Security Insurance Research Articles

Life After Retirement: Exploring the Survival Strategies of SSNIT Pensioners in the Greater Accra Region of Ghana.

Ghana's elderly population represents about 6.7% of the national populace. They comprise persons aged sixty years and above, including retirees. The main source of income for some of these individuals, particularly those who worked in the formal sector is the monthly pension they receive as compensation for contributing to Ghana's public pension scheme known as the Social Security and National Insurance Trust (SSNIT) while they were working. However, some beneficiaries of the scheme have raised concerns about the inadequacy of the pension income. Old age is accompanied by other social, economic, and health issues that tend to be detrimental to one's well-being. In this study, the survival strategies adopted by SSNIT pensioners to assuage the challenges they encounter, mainly due to inadequate pensions were explored. The mixed-methods research design was employed to gather data from 437 respondents. Whereas the quantitative findings were analyzed via the Stata software, the framework approach was adopted to analyze the qualitative data. The majority (78.7%) of the pensioners indicated that their pensions were insufficient to meet their needs. In their quest to address the challenges confronting them, the pensioners either adopted survival strategies they considered suitable or resorted to other non-prioritized coping mechanisms perceived to be relevant only in times of urgent necessity. Based on the findings of the study, some recommendations for policy and practice were presented.

Medicaid Enrollment and Service Use Among Adults With Down Syndrome

Down syndrome is the leading genetic cause of intellectual disability and automatically qualifies individuals for Social Security Insurance. Therefore, Medicaid is the major health insurance provider for a population at high risk for dementia, obesity, and premature mortality. Despite the importance of Medicaid for adults with Down syndrome, little is known about how this population uses Medicaid. To describe enrollment in, health care use in, and cost to Medicaid for adults with Down syndrome compared with adults with intellectual disability and a random sample of adults enrolled in Medicaid. In this cohort study, the data are from a claims cohort of adults aged 18 years or older enrolled in Medicaid at any point between January 1, 2011, and December 31, 2019. Participants were enrollees with 1 or more inpatient claim or 2 or more other claims with an International Classification of Diseases, Ninth Revision code or an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code for Down syndrome or intellectual disability as well as a random sample of those without developmental disability. Analyses were conducted from June 2022 to February 2023. Data were linked across 2 data reporting systems. Main outcomes were enrollee demographic characteristics, enrollment characteristics, cost, and service use. This cohort study included 123 024 individuals with Down syndrome (820 273 person-years of coverage; mean [SD] age, 35 [14.7] years; median age, 33 years [IQR, 21-48 years]; 51.6% men; 14.1% Black individuals; 16.7% Hispanic individuals; and 74.6% White individuals), 1 182 246 individuals with intellectual disability (mean [SD] age, 37.1 [16.8] years; median age, 33 years [IQR, 22-50 years]; 56.5% men; 22.0% Black individuals; 11.7% Hispanic individuals; and 69.5% White individuals), and 3 176 371 individuals with no developmental disabilities (mean [SD] age, 38 [18.6] years; median age, 33 years [IQR, 21-52 years]; 43.8% men; 23.7% Black individuals; 20.7% Hispanic individuals; and 61.3% White individuals). Median enrollment in Medicaid for a person with Down syndrome was 8.0 years (IQR, 5.0-9.0 years; mean [SD], 6.6 [2.6] years). Costs were higher for the Down syndrome group (median, $26 278 per person-year [IQR, $11 145-$55 928 per person-year]) relative to the group with no developmental disabilities (median, $6173 per person-year [IQR, $868-$58 390 per person-year]). Asian, Black, Hispanic, Native American, and Pacific Islander adults with Down syndrome had fewer costs and claims per person-year compared with White adults with Down syndrome. This cohort study of individuals with Down syndrome enrolled in Medicaid found consistent enrollment and high use of health care in a population with high health care needs. Results were similar comparing individuals with Down syndrome and those with intellectual disability, with both groups differing from a sample of Medicaid enrollees with no developmental disabilities. Medicaid data are a useful tool for understanding the health and well-being of individuals with Down syndrome.

CONTEMPORARY PROBLEMS OF TECHNOLOGICAL RISKS AND THE WAYS OF DEVELOPMENT

The article ‘’Contemporary problems of technological risks and ways of development ‘’ describes the role of technical risks in the economy of Georgia and the search for ways of its development. The problems that stand in this direction are mentioned. Today, in the era of technologies, the degree of technical risks increases in direct proportion of the development of technologies, which has become a heavy burden for users. Today, each of us uses plastic cards or simply has an account in some social network, and all this automatically puts us at technological risk. Therefore, the most frequently discussed issue is precisely the technical risks and possible serve consequences caused by them. Electronic commerce and internet banking are also noteworthy as the object of attack. Thus, we think that the topic is relevant. The paper discusses the changes that have been made to mitigate these risks. The results of the research are given, the analysis of which gives an idea of the quality of the existing technological risks and ways of elimination. The problems that prevent the better development of technological risks throughout the country are mentioned: 1. Lack of support from the government. 2. Unqualified staff. 3. Inadequate legislation in terms of cyber security. 4. Inadequate insurance of cyber risks. The article presents the results of survey conducted within the framework of the study and relevant statistics. 1. The government should find more support for people affected by technological risks. 2. Specialists employed in the field should be retrained. 3. Legislation should be refined and become victim-friendly. 4. Improve cyber security insurance. Taking all this into account will help’ to solve the problems in technological risks throughout the country. The article contains the opinions ad advice of the authors, seen from the point of view of scientists and its implementation in practice will help to effectively conduct the activities of the filed. Keywords: Technological risks. Cyber security. Economy. Plastic cards. Government. Insurance.

The binding nature of posting PDA1 issued under EU social security Coordination Regulations and the possible role of national courts

The EU social security Coordination Regulations envisage a special conflict rule that, under strict conditions, allows posted workers to maintain temporarily the social security insurance of the home Member State. The Portable Document A1 (PDA1), the proof of insurance, is a binding document for the institutions and courts of the host Member State that can only be invalidated or withdrawn by the institutions that issued it or by the corresponding national courts. The case-law of the European Court of Justice has clarified that under certain very specific circumstances a fraudulent foreign PDA1 can be disregarded by a Court, but never invalidated. Communication and collaboration between institutions of the issuing and receiving Member States and the judicial procedures for challenging a foreign PDA1 may need to be enhanced and improved, but the current rules of play respond to the logic of the Coordination Regulations, to sincere cooperation, to legal certainty, and to the uniqueness of the applicable law and the competent jurisdiction. The scarce available data shows that only a few of the three million PDA1s issued each year are being challenged. Given that the main role of the EU legislation is to protect workers, it does not seem logical to change the social security framework of posting, although it can be improved. Mutual trust must be restored.

Medication use by insurance coverage in subjects with coronary heart disease in the Southern Cone of Latin America

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) grant number HHSN268200900029C. Background Clinical guidelines recommend cardioprotective medication use in coronary heart disease (CHD) patients. Underuse of these drugs is common among patients of low resources, which may be explained by insufficient access in the public sector. Aim We aim to assess medication use and barriers to care by insurance coverage in subjects with CHD in the Southern Cone of Latin America. Methods We analysed cross-sectional data from 593 participants with CHD residing in Argentina, Chile and Uruguay, within the CESCAS community-based cohort study. Participants were categorized as covered by public insurance only or having additional coverage (social security or private insurance). We calculated the prevalence of recommended medications use, mean number of medications, use of ≥ 1 and ≥ 2 drugs, and reported barriers to needed care in insured and uninsured participants. Differences between coverage groups were assessed with univariable and multivariable analysis (logistic and Poisson regression) adjusted by age, sex, previous revascularization, educational level and barriers. Results Medication use ranged from 39.8% (lipid-lowering) to 84.1% (antihypertensives). Mean number of medications was 1.8 (SE 0.1), 95.4% used ≥ 1 drugs, and 59.8% used ≥ 2 drugs. There were no significant differences by coverage in medication use, except for higher ACE-inhibitor and nitrate use among participants in the public sector (35.8% vs. 53.2%, p=0.001; and 1.5% vs. 5.2%, p=0.047 respectively). In the multivariable analysis, having public coverage only was not significantly associated with medication use, but it was with reporting barriers to care (OR 2.06, 95% CI 1.21-3.52). Conclusion Insurance coverage was not associated with the use of most medications in CHD patients in the Southern Cone of Latin America, possibly due to public health programs providing them free of charge. Uninsured participants more often face barriers to access medical care, and future studies should address these healthcare inequalities.

"It was kind of a nightmare, it really was:" financial toxicity among rural women cancer survivors.

The purpose of this study was to examine how rural women cancer survivors experience and manage financial toxicity. A qualitative descriptive design was used to explore experiences of financial toxicity among rural women who received cancer treatment. We conducted qualitative interviews with 36 socioeconomically diverse rural women cancer survivors. Participants were categorized into three groups: (1) survivors who struggled to afford basic living expenses but did not take on medical debt; (2) survivors who took on medical debt but were able to meet their basic needs; and (3) survivors who reported no financial toxicity. The groups differed by financial and job security and insurance type. We describe each group and, for the first two groups, the strategies they used to manage financial toxicity. Financial toxicity related to cancer treatment is experienced differently by rural women cancer survivors depending on financial and job security and insurance type. Financial assistance and navigation programs should be tailored to support rural patients experiencing different forms of financial toxicity. Rural cancer survivors with financial security and private insurance may benefit from policies aimed at limiting patient cost-sharing and financial navigation to help patients understand and maximize their insurance benefits. Rural cancer survivors who are financially and/or job insecure and have public insurance may benefit from financial navigation services tailored to rural patients that can assist with living expenses and social needs.

Mammography prevalence in Mexico from 2001-2018: Results from the Mexican Health and Aging study

After introducing guidelines for breast cancer screening in 2003, Mexico began to prioritize the implementation of mammography screening nationally. Since then, there have been no studies assessing changes in mammography in Mexico using the two-year prevalence interval that corresponds to national guidelines for screening frequency. The present study analyzes the Mexican Health and Aging Study (MHAS), a national population-based panel study of adults aged 50 and older, to evaluate changes in 2-year mammography prevalence among women aged 50 to 69 across five survey waves from 2001 to 2018 (n = 11,773). We calculated unadjusted and adjusted mammography prevalence by survey year and health insurance type. Overall prevalence increased substantially from 2003 to 2012 and leveled off in the period from 2012 to 2018 (2001: 20.2 % [95 % CI 18.3, 22.1]; 2003: 22.7 % [20.4, 25.0]; 2012: 56.5 % [53.2, 59.7]; 2015: 62.0 % [58.8, 65.2]; 2018: 59.4 % [56.7,62.1]; unadjusted prevalence). Prevalence was higher among respondents with social security insurance, who are more likely to work in the formal economy, than among respondents without social security, who are more likely to work in the informal economy or be unemployed. The overall prevalence estimates observed were higher than previously published estimates of mammography prevalence in Mexico. More research is needed to confirm findings regarding two-year mammography prevalence in Mexico and to better understand the causes of observed disparities.

The Role of Informal Waste Management in Urban Metabolism: A Review of Eight Latin American Countries

Social and spatial segregation structures in Latin America are perceived as processes for the selective concentration of social or demographic groups in geographic sectors of the city. This voluntary or forced segregation creates poor, wealthy, and marginal areas, leading to the territory’s marginalization and fragmentation, destroying the symbolic and territorial urban continuity. To understand the behavior of waste pickers in a Mexican city, we sought to know the conditions of the informal collection activity in eight Latin American countries with similar conditions. Therefore, the goal was to carry out a bibliographic evaluation that included the environmental contribution of waste pickers, their organizations, and their link with urban metabolism. The tasks performed by informal waste pickers in the cities of the eight selected Latin American countries, their organizations, and their way of working were studied. Their role in reducing environmental impact and improving the quality of life of city dwellers was evaluated. Web sites, web searches, and face-to-face meetings created electronic communication channels with this community were analyzed. In some cases, they are well organized and become microentrepreneurs with salary, social security, and economical insurance by starting an ecological business. In contrast, marginal groups seeking economic support collect, separate, sort, and group recoverable waste daily and sell it at waste distribution points. This link in the urban metabolism reintroduces valuable solid waste into the production chain. In addition, materials with commercial value, such as metals, plastics, paper, cardboard, and wood, can re-enter the production chain as secondary materials for industry. Thus, a collective of well-organized waste pickers contributes to the city’s sustainability and provides better living conditions for the waste pickers. In Mexico, there is a lack of official information regarding the number of waste pickers, organizations, activities, and their environmental contribution. Therefore, a directory with that information is highly relevant to designing public policies to recognize the essential contributions of this sector.

Role of Health Insurance in Facing Health Expenditures Among Urban Female-headed Households in Iran

Background: Health insurance is one of the important parts of financing in the health system to reduce inequality in household health expenditures. Objectives: This study aimed to investigate the role of health insurance in facing health expenditures among urban female-headed households in Iran. Methods: This descriptive-analytical applied study was performed cross-sectionally using the double-sample selection econometrics method in Stata software (version 16) in 2021. The sample included 2645 female-headed households, and the data were prepared by the Statistics Center of Iran using a questionnaire. Results: The results showed that social security insurance, private insurance, and insurance of special organizations led to an increase in the health expenditures of female-headed households by 159896, 334137, and 18332 Rials, respectively. Increasing household size, having children, having an elderly person, increasing per capita income, and per capita tobacco expenditures led to an increase in the health expenditures of female-headed households by 875260, 1545153, 2441094, 0.32, and 1.65 Rials, respectively. Conclusions: Private insurance, social security insurance, and insurance of special organizations had the greatest impact on increasing the health expenditures of female-headed households, respectively. Therefore, it is necessary to create an integrated health insurance system that reduces insurance organizations and funds and provides the same level of coverage for health goods and services. It is also suggested to adopt policies to increase the educational level of female-headed households to reduce health expenditures.

Understanding the Perceptions and Practices of Homeowners in the Event of Hurricane: A Case Study of University Employees in Louisiana

The purpose of this qualitative study is to explore and gain an understanding of Louisiana homeowners’ perceptions and practices in preparing for hurricanes; contribute to academic research and student learning, while guiding the development of future projects. We focused specifically on how homeowners in Louisiana would protect their important documents and possessions. These documents and possessions include but are not limited to photographs, social security cards, birth certificates, and insurance paperwork. We collected the data throughout the fall semester of 2022 at Louisiana State University (LSU) by conducting a focus group and in-depth interviews. We collected a variety of answers, but most participants expressed a strong need to have their important documents and possessions protected and gave different strategies for how this was carried out, such as digitizing or protective storage. Participants also expressed a strong need for more information to be delivered to residents to talk more about ways they can protect their own documents and possessions. Emphases were also made on the need for: leaders of large institutions to be especially concerned with preparedness for vulnerable populations; outreach programs to be put in place to spread awareness of the importance of protecting important documents and possessions during a disaster; news outlets to switch their focus from normal survival tips to discussions on the importance of protecting documents and possessions; government and non-profit agencies to work together to share tips and information through social media and other forms of handouts.

The Pass, a medical and social device for vulnerable people

The permanence of access to health care is a system that aims to facilitate access to ambulatory medical care for poor and vulnerable people who do not have social security or health insurance coverage, or who have incomplete social security coverage (neither mutual insurance, nor complementary health insurance from the primary health insurance fund). A health care team from the Ile-de-France region shares its know-how and expertise with the most disadvantaged.

The Study on Effectiveness of Internal Audit on the Performance of the Public Sector in Sierra Leone: A Case Study of the National Social Security Insurance Trust

The Study on Effectiveness of Internal Audit on the Performance of the Public Sector in Sierra Leone: A Case Study of the National Social Security Insurance Trust

Material misrepresentations in insurance litigation: an analysis of insureds' arguments and court decisions

The section presents abstracts of U.S. court cases bearing on the regulation of insurance during the 2012-2013 period, including Colby v. Union Security Insurance Co., UnitedHealth Group Inc. v. Columbia Casualty Co. and Bankers Life and Casualty Co. v. Superintendent of Insurance.

Designing a Dynamic Model to Evaluate the Efficiency of Social Capital in the Insurance Industry

This research is organized with the aim of designing a dynamic model to evaluate the effectiveness of social capital in the insurance industry using the method of content analysis, which in terms of purpose is practical and in terms of the method of collecting information, it is a part of qualitative research. The statistical population consists of insurance industry experts and managers of Iran's social security insurance branches in Tehran. For sampling in this research, the purposeful sampling method, which is non-probability sampling, was used. In addition, after collecting the information, the codes related to the written interviews were analyzed using thematic analysis method. The credibility of the research was obtained through the agreement of experts and validity with the help of consensus of opinions and face validity. Qualitative data analysis in this study was done with thematic analysis method. ATLAS TI software was used for qualitative content analysis. Also, by examining the data obtained from the text, 1 overarching theme, 5 organizing themes, and 21 basic themes were extracted. The results showed that all the themes identified from Expert opinions are relevant and there is favorable consensus about their importance.

Risks of emergencies in the Far North of Krasnoyarsk region

The issue of security insurance in the Far North of the Russian Federation is being annually solved. The paper presents the calculation of emergency risks for the Far North of Krasnoyarsk region. The initial data for the calculation are the geographical characteristics and climatic features of the Far North of Krasnoyarsk region, which may entail the risk of emergencies and incidents; hazard categories of natural and man-made emergencies that may occur in the territory; the number of deaths caused by emergencies and incidents over the past five years. The most common cause of emergency in the northern territories of the region and in the circumpolar zone was identified. It is man-made fires. The number of fires in the industrial sector of the polar regions is much higher than in other regions. The paper suggests ways to reduce the unacceptable level of emergency risks. It seems that these measures will make the northern territories safer and more accessible to the population.

The challenges of telephone consultation program during severe acute respiratory syndrome-coronavirus-2 epidemic in Iran: A qualitative study.

With the spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) disease and its potential risks for vulnerable groups such as the elderly with chronic diseases, telehealth appointments gained more attention around the world. However, using such a system brought about challenges to patients and service providers that need to be addressed by policymakers for system improvement. The present study was conducted with the aim of investigating the challenges of the telephone consultation program, which was run by the Social Security Insurance Organization of Iran during the epidemic of SARS-CoV-2. This qualitative study was conducted through semi-structured interviews with physicians who participated in the program, using a purposive sampling approach. The interviews were recorded, transcribed verbatim, and analyzed through conventional content analysis by ATLAS.ti9 software. Based on the results of the qualitative content analysis, the challenges in three categories, including program development, implementation, and evaluation and monitoring, and with 10 themes (planning challenges, infrastructure provision, education and culture building, legal issues, motivational mechanisms, effective communication, efficiency, and effectiveness of care, organization, monitoring, and evaluation) and 26 sub-themes were extracted. Telephone appointments allow medical centers to serve some patients better. However, properly implementing the telephone consultation program requires better planning, training, appropriate infrastructure, and continuous evaluation and improvement of processes.

The Study on Effectiveness of Internal Audit on the Performance of the Public Sector in Sierra Leone: Case Study of The National Social Security Insurance Trust

The Study on Effectiveness of Internal Audit on the Performance of the Public Sector in Sierra Leone: Case Study of The National Social Security Insurance Trust

Lost to Follow-Up among Tuberculosis Patients during the Public-Private Mix Era in Rural Area of Indonesia.

Indonesia's national Tuberculosis (TB) strategy is public-private mix (PPM). The PPM aims to treat patients who have lost sight during TB treatment as these patients are TB carriers and at risk of transmitting TB. The purpose of this study was to identify predictive factors for loss to follow-up (LFTU) among TB patients receiving treatment when the PPM was at place in Indonesia. The design of this study was a retrospective cohort study. The data used in this study was sourced from the Tuberculosis Information System (SITB) of Semarang which was recorded routinely during 2020-2021. Univariate analysis, crosstabulation, and logistic regression were performed on 3434 TB patients meeting the minimum variables. The participation of health facilities in reporting TB during the PPM era in Semarang reached 97.6% consisting of 37 primary healthcare center (100%), 8 public hospitals (100%), 19 private hospitals (90.5%), and a community-based pulmonary health center (100%). The regression analysis reveal that the predictive factors of LTFU-TB during the PPM are the year of diagnosis (AOR=1.541; p-value=<0.001; 95% CI=1.228-1.934), referral status (AOR=1.562, p-value=0.007; 95% CI=1.130-2160), healthcare and social security insurance ownership (AOR=1.638; p-value=<0.001; 95% CI=1.263-2.124), drugs source (AOR=4.667; p-value=0.035; 95% CI=1.117-19.489). The PPM strategy in dealing with LTFU patients should focus on TB patients without Healthcare and Social Security Insurance and who receive TB treatment rather than program drugs.

Donor and non-donor perspectives on receiving information from routine genomic testing of donor blood.

Genomic testing is already used by blood collection agencies (BCAs) to identify rare blood types and ensure the best possible matching of blood. With ongoing technological developments, broader applications, such as the identification of genetic markers relevant to blood donor health, will become feasible. However, the perspectives of blood donors (and potential blood donors) on routine genomic testing of donor blood are under-researched. Eight online Focus Groups were conducted: four with donors and four with non-donors. Participants were presented with three hypothetical scenarios about the current and possible future applications of genomic testing: Performing rare blood type testing; identifying donors with genetic markers associated with iron metabolism; and identifying donors with genetic markers associated with bowel cancer. Testing to identify rare blood types was perceived to be an appropriate application for the BCA to undertake, while identifying markers associated with iron metabolism and cancer genetic markers were only partially supported. Participants raised concerns about the boundaries of acceptable testing and the implications of testing for privacy, data security, and health insurance. Perspectives of donors and non-donors on all scenarios were similar. The principles of who benefits from genomic testing and the perceived role of BCAs were key in shaping participants' perspectives. Participants generally agreed that testing should be directly related to blood donation or be of benefit to the recipient or donor. Findings indicate that consent and communication are key to the acceptability of current and expanded genomic testing.

Analysis of drug prescriptions and insurance deductions of the governmental pharmacy of Lorestan University of Medical Sciences

Background: Standards-based prescribing can increase the effectiveness of treatment and the optimal management of financial resources, including reducing the costs of insurance deductions. Therefore, reducing insurance deductions is necessary for pharmacy management. So, this study aimed to analysis the prescriptions and insurance deductions of the governmental pharmacy of Lorestan University of Medical Sciences. Materials and Methods: This study is a retrospective cross-sectional study that includes a review of all prescriptions of the Social Security and the Armed Forces insurances. The information was collected through the checklist. Then, they were statistically analyzed by SPSS22 and excel software’s. Results: The results showed that the highest number of prescriptions is related to general practitioners and the highest monetary amounts of the monthly deductions related to the Armed Forces Insurance is “price adjustment and low demand” (1700606 Rials) and the highest monetary amounts of the deductions in connection with the Social Security Insurance is “wrong code of the medical system (4617125 Rials). Conclusion: Based on the results, it can be concluded that the most important causes of the deductions are related to human errors. Hence to reduce the deductions, first be more coordination’s between the insurances and pharmacies for covered items and the regulations second monitoring and up-to-date training of individuals on the correct entry of information based on the standards and regulations