Insurance Benefits Research Articles

Regression discontinuity design for the study of health effects of exposures acting early in life.

Regression discontinuity design (RDD) is a quasi-experimental approach to study the causal effect of an exposure on later outcomes by exploiting the discontinuity in the exposure probability at an assignment variable cut-off. With the intent of facilitating the use of RDD in the Developmental Origins of Health and Disease (DOHaD) research, we describe the main aspects of the study design and review the studies, assignment variables and exposures that have been investigated to identify short- and long-term health effects of early life exposures. We also provide a brief overview of some of the methodological considerations for the RDD identification using an example of a DOHaD study. An increasing number of studies investigating the effects of early life environmental stressors on health outcomes use RDD, mostly in the context of education, social and welfare policies, healthcare organization and insurance, and clinical management. Age and calendar time are the mostly used assignment variables to study the effects of various early life policies and programs, shock events and guidelines. Maternal and newborn characteristics, such as age, birth weight and gestational age are frequently used assignment variables to study the effects of the type of neonatal care, health insurance, and newborn benefits, while socioeconomic measures have been used to study the effects of social and welfare programs. RDD has advantages, including intuitive interpretation, and transparent and simple graphical representation. It provides valid causal estimates if the assumptions, relatively weak compared to other non-experimental study designs, are met. Its use to study health effects of exposures acting early in life has been limited to studies based on registries and administrative databases, while birth cohort data has not been exploited so far using this design. Local causal effect around the cut-off, difficulty in reaching high statistical power compared to other study designs, and the rarity of settings outside of policy and program evaluations hamper the widespread use of RDD in the DOHaD research. Still, the assignment variables' cut-offs for exposures applied in previous studies can be used, if appropriate, in other settings and with additional outcomes to address different research questions.

How Does Potential Unemployment Insurance Benefit Duration Affect Reemployment Timing and Wages?

How Does Potential Unemployment Insurance Benefit Duration Affect Reemployment Timing and Wages?

Cost-utility analysis of proton beam therapy for locally advanced esophageal cancer in Japan.

Proton beam therapy (PBT) has recently been included in Japan's health insurance benefit package for certain cancer types. This study aimed to determine the cost-effectiveness of PBT as a replacement for conventional three-dimensional conformal radiotherapy (3D-CRT) for locally advanced esophageal cancer (LAEC) that is not covered by social insurance. We estimated the incremental cost-effectiveness ratio (ICER) of PBT as a replacement for 3D-CRT, using clinical evidence from the literature and expert opinions. We used an economic model, decision tree, and Markov model to illustrate the courses followed by patients with LAEC. Effectiveness was estimated as quality-adjusted life years (QALY) using utility weights for the health state. Social insurance fees were calculated as costs. We assumed two base cases depending on the two existing levels of fees for PBT in social insurance: 2,735,000 Japanese yen (US$20,652) or 1,600,000 yen (US$13,913). The stability of the ICER against these assumptions was appraised using sensitivity analysis. The effectiveness of PBT and 3D-CRT was 2.62 and 2.51 QALY, respectively. The estimated ICER was 14,025,268 yen (US$121,958) per QALY for the higher fee level and 7,026,402 yen (US$61,099) for the lower fee level. According to the Japanese threshold for cost-effectiveness of anticancer therapy of 7,500,000 yen (US$65,217) per QALY gain, the inclusion of PBT for LAEC in the benefit package of social insurance is cost-effective if a lower fee is applied. PBT is a cost-effective alternative to 3D-CRT for LAEC and making it available to patients under social insurance could be justifiable.

Comparing Healthcare Service Utilization in Insured vs. Non Insured Households in Rural Atsbi Womberta

Community-based health insurance schemes (CBHI) in Africa are gaining attention due to high healthcare costs in developing nations, affecting 6% of individuals in extreme poverty. The World Health Organization emphasizes the need for sustainable health funding schemes to ensure access to health services. Ethiopia faces poor healthcare funding, making it one of the world’s poorest nations. Tigray implemented community-based insurance as a pilot study in 69 rural communities since 2010. The objective of this study was compare differences in healthcare service utilization between community-based health insurance among insured and non-insured households in rural Atsbi-Wemberta district. A community-based comparative cross-sectional study with a qualitative approach was conducted on 172 households. Data was analyzed using SPSS, and inferential statistics were used to measure factors’ association with outcome variables. A study in Kebelle revealed that the majority of respondents were female-headed, engaged in both insurance schemes, and had higher education levels. Marital status was also significant, with 89% living with their families. The majority were married, with 91.8% insured and 86.0% uninsured. Family size and income were significant factors, with high-salary households less likely to be members of the Community Based Health Insurance (CBHI) scheme. The study found that most participants considered themselves intermediate healthcare providers, with limited service due to affordability and segregation. The study suggests increasing healthcare service utilization by introducing Community Benefits Health Insurance (CBHI) to improve access to healthcare and promote good governance. However, the study faces criticism for unfairness and insufficient benefits for non-insured participants. Household were enrolled in CBHI (56.2%) were more probable to use health care service than households who were not enrolled (43.8%) (χ2=21.359, p<0.001). Community Benefits Insurance (CBHI) has increased healthcare utilization among insured households due to reduced illness costs and increased healthcare professional involvement. Factors like income, family size, and travel time contribute to higher utilization. However, challenges include lack of knowledge and community awareness.

How does China's big data policy affect the digital economy of cities? Evidence from national big data comprehensive pilot zones

Based on the panel data of 280 cities in China from 2011 to 2019, this paper examines the effects of big data policies on the digital economy development by using the national big data comprehensive pilot zones as a quasi-natural experiment. The findings of this paper are as follows. First, the big data policy significantly promotes China's digital economy development. Second, cities at a higher administrative level receive higher policy benefits than cities at a lower administrative level. Third, technological innovation and human capital are important ways for the big data policy to improve the development of the digital economy. The conclusions of this paper not only help to assess the effectiveness of big data policies and ensure the efficacy of policy implementation, but also provide policy support for local governments to fully explore the value of data elements and grasp the new opportunities for the digital economy development with the help of the pilot zones.

Implementation of Big Data Information System Using Open-Source Metabase for Civil Registration and Vital Statistics Data Visualization in Surabaya

Civil registration involves the mandatory and continuous documentation of important life events of a country's population under local legal requirements. In many countries, these documents are required to access government services such as education, healthcare, social services, formal employment, insurance benefits, and inheritance rights. Indonesia should prioritize building a comprehensive Civil Registration and Vital Statistics (CRVS) using a big data information system to ensure every individual has a legal identity, can access government services, and collect accurate and reliable statistics on vital events through geospatial maps. Surabaya, a city in Indonesia, still needs a comprehensive Civil Registration and Vital Statistics (CRVS) system. We produce many informative visualizations from the query and modeling processes in Metabase. Based on the PIECES framework, this application's importance level is 4.56 or 91.25%, meaning the application is important, and the satisfaction level is 4.29 or 85.76%, meaning the application is satisfied for the respondents. This research provides a brief overview of how Metabase works and how it can be used to generate visualizations of job-type data. It demonstrates the ease with which visualizations can be changed and customized. It had a good affordability point, making its implementation easier and more beneficial. It also emphasizes the importance of having a powerful tool like Metabase for data analysis and decision-making, especially for the dispendukcapil as a civil registration agency.

Implementation of Big Data Information System Using Open-Source Metabase for Civil Registration and Vital Statistics Data Visualization in Surabaya

Civil registration involves the mandatory and continuous documentation of important life events of a country's population under local legal requirements. In many countries, these documents are required to access government services such as education, healthcare, social services, formal employment, insurance benefits, and inheritance rights. Indonesia should prioritize building a comprehensive Civil Registration and Vital Statistics (CRVS) using a big data information system to ensure every individual has a legal identity, can access government services, and collect accurate and reliable statistics on vital events through geospatial maps. Surabaya, a city in Indonesia, still needs a comprehensive Civil Registration and Vital Statistics (CRVS) system. We produce many informative visualizations from the query and modeling processes in Metabase. Based on the PIECES framework, this application's importance level is 4.56 or 91.25%, meaning the application is important, and the satisfaction level is 4.29 or 85.76%, meaning the application is satisfied for the respondents. This research provides a brief overview of how Metabase works and how it can be used to generate visualizations of job-type data. It demonstrates the ease with which visualizations can be changed and customized. It had a good affordability point, making its implementation easier and more beneficial. It also emphasizes the importance of having a powerful tool like Metabase for data analysis and decision-making, especially for the dispendukcapil as a civil registration agency.

Implementation of Big Data Information System Using Open-Source Metabase for Civil Registration and Vital Statistics Data Visualization in Surabaya

Civil registration involves the mandatory and continuous documentation of important life events of a country's population under local legal requirements. In many countries, these documents are required to access government services such as education, healthcare, social services, formal employment, insurance benefits, and inheritance rights. Indonesia should prioritize building a comprehensive Civil Registration and Vital Statistics (CRVS) using a big data information system to ensure every individual has a legal identity, can access government services, and collect accurate and reliable statistics on vital events through geospatial maps. Surabaya, a city in Indonesia, still needs a comprehensive Civil Registration and Vital Statistics (CRVS) system. We produce many informative visualizations from the query and modeling processes in Metabase. Based on the PIECES framework, this application's importance level is 4.56 or 91.25%, meaning the application is important, and the satisfaction level is 4.29 or 85.76%, meaning the application is satisfied for the respondents. This research provides a brief overview of how Metabase works and how it can be used to generate visualizations of job-type data. It demonstrates the ease with which visualizations can be changed and customized. It had a good affordability point, making its implementation easier and more beneficial. It also emphasizes the importance of having a powerful tool like Metabase for data analysis and decision-making, especially for the dispendukcapil as a civil registration agency.

Teacher's strategy in efforts to improve digital literacy skills of children aged 7-8 years

This study aims to explore the strategies of South Jakarta International School teachers in improving the digital literacy skills of students aged 7-8 years. This research uses a qualitative case study method focusing on learning activities, teacher strategies, and challenges teachers face. Research data were obtained from observation, interviews, and documentation. The research data were analyzed using Campbell's pattern matchmaking model. By utilizing BYOD (Bring Your Own Device) policies, teachers provide opportunities for students to access, be responsible, and utilize technology in learning. This policy benefits students, teachers, and schools. Teachers also implement digital literacy strategies to empower students in integrating technology into learning activities. Through digital learning resources teachers provide, students can develop digital literacy skills such as coding, typing, and digital applications. However, the study also found some obstacles, such as technical issues, self-learning, and online communication and security. This study recommends that teachers and students increase effectiveness, creativity, and initiative in the digital literacy learning process by using appropriate digital learning resources and applications. This study also recommends that parents be involved in the child's learning process by providing guidance and supervision, monitoring children's digital footprints regularly and having knowledge about information and digital literacy from various digital sources.

Analysis of Micro and Small Business Owners' Perceptions of The Benefits of Sharia Insurance In Managing Business Risks

This study aims to analyze the perceptions of Micro and Small Enterprise (MSE) owners towards the benefits of sharia insurance in managing business risks. This research is located in Serdang Bedagai, using a case study-based qualitative research method. Data was obtained through interviews with 10 owner research informants, who were selected based on the coverage of various business sectors and income levels. The results revealed that MSE owners have a positive perception of the benefits of Islamic insurance in managing business risks. Although the understanding of Islamic insurance is limited, MSE owners who have not adopted Islamic insurance have varied perspectives according to their understanding and needs. The majority expressed readiness to use sharia insurance if the premium is affordable and the benefits are as needed. However, there are also those who still need further education regarding the concept and halalness of Islamic insurance products. This positive perception shows the potential for growth and adoption of sharia insurance in Serdang Bedagai Regency. However, there are also challenges, namely that there are still owners who do not fully understand the basic principles of sharia insurance.

Analisis Jaminan Kematian Terhadap Ahli Waris BPJS Ketenagakerjaan Menurut Perspektif Asuransi Syariah (Studi Kasus BPJS Ketenagakerjaan Cabang Medan)

BPJS Employment is a state program that aims to provide guaranteed social protection for all Indonesian workers. Death Benefit (JKM) is a social security program implemented nationally based on social insurance principles with the aim of providing death benefits paid to the heirs of participants who die. Fulfilling worldly needs is an obligation. However, fulfilling the world's needs to achieve these needs can be done by protecting yourself, but still following Islamic law. This research aims to find out how the implementation of providing death insurance for the heirs of BPJS Employment Medan Branch according to the Sharia Insurance Perspective. This research uses a qualitative descriptive analysis method. Collecting research data through observation and interviews. The informants for this research are the Head of BPJS Employment Services, Medan Branch Office and the beneficiaries of the Death Insurance Program. The results of the research show that the implementation of providing death insurance to heirs has not been effectively implemented because the death compensation funds to heirs are late so that the death compensation cannot be felt during the death procession starting from the burial of the body to the prayer for the souls from the 7th day, even 40th day soul prayer. This is due to the heirs' lack of understanding in implementing the death insurance program and the application or processing of death insurance application documents requires too many requirements so that getting the death insurance benefits takes a long time. The non-payment of participants' death insurance claims for months by BPJS Employment has three strong indications of maladministration, namely protracted delays, non-compliance and unprofessionalism. Maladministration is behavior or acts against the law and ethics in the public service administration process. The forms of maladministration are procedural deviations, discriminatory actions, abuse of authority, including negligence or neglect of legal obligations, requests for rewards, and others. In the implementation of providing death insurance to heirs by BPJS Employment Medan Branch, it is not in accordance with sharia insurance principles, there is the occurrence of chance which has an impact on the element of maysir (gambling), there is an element of usury fadhl (excess between what is received and what is paid), including fines for lateness.

Employee Benefits and Firm Value of Listed Nigerian Consumer Goods Manufacturing Firms

The practice of rejigging the firm value of manufacturing companies by considering employee benefits after the adverse effect of the global lockdown of COVID-19 formed the crux of this study. The study investigated the influence of employee benefits on the firm value of listed manufacturing firms in Nigeria. Specifically, it examined the influence of incentives, health, safety, life insurance, and retirement benefits on firm value. The study adopted ex-post facto and longitudinal research designs. 22 consumer goods manufacturing firms listed on the Nigeria Exchange (NGX) formed the study population as of December 31, 2021. A census sampling technique was used, automatically making the 22 listed firms the study’s sample size. Data were obtained from published annual reports of the firms covering ten years, starting from 2012 to 2021 financial year. The data were analysed using descriptive statistics and panel regression. Findings revealed that incentives, health, safety, life insurance, and retirement benefits negatively and significantly affect Tobin’s list of consumer goods manufacturing firms in Nigeria. The study concluded that re-strategising incentives, health, safety, life insurance, and retirement benefits as policies would make firms perform better and increase their value. The study recommends that employee benefit policy and system be reviewed to reduce cost, staff population be cut down, and the firms adopt more non-monetary benefits to improve their wealth.

Protection against accidents for persons entitled to agricultural retirement pensions who did not stop conducting agricultural activities

The purpose of this study is to show the desired direction of changes in the accident component of social insurance of farmers, in order to provide protection against accidents to everyone at risk of accident during agricultural work. This need is dictated primarily by the statutory changes implemented in 2022 in which those entitled to agricultural retirement pensions can combine receiving a full agricultural retirement with no restrictions on conducting agricultural activities on their farm, but no longer subject to accident insurance. The objective of each social insurance system should be to provide protection in the form of social insurance benefits to persons conducting specific activities. Such benefits are supposed to guarantee that the requirements the legislator considers of essential social importance are satisfied. Undoubtedly, one of these is insurance coverage of persons liable to accidents during agricultural work by introducing separate regulations in this respect in the provisions concerning social insurance of farmers. Hence the need to consider these changes. Keywords: one-time compensation, social insurance of farmers

Medical Insurance Fraud Detection Using Machine Learning

Medical insurance fraud poses significant challenges to the healthcare industry, impacting financial resources and patient care. This research explores the application of machine learning methodologies to detect fraudulent activities within healthcare insurance claims. Medical insurance fraud detection is crucial to help insurance companies save money. Machine learning is a powerful tool that can be used to detect fraudulent activities in the healthcare industry. Fraud can be spread broadly and extremely costly to the therapeutic protection framework. Protection can be made unscrupulous and be a case designed to hide or alter such information meant for social insurance benefits. Cheats might be numerous and submitted by the protection guarantor or the safeguarded. The unscrupulous social insurance providers are the reason for extortion in the well-being segment. This research approach is to apply machine learning to find incidents of medical insurance fraud automatically. In conclusion, machine learning is a promising tool for detecting medical insurance fraud. It can help insurers detect fraudulent activities in real time, saving money on bogus claims.

POLICY SERIES: HEALTH AND AGING POLICY FELLOWS: LINKING POLICY AND PRACTICE TO BENEFIT OLDER PEOPLE

Abstract The Health and Aging Policy Fellows program was founded in 2008 after its founders observed a dearth of experts with overlapping experience in policy and aging. The program is creating a growing cadre of leaders to improve the health of older adults by influencing policy at the state and national levels that is joined through an alumni network of more than 150 fellows. The fellowship’s goal is to improve the lives of older people across life domains. Past fellows serve as staff members in Congress, in State and Federal Agencies, and in the private sector. The fellowship has helped to launch many policy-focused careers. In this seminar, current and past fellows from medicine, research, social work, and law will share their experiences before, during, and after their fellowship. They will describe what they learned through the training and a placement in a full- or part-time policy role, how viewing health and aging through a policy perspective changed their understanding of systems, and how they think the fellowship will enable them to influence policy to improve the lives of older people in the future. Fellows will also highlight ongoing policy challenges that stop or slow progress toward achieving the goal.

THE EFFECT OF INCOME SECURITY IN OLD AGE ON HEALTH OUTCOMES: A COMPARISON BETWEEN CHINA AND THE US

Abstract This paper examines the social determinants of health, particularly the social, political, and economic context of socioeconomic status and health outcomes. Many studies on the political economy of health have highlighted the effects of welfare states on health and health inequalities, typically using welfare state regimes as proxies for social policies. Few research studies have described the association between frailty phenotype and financial wellbeing, however, particularly considering the three-legged stool of retirement income security (public pensions, private pensions, and personal savings/assets) across different welfare state regimes. This study investigates the effects of old-age income disparities on frailty among older adults in the United States and China. Specifically, this paper examines the associations between different sources of old-age income (public and private pensions, personal savings and assets, earnings, workplace subsidies, worker’s compensation, household subsidies, and unemployment insurance benefits) and the five-item frailty phenotype from the RAND Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS). The findings reveal that health outcomes measured by the Fried’s frailty phenotype vary considerably by country and income type.

Does crop insurance ensure food security for Indian farmers? Evidence from a nationally representative survey

AbstractThis study examines the impact of farm households' decision to adopt crop insurance and its effect on food security. Using the National Sample Survey Office's 77th round of data (2019–2020) from Indian farming households, the endogenous switching regression results confirm that insuring crops against production risks increases food security (as measured by higher consumption expenditures and net farm income). Specifically, findings show that farming households would decrease consumption expenditures by 15% and net farm income by 26% if they had not adopted crop insurance. Similarly, the noninsured families would have 23% higher consumption expenditures and 31% higher net farm income if they had insured crops. However, we find heterogeneity in welfare impacts because large farmers reap more benefits than smallholders. Policy implications from this study call for increased awareness of insurance programs, educating farmers about crop insurance schemes, and an effective institutional framework to reduce heterogeneity in insurance benefits. [EconLit Citations: Q13, Q18, O53].

Achieving biodiversity net gain by addressing governance gaps underpinning ecological compensation policies.

Biodiversity compensation policies have emerged around the world to address the ecological harms of infrastructure expansion, but historically compliance is weak. The Westminster government is introducing a requirement that new infrastructure developments in England demonstrate they achieve a biodiversity net gain (BNG). We sought to determine the magnitude of the effects of governance gaps and regulator capacity constraints on the policy's potential biodiversity impacts. We collated BNG information from all new major developments across six early-adopter councils from 2020 to 2022. We quantified the proportion of the biodiversity outcomes promised under BNG at risk of noncompliance, explored the variation in strategies used to meet developers' biodiversity liabilities, and quantified the occurrence of simple errors in the biodiversity metric calculations. For large developments and energy infrastructure, biodiversity liabilities frequently met within the projects' development footprint. For small developments, the purchase of offsets was most common. We estimated that 27% of all biodiversity units fell into governance gaps that exposed them to a high risk of noncompliance because they were associated with better-condition habitats delivered on-site that were unlikely to be monitored or enforced. More robust governance mechanisms (e.g., practical mechanisms for monitoring and enforcement) would help ensure the delivery of this biodiversity on-site. Alternatively,more biodiversity gains could be delivered through off-site biodiversity offsetting. For the latter case, we estimated that the demand for offsets could rise by a factor of 4; this would substantially increase the financial contributions from developers for conservation activities on private land. Twenty-one percent of development applications contained a simple recurring error in their BNG calculations. One-half of these applications were approved by councils, which may indicate under-resourcing in council development assessments. Our findings demonstrate that resourcing and governance shortfalls risk undermining the policy's effectiveness.

Expectations for Policy Change and Participation

Abstract What policy changes do people expect from elections, and how do these expectations influence the decision to vote? This paper seeks to understand the relationship between people’s expectations and their subsequent voting behavior by examining beliefs about what candidates would actually do if given political power. I start with a survey of political scientists and compare their forecasts about what presidential candidates will accomplish to those of the general population. Public respondents expected much more legislation to result from the 2020 election. This comparison suggests an underestimation by the public of the impediments that the separation of powers poses to passing legislation. The study further reveals that voters expected much more policy change than nonvoters did, with high expectations serving as a strong predictor of validated voter turnout. These results support explanations for the decision to vote that center on the policy benefits that people believe their preferred candidate will deliver.

Ensuring employment of the population: international legal standards and national experience

The article examines a number of international regulatory acts containing the main legal standards in the field of ensuring employment of the population, combating unemployment and social security of a person in connection with the loss of a person's job for reasons beyond his control. It is noted that these areas of legal regulation are directly related to the right to work, the effective prohibition of discrimination and forced labor, as well as the right to free personal development and decent work. The change in trends in the social policy of the states is monitored from the simple support of a sufficient living standard of the unemployed through the provision of state or insurance benefits to the state employment policy, which stimulates employment based on professional orientation, choosing a profession with maximum consideration of natural abilities and already acquired skills, opportunities for professional training, retraining and advanced training, building a system of professional education in accordance with the needs of the labor market, etc. International legal standards, which are the basis for the development of the legal system of any modern state, determine the directions of reforming both the legal system as a whole and its individual branches. Accordingly, the labor and social security legislation of Ukraine is also developing in line with global and European trends. In particular, already during the years of independence, legislation on employment and social protection of the unemployed has undergone significant reforms, increasingly approaching the high standards of ensuring human rights in this area. The revision of the 2012 Law of Ukraine "On Employment of the Population" was a significant progressive step, as it provided for a number of measures to stimulate productive employment, help young people get their first job, and regulated the procedure for employment of foreign citizens in Ukraine. This Law and the relevant regulatory documents are subject to constant changes, especially in the last few years in connection with the problems of the pandemic caused by the spread of COVID-19 in the period of 2020-21 and the armed aggression of the Russian Federation against Ukraine from February 2022 to the present . It should be noted that the cooperation of the legislative and executive branches of government with experts of specialized international organizations brings positive results, as Ukrainian legal norms are increasingly approaching recognized international standards, in particular, the standards of the European Union, in which the main goal is to ensure human rights, respect for the individual, human dignity and equality of treatment in the spheres of employment and professional education.