remaining years of life. We therefore aimed to determine a ‘lifetime’ risk of revision as a more useful metric for total (TKA) and unicompartmental knee arthroplasty (UKA).The New Zealand Joint Registry was used to identify 96,497 primary TKAs and 13,481 primary UKAs performed between 1999 and 2019. Patient mortality and revision incidence were also extracted. Estimates of lifetime risk were calculated using an actuarial lifetable method. The estimates were stratified by age and gender. Reasons for revision were categorised using previously published standardised definitions.The lifetime risk of UKA revision was two-fold higher than TKA across all age groups (range 3.7-40.4% UKA, 1.6-22.4% TKA). Revision risk was higher for males with TKA (range 3.4%-25.2% males, 1.1%-20% females), but higher for females with UKA (range 4.3%-43.4% vs. 2.9%-37.4% for males). Revision due to infections were higher for TKA (1.5% males, 0.7% females) compared with UKA (0.4% males, 0.1% females). The increased risk in younger UKA patients was associated with higher incidence of aseptic loosening (UKA 2%, TKA 1%) and ‘unexplained pain’ (UKA 2%, TKA 0.2%).The risk for UKA was two-fold higher than TKA, and this was partially explained by a higher proportion of revisions due to ‘unexplained pain’. For TKA, males had higher risk of revision, in contrast to UKA where females had higher risk; this gender difference was associated with higher incidence of infections with TKA. Younger age, gender and higher ASA status were also associated with increased lifetime risk of UKA revision. Lifetime risk of revision can provide a meaningful measure of arthroplasty outcomes to aid patient counselling.

Analysis of option-like fund performance fees in asset management via Monte Carlo actuarial distortion pricing

Abstract A detailed analysis of management and performance fees for asset managers and investment funds is undertaken. While fund fees are considered as a cost of capital for investors, the structuring of such fee mechanisms in a fund can also influence a fund manager’s decisions and investment strategy, thereby also influencing the investment performance of the investors funds. The study undertaken will allow for an assessment of the effect of fee structures and the potential for asymmetric incentives to arise that may promote adverse risk-taking behaviours by the fund manager, to the detriment of the investor or retiree who places a portion of their retirement savings into such a managed fund with such fee structures. As such, understanding the mechanism of fee charging as well as pricing the fees correctly is vital. An exploration of the application of actuarial distortion pricing methods for complete and incomplete market valuation is performed on a variety of path-dependent option-like performance fee structures for various funds in the European and American markets. Furthermore, several scenario analysis and sensitivity studies are undertaken. The class of Net Asset Value models adopted are Lévy processes, and the pricing is performed via Monte Carlo techniques.

Data-Informed Case Formulation with the Trier Treatment Navigator

The current article presents a way of practising case formulation using technology augmentation in the context of data-informed psychotherapy. First, we explain how case formulation guides the decision-making processes in psychotherapy and how decisions made under an intuitive clinical judgement can be biased. The use of actuarial methods is pointed out as a way of addressing these biases, mainly through clinical decision support systems based on statistical tools and machine learning algorithms. We present the Trier Treatment Navigator (TTN), a clinical decision support system developed in a University research-based clinical training programme. We show how the TTN can contribute to an initial case formulation and its dynamic adaptations during treatment with a clinical case. Finally, we discuss how case formulation and data-informed psychotherapy are aimed at the same goal: treatment personalisation. We argue that case formulation and data-informed psychotherapy enrich and feedback on each other.

Non-Life Insurance Risk Classification Using Categorical Embedding

This article presents several actuarial applications of categorical embedding in the context of non-life insurance risk classification. In non-life insurance, many rating factors are naturally categorical, and often the categorical variables have a large number of levels. The high cardinality of categorical rating variables presents challenges in the implementation of traditional actuarial methods. Categorical embedding that is proposed in the machine learning literature for handling categorical variables has recently received attention in actuarial studies. The method is inspired by the neural network language models for learning text data and maps a categorical variable into a real-valued representation in the Euclidean space. Using a property insurance claims we demonstrate the use of categorical embedding in three applications. The first shows how embeddings are used to construct rating classes and calculate rating relativities for a single insurance risk. The second concerns predictive modeling for multivariate insurance risks and emphasizes the effects of dependence on tail risks. The third focuses on pricing new products where transfer learning is used to gather knowledge from existing products.

Incidence and survival of paediatric renal tumours in the Netherlands between 1990 and 2014

BackgroundThis population-based study is the first to provide a detailed analysis of trends in incidence and survival of children and adolescents diagnosed with renal malignancies in the Netherlands. MethodsData on all renal malignancies diagnosed in paediatric patients (0–18 years) between 1990 and 2014 [N = 648, 92% Wilms tumour (WT)] were extracted from the Netherlands Cancer Registry. Five-year overall survival (OS) was estimated using the actuarial method. Time trends in incidence were assessed by calculating average annual percentage change. A parametric survival model was used to compare the multivariable-adjusted risk of dying from WT between two diagnostic periods. ResultsThe incidence was 8 per million person-years and was constant over time (average annual percentage change -0.8%, p = 0.29). Patients with WT had a favourable outcome in both time periods; 5-year OS was 88% in 1990–2001 and 91% in 2002–2014. Multivariable analysis showed that the risk of dying from WT was not significantly decreased in the latest period (hazard ratio, 95% CI: 0.7, 0.4–1.3). Five-year OS decreased with increasing disease stage, ranging from 95 to 100% for stage I-II and about 80% for stage III–IV to 74% for bilateral disease. Five-year OS were 81% for renal cell carcinoma, 77% for clear cell sarcoma of the kidney and 20% for malignant rhabdoid tumour of the kidney. ConclusionsIncidence of paediatric renal malignancies in the Netherlands has been stable since the 1990s. Five-year OS of WT reached 91% and was similar to findings for other developed countries. Contrary to the excellent outcome for WT, the outcome of malignant rhabdoid tumour of the kidney remained inferior.

A-1 Comparison of Consensus and Actuarial Diagnosis of MCI in Hispanic and non-Hispanic Samples

Abstract Objective: The Jak/Bondi actuarial method has been found to be superior to consensus diagnosis in identifying MCI in some but not all populations and may not perform as well in diverse samples. In this study, diagnostic agreement between actuarial and clinical consensus methods was examined by ethnic group in the heavily Hispanic/Latinx Texas Alzheimer’s Research and Care Consortium (TARCC) cohort. Method: TARCC participants with consensus diagnoses of NC and MCI at baseline (n = 1011; 66.47% female; 49.75% Hispanic; Mage = 67.28; Medu = 13.21) were reclassified via actuarial criteria of two failed tests (>1 SD below normative [MOANS in TARCC] mean) in one cognitive domain OR one failed test in 3+ cognitive domains. Chi square analyses investigated diagnostic agreement and test fail rates by ethnicity. Results: Diagnostic agreement significantly differed between ethnic groups (Cramer’s V = 0.42). 57% of the Hispanic consensus-NC group were relabeled as actuarial-MCI while just 12% of the consensus-NC non-Hispanic sample were classified as actuarial-MCI. The non-Hispanic consensus-MCI sample was more likely to be reclassified as actuarial-NC (47% reclassified). Failure rates were significantly higher for the Hispanic group on 8 of 10 neuropsychological tests (Cramer’s V = 0.106–0.542). Conclusions: The Jak/Bondi MCI actuarial method could be prone to false-positive errors in Hispanic/Latinx samples, based on these findings in a significantly more diverse cohort than previously studied. Because the actuarial method relies on normed scores, its application may be more difficult in populations for which adequate norms are still being developed. Further research exploring use of “robust” norms or updated Hispanic/Latinx norms (e.g., NP-NUMBRS) when applying the Jak/Bondi method is needed.

Implementasi Metode Perhitungan Aktuaria Program Dana Pensiun Menggunakan Flask

The pension fund program is a program that seeks future planning by providing pension benefits to participants. The vital thing that becomes a concern in the pension fund program is the actuarial cost method. There are two categories for actuarial cost methods, which are Accrued Benefit-Cost Method and Projected Benefit-Cost Method. The normal contribution characteristic of the Projected Benefit-Cost Method is more stable than the Accrued Benefit-Cost Method, so it is better to use it from the participants’ perspective. This study discusses the use of the Projected Benefit-Cost Method by calculating normal contributions and actuarial liabilities from the methods included in it, which are Attained Age Normal, Entry Age Normal, and Individual Level Premium. Based on the calculation results, the Entry Age Normal and Individual Level Premium methods have a smaller final value of normal contribution payments and have a larger actuarial liability than the Attained Age Normal. Thus, of the three methods included in the Projected Benefit-Cost Method, the Entry Age Normal and Individual Level Premium methods are better used from the perspective of participants. For the calculation of pension funding using the Attained Age Normal, Entry Age Normal, and Individual Level Premium methods to be widely implemented by the public, this study created an application website using flask, which can be accessed at https://perhitunganaktuariadapen.herokuapp.com/.

A semi-analytic valuation of two-asset barrier options and autocallable products using Brownian bridge

Barrier options based upon the extremum of more than one underlying prices do not allow for closed-form pricing formulas, and thus require numerical methods to evaluate. One example is the autocallable structured product with knock-in feature, which has gained a great deal of popularity in the recent decades. In order to increase numerical efficiency for pricing such products, this paper develops a semi-analytic valuation algorithm which is free from the computational burden and the monitoring bias of the crude Monte Carlo simulation. The basic idea is to combine the simulation of the underlying prices at certain time points and the exit (or non-exit) probability of the Brownian bridge. In the literature, the algorithm was developed to deal with a single-asset barrier option under the Black–Scholes model. Now we extend the framework to cover two-asset barrier options and autocallable product. For the purpose, we explore the non-exit probability of the two-dimensional Brownian bridge, which has not been researched before. Meanwhile, we employ the actuarial method of Esscher transform to simplify our calculation and improve our algorithm via importance sampling. We illustrate our algorithm with numerical examples.

Tolerating Risk: Professional Judgment in Suicide Risk Assessment

As a leading cause of death among those suffering from mental health problems, suicide is an issue that challenges policy makers, organizations, and practitioners alike. One outcome has been the implementation of standardized decision-making tools, developed through actuarial methods and aimed at limiting risks inherent in professional judgments. However, despite legislative and policy attempts to standardize the outcomes of risk assessment, professional judgments in specific client scenarios remain highly divergent. This article presents an exploration of the practice-level implementation of policies related to suicide risk assessment and decision-making. Findings suggest that once a judgment regarding risk has been made, ultimately organizational dynamics and resource availability determine disposition. Although attempts to improve outcomes for suicidal clients should include ongoing professional development for practitioners, the findings point to the requirement for community-based and hospital-based services that provide the greatest range of options for addressing client needs and facilitating safety.

Long-Term Outcomes of the Mosaic Mitral Porcine Bioprosthesis in Japan - Results From the Japan Mosaic Valve Long-Term Multicenter Study.

This study retrospectively evaluated the long-term patient outcomes and durability of the Mosaic mitral porcine bioprosthesis in the Japan Mosaic valve long-term multicenter study.Methods and Results:The medical records of 390 patients who underwent mitral valve replacement with the Mosaic bioprosthesis at 10 centers in Japan (1999-2014) were reviewed. Patient data were collected using the Research Electronic Data Capture software. Patient survival was determined using the Kaplan-Meier method. Freedom from structural valve deterioration (SVD) and valve-related reoperation and death were determined using actuarial methods. The median (interquartile range [IQR]) age of the cohort was 73 (69-77) years. The median (IQR) follow-up period was 4.83 (1.84-8.26) years. The longest follow-up period was 15.8 years. The 30-day mortality rate was 5.4%. The 12-year actuarial survival rate was 54.1±4.5%, and the freedom from valve-related death was 85.3±3.4%. The freedom from reoperation at 12 years was 74.3±5.7%. The freedom from SVD at 12 years was 81.4±6.6% for patients aged ≥65 years and 71.6±11.1% for those aged <65 years. The median (IQR) mean pressure gradient was 4.1 (3.0-6.0) and 5.6 (4.0-6.7) mmHg at 1 and 10 years, respectively. The median (IQR) effective orifice area was 1.7 (1.4-2.0) and 1.4 (1.2-1.6) cm2at 1 and 10 years, respectively. The Mosaic porcine bioprosthesis offered satisfactory long-term outcomes for up to 12 years.

Does home equity liquidation reduce older adults’ poverty rate? Evidence from South Korea

We investigate relative poverty rates among older adults from a unique dataset using an actuarial method applied to a public reverse mortgage in South Korea, which liquidates home equity and converts the assets to a readily available income. We find that it increases disposable income by approximately 20 per cent on average for older adults, and the improvement is more effective in the low-income quintiles. Due to the increased income, elderly poverty rate reduces significantly by 10 percentage points to about 31 per cent. Therefore, the elderly poverty rate following the OECD standard overestimates the elderly poverty rate and could misguide welfare policies.

Self-Employed Finance in the New Russian Economy

We based our study on statistical, actuarial, and predictive methods, including the method of moving ages. We assessed qualitatively and quantitatively Russian self-employed. Their potential for participation in pension insurance is assessed using foreign experience. We proposed promising instruments for pensions of self-employed. We concretized the concept of self-employed for the Russian pension system based on international approaches. Their number, gender, age and professional composition and income level are estimated, including international comparison. Further, we predicted the demographic number of self-employed as potential recipients of social pensions. Their income potential for pension insurance is assessed. Finally, we developed recommendations for using the best foreign experience to expand the coverage of self-employed with pension insurance.

АКТУАРНАЯ ОЦЕНКА ПЕНСИОННЫХ ПРАВ В ДОБРОВОЛЬНОМ ПЕНСИОННОМ СТРАХОВАНИИ

Using actuarial methods on the basis of official statistical data for Russia and Rostov Oblast, the paper estimates the amount of net premium that must be paid to receive a pension corresponding to the average size, and the amount of potential pension that can be expected if the net premiums equal the contributions paid to the Pension Fund of Russia. An actuarial estimate was made for men and women living in urban and rural areas, without considering the settlement aspect. It is shown that voluntary pension insurance programs are a more promising way of accumulating future pensions for individuals starting their labor activity early than compulsory pension insurance. The necessity of using regional tables of mortality and life expectancy when introducing voluntary pension insurance programs has been substantiated.

Survival of patients with bladder cancer in Samara region

The morbidity and survival rates of patients with bladder cancer, depending on various causes, have been studied by many authors. However, there are a limited number of studies using the analysis of patient survival at the population level. Patient survival information can optimize the therapy and prevention of bladder cancer. The results of survival of patients with this disease in different gender and age categories should be studied more actively. The aim of the study was to study the observed and relative survival of patients with bladder cancer in gender-age groups in the Samara region for the period 2010–2012.The materials of the study were the primary records of 1059 patients for the period from 2010 to 2012. To obtain the results of survival, an actuarial method was used. To assess the reliability of the comparison of the obtained indicators, the Z and p criteria were used. In the course of the study, when assessing the 1-year and 5-year cumulative survival of patients with bladder cancer, there were lower rates of observed survival compared with the relative one.There were no statistically significant differences in the 1-year and 5-year relative survival rates for men and women. The 5-year observed survival rate for women was significantly higher than for men. With increasing age, survival rate for bladder cancer declines. The indicators of 1-year and 5-year relative survival of patients aged 50–59 years were significantly higher than the corresponding indicators of 60–69 years old. In the age group of 40–49-year-olds, there was a significantly higher relative survival rate of women compared with men.