WorldWideScience

Sample records for insurance pharmaceutical services

  1. [Logistics in the pharmaceutical service].

    Science.gov (United States)

    Stanko, P; Fulmeková, M

    2005-11-01

    The conception of the field of pharmaceutical service defines pharmaceutical service as the basic part of pharmacy, the principal task of which is to provide pharmaceutical care as an inseparable part of providing health care. It represents a set of professional activities of the pharmacist oriented to securing human and veterinary pharmaceutical products and health care products and to optimising effective, safe and quality pharmacotherapy. Technically, pharmaceutical service is an applied discipline, as it makes use of knowledge gained in other pharmaceutical, medical, psychological, social, and economic sciences. Because of its interdisciplinary character it is necessary to extend the theory of pharmaceutical service in such a way so that it may reflect all aspects of its sphere of activity. One of the possibilities is to define the pharmacy premises as an independent functional unit which operates on the basis of valid legal standards in such a way that on the one hand it secures the provision of health (pharmaceutical) care, and on the other hand it maintains its cost-effectiveness. To keep the quality of care of the patient and the economic aspect in balance, it is necessary to define the term pharmaceutical logistics also under the conditions of Slovak (Czech) pharmacy as early satisfaction of the requirements of the patient (client) in the pharmacy premises, which means that the appropriate pharmaceutical product or health care product and the appropriate information must be at the right time in the required amount and required quality in the right place.

  2. Social insurance for health service.

    Science.gov (United States)

    Roemer, M I

    1997-06-01

    Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.

  3. Marketing concepts for pharmaceutical service development.

    Science.gov (United States)

    Grauer, D W

    1981-02-01

    Marketing concepts as a mechanism to help pharmacy develop, communicate, and sell future pharmaceutical services to consumers are discussed. Pharmacy as a profession must define itself broadly to take advantage of future growth opportunities. These growth opportunities will be realized from unmet health-care needs and changing consumer life style trends and values. New services must therefore be oriented toward consumers (i.e., patients, health professionals, and third-party agencies) to gain acceptance. Dispensing and drug-knowledge-distribution pharmaceutical services are reviewed by a product life cycle analysis of sales profits versus time. A marketing mix for new pharmaceutical services is developed consisting of service, price, distribution, and promotion strategies. Marketing can encompass those key elements necessary to meet the organizational goals of pharmacy and provide a systematic, disciplined approach for presenting a new service to consumers.

  4. Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

    Science.gov (United States)

    Richardson, Jeff R J; Segal, Leonie

    2004-01-01

    The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising. Despite this, the queues facing public patients - which were the primary justification for the assistance to PHI - do not appear to be shortening. Against this backdrop, we seek to evaluate recent policies. It is shown that the reason commonly given for the support of PHI - the need to preserve the market share of private hospitals and relieve pressure upon public hospitals - is based upon a factually incorrect analysis of the hospital sector in the last decade. It is similarly true that the 'problem' of rising pharmaceutical expenditures has been exaggerated. The common element in both sets of policies is that they result in cost shifting from the public to the private purse and have little to do with the quality or quantity of health services.

  5. Billing third party payers for pharmaceutical care services.

    Science.gov (United States)

    Poirier, S; Buffington, D E; Memoli, G A

    1999-01-01

    To describe the steps pharmacists must complete when seeking compensation from third party payers for pharmaceutical care services. Government publications; professional publications, including manuals and newsletters; authors' personal experience. Pharmacists in increasing numbers are meeting with success in getting reimbursed by third party payers for patient care activities. However, many pharmacists remain reluctant to seek compensation because they do not understand the steps involved. Preparatory steps include obtaining a provider/supplier number, procuring appropriate claim forms, developing data collection and documentation systems, establishing professional fees, creating a marketing plan, and developing an accounting system. To bill for specific patient care services, pharmacists need to collect the patient's insurance information, obtain a statement of medical necessity from the patient's physician, complete the appropriate claim form accurately, and submit the claim with supporting documentation to the insurer. Although many claims from pharmacists are rejected initially, pharmacists who work with third party payers to understand the reasons for denial of payment often receive compensation when claims are resubmitted. Pharmacists who follow these guidelines for billing third party payers for pharmaceutical care services should notice an increase in the number of paid claims.

  6. Perceived Relationships among Components of Insurance Service for Users of Complementary Health Insurance Service

    OpenAIRE

    Urban Sebjan

    2013-01-01

    This article explores the relationship between the components of the services provided by complementary voluntary health insurance (CVHI), to which users ascribe different levels of importance. Research model that consists of four constructs (importance of quality service, additional coverage, price discounts of CVHI and insurance company reputation) and an indicator of the importance of insurance premium of CVHI was tested with structural equation modelling (SEM) on the sample of 300 Sloveni...

  7. Distribution channels of insurance and reinsurance services

    Directory of Open Access Journals (Sweden)

    Njegomir Vladimir

    2007-01-01

    Full Text Available Insurance and reinsurance industry is famous for its traditionalism, that is uninventiveness and neglecting of marketing as business concept and function and by doing so, neglecting opportunities for optimal combination of different distribution channels. However, having in mind Drucker's thesis that only marketing and innovations produce results and that everything else are costs, that applies to all businesses including insurance and reinsurance companies, it is clear that they need to change their way of managing business. Keeping current and attracting new customers, by using optimal combination of marketing mix elements and within its scope by creating optimal mix of distribution channels, as business requirement and objective of insurance and reinsurance companies with strong marketing orientation that leads them to fulfillment of primary objective of their existence - making profit, is becoming specially emphasized with opening of domestic insurance and reinsurance market to foreign competitors with long history of gaining high level of customers' loyalty. Besides that, issues of successful distribution channels' management of insurance and reinsurance services are not treated holistically in domestic literature. Distribution channels of insurance and reinsurance services, as this study shows, are of critical importance for business success of insurance and reinsurance companies.

  8. INTERNATIONAL PRACTICE OF INSURANCE SERVICES CONSUMER PROTECTION

    Directory of Open Access Journals (Sweden)

    Irina P. Khominitch

    2014-01-01

    Full Text Available The article considers the current compensationand guarantee mechanisms of policyholders’protection in the context of reforms inregulation and supervision of insurancecompanies. Models and fi nancing sourcesof insurance services consumer protectionfunds, their features in different countries as well as order and size of compensationpayments are identified in this article.

  9. SERVICE QUALITY MEASUREMENT AND DEMAND FOR INSURANCE: AN EMPIRICAL STUDY FROM NIGERIAN INSURANCE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Abass, OlufemiAdebowale

    2016-11-01

    Full Text Available Insurance provides financial protection to the insured, though; its acceptance by Nigerian insuring public is still low. This can sharply be traced to low awareness of insurance service. More importantly, quality of service to the few who embraced it had been low. Therefore, insuring public perceives insurance service as defective because customers’ expectations are not met. The objective of this research is to find out whether application of service quality measurement will drive demand for insurance products. Hypothesis was tested to find out whether SERVQUAL measurement is not significantly related to demand for insurance products in Nigeria. The study adopts descriptive research design; hypothesis was tested using regression analysis. The study reveals that there is a significant relationship between application of SERVQUAL measurement and demand for insurance. It is recommended that insurance companies operating in Nigeria should adopt SERVQUAL measurement which will further increase customer retention and loyalty.

  10. Health services utilization and costs of the insured and uninsured ...

    African Journals Online (AJOL)

    2013-07-05

    Jul 5, 2013 ... Background: Health insurance is a social security system that aims to ... civil servants have no appreciable advantage in terms of access to and cost of health .... self‑medication, pharmaceutical shops, traditional healers,.

  11. Exploring health insurance services in Sudan from the perspectives of insurers.

    Science.gov (United States)

    Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

    2018-01-01

    It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social

  12. Extending the Scope of Services in the Insurance Industry

    OpenAIRE

    von Watzdorf, Stephan; Gebauer, Heiko; Staake, Thorsten; Fleisch, Elgar

    2011-01-01

    The study at hand explores the influence of value-added services offered in addition to a motor insurance product on the customer's preference structure. It addresses the need of insurance companies to extend their core business with different types of supplementary services. A choice-based conjoint analysis is conducted which considers the price for the insurance product, the insurance franchise, the non-claims bonus as well as post-accident services and value-added services. Based on the re...

  13. 12 CFR 618.8040 - Authorized insurance services.

    Science.gov (United States)

    2010-01-01

    ... association, to accept or reject such insurance. (b) Bank and association board policies governing the... by receipt of commissions or gifts from underwriting insurance companies. However, employees may... extension of credit or provision of other service on the purchase of insurance sold or endorsed by a bank or...

  14. Interdependence of life insurance service quality and premium

    Directory of Open Access Journals (Sweden)

    Dragan Benazić

    2006-12-01

    Full Text Available Insurance companies in Croatia feel the need to find new sources of competitive advantage on the Croatian life insurance market amid increasing competition and a poorly profiled offer of life insurance services. Lately, both marketing literature and practice seem to point to the shaping of a relationship between service quality and price as a possible solution to improving the position of insurance companies on the Croatian market. In providing life insurance services, the insurance companies should focus on the quality elements that offer certain benefits a client is willing to pay for. Changes in individual quality features have been evaluated differently by clients. Such differences in their evaluation of changes in the individual elements of service quality also reflect the willingness of clients to pay a suitable increase on their insurance premium. Improvements in the service quality features that are subjectively evaluated as important should lead to the client’s acceptance of a higher life insurance premium. The paper considers the interdependence between the quality of life insurance services and the premium from the aspect of the client’s willingness to pay a higher life insurance premium for a higher service quality.

  15. [Occupational health services as the insurance product and insurance economic instruments].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2014-01-01

    One of the most controversial issues in restructuring the Polish health insurance system is the implementation of private voluntary insurance and creation within it a new insurance product known as occupational health services (OHS). In this article some opportunities and dilemmas likely to be faced by providers and employers/employees, when contracting with insurance institutions, are considered as a contribution to the discussion on private insurance in Poland. The basic question is how private insurance institutions could influence the promotion of different preventive activities at the company level by motivating both OHS providers and employers. The descriptive qualitative method has been applied in the analysis of legal acts, scientific publications selected according to keywords (Pubmed), documents and expert evaluations and research project results. Taking into account the experiences of European countries, described in publications, international experts' opinions and results of research projects the solution proposed in Poland could be possible under the following several prerequisites: inclusion of a full scope of occupational health services into the insurance product, constant supervision of occupational medicine professionals, monitoring of the health care quality and the relations between private insurers and OHS provider and implementation of the economic incentives scheme to ensure an adequate position of OHS providers on the market. The proposed reconstruction of the health insurance system, comprising undoubtedly positive elements, may entail some threats in the area of health, organization and economy. Private voluntary health insurance implementation requires precisely defined solutions concerning the scope of insurance product, motivation scheme and information system.

  16. Assessment of Patient Satisfaction with Pharmaceutical Services in ...

    African Journals Online (AJOL)

    Prof. Kongola

    Key words: Pharmaceutical services, patient satisfaction, Dar es Salaam. INTRODUCTION ... business venture and therefore customer ... Factors that influenced patients to go to particular pharmacies. .... identified as affecting the utilization of.

  17. Health insurance and health services utilization in Ireland.

    Science.gov (United States)

    Harmon, C; Nolan, B

    2001-03-01

    The numbers buying private health insurance in Ireland have continued to grow, despite a broadening in entitlement to public care. About 40% of the population now have insurance, although everyone has entitlement to public hospital care. In this paper, we examine in detail the growth in insurance coverage and the factors underlying the demand for insurance. Attitudinal responses reveal the importance of perceptions about waiting times for public care, as well as some concerns about the quality of that care. Individual characteristics, such as education, age, gender, marital status, family composition and income all influence the probability of purchasing private insurance. We also examine the relationship between insurance and utilization of hospital in-patient services. The positive effect of private insurance appears less than that of entitlement to full free health care from the state, although the latter is means-tested, and may partly represent health status. Copyright 2001 John Wiley & Sons, Ltd.

  18. Distribution channels of insurance and reinsurance services

    OpenAIRE

    Njegomir Vladimir

    2007-01-01

    Insurance and reinsurance industry is famous for its traditionalism, that is uninventiveness and neglecting of marketing as business concept and function and by doing so, neglecting opportunities for optimal combination of different distribution channels. However, having in mind Drucker's thesis that only marketing and innovations produce results and that everything else are costs, that applies to all businesses including insurance and reinsurance companies, it is clear that they need to chan...

  19. Access to medicines: relations with the institutionalization of pharmaceutical services

    Directory of Open Access Journals (Sweden)

    Rafael Damasceno de Barros

    2017-11-01

    Full Text Available ABSTRACT OBJETIVE To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services 2015, a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3; there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1; there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0; those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5; there is computerized system for pharmaceutical services management, OR

  20. Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

    Science.gov (United States)

    Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

    2010-01-01

    The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic

  1. The service blueprint as a tool for designing innovative pharmaceutical services.

    Science.gov (United States)

    Holdford, D A; Kennedy, D T

    1999-01-01

    To describe service blueprints, discuss their need and design, and provide examples of their use in advancing pharmaceutical care. Service blueprints are pictures or maps of service processes that permit the people involved in designing, providing, managing, and using the service to better understand them and deal with them objectively. A service blueprint simultaneously depicts the service process and the roles of consumers, service providers, and supporting services. Service blueprints can be useful in pharmacy because many of the obstacles to pharmaceutical care are a result of insufficient planning by service designers and/or poor communication between those designing services and those implementing them. One consequence of this poor design and communication is that many consumers and third party payers are uninformed about pharmacist roles. Service blueprints can be used by pharmacists to promote the value of pharmaceutical care to consumers and other decision makers. They can also assist in designing better pharmaceutical services. Blueprints are designed by identifying and mapping a process from the consumer's point of view, mapping employee actions and support activities, and adding visible evidence of service at each consumer action step. Key components of service blueprints are consumer actions, "onstage" and "backstage" employee actions, and support processes. Blueprints can help pharmacy managers identify and correct problems with the service process, provide pharmacy employees an opportunity to offer feedback in the planning stages of services, and demonstrate the value of pharmaceutical services to consumers. Service blueprints can be a valuable tool for designing, implementing, and evaluating pharmacy services.

  2. Management of pharmaceutical services in the Brazilian primary health care.

    Science.gov (United States)

    Gerlack, Letícia Farias; Karnikowski, Margô Gomes de Oliveira; Areda, Camila Alves; Galato, Dayani; Oliveira, Aline Gomes de; Álvares, Juliana; Leite, Silvana Nair; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Costa, Karen Sarmento; Guerra, Augusto Afonso; Acurcio, Francisco de Assis

    2017-11-13

    To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening.

  3. Oral Health, Dental Insurance and Dental Service use in Australia.

    Science.gov (United States)

    Srivastava, Preety; Chen, Gang; Harris, Anthony

    2017-01-01

    This study uses data from the 2004-2006 Australian National Survey of Adult Oral Health and a simultaneous equation framework to investigate the interrelationships between dental health, private dental insurance and the use of dental services. The results show that insurance participation is influenced by social and demographic factors, health and health behaviours. In turn, these factors affect the use of dental services, both directly and through insurance participation. Our findings confirm that affordability is a major barrier to visiting the dentist for oral health maintenance and treatment. Our results suggest that having supplementary insurance is associated with some 56 percentage points higher probability of seeing the dentist in the general population. For those who did not have private insurance cover, we predict that conditional on them facing the same insurance conditions, on average, having insurance would increase their visits to the dentist by 43 percentage points. The uninsured in the survey have lower income, worse oral health and lower rates of preventive and treatment visits. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Knowledge and attitude towards dental insurance and utilization of dental services among insured and uninsured patients: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Radhika Maniyar

    2018-01-01

    Conclusion: Knowledge regarding dental insurance was poor in both groups, while the insured group showed a more positive attitude toward benefits of dental insurance. Utilization of dental services was seen more among insured group.

  5. Implementing an online pharmaceutical service using design science research.

    Science.gov (United States)

    Lapão, Luís Velez; da Silva, Miguel Mira; Gregório, João

    2017-03-27

    The rising prevalence of chronic diseases is pressing health systems to introduce reforms. Primary healthcare and multidisciplinary models have been suggested as approaches to deal with this challenge, with new roles for nurses and pharmacists being advocated. More recently, implementing healthcare based on information systems and technologies (e.g. eHealth) has been proposed as a way to improve health services. However, implementing online pharmaceutical services, including their adoption by pharmacists and patients, is still an open research question. In this paper we present ePharmacare, a new online pharmaceutical service implemented using Design Science Research. The Design Science Research Methodology (DSRM) was chosen to implement this online service for chronic diseases management. In the paper, DSRM's different activities are explained, from the definition of the problem to the evaluation of the artifact. During the design and development activities, surveys, observations, focus groups, and eye-tracking glasses were used to validate pharmacists' and patients' requirements. During the demonstration and evaluation activities the new service was used with real-world pharmacists and patients. The results show the contribution of DSRM in the implementation of online services for pharmacies. We found that pharmacists spend only 50% of their time interacting with patients, uncovering a clear opportunity to implement online pharmaceutical care services. On the other hand, patients that regularly visit the same pharmacy recognize the value in patient follow-up demanding to use channels such as the Internet for their pharmacy interactions. Limitations were identified regarding the high workload of pharmacists, but particularly their lack of know-how and experience in dealing with information systems (IST) for the provision of pharmaceutical services. This paper summarizes a research project in which an online pharmaceutical service was proposed, designed, developed

  6. An evaluation of the adequacy of pharmaceutical services for the ...

    African Journals Online (AJOL)

    Background: With the introduction of nurse-initiated and -managed antiretroviral therapy (NIMART), new challenges have emerged with regard to the prescribing and dispensing of ART by nurses. One of the key challenges is ensuring adequate pharmaceutical services at PHC clinics. Objective: The objective of the study ...

  7. 42 CFR 416.48 - Condition for coverage-Pharmaceutical services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Pharmaceutical services. 416... Coverage § 416.48 Condition for coverage—Pharmaceutical services. The ASC must provide drugs and... direction of an individual designated responsible for pharmaceutical services. (a) Standard: Administration...

  8. 78 FR 12104 - Manufacturer of Controlled Substances; Notice of Registration; INB Hauser Pharmaceutical Services...

    Science.gov (United States)

    2013-02-21

    ...; Notice of Registration; INB Hauser Pharmaceutical Services, Inc. By Notice dated November 1, 2012, and published in the Federal Register on November 9, 2012, 77 FR 67398, InB Hauser Pharmaceutical Services, Inc... Hauser Pharmaceutical Services, Inc., to manufacture the listed basic class of controlled substance is...

  9. PNAUM: integrated approach to Pharmaceutical Services, Science, Technology and Innovation.

    Science.gov (United States)

    Gadelha, Carlos Augusto Grabois; Costa, Karen Sarmento; Nascimento, José Miguel do; Soeiro, Orlando Mário; Mengue, Sotero Serrate; Motta, Márcia Luz da; Carvalho, Antônio Carlos Campos de

    2016-12-01

    This paper describes the development process of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines) based on an integrated approach to pharmaceutical services, science, technology and innovation. It starts by contextualizing health and development in Brazil and features elements of the National Policy for Science, Technology and Innovation in Health in Brazil and the National Policy for Pharmaceutical Services. On presenting pharmaceutical policy guidelines, it stresses the lack of nationwide data. This survey, commissioned by the Brazilian Ministry of Health, has two components: household survey and evaluation of pharmaceutical services in primary care. The findings point to perspectives that represent, besides the enhancement of public policy for pharmaceutical services and public health, results of government action aimed at developing the economic and industrial health care complex to improve the health conditions of the Brazilian population. RESUMO O artigo apresenta o processo de construção da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamento a partir de uma concepção integradora da Assistência Farmacêutica, Ciência, Tecnologia e Inovação. Inicia-se contextualizando a saúde e o desenvolvimento no País e apresenta elementos da Política Nacional de Ciência Tecnologia e Inovação em Saúde no Brasil e da Política Nacional de Assistência Farmacêutica. Ao apresentar as diretrizes das Políticas Farmacêuticas, destaca-se a carência de dados de abrangência nacional. A presente pesquisa, encomendada pelo Ministério da Saúde, foi estruturada em dois componentes: inquérito domiciliar e avaliação dos serviços de assistência farmacêutica na atenção básica. As perspectivas dos resultados representam, além do incremento das políticas públicas farmacêuticas e de saúde p

  10. Designing Insurance to Promote Use of Childhood Obesity Prevention Services

    Directory of Open Access Journals (Sweden)

    Kimberly J. Rask

    2013-01-01

    Full Text Available Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

  11. 45 CFR 618.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services. 618....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

  12. 10 CFR 5.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 5.440 Section... Education Programs or Activities Prohibited § 5.440 Health and insurance benefits and services. Subject to § 5.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...

  13. 34 CFR 106.39 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services. 106.39... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...

  14. 10 CFR 1042.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Health and insurance benefits and services. 1042.440... in Education Programs or Activities Prohibited § 1042.440 Health and insurance benefits and services. Subject to § 1042.235(d), in providing a medical, hospital, accident, or life insurance benefit, service...

  15. 32 CFR 196.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services. 196... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  16. 29 CFR 36.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Health and insurance benefits and services. 36.440 Section... Education Programs or Activities Prohibited § 36.440 Health and insurance benefits and services. Subject to § 36.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...

  17. 45 CFR 86.39 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 86.39... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service...

  18. 45 CFR 2555.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  19. 7 CFR 15a.39 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 15a.39... Programs and Activities Prohibited § 15a.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a...

  20. INSURANCE MARKETING OF INNOVATIONS IN THE REGIONAL MARKET OF SERVICES UNDER PRESENT CONDITIONS: STRATEGIC ASPECTS

    Directory of Open Access Journals (Sweden)

    A. V. Kovalenko

    2012-01-01

    Full Text Available Innovative development of insurance activities must be directed towards creation of new insurance products. Up-to-date innovative insurance marketing should be carried out on the basis of an efficient innovative process management system. For a big insurance company with a largeclient base, high service standards may be warranted only through implementation of innovations linked with newest information technologies.

  1. The quality of insurance intermediary services: An analysis of conduct and performance in the German market of insurance intermediation

    OpenAIRE

    Eckardt, Martina

    2006-01-01

    Based on a sample of 946 German insurance intermediaries, the factors that affect the quality of the information services provided by them are studied using OLS-estimations. Applying a search theoretical approach, we analyze the impact of supply and demand side variables on service quality. Besides, the working of signaling devices (like reputation, advertising or certificates) to reduce asymmetric information with respect to the service quality of insurance intermediaries is examined. The re...

  2. 6 CFR 17.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 17... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 17.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  3. 38 CFR 23.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... Prohibited § 23.440 Health and insurance benefits and services. Subject to § 23.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and insurance...

  4. 36 CFR 1211.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance benefits... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  5. 22 CFR 229.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 229... on the Basis of Sex in Education Programs or Activities Prohibited § 229.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  6. 14 CFR 1253.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 1253.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  7. 18 CFR 1317.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... § 1317.440 Health and insurance benefits and services. Subject to § 1317.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Health and insurance...

  8. 44 CFR 19.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Health and insurance benefits... Education Programs or Activities Prohibited § 19.440 Health and insurance benefits and services. Subject to § 19.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...

  9. 41 CFR 101-4.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Health and insurance... insurance benefits and services. Subject to § 101-4.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...

  10. 24 CFR 3.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Health and insurance benefits and... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  11. 49 CFR 25.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 25.440... Basis of Sex in Education Programs or Activities Prohibited § 25.440 Health and insurance benefits and services. Subject to § 25.235(d), in providing a medical, hospital, accident, or life insurance benefit...

  12. 22 CFR 146.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 146... the Basis of Sex in Education Programs or Activities Prohibited § 146.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  13. 13 CFR 113.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Health and insurance benefits and....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

  14. 43 CFR 41.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 41.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  15. 7 CFR 1901.508 - Servicing of insured notes outstanding with investors.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Servicing of insured notes outstanding with investors. 1901.508 Section 1901.508 Agriculture Regulations of the Department of Agriculture (Continued) RURAL... Ownership and Insured Notes § 1901.508 Servicing of insured notes outstanding with investors. The Director...

  16. Health insurance and use of medical services by men infected with HIV.

    Science.gov (United States)

    Katz, M H; Chang, S W; Buchbinder, S P; Hessol, N A; O'Malley, P; Doll, L S

    1995-01-01

    Among 178 HIV-infected men from the San Francisco City Clinic Cohort (SFCCC), we examined the association between health insurance and use of outpatient services and treatment. For men with private insurance, we also assessed the frequency of avoiding the use of health insurance. Men without private insurance reported fewer outpatient visits than men with fee-for-service or managed-care plans. Use of zidovudine for eligible men was similar for those with fee-for-service plans (74%), managed-care plans (77%), or no insurance (61%). Use of Pneumocytstis carinii pneumonia prophylaxis was similar for those with fee-for-service (93%) and managed-care plans (83%) but lower for those with no insurance (63%). Of 149 men with private insurance, 31 (21%) reported that they had avoided using their health insurance for medical expenses in the previous year. In multivariate analysis, the independent predictors of avoiding the use of insurance were working for a small company and living outside the San Francisco Bay Area. Having private insurance resulted in higher use of outpatient services, but the type of private insurance did not appear to affect the use of service or treatment. Fears of loss of coverage and confidentiality may negate some benefits of health insurance for HIV-infected persons.

  17. Pharmaceutical services and health promotion: how far have we gone and how are we faring? Scientific output in pharmaceutical studies

    Directory of Open Access Journals (Sweden)

    Carina Akemi Nakamura

    2014-12-01

    Full Text Available The objective of this study was to investigate the scientific output on health promotion within the pharmaceutical field and its relation with the development of pharmaceutical services within health systems. A comprehensive review of published scientific articles from the Medline and Lilacs databases was carried out. The review comprised articles published until December 2011, and used combinations of the terms 'health promotion' or 'health education' and 'pharmacy', 'pharmacist' or 'pharmaceutical'. The articles were selected according to inclusion and exclusion criteria. A total of 170 full texts and 87 indexed abstracts were analyzed, evidencing that most described actions of health promotion in community pharmacies and other services. Following the Ottawa Charter, most of the studies dealt with new guidance of the service and the supply of pharmaceutical information and services. It was concluded that there is a lack of theoretical background on health promotion in the pharmaceutical field to sustain the professional education and practice required by the health system and the population.

  18. Qualitative analysis of national documents on health care services and pharmaceuticals` purchasing challenges: evidence from Iran.

    Science.gov (United States)

    Bastani, Peivand; Samadbeik, Mahnaz; Dinarvand, Rassoul; Kashefian-Naeeini, Sara; Vatankhah, Soudabeh

    2018-06-05

    Iranian health sector encountered many challenges in resource allocation and health service purchasing during the past decades, the aim of this study was to determine the main challenges of the present process of health service purchasing for national policymakers and other developing countries with the same setting. It was a qualitative study carried out via the complete content analysis of all relevant national documents from 2007 to 2014. In order to retrieve the related documents, we searched the official websites related to the Ministry of Health and Medical Education, four main Iranian insurance organizations, the Health Committee of the Parliament Profile, strategic vice president's site and Supreme Insurance Council. After recognition of documents, their credibility and authenticity were evaluated in terms of their publication or adjustment. For the analysis of documents, the four step-Scott method was used applying MAXQDA version 10. Findings illustrated that health service purchase challenges in the country can be classified in 6 main themes of policy-making, executive, intersectional, natural, legal and informational challenges with 26 subthemes. Furthermore, 5 themes of Basic Benefit Package, Reimbursement,Decision making, Technology and Contract are considered as the main Challenges in pharmaceutical purchasing area containing 13 relevant subthemes. It seems that according to documents, Iran has faced many structural and procedural problems with the purchase of the best health interventions. So it is highly recommended to consider consequences derived from the present challenges and try to use these evidences in their policy making process to decrease the existed problems and move to better procurement of health interventions.

  19. Continuing Professional Education of Insurance and Risk Management Practitioners: A Comparative Case Study of Customer Service Representatives, Insurance Agents and Risk Managers

    Science.gov (United States)

    Krauss, George E.

    2009-01-01

    The purpose of this study is to understand how selected insurance practitioners learn and developed in their practices setting. The selected insurance practitioners (collectively customer service representatives, insurance agents, and risk managers) are responsible for the counseling and placement of insurance products and the implementation of…

  20. 77 FR 67398 - Manufacturer of Controlled Substances; Notice of Application; INB Hauser Pharmaceutical Services...

    Science.gov (United States)

    2012-11-09

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Manufacturer of Controlled Substances; Notice of Application; INB Hauser Pharmaceutical Services, Inc. Pursuant to Sec. 1301.33(a), Title 21 of... Pharmaceutical Services, Inc., 6880 N. Broadway, Suite H, Denver, Colorado 80221, made application by letter to...

  1. 28 CFR 54.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 54.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  2. 40 CFR 5.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 5.440 Health and insurance benefits and services. Subject to § 5.235(d), in providing a medical, hospital, accident, or life insurance...

  3. 31 CFR 28.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 28.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

  4. Using design science research to develop online enhanced pharmaceutical care services.

    Science.gov (United States)

    Lapão, Luís Velez; Gregório, João; Mello, Diogo; Cavaco, Afonso; Mira Da Silva, Miguel; Lovis, Christian

    2014-01-01

    The ePharmaCare project aims at assessing the potential of eHealth services for the provision of pharmaceutical services interacting actively with patients. The results presented here focus on the first three steps of Design Science Research Methodology. A mixed methods approach was used with an online survey to collect data on use of information technologies in community pharmacy, followed by an exploratory observational time and business processes study, which use the shadowing method to identify and assess the opportunity to lunch online services. Combining this with the Service Experiment Blueprint and the Dáder method an enhanced pharmaceutical service was designed. Next, an artifact is developed and a prototype is implemented to demonstrate the value of online pharmaceutical services' delivery. This new service could represent a new perspective for pharmaceutical services integration within the health system.

  5. Regulation and competition in the Taiwanese pharmaceutical market under national health insurance.

    Science.gov (United States)

    Liu, Ya-Ming; Yang, Yea-Huei Kao; Hsieh, Chee-Ruey

    2012-05-01

    This article investigates the determinants of the prices of pharmaceuticals and their impact on the demand for prescription drugs in the context of Taiwan's pharmaceutical market where medical providers earn profit directly from prescribing and dispensing drugs. Based on product-level data, we find evidence that the profit-seeking behavior of the medical providers in the prescription drug market transfers the force of competition from the unregulated wholesale market to the regulated retail market and hence market competition still plays an important role in the determination of the regulated price. We also find that the profit-seeking behavior plays a similar role to advertising in that it increases the brand loyalty and hence lowers price elasticity. An important implication of our study is that the institutional features in the pharmaceutical market matter in shaping the nature of pharmaceutical competition and the responsiveness of pharmaceutical consumption with respect to changes in price. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Perceived needs of pharmaceutical care services among healthcare professionals in South Korea: a qualitative study.

    Science.gov (United States)

    Lee, Iyn-Hyang; Rhie, Sandy Jeong; Je, Nam Kyung; Rhew, Ki Yon; Ji, Eunhee; Oh, Jung Mi; Lee, Euni; Yoon, Jeong-Hyun

    2016-10-01

    Purpose To explore the need for pharmaceutical care services, key features of desirable pharmacy services, and perceived barriers for advancing the services in hospital environments with doctors and nurses who are key co-workers of the interdisciplinary team care services.Methods Semi-structured, in-depth interviews with eighteen doctors and fifteen nurses employing purposive and snowballing sampling strategies were conducted in ten hospitals in South Korea. Results The level of pharmaceutical care was varied across regions or institutions in South Korea. The concept of pharmaceutical care was insufficiently defined, and tended to be limited to some parts of medication counseling. Through pharmaceutical care services, doctors desired to acquire comprehensive drug information from and to share clinical responsibilities with pharmacists. Nurses wished to lower their burdens of medication counseling services from their daily practices. Doctors and nurses asked for pharmacists providing essential and carefully selected medication information to their patients in a patient-centered manner. The listed barriers to pharmaceutical care included the lack of appropriate systems for reward, insufficient accessibility to patient records by pharmacists, ambiguous role descriptions of pharmacist, and absence of effective communication among professionals. Conclusion A successful pharmaceutical care service model should allow efficient exchange of information among healthcare professionals to build inter-professional trust and to provide a continuity of care both in terms of time and setting. As prerequisites of such system, it was warranted to develop clinical evidence and an appropriate reward system for pharmaceutical care services.

  7. 77 FR 40088 - Rollins College; T.A. Loving Co.; US Ecology Idaho, Inc.; and West Pharmaceutical Services, Inc...

    Science.gov (United States)

    2012-07-06

    ...] Rollins College; T.A. Loving Co.; US Ecology Idaho, Inc.; and West Pharmaceutical Services, Inc... Pharmaceutical Services, Inc. V-77-9 01/20/1978 43 FR 2945 1910.217(c)(3)(i)(e) and (formerly The West Co.). 1910... the variance (Ex. 2--OSHA-2012-0024). 3. West Pharmaceutical Services, Inc. The Agency granted The...

  8. Characteristics of good quality pharmaceutical services common to community pharmacies and dispensing general practices.

    Science.gov (United States)

    Grey, Elisabeth; Harris, Michael; Rodham, Karen; Weiss, Marjorie C

    2016-10-01

    In the United Kingdom, pharmaceutical services can be delivered by both community pharmacies (CPs) and dispensing doctor practices (DPs). Both must adhere to minimum standards set out in NHS regulations; however, no common framework exists to guide quality improvement. Previous phases of this research had developed a set of characteristics indicative of good pharmaceutical service provision. To ask key stakeholders to confirm, and rank the importance of, a set of characteristics of good pharmaceutical service provision. A two-round Delphi-type survey was conducted in south-west England and was sent to participants representing three stakeholder groups: DPs, CPs and patients/lay members. Participants were asked to confirm, and rank, the importance of these characteristics as representing good quality pharmaceutical services. Thirty people were sent the first round survey; 22 participants completed both rounds. Median ratings for the 23 characteristics showed that all were seen to represent important aspects of pharmaceutical service provision. Participants' comments highlighted potential problems with the practicality of the characteristics. Characteristics relating to patient safety were deemed to be the most important and those relating to public health the least important. A set of 23 characteristics for providing good pharmaceutical services in CPs and DPs was developed and attained approval from a sample of stakeholders. With further testing and wider discussion, it is hoped that the characteristics will form the basis of a quality improvement tool for CPs and DPs. © 2016 Royal Pharmaceutical Society.

  9. [Coordination between pharmaceutical services for integrated pharmacotherapy: the case of Catalonia].

    Science.gov (United States)

    Costa, Karen Sarmento; Goldbaum, Moisés; Guayta-Escolies, Rafel; Modamio, Pilar; Mariño, Eduardo Luis; Tolsá, José Luis Segú

    2017-08-01

    Pharmaceutical policies have been considered strategies to contribute to the guarantee of care coordination and clinical integration. This study sought to describe the pharmaceutical services developed at different levels of care in the health network in Catalonia, as well as to identify and analyze the mechanisms and instruments that act as facilitators and/or barriers to the coordination of pharmacotherapy. This is a descriptive study of 12 cases of hospital pharmacy services, primary care and community pharmacies. Advances related to the perception, formalization and clinical and assistance coordination of the pharmaceutical services were identified. However, weaknesses and potential improvements in coordination were observed. The conclusion drawn was that the different tools and instruments implemented appear to facilitate a greater possibility of integration between pharmaceutical services and the latter with the health services network to contribute to integrated pharmacotherapy.

  10. Conceptual Model of Relationships among Customer Perceptions of Components of Insurance Service

    Directory of Open Access Journals (Sweden)

    Sebjan Urban

    2015-04-01

    Full Text Available The objective of this study was to examine the conceptual model and to study the relationships between customer perceptions of the benefits of sales promotion, quality, adequacy of premium, and adequacy of information about the coverage of insurance services. The research model was tested with structural equation modeling (SEM with a sample of 200 Slovenian users of insurance services. The results indicated that higher perceived benefits of sales promotion were associated with higher perceived quality of insurance services. In addition, higher perceived quality was associated with higher perceived adequacy of information about the coverage and the premium for insurance services. The study also found that higher perceived adequacy of premium was associated with higher perceived adequacy of information about the coverage of insurance services.

  11. Insurer views on reimbursement of preventive services in the dental setting: results from a qualitative study.

    Science.gov (United States)

    Feinstein-Winitzer, Rebecca T; Pollack, Harold A; Parish, Carrigan L; Pereyra, Margaret R; Abel, Stephen N; Metsch, Lisa R

    2014-05-01

    We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants, whose firms' cumulative market share exceeded 50% of US employer-based dental insurance markets. Participants represented viewpoints from a significant share of the dental insurance industry. Some preventive screenings, such as for oral cancer, received widespread insurer support and reimbursement. Others, such as population-based HIV screening, appeared to face many barriers to insurance reimbursement. The principal barriers were minimal employer demand, limited evidence of effectiveness and return on investment specific to dental settings, implementation and organizational constraints, lack of provider training, and perceived lack of patient acceptance. The dental setting is a promising venue for preventive screenings, and addressing barriers to insurance reimbursement for such services is a key challenge for public health policy.

  12. Successful implementation effect of insurance services in money and capital financial markets

    Directory of Open Access Journals (Sweden)

    Nemat Tahmasebi

    2016-11-01

    Full Text Available One of the most important sectors of the economy of each country is capital market. Economic growth can lead to the development and prosperity of the capital market. On the other hand to achieve the desired economic development, without existence of effective financial institutions and appropriate equipment of financial resources, it is impossible. In this regard, efficient financial systems through seeking information about investment opportunities, integrate and mobilize savings, monitoring investments and exert corporate governance can facilitate the exchange of goods and services, distribution and risk management, reducing transaction costs and data analysis may lead to better allocation of resources and ultimately economic growth. Insurance companies and generally insurance industry in each country is the most important and active financial institutions operating in the financial market especially capital markets in addition to securing economic activity could have basic role in mobility of financial markets and providing funds to invest in the economic activity through the provision of insurance services. In this study, successful financial services of insurance and investment funds in insurance companies such as Dana, Alborz, and Asia have been studied in Tehran. According to the hypothesis, there is a significant correlation between successful implementation of insurance services and money and capital financial markets. There is a significant correlation between different types of insurance services (institution-building, instrument making, and general insurance policies and money and capital financial markets.

  13. The role of insurance services scope in the economy of the regions

    Directory of Open Access Journals (Sweden)

    Aleksandr Ivanovich Tatarkin

    2011-09-01

    Full Text Available This paper discloses peculiarities of forming the contribution of the region’s insurance sector into the gross regional product (GRP. The algorithm and the stages of cash flows transformation in the system of insurance, services reproduction and the GRP forming have been considered. It has been found that value added, which is formed at the stage of creating the insurance product, is quantitatively formed in the process of value distribution. Certain suggestions have been formulated to improve the methodology of contribution assessment of the “Financial Corporations” sector and the “Insurance Corporations and Pension Funds” subsection. The following main trends of increasing “the share of insurance in GRP” have been marked out: creating conditions for contributions to increase the number of resident insurance companies, mutual insurance societies and insurance mediators (insurance agents and brokers; making the techniques of more accurate GRP working out while combining these with perfecting statistical, accounting and tax reporting by the subjects of insurance; creating attractive investment conditions in the regions.

  14. Service quality effect on satisfaction and word of mouth in insurance industry

    Directory of Open Access Journals (Sweden)

    Masoud Pourkiani

    2014-08-01

    Full Text Available Quality tends to play an essential role in service industries such as banking and insurance services, as quality of service is crucial to count for the survival and profitability of the organization. Today, customer satisfaction and service quality is critical in most service industries. Taking into consideration the competitive issues from observing services quality, the subject also in the insurance industry is important based on administrative reform plan, which is required to provide quality services and meet customers' demands. This study aims to assess the factors influencing the positive words of mouth in the insurance services market. The population is Iran insurance company's customers in Guilan and 409 individuals were selected by simple random sampling. To collect data, a questionnaire was used and structural equation SEM and LISREL software was used to analyze the data. The findings indicate a significant positive relationship between all aspects of service quality and customer satisfaction. The results indicate that there was a significant positive relationship between customer satisfaction and customer words of mouth. Therefore, we can conclude that there were significant positive relationships between the dimensions of service quality with customer satisfaction and customer words of mouth in Iran insurance company in Guilan province.

  15. Pricing the property claim service (PCS) catastrophe insurance options using gamma distribution

    Science.gov (United States)

    Noviyanti, Lienda; Soleh, Achmad Zanbar; Setyanto, Gatot R.

    2017-03-01

    The catastrophic events like earthquakes, hurricanes or flooding are characteristics for some areas, a properly calculated annual premium would be closely as high as the loss insured. From an actuarial perspective, such events constitute the risk that are not insurable. On the other hand people living in such areas need protection. In order to securitize the catastrophe risk, futures or options based on a loss index could be considered. Chicago Board of Trade launched a new class of catastrophe insurance options based on new indices provided by Property Claim Services (PCS). The PCS-option is based on the Property Claim Service Index (PCS-Index). The index are used to determine and payout in writing index-based insurance derivatives. The objective of this paper is to price PCS Catastrophe Insurance Option based on PCS Catastrophe index. Gamma Distribution is used to estimate PCS Catastrophe index distribution.

  16. Child outpatient mental health service use: why doesn't insurance matter?

    Science.gov (United States)

    Glied, Sherry; Bowen Garrett, A.; Hoven, Christina; Rubio-Stipec, Maritza; Regier, Darrel; Moore, Robert E.; Goodman, Sherryl; Wu, Ping; Bird, Hector

    1998-12-01

    BACKGROUND: Several recent studies of child outpatient mental health service use in the US have shown that having private insurance has no effect on the propensity to use services. Some studies also find that public coverage has no beneficial effect relative to no insurance. AIMS: This study explores several potential explanations, including inadequate measurement of mental health status, bandwagon effects, unobservable heterogeneity and public sector substitution for private services, for the lack of an effect of private insurance on service use. METHODS: We use secondary analysis of data from the three mainland US sites of NIMH's 1992 field trial of the Cooperative Agreement for Methodological Research for Multi-Site Surveys of Mental Disorders in Child and Adolescent Populations (MECA) Study. We examine whether or not a subject used any mental health service, school-based mental health services or outpatient mental health services, and the number of outpatient visits among users. We also examine use of general medical services as a check on our results. We conduct regression analysis; instrumental variables analysis, using instruments based on employment and parental history of mental health problems to identify insurance choice, and bivariate probit analysis to examine multiservice use. RESULTS: We find evidence that children with private health insurance have fewer observable (measured) mental health problems. They also appear to have a lower unobservable (latent) propensity to use mental health services than do children without coverage and those with Medicaid coverage. Unobserved differences in mental health status that relate to insurance choice are found to contribute to the absence of a positive effect for private insurance relative to no coverage in service use regressions. We find no evidence to suggest that differences in attitudes or differences in service availability in children's census tracts of residence explain the non-effect of insurance

  17. Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care.

    Science.gov (United States)

    Souza, Gisélia Santana; Costa, Ediná Alves; Barros, Rafael Damasceno de; Pereira, Marcelo Tavares; Barreto, Joslene Lacerda; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Álvares, Juliana; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

    2017-11-13

    To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines), a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%), partial (35.0%-69.0%), and advanced (70.0%-100%), estimated based on the interviewees' answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of pautonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional disparities. Variables related to the normative aspects of institutionalization were positively highlighted in all dimensions; however, it is necessary to conduct new studies to evaluate the institutionalization of pharmaceutical services' finalistic activities.

  18. EVOLUTIONARY ASPECTS OF FINANCIAL INTERMEDIATION AND INSURANCE SERVICES IN ROMANIA IN 2008-2015

    Directory of Open Access Journals (Sweden)

    RĂBONTU CECILIA IRINA

    2017-11-01

    Full Text Available Financial intermediation and insurance services are a well-defined category of services in the statistical databases and in the classification of the national economy activities, which determine us to analyze them in this manner. They contain a significant number of activities, including the activities of banking and non-banking organizations, insurance and reinsurance organizations, fund management organizations etc. Thus, simply by incorporating the activities included in the financial and insurance intermediation services, as well as presenting the main indicators related to this activity, will help us to identify the role of this category of services in the economy and in society. We plan on this paper to identify the main activities from this category of services and to analyze their evolution for an identified period of time so as to establish their trajectory in a world of services, even in Romania.

  19. Health services utilization and costs of the insured and uninsured ...

    African Journals Online (AJOL)

    Background: Health insurance is a social security system that aims to facilitate fair financing of health costs through pooling and judicious utilization of financial resources, in order to provide financial risk protections and cost burden sharing for people against high cost of healthcare through various prepayment methods ...

  20. Assessment of satisfaction with pharmaceutical services in patients receiving antiretroviral therapy in outpatient HIV treatment setting.

    Science.gov (United States)

    Agu, Kenneth Anene; Oqua, Dorothy; Agada, Peter; Ohiaeri, Samuel I; Adesina, Afusat; Abdulkareem, Mohammed Habeeb; King, Rosalyn C; Wutoh, Anthony K

    2014-06-01

    The patient's perception and satisfaction are increasingly considered as a useful factor in the assessment of competency of health care providers and quality of care. However, these patient focused assessments are largely ignored when assessing health care outcomes. The study assessed the perception and satisfaction of patients receiving antiretroviral therapy (ART) with pharmaceutical services received in outpatient HIV treatment settings. Seventeen HIV treatment centres in Nigeria. This cross-sectional survey included 2,700 patients randomly selected from 26,319 HIV patients on ART, who received pharmaceutical services in the study setting. A study-specific Likert-type instrument was administered to the participants at point of exit from the pharmacy. Midpoint of the 5-point scale was computed and scores above it were regarded as positive while below as negative. Chi-square was used for inferential statistics. All reported p values were 2-sided at 95 % confidence interval (CI). Patient satisfaction with pharmaceutical services. Of 2,700 patients sampled, data from 1,617 (59.9 %) were valid for analysis; 62.3 % were aged 26-40 years and 65.4 % were females. The participants had received pharmaceutical services for a mean duration of 25.2 (95 % CI 24.3-26.1) months. Perception of participants regarding the appearance of pharmacy was positive while that regarding the pharmacists' efforts to solve patients' medication related problems was negative. The participants' rating of satisfaction with the waiting time to access pharmaceutical services was negative; the satisfaction decreases with increasing waiting time. However, the satisfaction with the overall quality of pharmaceutical services received was rated as positive; 90.0 % reported that they got the kind of pharmaceutical services they wanted; 98.2 % would come back to the pharmacy if they were to seek help again and would recommend services to others. The level of satisfaction was found to be associated with

  1. Measuring patients' satisfaction with pharmaceutical services at a public hospital in Qatar.

    Science.gov (United States)

    Khudair, Imran Fahmi; Raza, Syed Asif

    2013-01-01

    The aim of this paper is to study pharmacy service impact on patient satisfaction and to determine what factors saliently link with pharmaceutical service performance at Hamad General Hospital. A patient satisfaction questionnaire was designed using the literature and consultation with Hamad General Hospital medical experts. The questionnaire contained 22 items that focused on five influencing factors: promptness; attitude; supply; location; medication education; and respondent demographic aspects. A total of 220 respondents completed the questionnaire. An exploratory factor analysis was used to group items and a structural equation model was developed to test causality between five factors along with their influence on patient satisfaction. The study establishes statistical evidence that patient satisfaction is positively influenced by service promptness, pharmacist attitude, medication counseling, pharmacy location and waiting area. Several socio-demographic characteristics have statistically different effect on satisfaction, notably: gender; marital status; health status; age; educational level; and ethnicity. However, medication supply did not influence patient satisfaction. Pharmaceutical services are recognized as an essential healthcare-system component. Their impact on customer satisfaction has been investigated in many countries; however, there is no such study in Qatar. The findings identify pharmaceutical service performance indicators and provide guidelines to improve Qatari pharmaceutical services.

  2. Assessing the antecedents of customer loyalty on healthcare insurance products: Service quality; perceived value embedded model

    Directory of Open Access Journals (Sweden)

    Fadi Abdelmuniem Abdelfattah

    2015-11-01

    Full Text Available Purpose: This research aim to investigate the influence of service quality attributes towards customers’ loyalty on health insurance products. In addition, this research also tested the mediation role of perceived value in between service quality and customers’ loyalty on health insurance products. Design/methodology/approach: Based on the literature review, this research developed a conceptual model of customers loyalty embedded with service quality and perceived value. The study surveyed 342 healthcare insurance customers. Apart from assessing the reliability and validity of the constructs through confirmatory factor analysis, this research also used structural equation modelling (SEM approach to test the proposed hypothesis. Findings: The results from the inferential statistics revealed that the healthcare insurance customers are highly influenced by service quality followed by the perceived value in reaching their loyalty towards a particular health insurance service provider. Research limitations/implications: The sample for this study is based on health insurance customers only and it is suggested that future studies enlarge the scope to include others type of customers of different insurance products. Practical implications: In order to encourage the customers to more loyal towards their service providers, this research will add value for the mangers to understand the items of service quality and considering the perceived value of the target customers in order to optimize their loyalty. As whole, the outcome of this research will assist managers for better understanding of the customers’ loyalty antecedents under the perspective of healthcare insurance products. Originality/value: This paper has tried to provide a comprehensive understanding about customers’ loyalty under the perspective of service quality and perceived values context in the Malaysian health care insurance industry. Since there was a lack of such research in

  3. The protection of financial services users: The case of insurance companies and investment funds

    Directory of Open Access Journals (Sweden)

    Njegomir Vladimir

    2012-01-01

    Full Text Available The users of financial services generally do not have the required expertise that they need to process the available financial information when they make financial and investment decisions, and as such they represent a sensitive category of financial market participants, which may intentionally or unintentionally be exposed to manipulation. If the beneficiaries do not have relevant and accurate information, the relationship between the provider and the service user is characterized with information asymmetry, and because of these reasons adequate regulatory instruments are necessary in order to protect the interests of financial services users. In the financial services sector, the development of a long-term successful relationship between providers and users of services should be based on mutual trust and users' feel that they have received a value for the price paid. The aim of the paper is to highlight the modern ways of improving the protection of the interests of consumers of financial services provided by insurance companies and investment funds. The paper analyses the reasons for protection of consumers of financial services, specifics of insurance as financial service, the importance of trust as a key factor for the attraction of service users and the basic principles of operation of investment funds in the developed and the domestic financial market are compared. The particular attention is given to insurance companies and investment funds in terms of regulatory and other mechanisms of governments that are related to the protection of insureds and investment funds investors.

  4. Characterization of the institutionalization of pharmaceutical services in Brazilian primary health care

    Directory of Open Access Journals (Sweden)

    Gisélia Santana Souza

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To characterize the current stage of the institutionalization of pharmaceutical services in Brazilian cities. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines, a cross-sectional, exploratory, and evaluative study composed by an information survey in a representative sample of cities, stratified by Brazilian regions. We interviewed municipal secretaries of health, responsible for pharmaceutical services, and pharmacists responsible for the dispensing of medicines. The variables selected from the interviews were grouped into five dimensions that defined three stages of pharmaceutical services institutionalization: incipient (0%-34.0%, partial (35.0%-69.0%, and advanced (70.0%-100%, estimated based on the interviewees’ answers. Frequencies were estimated with 95% confidence intervals. For the statistical association analysis, the Chi-square test was applied, with significance level of p<0.05. RESULTS Our results show a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazil, and an advanced stage in formal structures, such as the municipal health plans and the existence of a standardized list of medicines. The analysed variables in the “organization, structure, and financing” dimension configured stages that range from partial to advanced. The management presented partial institutionalization, positively showing the existence of computerized system, but also disparate results regarding the autonomy in the management of financial resources. Indispensable items related to the structure expressed disparities between the regions, with statistically significant differences. CONCLUSION The study showed a partial and heterogeneous process of institutionalization of pharmaceutical services in Brazilian cities, showing regional

  5. The aplication of electronic commerce in the distribution of insurance services

    Directory of Open Access Journals (Sweden)

    Piljan Ivan

    2016-01-01

    Full Text Available The paper describes the importance of information and communication technology for the development of the insurance companies, with special emphasis on the current development and potential for further development of marketing, and the distribution of insurance products in particular, which relies on information and communication technologies, especially the Internet. A special place here is reserved for the internet marketing as the most common of Internet uses among insurance companies. Transforming business processes so that they comply with the principles of electronic commerce will in the neaar future become common even in smaller businesses, formerly conservative financial institutions, e.g. insurance companies, are increasingly turning to e-insurance which, despite high costs of its introduction and initial problems in the operation, are to be relied upon in the near future. Therefore, in many countries, it is becoming accepted, to a greater or lesser extent. Mobile communication brings the biggest changes in electronic commerce. Even today, its prevalence among consumers offers great opportunities for service providers. Insurance companies in our country at this moment do not offer their services through this specific communication channel, but in the very near future changes can be expected in this field, due to the fact that the prerequisites for that exist in Serbia. This is supported by information that some insurance companies in the neighboring countries have already activated their first applications for smart phones and similar applications in the Serbian banking industry already exist.

  6. 15 CFR 8a.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 8a.440 Section 8a.440 Commerce and Foreign Trade Office of the Secretary of Commerce... benefits and services. Subject to § 8a.235(d), in providing a medical, hospital, accident, or life...

  7. PROVIDER CHOICE FOR OUTPATIENT HEALTH CARE SERVICES IN INDONESIA: THE ROLE OF HEALTH INSURANCE

    Directory of Open Access Journals (Sweden)

    Budi Hidayat

    2012-11-01

    Full Text Available Background: Indonesian's health care system is characterized by underutilized of the health-care infrastructure. One of the ways to improve the demand for formal health care is through health insurance. Responding to this potentially effective policy leads the Government of Indonesia to expand health insurance coverage by enacting the National Social Security Act in 2004. In this particular issue, understanding provider choice is therefore a key to address the broader policy question as to how the current low uptake of health care services could be turned in to an optimal utilization. Objective:To estimate a model of provider choice for outpatient care in Indonesia with specific attention being paid to the role of health insurance. Methods: A total of 16485 individuals were obtained from the second wave of the Indonesian Family Life survey. A multinomial logit regression model was applied to a estimate provider choice for outpatient care in three provider alternative (public, private and self-treatment. A policy simulation is reported as to how expanding insurance benefits could change the patterns of provider choice for outpatient health care services. Results: Individuals who are covered by civil servant insurance (Askes are more likely to use public providers, while the beneficiaries of private employees insurance (Jamsostek are more likely to use private ones compared with the uninsured population. The results also reveal that less healthy, unmarried, wealthier and better educated individuals are more likely to choose private providers than public providers. Conclusions: Any efforts to improve access to health care through health insurance will fail if policy-makers do not accommodate peoples' preferences for choosing health care providers. The likely changes in demand from public providers to private ones need to be considered in the current social health insurance reform process, especially in devising premium policies and benefit packages

  8. A Pharmaceutical Bioethics Consultation Service: Six-Year Descriptive Characteristics and Results of a Feedback Survey.

    Science.gov (United States)

    Van Campen, Luann E; Allen, Albert J; Watson, Susan B; Therasse, Donald G

    2015-04-03

    Background : Bioethics consultations are conducted in varied settings, including hospitals, universities, and other research institutions, but there is sparse information about bioethics consultations conducted in corporate settings such as pharmaceutical companies. The purpose of this article is to describe a bioethics consultation service at a pharmaceutical company, to report characteristics of consultations completed by the service over a 6-year period, and to share results of a consultation feedback survey. Methods : Data on the descriptive characteristics of bioethics consultations were collected from 2008 to 2013 and analyzed in Excel 2007. Categorical data were analyzed via the pivot table function, and time-based variables were analyzed via formulas. The feedback survey was administered to consultation requesters from 2009 to 2012 and also analyzed in Excel 2007. Results : Over the 6-year period, 189 bioethics consultations were conducted. The number of consultations increased from five per year in 2008 to approximately one per week in 2013. During this time, the format of the consultation service was changed from a committee-only approach to a tiered approach (tailored to the needs of the case). The five most frequent topics were informed consent, early termination of a clinical trial, benefits and risks, human biological samples, and patient rights. The feedback survey results suggest the consultation service is well regarded overall and viewed as approachable, helpful, and responsive. Conclusions : Pharmaceutical bioethics consultation is a unique category of bioethics consultation that primarily focuses on pharmaceutical research and development but also touches on aspects of clinical ethics, business ethics, and organizational ethics. Results indicate there is a demand for a tiered bioethics consultation service within this pharmaceutical company and that advice was valued. This company's experience indicates that a bioethics consultation service

  9. Breast Health Services: Accuracy of Benefit Coverage Information in the Individual Insurance Marketplace.

    Science.gov (United States)

    Hamid, Mariam S; Kolenic, Giselle E; Dozier, Jessica; Dalton, Vanessa K; Carlos, Ruth C

    2017-04-01

    The aim of this study was to determine if breast health coverage information provided by customer service representatives employed by insurers offering plans in the 2015 federal and state health insurance marketplaces is consistent with Patient Protection and Affordable Care Act (ACA) and state-specific legislation. One hundred fifty-eight unique customer service numbers were identified for insurers offering plans through the federal marketplace, augmented with four additional numbers representing the Connecticut state-run exchange. Using a standardized patient biography and the mystery-shopper technique, a single investigator posed as a purchaser and contacted each number, requesting information on breast health services coverage. Consistency of information provided by the representative with the ACA mandates (BRCA testing in high-risk women) or state-specific legislation (screening ultrasound in women with dense breasts) was determined. Insurer representatives gave BRCA test coverage information that was not consistent with the ACA mandate in 60.8% of cases, and 22.8% could not provide any information regarding coverage. Nearly half (48.1%) of insurer representatives gave coverage information about ultrasound screening for dense breasts that was not consistent with state-specific legislation, and 18.5% could not provide any information. Insurance customer service representatives in the federal and state marketplaces frequently provide inaccurate coverage information about breast health services that should be covered under the ACA and state-specific legislation. Misinformation can inadvertently lead to the purchase of a plan that does not meet the needs of the insured. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  10. An evaluation of governance capacity of the specialized component of pharmaceutical services in Brazil.

    Science.gov (United States)

    Rover, Marina Raijche Mattozo; Peláez, Claudia Marcela Vargas; Faraco, Emília Baierle; Farias, Mareni Rocha; Leite, Silvana Nair

    2017-08-01

    This paper presents application of an indicator protocol to assessment of current levels of governance capacity of the Specialized Component of Pharmaceutical Services (CEAF) in a state of the South of Brazil. We chose the theoretical referential of 'governance capacity' proposed by Carlos Matus, which reflects in the concepts of management capacity and pharmaceutical service management, due to the perception of a need to overcome the fragmentation and technicist reductionism that we believe has been imposed on the area of pharmaceutical services. Data was collected using the protocol in 74 municipal or state units. The results of the analysis indicate that the currently existing governance capacity needs improvement in all three dimensions that were evaluated, principally in relation to the aspects that seek sustainability of the governance. The model and the protocol used indicate a way forward for governance of pharmaceutical service by proposing a change from the technicist-logistical focus to an emphasis on strategic and political actions, or ones which foster greater participation and autonomy. With these results in hand, it will be possible to develop strategies for improvement of access to medicines in the SUS, in the sense that the CEAF becomes able to guarantee integrality of medicines treatments.

  11. Health Care Communication Laws in the United States, 2013: Implications for Access to Sensitive Services for Insured Dependents.

    Science.gov (United States)

    Kristoff, Iris; Cramer, Ryan; Leichliter, Jami S

    Young adults may not seek sensitive health services when confidentiality cannot be ensured. To better understand the policy environment for insured dependent confidentiality, we systematically assessed legal requirements for health insurance plan communications using WestlawNext to create a jurisdiction-level data set of health insurance plan communication regulations as of March 2013. Two jurisdictions require plan communications be sent to a policyholder, 22 require plan communications to be sent to an insured, and 36 give insurers discretion to send plan communications to the policyholder or insured. Six jurisdictions prohibit disclosure, and 3 allow a patient to request nondisclosure of certain patient information. Our findings suggest that in many states, health insurers are given considerable discretion in determining to whom plan communications containing sensitive health information are sent. Future research could use this framework to analyze the association between state laws concerning insured dependent confidentiality and public health outcomes and related sensitive services.

  12. Financing of Pharmaceutical Services in the municipal management of the Brazilian Unified Health System.

    Science.gov (United States)

    Faleiros, Daniel Resende; Acurcio, Francisco de Assis; Álvares, Juliana; Nascimento, Renata Cristina Rezende Macedo do; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Leite, Silvana Nair; Karnikowski, Margô Gomes de Oliveira; Costa, Karen Sarmento; Guerra, Augusto Afonso

    2017-11-13

    To discuss factors related to the financing of the Basic Component of Pharmaceutical Services within the municipal management of the Brazilian Unified Health System. The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil - Serviços (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services) is a cross-sectional, exploratory, and evaluative study that performed an information survey in a representative sample, stratified by Brazilian regions It considered different study populations in the sampling plan, which represent primary health care services in the cities. Data were collected in 2015 by two methods: in person, by applying direct observation scripts and interviews with users, physicians, and professionals responsible for the dispensing of medicines in primary care services; by telephone interviews with municipal health managers and municipal professionals responsible for Pharmaceutical Services. The results were extracted from the questionnaires applied by telephone. Of the sample of 600 eligible cities, we collected 369 interviews (61.5%) with secretaries and 507 (84.5%) with pharmaceutical services managers. 70.8% of the cities have a computerized management system; and 11.9% have qualification/training of professionals. More than half (51.3%) of the cities received funds for the structuring of pharmaceutical services, and almost 60% of these cities performed this type of spending. In 35.4% of cases, municipal secretaries of health said that they use resources of medicines from the Componente Básico da Assistência Farmacêutica (CBAF - Basic Component of Pharmaceutical Services) to cover demands of other medicines, but only 9.7% believed that these funds were sufficient to cover the demands. The existence of a permanent bidding committee exclusively for acquiring medicines was reported in 40.0% of the cities. We found serious deficiencies in the public financing of

  13. Impacts of cost containment strategies on pharmaceutical expenditures of the National Health Insurance in Taiwan, 1996-2003.

    Science.gov (United States)

    Lee, Yue-Chune; Yang, Ming-Chin; Huang, Yu-Tung; Liu, Chien-Hsiang; Chen, Sun-Bing

    2006-01-01

    Pharmaceutical expenditure (PE) of the National Health Insurance (NHI) programme in Taiwan grew from 62.2 billion Taiwan new dollars (NT dollars) in 1996 to NT94.5 dollars billion in 2003.The government has been introducing many strategies to control PE since the inception of NHI including price adjustment based on the prices of international products or existing products (inter-brands comparison), or market price and volume survey; delegation of financial responsibility to regional bureaux; co-payment for outpatient drugs; generic grouping (the reference pricing scheme based on chemical equivalence); a global budget payment system for clinics and hospitals; and reduction in the flat daily payment rate of the drugs for clinics. The aim of this study was to evaluate the impact of these cost containment strategies on the PE of the NHI programme from 1996 to 2003. To take the growth and seasonal trends of monthly PE into consideration, Box and Tiao's time-series event intervention analysis based on the Box-Jenkins auto-regressive integrated moving-average model was applied to evaluate the impact of various cost containment strategies on total and subsector (outpatient, inpatient, clinic and hospital sectors) PE. Monthly data of PE of the NHI programme from 1996 to 2003 (the dependent variables) were obtained from the Bureau of the NHI. Drugs prescribed by dentists and Chinese medical doctors at outpatient departments were excluded. After fitting the patterns of time series and controlling for the calendar effect of the Chinese New Year and the severe acute respiratory syndrome outbreak in 2003, three strategies (generic grouping, delegation of financial responsibility and reduction of the flat payment rate of clinics) were significantly associated with a reduction in PE. However, the hospital global budget strategy offset partial savings from these three strategies. Cumulative savings during the study period were estimated to be NT25.442 dollars billion (US0

  14. Extended applications with smart cards for integration of health care and health insurance services.

    Science.gov (United States)

    Sucholotiuc, M; Stefan, L; Dobre, I; Teseleanu, M

    2000-01-01

    In 1999 in Romania has initiated the reformation of the national health care system based on health insurance. In 1998 we analyzed this system from the point of view of its IT support and we studied methods of optimisation with relational, distributed databases and new technologies such as Our objectives were to make a model of the information and services flow in a modern health insurance system, to study the smart card technology and to demonstrate how smart card can improve health care services. The paper presents only the smart cards implementations.

  15. Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

    Science.gov (United States)

    Gregório, João; Russo, Giuliano; Lapão, Luís Velez

    2016-01-01

    The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Request of pharmaceutical care service in a private owned community pharmacy.

    Directory of Open Access Journals (Sweden)

    Pires CF

    2006-03-01

    Full Text Available Pharmacists, more than drug producer, is being a co-responsible for drug therapy and promoter of the rational use of medicines, enhancing their role. Appearance of a new philosophy, pharmaceutical care, came to organize, enhance and allowing this new role of the pharmacist in primary health care. Objectives of the present study were to determine the existence and to characterize the request for pharmaceutical care services and to assess the wiliness to pay for these services in a privately owned community pharmacy. An interview following a check-list was used by researchers to gather data. In 236 interviewed customers, 88.1% did not know the term ‘pharmaceutical care’, 67.2% showed to be interested on the service. Regarding the wiliness to pay, 39.9% conditioned it to the amount, and 10.1% stated that they would pay for the service. This allows us to conclude than in this setting, a demand existed, what allows repeating this survey in other settings, what lead us to the necessity of defining a standard of practice in Brazil, and in the rest of the world, to provide care to those who need it.

  17. Black Box Thinking: Analysis of a Service Outsourcing Case in Insurance

    Science.gov (United States)

    Witman, Paul D.; Njunge, Christopher

    2016-01-01

    Often, users of information systems (both automated and manual) must analyze those systems in a "black box" fashion, without being able to see the internals of how the system is supposed to work. In this case of business process outsourcing, an insurance industry customer encounters an ongoing stream of customer service issues, with both…

  18. National Health Insurance, Profitability, and Service Quality: Case Study at the Private Hospital in West Java

    Directory of Open Access Journals (Sweden)

    Andriyani Rahmah Fahriati

    2018-02-01

    Full Text Available National health insurance is one of the government programs to facilitate health services for the people. The purpose of this research to determine whether there are effects of National Health Insurance program (JKN on profitability and service quality at Juanda Kuningan Hospital, of West Java. The method using the paired-t-test to analyze the difference between before and after the National Health Insurance program. The result showed that there is a difference in profitability and service quality between pre and post the implementation of national health insurance program. Gross profit margin measured the profitability, net profit margin, return on total assets, and return on equity. This result means that the value of the company's profitability is better when the program JKN yet takes place in the Juanda hospital. While on the service quality variable it is found that the mean value is higher when the JKN program has conducted at the hospital.DOI: 10.15408/etk.v17i1.7064

  19. The effect of urban basic medical insurance on health service utilisation in Shaanxi Province, China: a comparison of two schemes.

    Science.gov (United States)

    Zhou, Zhongliang; Zhou, Zhiying; Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

    2014-01-01

    Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (pinsured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.

  20. Public-private partnership role in increasing the quality of the health insurance services

    Directory of Open Access Journals (Sweden)

    Dan CONSTANTINESCU

    2012-10-01

    Full Text Available In a context in which the social politics tend to become an optimization instrument for adapting the social security system to the market’s forces, and the talk of some analysts about reinventing the European social model, the partnership between the public sector and the private one in the social domain presumes, besides a tight collaboration, a combination of advantages specific to the private sector, more competitive and efficient, with the ones from the public sector, more responsible toward the society regarding the public money spending. The existence of the private health insurances cannot be tied, causally, to a social politics failure, reason for which they don’t intend, usually, to replace the public insurances, but rather, to offer a complementary alternative for them. In such a context, the public-private partnership’s goal regards both increasing the insurant’s satisfaction and increasing his/her access degree to services, and increasing the investments profitability made by the insurant and insurer. We are facing thus a mixed competitive system that combines the peculiarities of the public and private sectors. Interesting is the fact that, although the different meanings for the quality term may generate some problems regarding implementing quality management in the two health insurance sectors, the experts in the area reckon that establishing a good relationship between public buyers and private providers of healthcare can reduce the costs of public health programs. An essential condition for operating efficiently the partnership model is defining correctly the basic medical services packet financed by the public budget. Which doesn’t exclude the possibility of administrating by the private insurers, the sums of money gathered from the employees and employers contributions to the health fund, as a recently initiated project of law intends to do in Romania.

  1. Impact of a private health insurance mandate on public sector autism service use in Pennsylvania.

    Science.gov (United States)

    Stein, Bradley D; Sorbero, Mark J; Goswami, Upasna; Schuster, James; Leslie, Douglas L

    2012-08-01

    Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on use of Medicaid-funded ASD services. We used Medicaid claims data from July 1, 2006, through June 30, 2010, to identify children with ASD and to assess their use of behavioral health services and psychotropic medications. Service and medication use were examined in four consecutive 12-month periods: the 2 years preceding passage of the legislation, the year after passage but before implementation, and the year after implementation. We examined differences in use of services and medications, and used growth rates from nonwaiver children to estimate the impact of the legislation on Medicaid spending for waiver-eligible children with ASD. The number of children with ASD receiving Medicaid services increased 20% from 2006-2007 to 2009-2010. The growth rate among children affected by the legislation was comparable to that of other groups before passage of the legislation but decreased after the legislation's passage. We project that, without the legislation, growth in this population would have been 46% greater in 2009-2010 than observed, associated with spending of more than $8 million in 2009-2010. Passage of legislation increasing private insurance coverage of ASD services may decrease the number of families seeking eligibility to obtain Medicaid-funded services, with an associated substantial decrease in Medicaid expenditures. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. The lay user perspective on the quality of pharmaceuticals, drug therapy and pharmacy services--results of focus group discussions

    DEFF Research Database (Denmark)

    Traulsen, Janine Marie; Almarsdóttir, Anna Birna; Björnsdóttir, Ingunn

    2002-01-01

    This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland.......This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland....

  3. Satisfaction Analysis of Outpatient Services to National Health Insurance Program in the Pratama Hospitals Supiori District Papua Province

    OpenAIRE

    Dominggus N. Sani; A. L. Rantetampang; Agus Zainuri

    2017-01-01

    Improved access for the public in order to ensure that the efforts of personal health services that provide inpatient, outpatient, emergency, and other supporting services. To get health insurance better and thorough, the government issued a health insurance, so that it can be felt by all walks of life and can improve patient satisfaction. Hospitals type D Primaries only provide care services Grade 3 (three) to increase access for the public in order to guarantee health care efforts and a pro...

  4. Greening Pharmaceutical Supply Chains, Mitigating Pharmaceutical Pollution Risks and Leveraging Private Investment for Environmental Protection Through Improved Risk Accountability and Insurance Risk Transfer

    DEFF Research Database (Denmark)

    le Gal, Elodie Jeanine Odette

    and outsource many of their economic activities in developing countries to lower their production and manufacturing costs. Some of these activities, which are carried out in emerging countries which apply sustainability, environmental and labour standards that are perceived as less stringent than those...... of environmental pollution cases from pharmaceutical manufacturing have been reported in the scientific literature. These cases highlight how offshoring production activities can adversely impact upon quality risk. They illustrate how the transfer of the resulting costs of pollution from developed countries......With the environmental, social and economic impacts of climate change and biodiversity loss triggered by anthropogenic activities, including commercial operations, industries and corporations in all sectors throughout the world have to rethink their business models and production systems to change...

  5. Information Technology Managerial Capabilities and Customer Service Performance Among Insurance Firms in Nigeria

    Directory of Open Access Journals (Sweden)

    Sunday Adekunle Aduloju

    2014-12-01

    Full Text Available The potential of information technology (IT as an enabler of customer service process continues to generate interest, which is reflected in the large number of IT-related studies. In spite of the significant progress made in this area, research findings have been mixed and inconsistent. Also, the underlying mechanisms by which IT can affect customer service process remain underexamined. The aim of this study was to find out whether IT investments and IT managerial capabilities can account for variations in customer service performance among insurance companies in Nigeria. Using survey research design, the three formulated hypotheses were tested with data gathered from 402 staff at the managerial level drawn from the selected insurance companies in Nigeria, which have been among the largest investors in IT, and where customer service is widely perceived as strategically important. Responses were analyzed using linear regression. A major finding of this study is that IT is a necessary, but not sufficient, condition for sustainable competitive advantage in customer service. Results show that the interaction of IT investments and tacit, path-dependent, and firm-specific IT managerial capabilities significantly explains variations in customer service performance. Consequently, this study recommends that to realize IT-business value, investments in IT should be accompanied by building and developing IT managerial capabilities.

  6. Assessing responsiveness of health care services within a health insurance scheme in Nigeria: users' perspectives.

    Science.gov (United States)

    Mohammed, Shafiu; Bermejo, Justo Lorenzo; Souares, Aurélia; Sauerborn, Rainer; Dong, Hengjin

    2013-12-01

    Responsiveness of health care services in low and middle income countries has been given little attention. Despite being introduced over a decade ago in many developing countries, national health insurance schemes have yet to be evaluated in terms of responsiveness of health care services. Although this responsiveness has been evaluated in many developed countries, it has rarely been done in developing countries. The concept of responsiveness is multi-dimensional and can be measured across various domains including prompt attention, dignity, communication, autonomy, choice of provider, quality of facilities, confidentiality and access to family support. This study examines the insured users' perspectives of their health care services' responsiveness. This retrospective, cross-sectional survey took place between October 2010 and March 2011. The study used a modified out-patient questionnaire from a responsiveness survey designed by the World Health Organization (WHO). Seven hundred and ninety six (796) enrolees, insured for more than one year in Kaduna State-Nigeria, were interviewed. Generalized ordered logistic regression was used to identify factors that influenced the users' perspectives on responsiveness to health services and quantify their effects. Communication (55.4%), dignity (54.1%), and quality of facilities (52.0%) were rated as "extremely important" responsiveness domains. Users were particularly contented with quality of facilities (42.8%), dignity (42.3%), and choice of provider (40.7%). Enrolees indicated lower contentment on all other domains. Type of facility, gender, referral, duration of enrolment, educational status, income level, and type of marital status were most related with responsiveness domains. Assessing the responsiveness of health care services within the NHIS is valuable in investigating the scheme's implementation. The domains of autonomy, communication and prompt attention were identified as priority areas for action to improve

  7. Delivery of pharmaceutical services at ward level in a teaching hospital.

    Science.gov (United States)

    Schellack, N; Martins, V; Botha, N; Meyer, J C

    2009-03-01

    Poor management of pharmaceuticals could lead to wastage of financial resources and poor services in the public sector. The main aim of the study was to investigate the quality of pharmaceutical services at ward level in a teaching hospital. The design of the study was descriptive. Three data collection instruments were designed and pilot-tested prior to the actual data collection. Two structured questionnaires were used to interview the sister-in-charge of each ward and the stock and drug controller at the pharmacy. A checklist for the management of pharmaceuticals was completed for each ward. Descriptive statistics were used to describe and summarise the data. Sisters-in-charge of 30 wards and the stock and drug controller at the pharmacy participated in the study. The relationship with the pharmacy was perceived to be average by 54% (n = 30) of the sisters-in-charge of the wards. Communication with the pharmacy was mainly by telephone and 57% of the sisters-in-charge mentioned that they experienced difficulties in conveying messages to the pharmacy. Ten of the wards received regular ward visits by a pharmacist. Expiry dates were checked by all wards but at different intervals. The majority of the wards (90%) used patient cards, which refer to prescription charts, for stock control and ordering from the pharmacy. Fridge temperatures were checked and charted on a daily basis by 30% of the wards. Written standard operating procedures (SOPs) were used by the pharmacy for issuing ward stock. Although 83% of the wards indicated that they used SOPs, evidence of written SOPs was not available. The results indicated that the management of pharmaceutical services at ward level could be improved. Implementation of appropriate communication systems will enhance cooperation between the pharmacy and the wards. A uniform ward stock control system, either by computer or stock cards, should be introduced. Regular ward visits by a pharmacist to oversee ward stock management are

  8. CONCEPTUALIZATION OF THE CONCEPT INSTITUTE OF THE MARKET OF INSURANCE SERVICES BASED ON THE NEO-CLASSIC ECONOMY

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    Yurii Klapkiv

    2017-08-01

    Full Text Available The article explores the issues related to the institutional and financial infrastructure based on the scientific achievements of the neoclassical economy. The specific features of the concept of "institutionalization" are substantiated. The initial interpretation of the interpretation of institutions is revealed. Conceptual approaches to the study of the concept of “institutionalization” and “institute” in the insurance services market are defined. The attention to the galaxy values provided by the notion of an institution or organization. Key words: institutionalization, institute, organization, market of insurance services, insurance culture.

  9. The utilization of dental care services according to health insurance coverage in Catalonia (Spain).

    Science.gov (United States)

    Pizarro, Vladimir; Ferrer, Montse; Domingo-Salvany, Antonia; Benach, Joan; Borrell, Carme; Pont, Angels; Schiaffino, Anna; Almansa, Josue; Tresserras, Ricard; Alonso, Jordi

    2009-02-01

    The aim of this study was to assess the relationship of dental care service use with health insurance and its evolution. The Catalan Health Interview Survey is a cross-sectional study conducted in 1994 (n = 15 000) and 2001-2 (n = 8400) by interviews at home to a representative sample of Catalonia (Spain). All the estimates were obtained by applying weights to restore the representativeness of the Catalonia general population. In the bivariate analysis, age, gender, social class and health insurance coverage were statistically associated with a dental visit in the previous year (P use in the previous year, from 26.7% in 1994 to 34.3% in 2002. Future studies will be needed to monitor this tendency.

  10. Rethinking Economics, the Role of Insurance: Adam Smith Upside Down—The Central Role of Insurance in the New Post-Industrial (Service Economy

    Directory of Open Access Journals (Sweden)

    Orio Giarini

    2016-10-01

    Full Text Available In the first page of The Wealth of Nations, Adam Smith described an apparently trivial issue, the making of a pin. In his search for ways to effectively fight poverty, he formulated the basis for a new view of economy based on the Industrial Revolution. Two centuries later, the perspective he developed remains intact and is largely outdated. It does not reflect the radical shift from an industrial to a service economy, which occurred during the later half of the 20th century and prevails today. Insurance, a very important component of the modern service economy, was and has been ignored or dismissed by past and contemporary economists. Founded on the principle of uncertainty, insurance now provides the basis for valuable insights into the unique characteristics of the service economy. A rethinking of economics is needed from this perspective.

  11. Outcomes, costs and stakeholders' perspectives associated with the incorporation of community pharmacy services into the National Health Insurance System in Thailand: a systematic review.

    Science.gov (United States)

    Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee

    2018-02-01

    Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.

  12. Validation of a tool for assessing the quality of pharmaceutical services

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    Cosendey Marly Aparecida E.

    2003-01-01

    Full Text Available This paper presents the validation process for a tool assessing basic pharmaceutical services through an analysis of the implementation of a Basic Pharmaceuticals Distribution Program by the Brazilian Federal government. The process began with the drafting of a theoretical model, based on a state-of-the-art review and allowing the selection of various conceptual dimensions and respective criteria that best represented the construct. The second step involved weighting indicators for the construction of quality scores. Three models were tested for ranking implementation levels, and seven simulations were conducted, determining the score most closely reflecting the selected indicators in two different matrices. The objective was to select the most coherent and consistent version between implementation levels and expected outcomes, while simultaneously enhancing validity of chosen criteria. Testing of the various models and the results obtained showed that augmenting the validity of the study was possible without altering data. This endeavor is justified in understanding the scope and limitations of these measurements and of the choices involved in issues concerning their weighting and interpretation.

  13. Online Pharmaceutical Care Provision: Full-Implementation of an eHealth Service Using Design Science Research.

    Science.gov (United States)

    Gregório, João; Pizarro, Ângela; Cavaco, Afonso; Wipfli, Rolf; Lovis, Christian; Mira da Silva, Miguel; Lapão, Luís Velez

    2015-01-01

    Chronic diseases are pressing health systems to introduce reforms, focused on primary care and multidisciplinary models. Community pharmacists have developed a new role, addressing pharmaceutical care and services. Information systems and technologies (IST) will have an important role in shaping future healthcare provision. However, the best way to design and implement an IST for pharmaceutical service provision is still an open research question. In this paper, we present a possible strategy based on the use of Design Science Research Methodology (DSRM). The application of the DSRM six stages is described, from the definition and characterization of the problem to the evaluation of the artefact.

  14. State insurance parity legislation for autism services and family financial burden.

    Science.gov (United States)

    Parish, Susan; Thomas, Kathleen; Rose, Roderick; Kilany, Mona; McConville, Robert

    2012-06-01

    We examined the association between states' legislative mandates that private insurance cover autism services and the health care-related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N  =  2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.

  15. The challenges of strategic purchasing of healthcare services in Iran Health Insurance Organization: a qualitative study

    Science.gov (United States)

    Gorji, Hasan Abolghasem; Shojaei, Ali; Keshavarzi, Anahita; Zare, Hossein

    2018-01-01

    Background Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, has not been made possible to achieve or even to implement, due to the associated problems. Objective To determine the associated problems of strategic purchasing in the Iran Health Insurance Organization (IHIO). Methods This study is a qualitative study, and framework analysis which was conducted in Iran in 2014–15. The participants in this study were 34 individuals from decision-makers and executives in the IHIO purchasing process, and university experts who have been chosen purposefully. This study conducted frame analysis, by using MAXQDA 10. Results The findings included associated problems of IHIO strategic purchasing in 12 themes and 65 subthemes. The themes included: Laws and regulations for purchasing, Organization of purchasing, Qualified and authorized providers, Right type of services, Right type of contracts, Target groups for purchasing, Resources allocation, financing and pricing system, Purchasing as improving performance and quality, Purchasing as shaping the market and competition, Purchasing as health progress state of people and society, Guided purchasing and stewardship of government, Structure of decision-making process in the health and welfare ministries. Conclusion The findings of this study showed associated problems in IHIO strategic purchasing. To achieve strategic purchasing goals in Iran, identification of all issues and factors of the total insurers and health system sets which affect strategic purchasing is essential. PMID:29629051

  16. The challenges of strategic purchasing of healthcare services in Iran Health Insurance Organization: a qualitative study.

    Science.gov (United States)

    Gorji, Hasan Abolghasem; Mousavi, Sayyed Masoud Shajari Pour; Shojaei, Ali; Keshavarzi, Anahita; Zare, Hossein

    2018-02-01

    Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, has not been made possible to achieve or even to implement, due to the associated problems. To determine the associated problems of strategic purchasing in the Iran Health Insurance Organization (IHIO). This study is a qualitative study, and framework analysis which was conducted in Iran in 2014-15. The participants in this study were 34 individuals from decision-makers and executives in the IHIO purchasing process, and university experts who have been chosen purposefully. This study conducted frame analysis, by using MAXQDA 10. The findings included associated problems of IHIO strategic purchasing in 12 themes and 65 subthemes. The themes included: Laws and regulations for purchasing, Organization of purchasing, Qualified and authorized providers, Right type of services, Right type of contracts, Target groups for purchasing, Resources allocation, financing and pricing system, Purchasing as improving performance and quality, Purchasing as shaping the market and competition, Purchasing as health progress state of people and society, Guided purchasing and stewardship of government, Structure of decision-making process in the health and welfare ministries. The findings of this study showed associated problems in IHIO strategic purchasing. To achieve strategic purchasing goals in Iran, identification of all issues and factors of the total insurers and health system sets which affect strategic purchasing is essential.

  17. Auditing Access to Outpatient Rehabilitation Services for Children With Traumatic Brain Injury and Public Insurance in Washington State.

    Science.gov (United States)

    Fuentes, Molly M; Thompson, Leah; Quistberg, D Alex; Haaland, Wren L; Rhodes, Karin; Kartin, Deborah; Kerfeld, Cheryl; Apkon, Susan; Rowhani-Rahbar, Ali; Rivara, Frederick P

    2017-09-01

    To identify insurance-based disparities in access to outpatient pediatric neurorehabilitation services. Audit study with paired calls, where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury and public or private insurance. Outpatient rehabilitation clinics. Sample of rehabilitation clinics (N=287): 195 physical therapy (PT) clinics, 109 occupational therapy (OT) clinics, 102 speech therapy (ST) clinics, and 11 rehabilitation medicine clinics. Not applicable. Acceptance of public insurance and the number of business days until the next available appointment. Therapy clinics were more likely to accept private insurance than public insurance (relative risk [RR] for PT clinics, 1.33; 95% confidence interval [CI], 1.22-1.44; RR for OT clinics, 1.40; 95% CI, 1.24-1.57; and RR for ST clinics, 1.42; 95% CI, 1.25-1.62), with no significant difference for rehabilitation medicine clinics (RR, 1.10; 95% CI, 0.90-1.34). The difference in median wait time between clinics that accepted public insurance and those accepting only private insurance was 4 business days for PT clinics and 15 days for ST clinics (P≤.001), but the median wait time was not significantly different for OT clinics or rehabilitation medicine clinics. When adjusting for urban and multidisciplinary clinic statuses, the wait time at clinics accepting public insurance was 59% longer for PT (95% CI, 39%-81%), 18% longer for OT (95% CI, 7%-30%), and 107% longer for ST (95% CI, 87%-130%) than that at clinics accepting only private insurance. Distance to clinics varied by discipline and area within the state. Therapy clinics were less likely to accept public insurance than private insurance. Therapy clinics accepting public insurance had longer wait times than did clinics that accepted only private insurance. Rehabilitation professionals should attempt to implement policy and practice changes to promote equitable access to care. Copyright © 2017

  18. Consumer Expectations of Online Services in the Insurance Industry: An Exploratory Study of Drivers and Outcomes.

    Science.gov (United States)

    Méndez-Aparicio, M Dolores; Izquierdo-Yusta, Alicia; Jiménez-Zarco, Ana I

    2017-01-01

    Today, the customer-brand relationship is fundamental to a company's bottom line, especially in the service sector and with services offered via online channels. In order to maximize its effects, organizations need (1) to know which factors influence the formation of an individual's service expectations in an online environment; and (2) to establish the influence of these expectations on customers' likelihood of recommending a service before they have even used it. In accordance with the TAM model (Davis, 1989; Davis et al., 1992), the TRA model (Fishbein and Ajzen, 1975), the extended UTAUT model (Venkatesh et al., 2012), and the approach described by Alloza (2011), this work proposes a theoretical model of the antecedents and consequences of consumer expectations of online services. In order to validate the proposed theoretical model, a sample of individual insurance company customers was analyzed. The results showed, first, the importance of customers' expectations with regard to the intention to recommend the "private area" of the company's website to other customers prior to using it themselves. They also revealed the importance to expectations of the antecedents perceived usefulness, ease of use, frequency of use, reputation, and subjective norm.

  19. Consumer Expectations of Online Services in the Insurance Industry: An Exploratory Study of Drivers and Outcomes

    Directory of Open Access Journals (Sweden)

    M. Dolores Méndez-Aparicio

    2017-07-01

    Full Text Available Today, the customer-brand relationship is fundamental to a company’s bottom line, especially in the service sector and with services offered via online channels. In order to maximize its effects, organizations need (1 to know which factors influence the formation of an individual’s service expectations in an online environment; and (2 to establish the influence of these expectations on customers’ likelihood of recommending a service before they have even used it. In accordance with the TAM model (Davis, 1989; Davis et al., 1992, the TRA model (Fishbein and Ajzen, 1975, the extended UTAUT model (Venkatesh et al., 2012, and the approach described by Alloza (2011, this work proposes a theoretical model of the antecedents and consequences of consumer expectations of online services. In order to validate the proposed theoretical model, a sample of individual insurance company customers was analyzed. The results showed, first, the importance of customers’ expectations with regard to the intention to recommend the “private area” of the company’s website to other customers prior to using it themselves. They also revealed the importance to expectations of the antecedents perceived usefulness, ease of use, frequency of use, reputation, and subjective norm.

  20. Connecticut's Value-Based Insurance Plan Increased The Use Of Targeted Services And Medication Adherence.

    Science.gov (United States)

    Hirth, Richard A; Cliff, Elizabeth Q; Gibson, Teresa B; McKellar, M Richard; Fendrick, A Mark

    2016-04-01

    In 2011 Connecticut implemented the Health Enhancement Program for state employees. This voluntary program followed the principles of value-based insurance design (VBID) by lowering patient costs for certain high-value primary and chronic disease preventive services, coupled with requirements that enrollees receive these services. Nonparticipants in the program, including those removed for noncompliance with its requirements, were assessed a premium surcharge. The program was intended to curb cost growth and improve health through adherence to evidence-based preventive care. To evaluate its efficacy in doing so, we compared changes in service use and spending after implementation of the program to trends among employees of six other states. Compared to employees of other states, Connecticut employees were similar in age and sex but had a slightly higher percentage of enrollees with chronic conditions and substantially higher spending at baseline. During the program's first two years, the use of targeted services and adherence to medications for chronic conditions increased, while emergency department use decreased, relative to the situation in the comparison states. The program's impact on costs was inconclusive and requires a longer follow-up period. This novel combination of VBID principles and participation requirements may be a tool that can help plan sponsors increase the use of evidence-based preventive services. Project HOPE—The People-to-People Health Foundation, Inc.

  1. Pharmaceutical assistance in local public health services in Santa Catarina (Brazil: characteristics of its organization

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    Ana Paula Veber

    2011-03-01

    Full Text Available This study outlines the diagnosis stage of 201 Municipal Pharmaceutical Assistance Plans sent to the Directorate of Pharmaceutical Assistance of the State Secretariat for Health of Santa Catarina (DIAF-SES/SC between November 12, 2005 and July 6, 2006. Multiple Correspondence Analysis was used in conjunction with SPAD 3.5 software, followed by hypothesis testing. The variables "pharmacist presence" and "population" were those which most contributed to the formation of the three clusters of municipalities observed. The number of drugs contained in the Municipal Lists of Essential Drugs (REMUMEs ranged from 15 to 413. A total of 67 towns had between 101 and 200 drugs- a range considered ideal in this study according to the 2006 National List of Essential Drugs. No tendency toward correlation between number of drugs listed in the REMUMES and municipality population size was found. Results confirmed the known disparity in Pharmaceutical Assistance among municipalities of different sizes and highlighted the need for structuring the activities of Pharmaceutical Assistance in the municipalities studied. There is also a need for greater commitment from all management spheres so that activities of Pharmaceutical Assistance at a local level ensure access to quality drugs and services, while fostering rational use.Este estudo retrata a etapa de diagnóstico de 201 Planos Municipais de Assistência Farmacêutica enviados entre 12 de novembro de 2005 a 06 de julho de 2006 à Diretoria de Assistência Farmacêutica da Secretaria de Estado da Saúde de Santa Catarina (DIAF-SES/SC. Utilizou-se a Análise de Correspondência Múltipla, através do programa SPAD 3.5 e posteriormente realizou-se teste de hipótese. As variáveis "presença de farmacêutico" e "população" foram as que mais contribuíram para a formação dos três agrupamentos de municípios evidenciados. O número de medicamentos constantes das Relações Municipais de Medicamentos Essenciais

  2. Civic Engagement as Risk Management and Public Relations: What the Pharmaceutical Industry Can Teach Us about Service-Learning

    Science.gov (United States)

    Scott, J. Blake

    2009-01-01

    The pharmaceutical industry's corporate responsibility reports illustrate how the liberal rhetoric of civic engagement can be reappropriated to serve the market-driven aims of risk management and public relations. Tracing the ideologic linkage of corporate responsibility and service-learning versions of civic engagement, and contextualizing…

  3. Forest insurance

    Science.gov (United States)

    Ellis T. Williams

    1949-01-01

    Standing timber is one of the few important kinds of property that are not generally covered by insurance. Studies made by the Forest Service and other agencies have indicated that the risks involved in the insurance of timber are not unduly great, provided they can be properly distributed. Such studies, however, have thus far failed to induce any notable development...

  4. Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study

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    Ukkola Anniina

    2012-09-01

    Full Text Available Abstract Background Approximately 1% of the population suffer from coeliac disease. However, the disease is heavily underdiagnosed. Unexplained symptoms may lead to incremented medical consultations and productivity losses. The aim here was to estimate the possible concealed burden of untreated coeliac disease and the effects of a gluten-free diet. Methods A nationwide cohort of 700 newly detected adult coeliac patients were prospectively evaluated. Health care service use and sickness absence from work during the year before diagnosis were compared with those in the general population; the data obtained from an earlier study. Additionally, the effect of one year on dietary treatment on the aforementioned parameters and on consumption of pharmaceutical agents was assessed. Results Untreated coeliac patients used primary health care services more frequently than the general population. On a gluten-free diet, visits to primary care decreased significantly from a mean 3.6 to 2.3. The consumption of medicines for dyspepsia (from 3.7 to 2.4 pills/month and painkillers (6.8-5.5 pills/month and the number of antibiotic courses (0.6-0.5 prescriptions/year was reduced. There were no changes in hospitalizations, outpatient visits to secondary and tertiary care, use of other medical services, or sickness absence, but the consumption of nutritional supplements increased on treatment. Conclusions Coeliac disease was associated with excessive health care service use and consumption of drugs before diagnosis. Dietary treatment resulted in a diminished burden to the health care system and lower use of on-demand medicines and antibiotic treatment. The results support an augmented diagnostic approach to reduce underdiagnosis of coeliac disease. Trial registration ClinicalTrials.gov NCT01145287

  5. Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study.

    Science.gov (United States)

    Ukkola, Anniina; Kurppa, Kalle; Collin, Pekka; Huhtala, Heini; Forma, Leena; Kekkonen, Leila; Mäki, Markku; Kaukinen, Katri

    2012-09-27

    Approximately 1% of the population suffer from coeliac disease. However, the disease is heavily underdiagnosed. Unexplained symptoms may lead to incremented medical consultations and productivity losses. The aim here was to estimate the possible concealed burden of untreated coeliac disease and the effects of a gluten-free diet. A nationwide cohort of 700 newly detected adult coeliac patients were prospectively evaluated. Health care service use and sickness absence from work during the year before diagnosis were compared with those in the general population; the data obtained from an earlier study. Additionally, the effect of one year on dietary treatment on the aforementioned parameters and on consumption of pharmaceutical agents was assessed. Untreated coeliac patients used primary health care services more frequently than the general population. On a gluten-free diet, visits to primary care decreased significantly from a mean 3.6 to 2.3. The consumption of medicines for dyspepsia (from 3.7 to 2.4 pills/month) and painkillers (6.8-5.5 pills/month) and the number of antibiotic courses (0.6-0.5 prescriptions/year) was reduced. There were no changes in hospitalizations, outpatient visits to secondary and tertiary care, use of other medical services, or sickness absence, but the consumption of nutritional supplements increased on treatment. Coeliac disease was associated with excessive health care service use and consumption of drugs before diagnosis. Dietary treatment resulted in a diminished burden to the health care system and lower use of on-demand medicines and antibiotic treatment. The results support an augmented diagnostic approach to reduce underdiagnosis of coeliac disease. ClinicalTrials.gov NCT01145287.

  6. Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003

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    Collins Charles D

    2007-03-01

    Full Text Available Abstract Background In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS and Labour Insurance Scheme (LIS to the new Urban Employee Basic Health Insurance Scheme (BHIS. Methods This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. Results An examination of the data reveals a number of key points: a The overall coverage of the newly established scheme has decreased from 1998 to 2003. b The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c Higher levels of participation in mainstream insurance schemes (i.e. GIS-LIS and BHIS were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. Conclusion The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in

  7. An Investigation of Social Factors Affecting on Personnel Job Satisfaction of Remedial Service Insurance Department

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    Sayyed Yaser Ebrahimian Jolodar

    2012-01-01

    Full Text Available Because of the paramount importance of job satisfaction and due to its main consequences such as reduction of work absence and resignation, personnel promotion and society‟s health, and more importantly, its role in achievement of organization goals, this study aimed at investigating the effects of six social factors including personnel‟s belief, salary and benefits, participation in organizational decision-making, sense of job security, interaction with colleagues and meeting the basic needs of personnel on job satisfaction. The statistical population of this study was the personnel of Remedial Service Insurance Department in Sari and the questionnaire was distributed among them. The results showed that there is a significant and positive correlation among all these factors and they have meaningful effects on personnel job satisfaction based on multiple regression analysis. Furthermore, findings revealed that personnel‟s belief about their job has the most effects on job satisfaction.

  8. Measuring organizational flexibility in community pharmacy: Building the capacity to implement cognitive pharmaceutical services.

    Science.gov (United States)

    Feletto, Eleonora; Wilson, Laura Kate; Roberts, Alison Sarah; Benrimoj, Shalom Isaac

    2011-03-01

    Community pharmacy is undergoing transformation with increasing pressure to build its capacity to deliver cognitive pharmaceutical services ("services"). The theoretical framework of organizational flexibility (OF) may be used to assess the capacity of community pharmacy to implement change programs and guide capacity-building initiatives. To test the applicability of an existing scale measuring OF to the industry of community pharmacy in Australia. A mail survey was used to test a preexisting scale measuring OF amended from 28 items to 20 items testing 3 underlying factors of operational, structural, and strategic flexibility in the Australian community pharmacy context. The sample was 2006 randomly-stratified community pharmacies. A confirmatory factor analysis was conducted to assess the validity and reliability of the 1-factor models for each underlying construct and the full measurement model. Responses were received from a total of 395 (19.7%) community pharmacies. The 1-factor models of operational, structural, and strategic flexibility fit the data with appropriate respecification. Overall, the favorable fit of the individual factor constructs suggested that the multiple-factor measurement model should be tested. However, this model did not yield an interpretable response. Operational flexibility covaried negatively to the other factors, whereas structural and strategic flexibility shared covariance. Despite this, the results highlighting the individual factor fit suggest the constructs have application to pharmacy. The individual OF constructs were useful in the development and initial testing of a scale adapted for community pharmacy. When further developed and validated, the scale could be used to identify group of pharmacies that require individualized assistance to build capacity and integrate services and other new endeavors. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. 48 CFR 728.313 - Contract clauses for insurance of transportation or transportation-related services.

    Science.gov (United States)

    2010-10-01

    ...) USAID is required by law to include language in all its direct contracts and subcontracts ensuring that all U.S. marine insurance companies have a fair opportunity to bid for marine insurance when such...

  10. The effects of China's urban basic medical insurance schemes on the equity of health service utilisation: evidence from Shaanxi Province.

    Science.gov (United States)

    Zhou, Zhongliang; Zhu, Liang; Zhou, Zhiying; Li, Zhengya; Gao, Jianmin; Chen, Gang

    2014-03-09

    In order to alleviate the problem of "Kan Bing Nan, Kan Bing Gui" (medical treatment is difficult to access and expensive) and improve the equity of health service utilisation for urban residents in China, the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) were established in 1999 and 2007, respectively. This study aims to analyse the effects of UEBMI and URBMI on the equity of outpatient and inpatient utilisation in Shaanxi Province, China. Using the data from the fourth National Health Services Survey in Shaanxi Province, the method of Propensity Score Matching was employed to generate comparable samples between the insured and uninsured residents, through a one-to-one match algorithm. Next, based on the matched data, the method of decomposition of the concentration index was employed to compare the horizontal inequity indexes of health service utilisation between the UEBMI/URBMI insured and the matched uninsured residents. For the UEBMI insured and matched uninsured residents, the horizontal inequity indexes of outpatient visits are 0.1256 and -0.0511 respectively, and the horizontal inequity indexes of inpatient visits are 0.1222 and 0.2746 respectively. Meanwhile, the horizontal inequity indexes of outpatient visits are -0.1593 and 0.0967 for the URBMI insured and matched uninsured residents, and the horizontal inequity indexes of inpatient visits are 0.1931 and 0.3199 respectively. The implementation of UEBMI increased the pro-rich inequity of outpatient utilisation (rich people utilise outpatient facilities more than the poor people) and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation.

  11. Private finance of services covered by the National Health Insurance package of benefits in Israel.

    Science.gov (United States)

    Engelchin-Nissan, Esti; Shmueli, Amir

    2015-01-01

    Private health expenditure in systems of national health insurance has raised concern in many countries. The concern is mainly about the accessibility of care to the poor and the sick, and inequality in use and in health. The concern thus refers specifically to the care financed privately rather than to private health expenditure as defined in the national health accounts. To estimate the share of private finance in total use of services covered by the national package of benefits. and to relate the private finance of use to the income and health of the users. The Central Bureau of Statistics linked the 2009 Health Survey and the 2010 Incomes Survey. Twenty-four thousand five hundred ninety-five individuals in 7175 households were included in the data. Lacking data on the share of private finance in total cost of care delivered, we calculated instead the share of uses having any private finance-beyond copayments-in total uses, in primary, secondary, paramedical and total care. The probability of any private finance in each type of care is then related, using random effect logistic regression, to income and health state. Fifteen percent of all uses of care covered by the national package of benefits had any private finance. This rate ranges from 10 % in primary care, 16 % in secondary care and 31 % in paramedical care. Twelve percent of all uses of physicians' services had any private finance, ranging from 10 % in family physicians to 20 % in pulmonologists, psychiatrists, neurologists and urologists. Controlling for health state, richer individuals are more likely to have any private finance in all types of care. Controlling for income, sick individuals (1+ chronic conditions) are 30 % in total care and 60 % in primary care more likely to have any private finance compared to healthy individuals (with no chronic conditions). The national accounts' "private health spending" (39 % of total spending in 2010) is not of much use regarding equity of and

  12. Evidence of the clinical effectiveness of cognitive pharmaceutical services for aged patients.

    Science.gov (United States)

    Sáez-Benito, Loreto; Fernandez-Llimos, Fernando; Feletto, Eleonora; Gastelurrutia, Miguel Angel; Martinez-Martinez, Fernando; Benrimoj, Shalom I

    2013-07-01

    cognitive pharmaceutical services (CPSs) encompass a variety of pharmacists' interventions to optimise pharmacotherapy. The clinical effectiveness of CPSs for aged patients remains controversial. to analyse and describe the evidence of the clinical effectiveness of CPSs in aged patients by means of performing a systematic review of systematic reviews. using the recommended methodology by Cochrane, a search was undertaken for systematic reviews of the clinical effectiveness of CPSs in MEDLINE, EMBASE, DOAJ, SCIELO and COCHRANE LIBRARY. Reviews were assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. Quality of the evidence in the reviews was ranked using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. a total of 14 systematic reviews and one meta-analysis were analysed. The overall quality of the reviews was moderate. High and moderate strength of evidence was found for the positive effect of certain CPSs on reducing the number and improving the appropriateness of medicines. There was conflicting evidence of the effect on adherence. There was limited evidence of high and moderate strength on clinical outcomes. No positive evidence was found on mortality, hospitalisations, functional capacity and cognitive function. No systematic reviews reported the effect on the level of control of health problems. certain types of CPSs reduce the number of medicines and improve the appropriateness of prescriptions. Longer follow-up periods and/or the use of surrogate clinical variables measuring the short-term impact are required to demonstrate the effect on clinical outcomes.

  13. Assessment of Patient Satisfaction with Pharmaceutical Community Services in R. Macedonia

    Directory of Open Access Journals (Sweden)

    Zoran Sterjev

    2011-06-01

    Full Text Available Measuring and analyzing patients’ satisfaction with pharmacist’s consultation is a relatively new development which is enforced by the new demands of society. High number of variables, such as their state of health, socio-demographic variables (age, sex, and cultural level, characteristics of their healthcare provider (affective care, quantity of information, technical expertise, etc, or waiting time are related to patients’ satisfaction. At present, in R.Macedonia, there are 834 community pharmacies, which accounts for pharmacy vs. population ratio of 1:2500. The pharmacies are situated in 8 different regions (the Vardar region, Pelagonia, North-East, South-West, Polog, East and South East. The present cross-sectional descriptive study based on interview data was carried out in order to ascertain patients’ satisfaction from their experience with the cumulative quality of pharmaceutical services. A total of 651 patients of both sexes (59,3% male and 39,1% female were included in the study. The results from our analysis showed the influence of different factors in the process of choosing pharmacy: distance, medicines price, well-stocked with medicines, professional advice by the employees in the pharmacy, hygiene in pharmacies, the privacy they offer, waiting time, possibility for private conversation with professionals.

  14. 17 CFR 239.43 - Form F-N, appointment of agent for service of process by foreign banks and foreign insurance...

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Form F-N, appointment of agent for service of process by foreign banks and foreign insurance companies and certain of their holding... agent for service of process by foreign banks and foreign insurance companies and certain of their...

  15. Primary Care Providers' experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle

    2012-01-01

    Full Text Available This study explored primary care providers' (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 "MTM is just part of our team approach to the practice of medicine": MTM as an integral part of PCPs' practices; (2 "Frankly it's education for the patient but it's also education for me": MTM services as a source of education; (3 "It's not exactly just the pharmacist that passes out the medicines at the pharmacy": The MTM practitioner is different from the dispensing pharmacist; (4 "So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved": MTM services as preventative health care efforts; (5"I think that time is the big thing": MTM pharmacists spend more time with patients; (6 "There's an access piece, there's an availability piece, there's a finance piece": MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge äóñmedication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients' medications, and their capability to

  16. Primary Care Providers’ experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle, Pharm.D.

    2012-01-01

    Full Text Available This study explored primary care providers’ (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 “MTM is just part of our team approach to the practice of medicine”: MTM as an integral part of PCPs’ practices; (2 “Frankly it’s education for the patient but it’s also education for me”: MTM services as a source of education; (3 “It’s not exactly just the pharmacist that passes out the medicines at the pharmacy”: The MTM practitioner is different from the dispensing pharmacist; (4 “So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved”: MTM services as preventative health care efforts; (5“I think that time is the big thing”: MTM pharmacists spend more time with patients; (6 “There’s an access piece, there’s an availability piece, there’s a finance piece”: MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge –medication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients

  17. The Health Costs and Diseases in Medical Services Insurance Organization, Tehran Province, 1386 (2008

    Directory of Open Access Journals (Sweden)

    Ali Shojaei

    2012-01-01

    Full Text Available Objectives: The current research in addition to study of the diseases in the elders, surveys the health costs of these diseases. Methods & Materials: Study of the cost information and related diseases in (MSIO- Medical Services Insurance Organization, Tehran province, surveys costs and Medical Services of this group on 183093 hospitalized files. Results: 31% of hospital`s referrals and 37% of inpatient costs related to elders and display the expensive Services of this group of the Insured. The mean costs of every hospitalization in elderly groups were 4634384 rials, which was more than total mean costs, from all groups. Diagnostic code I27 (other cardio-vascular diseases, I20 (Angina pectoris, H25 (cataract, I25 (chronic IHD, I50 (heart failure, devote first to fifth grade of the prevalent Diagnosis cods (ICD in the aged group older than 60 and displays the most prevalence of the cardio-vascular system diseases in the elders. The most common surgical Code (California code in elderly (above 60 yrs. was related to Coronary Angioplasty, with its mean cost of 9116371 rials. And then was Cataract. 15% of the Global files are related to the elders which is equal to 23% of the charges of these files in this group of the elders. Extraction of Lens (Intra-capsular and extra-capsular Lens Insertion (57 code One-lateral Inguinal Hernia with or without excision of Hydrocele or Spermatocele except Incarcerated Inguinal Hernia (Global code 28, cholecystectomy with or without cholangiography or exploration of Biliary ducts (Global code 27 from first to third grade of the prevalent Global surgeries of the elders. Statistical test displays the Pierson coherent between the age and residence period and paid costs, There is a little positive coherent between the age and residence period in hospital and paid costs. Conclusion: These reviews show the results of the current study (the prevalent in-patient causes are adapted to the performed studies in this field and

  18. Interoperable computerized smart card based system for health insurance and health services applied in cardiology.

    Science.gov (United States)

    Cocei, Horia-Delatebea; Stefan, Livia; Dobre, Ioana; Croitoriu, Mihai; Sinescu, Crina; Ovricenco, Eduard

    2002-01-01

    In 1999 Romania started its health care reform by promulgating the Health Insurance Law. A functional and efficient health care system needs procedures for monitoring and evaluation of the medical services, communication between different service providers and entities involved in the system, integration and availability of the information. The final goal is a good response to the needs and demands of the patients and of the real life. For this project we took into account, on one hand, the immediate need for computerized systems for the health care providers and, on the other hand, the large number of trials and experiments with health smart cards across Europe. Our project will implement a management system based on electronic patient records to be used in all cardiology clinics and will experiment the health smart cards, will promote and demonstrate the capabilities of the smart card technology. We focused our attention towards a specific and also critical category of patients, those with heart diseases, and also towards a critical sector of the health care system--the emergency care. The patient card was tested on a number of 150 patients at a cardiology clinic in Bucharest. This was the first trial of a health smart card in Romania.

  19. Chinese nuclear insurance and Chinese nuclear insurance pool

    International Nuclear Information System (INIS)

    Gong Zhiqi

    2000-01-01

    Chinese Nuclear Insurance Started with Daya Bay Nuclear Power Station, PICC issued the insurance policy. Nuclear insurance cooperation between Chinese and international pool's organizations was set up in 1989. In 1996, the Chinese Nuclear Insurance Pool was prepared. The Chinese Nuclear Insurance Pool was approved by The Chinese Insurance Regulatory Committee in May of 1999. The principal aim is to centralize maximum the insurance capacity for nuclear insurance from local individual insurers and to strengthen the reinsurance relations with international insurance pools so as to provide the high quality insurance service for Chinese nuclear industry. The Member Company of Chinese Nuclear Pool and its roles are introduced in this article

  20. Economic aspects of the use of innovative methods of stationary medical services payment in obligatory health insurance system

    Directory of Open Access Journals (Sweden)

    Bryksina N.V.

    2016-11-01

    Full Text Available the article considers the payment of medical services experience in a hospital with clinical and statistical groups, formed in the system of obligatory medical insurance of the Sverdlovsk region. Based on the analysis of statistical data shows that the use of this method of payment meets the challenges of the single-channel financing, allowing to influence the structure of hospitalization, the use of new medical technologies, the increase in operational activity and contributes to more optimal allocation of limited financial resources in the system of obligatory medical insurance.

  1. Trends in breast reconstruction: Implications for the National Health Insurance Service.

    Science.gov (United States)

    Hong, Ki Yong; Son, Yoosung; Chang, Hak; Jin, Ung Sik

    2018-05-01

    Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (PNHIS coverage (PNHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

  2. Effect of Health Insurance on the Use and Provision of Maternal Health Services and Maternal and Neonatal Health Outcomes: A Systematic Review

    Science.gov (United States)

    Peterson, Lauren A.; Hatt, Laurel E.

    2013-01-01

    Financial barriers can affect timely access to maternal health services. Health insurance can influence the use and quality of these services and potentially improve maternal and neonatal health outcomes. We conducted a systematic review of the evidence on health insurance and its effects on the use and provision of maternal health services and on maternal and neonatal health outcomes in middle- and low-income countries. Studies were identified through a literature search in key databases and consultation with experts in healthcare financing and maternal health. Twenty-nine articles met the review criteria of focusing on health insurance and its effect on the use or quality of maternal health services, or maternal and neonatal health outcomes. Sixteen studies assessed demand-side effects of insurance, eight focused on supply-side effects, and the remainder addressed both. Geographically, the studies provided evidence from sub-Saharan Africa (n=11), Asia (n=9), Latin America (n=8), and Turkey. The studies included examples from national or social insurance schemes (n=7), government-run public health insurance schemes (n=4), community-based health insurance schemes (n=11), and private insurance (n=3). Half of the studies used econometric analyses while the remaining provided descriptive statistics or qualitative results. There is relatively consistent evidence that health insurance is positively correlated with the use of maternal health services. Only four studies used methods that can establish this causal relationship. Six studies presented suggestive evidence of overprovision of caesarean sections in response to providers’ payment incentives through health insurance. Few studies focused on the relationship between health insurance and the quality of maternal health services or maternal and neonatal health outcomes. The available evidence on the quality and health outcomes is inconclusive, given the differences in measurement, contradictory findings, and

  3. Use of hospital services and socio-economic status in urban India: Does health insurance ensure equitable outcomes?

    OpenAIRE

    Dutta, Mousumi; Husain, Zakir

    2012-01-01

    In recent years universal health coverage has become an important issue in developing countries. Successful introduction of such a social security system requires knowledge of the relationship between socio-economic status and usage of health care services. This paper examines this relationship, and analyzes the impact of introducing health insurance into the model, using data for India, a major developing country with poor health outcomes. In contrast to similar works undertaken for develope...

  4. The affect of loyal customer concentration benefits when choosing banking and insurance service provider, Case: Etelä-Karjalan Osuuspankki

    OpenAIRE

    Suhonen, Sari

    2013-01-01

    The objective of this thesis was to examine how the loyal customer concentration benefits affect when a customer is choosing a banking and insurance service provider. The loyal customer concentration benefits are used in OP-Pohjola Group but this research only concerns Etelä-Karjalan Osuuspankki’s loyal customer concentration benefits. The purpose of the research was also to gain information about what clients think about these benefits: what benefits are important and how these benefits can ...

  5. Disposition of Insurance Allotment Payments

    National Research Council Canada - National Science Library

    Young, Shelton

    2001-01-01

    .... The request was prompted by action taken by the Florida Department of Insurance against two life insurance companies that had received large numbers of insurance allotments from Service members...

  6. INSURANCE INTERMEDIARIES

    Directory of Open Access Journals (Sweden)

    Andreea Stoican

    2013-11-01

    Full Text Available The actual Civil code regulates for the first time in the Romanian legislation the intermediation contract, until its entering into force existing multiple situations that lent themselves to this legal operation, but did not benefit of such particular legal rules. Yet, the case law has shown that the situations that arise in the activity of the legal or natural persons are much more complex, this leading, in time, to the reglementation of such particular rules. Such a case is that found in the matter of insurance contracts, the position of the insurance intermediaries being regulated especially by Law no. 32/2000, according to which they represent the natural or legal persons authorized in the conditions of the above mentioned legal document, that perform intermediation activities in the insurance field, in exchange of a remuneration, as well as the intermediaries from the EU member states that perform such an activity on the Romanian territory, in accordance with the freedom in performing services. Therefore, the present paper aims to analyze the conclusion of such insurance contracts and to underline the particular position of the insurance brokers, having the following structure: 1 Introduction; 2 The reglementation of the intermediation contract/brokerage agreement in the Romanian Law; 3 The importance of the intermediaries in the insurance contracts; 4 The conclusion of the insurance contracts; 5 Conclusions.

  7. Trends in breast reconstruction: Implications for the National Health Insurance Service

    Directory of Open Access Journals (Sweden)

    Ki Yong Hong

    2018-05-01

    Full Text Available Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases in 2012 to 18.3% (76 cases in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05. Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05, but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05. Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

  8. Value and Service Quality Assessment of the National Health Insurance Scheme in Ghana: Evidence from Ashiedu Keteke District.

    Science.gov (United States)

    Nsiah-Boateng, Eric; Aikins, Moses; Asenso-Boadi, Francis; Andoh-Adjei, Francis-Xavier

    2016-09-01

    Ghana introduced the National Health Insurance Scheme (NHIS) in 2003 to provide financial access to health care for all residents. This article analyzed claims reimbursement data of the NHIS to assess the value of the benefit package to the insured and responsiveness of the service to the financial needs of health services providers. Medical claims data reported between January 1, 2010, and December 31, 2014, were retrieved from the database of Ashiedu Keteke District Office of the National Health Insurance Authority. The incurred claims ratio, promptness of claims settlements, and claims adjustment rate were analyzed over the 5-year period. In all, 644,663 medical claims with a cost of Ghana cedi (GHS) 11.8 million (US $3.1 million) were reported over the study period. The ratio of claims cost to contributions paid increased from 4.3 to 7.2 over the 2011-2013 period, and dropped to 5.0 in 2014. The proportion of claims settled beyond 90 days also increased from 26% to 100% between 2011 and 2014. Generally, the amount of claims adjusted was low; however, it increased consistently from 1% to about 4% over the 2011-2014 period. The reasons for claims adjustments included provision of services to ineligible members, overbilling of services, and misapplication of diagnosis related groups. There is increased value of the NHIS benefit package to subscribers; however, the scheme's responsiveness to the financial needs of health services providers is low. This calls for a review of the NHIS policy to improve financial viability and service quality. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Assessment of pharmaceutical services in HIV/AIDS health units in the city of Niterói, Brazil

    Directory of Open Access Journals (Sweden)

    Nilo Jorge Piccoli

    2017-06-01

    Full Text Available ABSTRACT This study aimed to conduct an assessment of pharmaceutical services in HIV/AIDS in the city of Niteroi, Brazil, with emphasis on management. It was done a descriptive cross-sectional study, and the approach used was a normative assessment focused on quality. The indicators used were analyzed individually or grouped according to the components of pharmaceutical services. The assessment identified some good points, especially regarding the good availability of ARVs, and good guide patients in the use of these drugs, and also some problems such as low levels of compliance in relation to good dispensing practices criteria and storage and a high time for the distribution of medicines. The result was a degree of 50.3% compliance with the quality criteria, considered only regular in accordance with trial made. Proposals were suggested for actions and interventions, especially in relation to the improvement of structural conditions of pharmacies of health facilities in the city, and increased training of professionals involved in the services.

  10. Trade in Health Service: Unfair Competition of Pharmaceutical Products in Nepal

    Directory of Open Access Journals (Sweden)

    Madhusudan Subedi

    2010-02-01

    Full Text Available About 35 percent of the total demand for medicines in Nepal is covered by Nepali Pharmaceutical companies, and such companies are moving ahead for producing different kinds of medicines. The Government of Nepal, Department of Drug Administration (DDA has formulated different regulations and guidelines to ensure ethical practices in the medical sector of Nepal. Ethical Promotion of Medicine-2007 was developed and released to encourage the improvement of health care through the rational use of medicine and discourage unethical practices. It is distressing that the guidelines have not been implemented properly due to the conflict of interests among concerned stakeholders. The cost of medicine has been very expensive and poor people have always suffered. Key Words: Bonus; Ethical Guideline; Unethical Practices; Pharmaceutical Regulation; Conflict of Interest DOI: 10.3126/dsaj.v3i0.2783 Dhaulagiri Journal of Sociology and Anthropology Vol.3 2009 123-142

  11. Effects of managed care on service use and access for publicly insured children with chronic health conditions.

    Science.gov (United States)

    Davidoff, Amy; Hill, Ian; Courtot, Brigette; Adams, Emerald

    2007-05-01

    Our goal was to estimate the effects of managed care program type on service use and access for publicly insured children with chronic health conditions. Data on Medicaid and State Children's Health Insurance Program managed care programs were linked by county and year to pooled data from the 1997-2002 National Health Interview Survey. We used multivariate techniques to examine the effects of managed care program type, relative to fee-for-service, on a broad array of service use and access outcomes. Relative to fee-for-service, managed care program assignment was associated with selected reductions in service use but not with deterioration in reported access. Capitated managed care plans with mental health or specialty carve-outs were associated with a 7.4-percentage-point reduction in the probability of a specialist visit, a 6.3-percentage-point reduction in the probability of a mental health specialty visit, and a 5.9-percentage-point decrease in the probability of regular prescription drug use. Reductions in use associated with primary care case management and integrated capitated programs (without carve-outs) were more limited, and integrated capitated plans were associated with a reduction in unmet medical care need. We failed to find significant effects of special managed care programs for children with chronic health conditions. Managed care is associated with reduced service use, particularly when capitated programs carve out services. This finding is of key policy importance, as the proportion of children enrolled in plans with carve-out arrangements has been increasing over time. It is not possible to determine whether reductions in services represent better care management or skimping. However, despite the reductions in use, we did not observe a corresponding increase in perceived unmet need; thus, the net change may represent improved care management.

  12. Supply sensitive services in Swiss ambulatory care: An analysis of basic health insurance records for 2003-2007

    Directory of Open Access Journals (Sweden)

    Künzi Beat

    2010-11-01

    Full Text Available Abstract Background Swiss ambulatory care is characterized by independent, and primarily practice-based, physicians, receiving fee for service reimbursement. This study analyses supply sensitive services using ambulatory care claims data from mandatory health insurance. A first research question was aimed at the hypothesis that physicians with large patient lists decrease their intensity of services and bill less per patient to health insurance, and vice versa: physicians with smaller patient lists compensate for the lack of patients with additional visits and services. A second research question relates to the fact that several cantons are allowing physicians to directly dispense drugs to patients ('self-dispensation' whereas other cantons restrict such direct sales to emergencies only. This second question was based on the assumption that patterns of rescheduling patients for consultations may differ across channels of dispensing prescription drugs and therefore the hypothesis of different consultation costs in this context was investigated. Methods Complete claims data paid for by mandatory health insurance of all Swiss physicians in own practices were analyzed for the years 2003-2007. Medical specialties were pooled into six main provider types in ambulatory care: primary care, pediatrics, gynecology & obstetrics, psychiatrists, invasive and non-invasive specialists. For each provider type, regression models at the physician level were used to analyze the relationship between the number of patients treated and the total sum of treatment cost reimbursed by mandatory health insurance. Results The results show non-proportional relationships between patient numbers and total sum of treatment cost for all provider types involved implying that treatment costs per patient increase with higher practice size. The related additional costs to the health system are substantial. Regions with self-dispensation had lowest treatment cost for primary care

  13. Evolution of insurance company service quality survey, using self-learning neural network

    Directory of Open Access Journals (Sweden)

    Vladimír Konečný

    2011-01-01

    Full Text Available The objective of the paper is to demonstrate the abilities and possible approaches to classification of set of objects using self-organizing maps. As the objects, clients of an insurance company that made an agreement regarding mandatory insurance of motor vehicles were selected. The opinions of the clients and their overall satisfaction reflected in responses to presented answers. The clients were classified into three groups. The first two contained satisfied clients (i.e. good clients for the company, the last group contained clients that could potentially switch to the competitors. Subsequent analysis enabled discovering the reasons of low customer satisfaction and critical factors of losing the least satisfied clients. For the analysis of the responses (one hundred fifty-one and the insurance company, experimental model of self-organizing map realized at the Department of informatics was used. Used experimental model has proved very effective software tool.

  14. Impacts of international sanctions on Iranian pharmaceutical market.

    Science.gov (United States)

    Cheraghali, Abdol Majid

    2013-07-31

    Iran in recent decade faced several regional and international sanctions in foreign trade, financial and banking services. Iran national pharmaceutical industry has always played a major role in providing medicines to the Iranian patients. However, following the sanctions it has faced profound difficulties for importing of both finished products and pharmaceutical raw materials. Although medicines are exempted from sanctions, due to restriction on money transaction and proper insurance Iranian pharmaceutical companies have to pay cash in advance for imports of medicines and raw materials or to secure offshore funds at very high risks. Current situation in Iran pharmaceutical market confirms that the sanctions against Iran are affecting ordinary citizens and national health sector which resulted to reduction of availability of lifesaving medicines in the local market and has caused increasing pain and suffering for Iranian patients.

  15. Utilization of healthcare services and renewal of health insurance membership : evidence of adverse selection in Ghana

    NARCIS (Netherlands)

    Duku, Stephen Kwasi Opoku; Asenso-Boadi, Francis; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

    2016-01-01

    Background: Utilization of healthcare in Ghana’s novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme’s financial sustainability. This paper investigates the presence of adverse selection by assessing the effect

  16. A matter of trust : clients' perspective on health and health insurance services in Ghana

    NARCIS (Netherlands)

    Fenenga, Christine

    2015-01-01

    Dit participatieve actie onderzoek (PAA) betreft percepties en ervaringen van zorgklanten van het National Health Insurance Scheme (NHIS) in Ghana (2011-2014). Het beantwoordt de onderzoeksvraag: Wat drijft zorgklanten gebruik te maken van de gezondheidszorg en het NHIS? De onderzoeker voert

  17. [Present Status of Displaying Pharmaceutical Products for Sale on Flea Market Applications for Smartphones and the Responses to Illicit Selling by Service Providers].

    Science.gov (United States)

    Kishimoto, Keiko; Takeuchi, Tomoe; Fukushima, Noriko

    2017-12-01

     In Japan, a pharmacy or drug store license is required for selling pharmaceutical products. However, civilians without a pharmacy or drug store license are displaying pharmaceutical products for sale on a flea market application, which is illegal dealing. This study discussed the modality for implementing countermeasures for the illicit selling of pharmaceutical products. We extracted pharmaceutical products displayed for sale on three flea market applications (Mercari, Rakuma, Fril) on one day. One hundred and eighty-one pharmaceutical products were displayed (49 on Mercari, 86 on Rakuma, and 46 on Fril). There were 6.1% (11/181) domestically prescribed drugs, 69.1% (125/181) domestic OTC drugs, 23.8% (43/181) foreign-made prescribed drugs, and 1.1% (2/181) foreign-made OTC drugs. The seller could display the product for sale without confirming whether it is prohibited. We alerted the service providers of this illicit selling at flea markets at three different instances. The pharmaceutical product displays were deleted by the service providers at a rate of 55.1% (27/49) for Mercari and 51.2% (44/86) for Rakuma. The average number of drugs that were displayed for sale by each seller was 1.4 and the average number of total products that were displayed for sale by each seller was 100. The seller could have unintentionally displayed the pharmaceutical products for sale, without the knowledge that it is illegal. The service providers of flea market applications should create mechanisms to alert the sellers that displaying pharmaceutical products for sale is an illicit act and regulate these violations.

  18. 76 FR 7767 - Student Health Insurance Coverage

    Science.gov (United States)

    2011-02-11

    ... Student Health Insurance Coverage AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION... health insurance coverage under the Public Health Service Act and the Affordable Care Act. The proposed rule would define ``student health insurance [[Page 7768

  19. Service use, charge, and access to mental healthcare in a private Kenyan inpatient setting: the effects of insurance.

    Directory of Open Access Journals (Sweden)

    Victoria Pattison de Menil

    Full Text Available The gap in Kenya between need and treatment for mental disorders is wide, and private providers are increasingly offering services, funded in part by private health insurance (PHI. Chiromo, a 30-bed psychiatric hospital in Nairobi, forms part of one of the largest private psychiatric providers in East Africa. The study evaluated the effects of insurance on service use and charge, questioning implications on access to care. Data derive from invoices for 455 sequential patients, including 12-month follow-up. Multi-linear and binary logistic regressions explored the effect of PHI on readmission, cumulative length of stay, and treatment charge. Patients were 66.4% male with a mean age of 36.8 years. Half were employed in the formal sector. 70% were admitted involuntarily. Diagnoses were: substance use disorder 31.6%; serious mental disorder 49.5%; common mental disorder 7%; comorbid 7%; other 4.9%. In addition to daily psychiatric consultations, two-thirds received individual counselling or group therapy; half received lab tests or scans; and 16.2% received ECT. Most took a psychiatric medicine. Half of those on antipsychotics were given only brands. Insurance paid in full for 28.8% of patients. Mean length of stay was 11.8 days and, in 12 months, 16.7 days (median 10.6. 22.2% were readmitted within 12 months. Patients with PHI stayed 36% longer than those paying out-of-pocket and had 2.5 times higher odds of readmission. Mean annual charge per patient was Int$ 4,262 (median Int$ 2,821. Insurers were charged 71% more than those paying out-of-pocket--driven by higher fees and longer stays. Chiromo delivers acute psychiatric care each year to approximately 450 people, to quality and human rights standards higher than its public counterpart, but at considerably higher cost. With more efficient delivery and wider insurance coverage, Chiromo might expand from its occupancy of 56.6% to reach a larger population in need.

  20. Impact of universal medical insurance system on the accessibility of medical service supply and affordability of patients in China

    Science.gov (United States)

    Zhang, Zhiguo; Ren, Jing; Zhang, Jie; Pan, Xiaoyun; Zhang, Liang; Jin, Si

    2018-01-01

    Background China’s universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. Methods Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS. The rates of catastrophic payments and seeking-care choices for UMIS beneficiaries were selected to measure the affordability and medical service flow of patients after the implementation of UMIS. Results China’s UMIS was established in 2008. After that, the trending increase of the expenditure of the UMIS was higher than that of increase in revenue compared to previous years. Up to 2014, the UMIS had covered 97.5% of the entire population in China. After introduction of the UMIS, there were significant increases in licensed physicians, nurses, and hospital beds per 1000 individuals. In addition, hospital outpatient visits and inpatient visits per year increased compared to the pre-UMIS period. The average fatality rate of inpatients in the overall hospital and general hospital and the average fatality rate due to acute myocardial infarction (AMI) in general hospitals was significantly decreased. In contrast, no significant and prospective changes were observed in rural physicians per 1000 individuals, inpatient visits and inpatient fatality rate in the community centers and township hospitals compared to the pre-UMIS period. After 2008, the rates of catastrophic payments for UMIS inpatients at different income levels were declining at three levels of hospitals. Whichever income level, the rate of catastrophic payments for

  1. The insurance and risk management industries: new players in the delivery of energy-efficient and renewable energy products and services

    International Nuclear Information System (INIS)

    Mills, Evan

    2003-01-01

    The insurance and risk management industries are typically considered to have little interest in energy issues, other than those associated with large energy supply systems. The historical involvement of these industries in the development and deployment of familiar loss-prevention technologies such as automobile air bags, fire prevention/suppression systems, and anti-theft devices, evidences a tradition of mediating and facilitating the use of technology to improve safety and otherwise reduce the likelihood of losses. Through an examination of the connection between risk management and energy technology, we have identified nearly 80 examples of energy-efficient and renewable energy technologies that offer loss-prevention benefits (such as improved fire safety). This article presents the business case for insurer involvement in the sustainable energy sector and documents early case studies of insurer efforts along these lines. We have mapped these opportunities onto the appropriate market segments (life, health, property, liability, business interruption, etc.). We review steps taken by 53 forward-looking insurers and reinsurers, 5 brokers, 7 insurance organizations, and 13 non-insurance organizations. We group the approaches into the categories of: information, education, and demonstration; financial incentives; specialized policies and insurance products; direct investment; customer services and inspections; codes, standards, and policies; research and development; in-house energy management; and an emerging concept informally known as 'carbon insurance'. While most companies have made only a modest effort to position themselves in the 'green' marketplace, a few have comprehensive environmental programs that include energy efficiency and renewable energy activities

  2. Distributor– Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale

    Science.gov (United States)

    Mehralian, Gholamhossein; Babapour, Jafar; peiravian, farzad

    2016-01-01

    In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor–retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor–retailer interface. PMID:28243297

  3. Distributor- Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale.

    Science.gov (United States)

    Mehralian, Gholamhossein; Babapour, Jafar; Peiravian, Farzad

    2016-01-01

    In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor-retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor-retailer interface.

  4. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    Science.gov (United States)

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

  5. CRITERIA AND FACTORS THAT INSURE THE QUALITY IN PROVISION OF AUDIT SERVICES, DIFFERENT FROM AUDIT

    Directory of Open Access Journals (Sweden)

    Antoniuk O.

    2018-03-01

    Full Text Available Introduction. Quality management of audit services requires further theoretical research and development in the field of audit activity and quality of audit, continuous improvement of the organization and methodology in providing audit services. Purpose. The article deals with the theoretical and practical questions of assessing the quality of audit services that are different from the audit in order to identify ways to improve the methodological quality assurance in the provision of these services. Results. It is proved that factors (economic, methodological, organizational and conditions have an impact on the quality of audit services. This, in general, affects the content of audit services regulation and their social and economic significance. The terms of quality assurance, which are considered in the article, have a decisive influence on the implementation of those specific factors that directly change the properties of the audit services and create the services of the required quality. Assurance of the quality of audit services is considered as the creation of the necessary conditions for the implementation of all factors that affect the quality of audit services, maintanence of the given level of quality of audit services in accordance with the requirements of legal acts and market needs. Conclusions. The issue of identifying criteria, factors and indicators for assessing the quality in audit services is raised. In the generalized form, the matrix of quality assurance of audit services is presented, which indicates the interconnection of various conditions, factors, quality indicators in audit services.

  6. Reengineering the retail/ambulatory pharmacy for provision of biotechnology pharmaceutical services.

    Science.gov (United States)

    Schneider, P J

    1998-07-01

    Biotechnology products offer both problems and opportunities for pharmacists. On one hand, they are expensive to purchase and keep on inventory. Typical compensation for outpatient prescriptions does not offset the cost of maintaining the inventory, or providing the education and training that patients often need to use biotechnology products properly. On the other hand, there are issues related to proper storage, preparation, and administration for which pharmacists are well prepared to address. Pharmacists are also convenient, trusted, and provide service at relatively low cost. Examples of special services that pharmacists can provide to improve the use of biotechnology products include patient education, injection clinics, provision of medical supplies, and predrawing syringes for patients. Patients are often sent to many providers for these services, resulting in inconvenience and fragmentation of care. If new compensation methods can be established to support more comprehensive pharmacy services, the use of biotechnology products by patients will improve.

  7. Building capacity to implement cognitive pharmaceutical services: Quantifying the needs of community pharmacies.

    Science.gov (United States)

    Feletto, Eleonora; Wilson, Laura Kate; Roberts, Alison Sarah; Benrimoj, Shalom Isaac

    2010-09-01

    Community pharmacy is an industry undergoing a transformation, evolving from a traditional product supply orientation to a business capable of incorporating services. The theoretical framework of organizational flexibility is used to understand how pharmacies' capacity can be built to provide services and identify key areas needing improvement. To determine the needs of pharmacies that were important and the elements requiring improvement when implementing and delivering services. A mail survey of 2006 Australian community pharmacies was used to identify needs for service implementation. A 25-item scale was used to measure the level of importance (importance measure) of the items and the level of improvement (improvement measure) when implementing services. An exploratory factor analysis was conducted to assess the construct validity and reliability. Responses were received from a total of 395 community pharmacies, with 355 usable responses (17.7%). Factor analysis yielded 3 factors on the importance measure, explaining 42.6% of the variance: (1) planning and performance (item loading range 0.749-0.455; Cronbach's alpha 0.806), (2) people and processes (0.829-0.392; 0.713), and (3) service awareness and infrastructure (0.723-0.310; 0.705). For the improvement measure, 46.9% of the variance was explained by 3 factors: (1) planning, performance, and service awareness (0.827-0.447; 0.858), (2) infrastructure (0.900-0.637; 0.822), and (3) people and processes (0.903-0.311; 0.707). The analyses showed that there are gaps in the capacity of community pharmacy that could be addressed through business and management programs. The theoretical framework of organizational flexibility was useful in highlighting the key areas for stimulating change. To effectively implement services and sustain service delivery, more sophisticated planning and performance monitoring systems are required, supported by changes to infrastructure and staff mix. The critical area for policy makers

  8. Export insurance

    International Nuclear Information System (INIS)

    1981-01-01

    These notes are intended as a general guide for the use of members of the Canadian Nuclear Association who are, or may become, involved in supplying goods or services or contracting/ erecting as part of a contract to supply a nuclear facility to an overseas country. They give information to the type of insurances needed and available, the parties normally responsible for providing the coverages, the intent and operation of the various policies, general methods of charging premiums, and main exclusions

  9. Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset

    Directory of Open Access Journals (Sweden)

    Sun-ju Byeon

    2017-03-01

    Full Text Available Background Pathologic examinations play an important role in medical services. Until recently, the overall status of pathologic examinations in Korea has not been identified. I conducted a nationwide survey of pathologic examination status using the insurance reimbursements (IRs dataset from the Health Insurance Review and Assessment Service (HIRA. The aims of this study were to estimate current pathologic examination status in Korea and to provide information for future resource arrangement in the pathology area. Methods I asked HIRA to provide data on IR requests, including pathologic examinations from 2011 to 2015. Pathologic examination status was investigated according to the following categories: annual statistics, requesting department, type of medical institution, administrative district, and location at which pathologic examinations were performed. Results Histologic mapping, immunohistochemistry, and cervicovaginal examinations have increased in the last 5 years. Internal medicine, general surgery, obstetrics/gynecology, and urology were the most common medical departments requesting pathologic examinations. The majority of pathologic examinations were frequently performed in tertiary hospitals. About 60.3% of pathologic examinations were requested in medical institutions located in Seoul, Gyeonggi-do, and Busan. More than half of the biopsies and aspiration cytologic examinations were performed using outside services. The mean period between IR requests and 99 percentile IR request completion inspections was 6.2 months. Conclusions This survey was based on the HIRA dataset, which is one of the largest medical datasets in Korea. The trends of some pathologic examinations were reflected in the policies and needs for detailed diagnosis. The numbers and proportions of pathologic examinations were correlated with the population and medical institutions of the area, as well as patient preference. These data will be helpful for future

  10. Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach

    OpenAIRE

    Agyepong, Irene A; Aryeetey, Geneieve C; Nonvignon, Justice; Asenso-Boadi, Francis; Dzikunu, Helen; Antwi, Edward; Ankrah, Daniel; Adjei-Acquah, Charles; Esena, Reuben; Aikins, Moses; Arhinful, Daniel K

    2014-01-01

    Background Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured ...

  11. CRITERIA AND FACTORS THAT INSURE THE QUALITY IN PROVISION OF AUDIT SERVICES, DIFFERENT FROM AUDIT

    OpenAIRE

    Antoniuk O.

    2018-01-01

    Introduction. Quality management of audit services requires further theoretical research and development in the field of audit activity and quality of audit, continuous improvement of the organization and methodology in providing audit services. Purpose. The article deals with the theoretical and practical questions of assessing the quality of audit services that are different from the audit in order to identify ways to improve the methodological quality assurance in the provision of thes...

  12. Predictors for increasing eligibility level among home help service users in the Japanese long-term care insurance system.

    Science.gov (United States)

    Kamiya, Kuniyasu; Sasou, Kenji; Fujita, Makoto; Yamada, Sumio

    2013-01-01

    This cross-sectional study described the prevalence of possible risk factors for increasing eligibility level of long-term care insurance in home help service users who were certified as support level 1-2 or care level 1-2 in Japan. Data were collected from October 2011 to November 2011. Variables included eligibility level, grip strength, calf circumference (CC), functional limitations, body mass index, memory impairment, depression, social support, and nutrition status. A total of 417 subjects (109 males and 308 females, mean age 83 years) were examined. There were 109 subjects with memory impairment. When divided by cut-off values, care level 2 was found to have higher prevalence of low grip strength, low CC, and depression. Some potentially modifiable factors such as muscle strength could be the risk factors for increasing eligibility level.

  13. The effects of China’s urban basic medical insurance schemes on the equity of health service utilisation: evidence from Shaanxi Province

    Science.gov (United States)

    2014-01-01

    Introduction In order to alleviate the problem of “Kan Bing Nan, Kan Bing Gui” (medical treatment is difficult to access and expensive) and improve the equity of health service utilisation for urban residents in China, the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) were established in 1999 and 2007, respectively. This study aims to analyse the effects of UEBMI and URBMI on the equity of outpatient and inpatient utilisation in Shaanxi Province, China. Methods Using the data from the fourth National Health Services Survey in Shaanxi Province, the method of Propensity Score Matching was employed to generate comparable samples between the insured and uninsured residents, through a one-to-one match algorithm. Next, based on the matched data, the method of decomposition of the concentration index was employed to compare the horizontal inequity indexes of health service utilisation between the UEBMI/URBMI insured and the matched uninsured residents. Results For the UEBMI insured and matched uninsured residents, the horizontal inequity indexes of outpatient visits are 0.1256 and -0.0511 respectively, and the horizontal inequity indexes of inpatient visits are 0.1222 and 0.2746 respectively. Meanwhile, the horizontal inequity indexes of outpatient visits are -0.1593 and 0.0967 for the URBMI insured and matched uninsured residents, and the horizontal inequity indexes of inpatient visits are 0.1931 and 0.3199 respectively. Conclusions The implementation of UEBMI increased the pro-rich inequity of outpatient utilisation (rich people utilise outpatient facilities more than the poor people) and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation. PMID:24606592

  14. Counseling as an Insured Benefit: Perspectives from the Insurance Industry

    Science.gov (United States)

    Fulton, Wallace C.

    1974-01-01

    Article discusses the feasibility of marriage counseling as an insurance benefit in the future. It is suggested that the physician be used as a marriage counselor in that insurance companies will pay for medical services. (EK)

  15. 77 FR 8725 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2012-02-15

    ... regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by... plans and group health insurance issuers on April 16, 2012. FOR FURTHER INFORMATION CONTACT: Amy Turner... addition, information from HHS on private health insurance for consumers can be found on the CMS Web site...

  16. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ... to the interim final regulations implementing the rules for group health plans and health insurance... dates. These interim final regulations generally apply to group health plans and group health insurance... from HHS on private health insurance for consumers can be found on the Centers for Medicare & Medicaid...

  17. Attracting Health Insurance Buyers through Selective Contracting: Results of a Discrete-Choice Experiment among Users of Hospital Services in the Netherlands

    Directory of Open Access Journals (Sweden)

    Evelien Bergrath

    2014-04-01

    Full Text Available In 2006, the Netherlands commenced market based reforms in its health care system. The reforms included selective contracting of health care providers by health insurers. This paper focuses on how health insurers may increase their market share on the health insurance market through selective contracting of health care providers. Selective contracting is studied by eliciting the preferences of health care consumers for attributes of health care services that an insurer could negotiate on behalf of its clients with health care providers. Selective contracting may provide incentives for health care providers to deliver the quality that consumers need and demand. Selective contracting also enables health insurers to steer individual patients towards selected health care providers. We used a stated preference technique known as a discrete choice experiment to collect and analyze the data. Results indicate that consumers care about both costs and quality of care, with healthy consumers placing greater emphasis on costs and consumers with poorer health placing greater emphasis on quality of care. It is possible for an insurer to satisfy both of these criteria by selective contracting health care providers who consequently purchase health care that is both efficient and of good quality.

  18. Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys

    Directory of Open Access Journals (Sweden)

    Dong Hee Ryu

    2016-03-01

    Full Text Available Objectives: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI and to investigate its influence on their utilization of medical services. Methods: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. Results: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only (‘I’-only and of fixed amount+indemnity-type (‘F+I’ increased, whereas the proportion of holders with fixed amount-type only (‘F’-only decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with ‘F’-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69, whereas subjects with ‘I’-only PMI or ‘F+I’ PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for ‘I’-only: 1.39, 1.63, and 1.38, respectively; ORs for ‘F+I’: 1.67, 2.09, and 1.37, respectively. Conclusions: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

  19. Does the Universal Health Insurance Program Affect Urban-Rural Differences in Health Service Utilization among the Elderly? Evidence from a Longitudinal Study in Taiwan

    Science.gov (United States)

    Liao, Pei-An; Chang, Hung-Hao; Yang, Fang-An

    2012-01-01

    Purpose: To assess the impact of the introduction of Taiwan's National Health Insurance (NHI) on urban-rural inequality in health service utilization among the elderly. Methods: A longitudinal data set of 1,504 individuals aged 65 and older was constructed from the Survey of Health and Living Status of the Elderly. A difference-in-differences…

  20. Health Insurance: Understanding Your Health Plan's Rules

    Science.gov (United States)

    ... to know what your insurance company is paying…Health Insurance: Understanding What It CoversRead Article >>Insurance & BillsHealth Insurance: Understanding What It CoversYour insurance policy lists a package of medical benefits such as tests, drugs, and treatment services. These ...

  1. Differences in health insurance and health service utilization among Asian Americans: method for using the NHIS to identify unique patterns between ethnic groups.

    Science.gov (United States)

    Ruy, Hosihn; Young, Wendy B; Kwak, Hoil

    2002-01-01

    The purpose of this study is to outline a method to identify the characteristics of socioeconomic variables in determining the differences in health insurance coverage and health services utilization patterns for different ethnic groups, using the behavioural model of health service utilization. A sample drawn from Asian American adult respondents to the 1992, 1993, and 1994 National Health Interview Surveys (NHIS) in the USA formed the data set. The results showed Asian Americans as not being homogeneous. There were distinctly different demographic and socioeconomic characteristics between six Asian American ethnic groups that affect health insurance coverage and health service utilization. The study method is useful for constructing health policy and services to address the general public need without adversely affecting smaller minority groups. Secondary analysis of well-constructed national data sets such as the specific Asian ethnic groups in NHIS, offers a rich method for predicting the differential impact of specific health policies on various ethnic groups.

  2. 12 CFR 362.12 - Service corporations of insured State savings associations.

    Science.gov (United States)

    2010-01-01

    .... (B) Equity securities of a company that acquires and retains adjustable-rate and money market...) Acquiring and retaining adjustable-rate and money market preferred stock. A service corporation may engage... instruments held under this paragraph (b)(2)(ii)(B), paragraph (b)(2)(iv) of this section, and § 362.11(b)(2...

  3. Why some countries have national health insurance, others have national health services, and the U.S. has neither.

    Science.gov (United States)

    Navarro, V

    1989-01-01

    This article presents a discussion of why some capitalist developed countries have national health insurance schemes, others have national health services, and the U.S. has neither. The first section provides a critical analysis of some of the major answers given to these questions by authors belonging to the schools of thought defined as 'public choice', 'power group pluralism' and 'post-industrial convergence'. The second section puts forward an alternative explanation rooted in an historical analysis of the correlation of class forces in each country. The different forms of funding and organization of health services, structured according to the corporate model or to the liberal-welfare market capitalism model, have appeared historically in societies with different correlations of class forces. In all these societies the major social force behind the establishment of a national health program has been the labor movement (and its political instruments--the socialist parties) in its pursuit of the welfare state. In the final section the developments in the health sector after World War II are explained. It is postulated that the growth of public expenditures in the health sector and the growth of universalism and coverage of health benefits that have occurred during this period are related to the strength of the labor movement in these countries.

  4. Incoherent policies on universal coverage of health insurance and promotion of international trade in health services in Thailand.

    Science.gov (United States)

    Pachanee, Cha-aim; Wibulpolprasert, Suwit

    2006-07-01

    The Thai government has implemented universal coverage of health insurance since October 2001. Universal access to antiretroviral (ARV) drugs has also been included since October 2003. These two policies have greatly increased the demand for health services and human resources for health, particularly among public health care providers. After the 1997 economic crisis, private health care providers, with the support of the government, embarked on new marketing strategies targeted at attracting foreign patients. Consequently, increasing numbers of foreign patients are visiting Thailand to seek medical care. In addition, the economic recovery since 2001 has greatly increased the demand for private health services among the Thai population. The increasing demand and much higher financial incentives from urban private providers have attracted health personnel, particularly medical doctors, from rural public health care facilities. Responding to this increasing demand and internal brain drain, in mid-2004 the Thai government approved the increased production of medical doctors by 10,678 in the following 15 years. Many additional financial incentives have also been applied. However, the immediate shortage of human resources needs to be addressed competently and urgently. Equity in health care access under this situation of competing demands from dual track policies is a challenge to policy makers and analysts. This paper summarizes the situation and trends as well as the responses by the Thai government. Both supply and demand side responses are described, and some solutions to restore equity in health care access are proposed.

  5. [Methods and Applications to estimate the conversion factor of Resource-Based Relative Value Scale for nurse-midwife's delivery service in the national health insurance].

    Science.gov (United States)

    Kim, Jinhyun; Jung, Yoomi

    2009-08-01

    This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.

  6. DEVELOPMENT OF CUSTOMER RELATIONSHIP MANAGEMENT SYSTEM TO IMPROVE SERVICE QUALITY IN PT MANULIFE LIFE INSURANCE INDONESIA

    Directory of Open Access Journals (Sweden)

    Chriswanto Chriswanto

    2014-10-01

    Full Text Available Customer Relationship Management System (CRMS Development in order to improve service quality in PT. AJ. Manulife Indonesia is done by comprehending the performance model of the company and the factors that are affecting the company performance improvement and the quality of the decision to be taken by top management. System Dynamic is a method that can be used to stimulate complex systems. System Dynamics approach is expected to build a model of corporate performance that can be used to evaluate the quality of service to customers so that they can make decisions quickly and accurately. This study proves that the model is built with standard models used as changing targets and it can simulate a target quality of service to customers by delivering current and future achievement. Achievement in the future is influenced by the value of achievement of SLA, Response Time, and Defect, where the greater value of control, the greater value of the correction rate so that the GAP will be smaller. Correction rate which is determined in this study was 10%, 20%, and 30% of GAP (CB

  7. FACTORS RELATED TO THE USE OF HOME CARE SERVICES BY STROKE PATIENTS UNDER JAPAN’S LONG TERM CARE INSURANCE SYSTEM

    Directory of Open Access Journals (Sweden)

    Kazuya Ikenishi

    2015-01-01

    Full Text Available Introduction: As the population aged 65 years or older in Japan grows, the number of people who receive long-term care is increasing. Amongst the various disease groups, stroke sufferers are currently the largest group who use home care nursing services. This study explores the factors that affect the insurance system’s home care services use rate among stroke patients and their main caregivers in Japan. Aims: This study aims to identify the key factors of stroke patients and that of their main caregivers to determine their relationship with the use situation of home care services under Japan’s long-term care insurance system. Methods: We enrolled 14 subjects and their caregivers in the Tokai and Kinki regions of Japan. Questionnaires were used for the main caregivers and survey forms were used for home care nursing center personnel. The data were analyzed by univariate analysis. Results: Barthel Index (BI score and the number of higher brain function disorders were found to be relevant to the use rate of long-term care insurance:. As a result of removing an outlier, the rate of number of units for home care increased as the BI score fell. Conclusions: Two characteristics of stroke patients were found relevant to the use rate of long-term care insurance: BI score and the number of higher brain function disorders. As a result of removing an outlier, the rate of the number of units for home care nursing increased as the BI score fell.

  8. Insurance industry guide

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This is an insurance industry guide for the independent power industry. The directory includes the insurance company's name, address, telephone and FAX numbers and a description of the company's area of expertise, products and services, and limitations. The directory is international in scope. Some of the companies specialize in independent power projects

  9. Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Padula, William V; Heru, Shiona; Campbell, Jonathan D

    2016-04-01

    Recently, the Massachusetts Group Insurance Commission (GIC) prioritized research on the implications of a clause expressly prohibiting the denial of health insurance coverage for transgender-related services. These medically necessary services include primary and preventive care as well as transitional therapy. To analyze the cost-effectiveness of insurance coverage for medically necessary transgender-related services. Markov model with 5- and 10-year time horizons from a U.S. societal perspective, discounted at 3% (USD 2013). Data on outcomes were abstracted from the 2011 National Transgender Discrimination Survey (NTDS). U.S. transgender population starting before transitional therapy. No health benefits compared to health insurance coverage for medically necessary services. This coverage can lead to hormone replacement therapy, sex reassignment surgery, or both. Cost per quality-adjusted life year (QALY) for successful transition or negative outcomes (e.g. HIV, depression, suicidality, drug abuse, mortality) dependent on insurance coverage or no health benefit at a willingness-to-pay threshold of $100,000/QALY. Budget impact interpreted as the U.S. per-member-per-month cost. Compared to no health benefits for transgender patients ($23,619; 6.49 QALYs), insurance coverage for medically necessary services came at a greater cost and effectiveness ($31,816; 7.37 QALYs), with an incremental cost-effectiveness ratio (ICER) of $9314/QALY. The budget impact of this coverage is approximately $0.016 per member per month. Although the cost for transitions is $10,000-22,000 and the cost of provider coverage is $2175/year, these additional expenses hold good value for reducing the risk of negative endpoints--HIV, depression, suicidality, and drug abuse. Results were robust to uncertainty. The probabilistic sensitivity analysis showed that provider coverage was cost-effective in 85% of simulations. Health insurance coverage for the U.S. transgender population is affordable

  10. Growth in Spending on and Use of Services for Mental and Substance Use Disorders After the Great Recession Among Individuals With Private Insurance.

    Science.gov (United States)

    Mark, Tami L; Hodgkin, Dominic; Levit, Katharine R; Thomas, Cindy Parks

    2016-05-01

    Recessions are associated with increased prevalence of mental and substance use disorders, but their effect on use of behavioral health services is less clear. This study examined changes in spending per enrollee for behavioral health services compared with general medical services among individuals with private insurance following the Great Recession that began in 2007. The National Survey on Drug Use and Health was used to examine the prevalence of behavioral health conditions among persons with private insurance from 2004 to 2013. Truven Health MarketScan Commercial Claims and Encounters data (2004-2012) were used to calculate use of and spending on treatment of behavioral and general medical conditions before and after the recession among individuals with employer-sponsored private health insurance. There was a statistically significant increase in serious psychological distress and episodes of major depression between 2007 and 2010. Between 2004-2009 and 2009-2012, the growth in average annual spending per individual slowed for general medical care (from 6.6% to 3.7%) but accelerated for behavioral health care (from 4.8% to 6.6%). From 2009 to 2012, the percentage of individuals receiving inpatient treatment, outpatient treatment, and prescription drugs for behavioral conditions increased, whereas use of these services for general medical care decreased or remained flat. Out-of-pocket costs increased more slowly for behavioral conditions than for other medical conditions. The recession was associated with increased need for and use of behavioral health services among individuals with private insurance. The Mental Health Parity and Addiction Equity Act may have also played a role in facilitating increasing use of behavioral health services after 2008.

  11. Timely Health Service Utilization of Older Foster Youth by Insurance Type.

    Science.gov (United States)

    Day, Angelique; Curtis, Amy; Paul, Rajib; Allotey, Prince Addo; Crosby, Shantel

    2016-01-01

    To evaluate the impact of a policy change for older foster care youth from a fee-for-service (FFS) Medicaid program to health maintenance organization (HMO) providers on the timeliness of first well-child visits (health care physicals). A three-year retrospective study using linked administrative data collected by the Michigan Departments of Human Services and Community Health of 1,657 youth, ages 10-20 years, who were in foster care during the 2009-2012 study period was used to examine the odds of receiving a timely well-child visit within the recommended 30-day time frame controlling for race, age, days from foster care entry to Medicaid enrollment, and number of foster care placements. Youth entering foster care during the HMO period were more likely to receive a timely well-child visit than those in the FFS period (odds ratio, 2.46; 95% confidence interval, 1.84-3.29; p foster care during the FFS period to 29 days for the HMO period. Among the other factors examined, more than 14 days to Medicaid enrollment, being non-Hispanic black and having five or more placements were negatively associated with receipt of a timely first well-child visit. Those youth who entered foster care during the HMO period had significantly greater odds of receiving a timely first well-child visit; however, disparities in access to preventive health care remain a concern for minority foster care youth, those who experience delayed Medicaid enrollment and those who experienced multiple placements. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Health insurance is important in improving maternal health service utilization in Tanzania-analysis of the 2011/2012 Tanzania HIV/AIDS and malaria indicator survey.

    Science.gov (United States)

    Kibusi, Stephen M; Sunguya, Bruno Fokas; Kimunai, Eunice; Hines, Courtney S

    2018-02-13

    Maternal mortality rates vary significantly from region to region. Interventions such as early and planned antenatal care attendance and facility delivery with skilled health workers can potentially reduce maternal mortality rates. Several factors can be attributed to antenatal care attendance, or lack thereof, including the cost of health care services. The aim of this study was to examine the role of health insurance coverage in utilization of maternal health services in Tanzania. Secondary data analysis was conducted on the nationally representative sample of men and women aged 15-49 years using the 2011/12 Tanzania HIV and Malaria Indicator Survey. It included 4513 women who had one or more live births within three years before the survey. The independent variable was health insurance coverage. Outcome variables included proper timing of the first antenatal care visit, completing the recommended number of antenatal care (ANC) visits, and giving birth under skilled worker. Data were analyzed both descriptively and using regression analyses to examine independent association of health insurance and maternal health services. Of 4513 women, only 281 (6.2%) had health insurance. Among all participants, only 16.9%, 7.1%, and 56.5%, respectively, made their first ANC visit as per recommendation, completed the recommended number of ANC visits, and had skilled birth assistance at delivery. A higher proportion of women with health insurance had a proper timing of 1st ANC attendance compared to their counterparts (27.0% vs. 16.0%, p skilled birth attendance (77.6% vs. 55.1%, p skilled birth attendance (AOR = 2.01, p services were low in this nationally representative sample in Tanzania. Women covered by health insurance were more likely to have proper timing of the first antenatal visit and receive skilled birth assistance at delivery. To improve maternal health, health insurance alone is however not enough. It is important to improve other pillars of health

  13. Exploring the effect of customer orientation on Dana insurance performance considering the intermediary role of customer relations and service quality management

    Directory of Open Access Journals (Sweden)

    Mokhtaran Mahrokh

    2016-01-01

    Full Text Available The aim of the present research was to explore the effect of customer orientation on Dana Insurance Company's performance with a focus on the intermediary role of managing customer relations and services quality. To this end, 180 Dana insurance representatives in Tehran, Iran were randomly sampled. As an applied study in terms of its goal, this research is carried out in a cross-sectional descriptive-survey design. The information was collected through literature review and a questionnaire with 55 items which was validated through expert panel. The reliability of the questionnaire was approved at 0.986 probability level as calculated using Cronbach's Alpha measure. Data analysis was performed at two descriptive and interpretative statistical levels using SPSS software program. The results from regression analysis indicated that customer orientation of Dana insurance company has a significant positive effect on marketing performance, financial performance, and organizational performance. In addition, customer orientation has a significant positive effect on Dana Insurance company's customer relationship management and service quality.

  14. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

  15. Analysis of pharmaceutical assistance in the Taquari Valley, Rio Grande do Sul: profile of service users and access to medication

    Directory of Open Access Journals (Sweden)

    Carla Kauffmann

    2009-12-01

    Full Text Available Pharmaceutical assistance concerns actions developed by the pharmacist and other professionals with the purpose of promoting, protecting and restoring health. Medications are an essential tool in this process that focuses on the access to, and the rational use of, drugs. This study is aimed at evaluating the Pharmaceutical Assistance provided by Municipal Health Offices in the Taquari Valley, Rio Grande do Sul. For this purpose, 2,794 users of public pharmacies were interviewed and data was analyzed using descriptive statistics. The users of the public pharmacies were mainly female and individuals with low educational level and income. On average, 2.41 drugs were prescribed per medical prescription and 1.72 of these were procured. Out of the total medicines prescribed, 76.5% were listed in the municipal standard drug list (SDL. Medication was prescribed by its generic name in 81.8% of the prescriptions. Antibiotics and injections were prescribed in 11.9% and 4.0% of the prescriptions, respectively. Users' access to information is partial, which can impair adherence to the treatment. Thus, it is possible to conclude that review of the service is necessary for it to be effective.A Assistência Farmacêutica se preocupa com ações desenvolvidas pelo farmacêutico ou outros profissionais com o propósito de promover, proteger e restaurar a saúde. Medicamentos são ferramentas essenciais nesse processo, que se concentra no acesso e no uso racional de fármacos. Este estudo objetivou a avaliação da Assitência Farmacêutica suprida pela Secretaria Municipal da Saúde no Vale do Taquari, no Rio Grande do Sul. Com esse propósito, 2.794 usuários das farmácias públicas foram entrevistados e analisaram-se os dados usando estatística descritiva. Os usuários das farmácias públicas eram, principalmente, mulheres e indivíduos com baixo nível educacional e financeiro. Na média, 2,41 fármacos eram prescritos por prescrição médica e 1,72 destes

  16. UTILIZATION OF HEALTH CARE SERVICES AMONG INTERNAL MIGRANTS IN HANOI AND ITS CORRELATION WITH HEALTH INSURANCE: A CROSS-SECTIONAL STUDY.

    Science.gov (United States)

    Le, Anh Thi Kim; Vu, Lan Hoang; Schelling, Esther

    2015-12-01

    Economic transition ( DoiMoi ) in the 1980s in Viet Nam has led to internal migration, particularly rural-to-urban migration. Many studies suggested that there is a difference between non-migrants and migrants in using health care services. Current studies have mostly focused on migrants working in industrial zones (IZs) but migrants working in private small enterprises (PSEs) and seasonal migrants seem to be ignored. However, these two groups of migrants are more vulnerable in health care access than others because they usually work without labor contracts and have no health insurance. The study aims to compare the utilization of health care services and explore its correlated factors among these three groups. This cross-sectional study included 1800 non-migrants and migrants aged 18-55 who were selected through stratified sampling in Long Bien and Ba Dinh districts, Hanoi. These study sites consist of large industrial zones and many slums where most seasonal migrants live in. A structured questionnaire was used to collect information on health service utilization in the last 6 months before the study. Utilization of heath care services was identified as "an ill person who goes to health care centers to seek any treatment (i.e. both private and public health care centers)". 644 of 1800 participants reported having a health problem in the last 6 months before the study. Among these 644 people, 335 people used health care services. The percentage of non-migrants using health care service was the highest (67.6%), followed by migrants working in IZ (53.7%), migrants working in PSE (44%), and seasonal migrants (42%). Multivariate logistic regression showed migrants, especially seasonal migrants and migrants working in PSE, were less likely to use health care services (OR=0.35, p=0.016 and 0.38, p= 0.004, respectively), compared to non-migrants. The study also found that having no health insurance was a risk factor of the utilization (OR=0.29, pincome were not related

  17. The influence of exercise intervention upon quality of life and activity of daily living in elderly people who use nursing care insurance services

    OpenAIRE

    竹内, 亮

    2012-01-01

    The purpose of this study was to confirm the importance of enhancing quality of life (QOL) and activity of daily living (ADL) in elderly people, and to examine methods of exercise intervention for QOL and ADL outcomes in elderly people who use nursing care insurance services. Chapter 2 clarifies the relationship between QOL, ADL, and changes in the level of independence in elderly residents. Higher QOL outcomes (sense of well-being, satisfaction with social support, independence, and beh...

  18. Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults

    OpenAIRE

    Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex

    2017-01-01

    The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as...

  19. Consumer choice of social health insurance in managed competition

    NARCIS (Netherlands)

    Kerssens, Jan J.; Groenewegen, Peter P.

    2003-01-01

    Objective To promote managed competition in Dutch health insurance, the insured are now able to change heaith insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

  20. Consumer choice of social health insurance in managed competition.

    NARCIS (Netherlands)

    Kerssens, J.J.; Groenewegen, P.P.

    2003-01-01

    Objective: To promote managed competition in Dutch health insurance, the insured are now able to change health insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to

  1. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  2. Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea.

    Science.gov (United States)

    Seong, Sang Cheol; Kim, Yeon-Yong; Park, Sue K; Khang, Young Ho; Kim, Hyeon Chang; Park, Jong Heon; Kang, Hee-Jin; Do, Cheol-Ho; Song, Jong-Sun; Lee, Eun-Joo; Ha, Seongjun; Shin, Soon Ae; Jeong, Seung-Lyeal

    2017-09-24

    The National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) is a cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea. The NHIS constructed the NHIS-HEALS cohort database in 2015. The purpose of this cohort is to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker. To construct the NHIS-HEALS database, a sample cohort was first selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 in 2002 and followed up through 2013. This cohort included 514 866 health screening participants who comprised a random selection of 10% of all health screening participants in 2002 and 2003. The age-standardised prevalence of anaemia, diabetes mellitus, hypertension, obesity, hypercholesterolaemia and abnormal urine protein were 9.8%, 8.2%, 35.6%, 2.7%, 14.2% and 2.0%, respectively. The age-standardised mortality rate for the first 2 years (through 2004) was 442.0 per 100 000 person-years, while the rate for 10 years (through 2012) was 865.9 per 100 000 person-years. The most common cause of death was malignant neoplasm in both sexes (364.1 per 100 000 person-years for men, 128.3 per 100 000 person-years for women). This database can be used to study the risk factors of non-communicable diseases and dental health problems, which are important health issues that have not yet been fully investigated. The cohort will be maintained and continuously updated by the NHIS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. The Great Recession, insurance mandates, and the use of in vitro fertilization services in the United States.

    Science.gov (United States)

    Kiatpongsan, Sorapop; Huckman, Robert S; Hornstein, Mark D

    2015-02-01

    To investigate the relationship between economic activities, insurance mandates, and the use of in vitro fertilization (IVF) in the United States. We examined the correlation between the coincident index (a proxy for overall economic conditions) and IVF use at the national level from 2000 to 2011. We then analyzed the relationship at the state level through longitudinal regression models. The base model tested the correlation at the state level. Additional models examined whether this relationship was affected, both separately and jointly, by insurance mandates and the Great Recession. Not applicable. Not applicable. None. Direction and magnitude of the relationship between the coincident index and IVF use, and influences of insurance mandates and the Great Recession. The coincident index was positively correlated with IVF use at the national level (correlation coefficient = 0.89). At the state level, an increase of one unit in the coincident index was associated with an increase of 16 IVF cycles per 1 million women, with a significantly greater increase in IVF use in states with insurance mandates than in states without mandates (27 versus 15 IVF cycles per 1 million women). The Great Recession did not alter the relationship between the coincident index and IVF use. Our study demonstrates a positive relationship between the economy and IVF use, with greater magnitude in states with insurance mandates. This relationship was not affected by the Great Recession regardless of mandated insurance coverage. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. C-C3-04: Neighborhood Socioeconomic Conditions and Use of Preventive Health Care Services in Insured Populations

    Science.gov (United States)

    Doubeni, Chyke; Robinson, Scott; Fouayzi, Hassan; Roblin, Douglas; Field, Terry; Fletcher, Robert

    2010-01-01

    Background and Aims: Several studies have found variations in cancer health outcomes among persons in different socioeconomic (SES) groups, but the presence and extent of such disparities in insured populations is unclear. The objective of this study was to determine whether, among persons enrolled in HMOs, there are differences in the use of services for early detection of cancer according to neighborhood SES. Methods: This was a retrospective cohort study of men and women aged 50+ years, enrolled for at least 1 calendar year beginning in 2000 at one of 3 health plans participating in the Cancer Research Network. Follow-up was to the date of disenrollment from the health plan, or December 31, 2007, whichever was earlier. Using administrative data, we obtained dates of examinations and tests related to screening for colorectal cancer (CRC) for men and women and mammography among women. CRC tests were defined as time to the first colonoscopy or sigmoidoscopy (endoscopy) during the follow-up period; and also time to an endoscopy that was not preceded by gastrointestinal conditions in the 6 months prior to the test. SES neighborhood measure was computed using 12 US Census (2000) measures of racial and SES composition and context at the tract level. Results: A total of 123,222 members, 54% women and average age 64 years, were followed for an average of 5.5 (SD=2.8) years. During 673,938 person-years of follow-up, about 41% had at least 1 endoscopy and 32% had an endoscopy not associated with prior GI-related diagnoses. Among women, 77% had at least 1 mammogram during the study period; 7% had mammograms during each of the first 5 years of follow-up. In Cox regression models, compared to lowest quartile of SES, persons residing in the highest quartile had a hazard ratio (HR) of 0.76: (95% confidence interval (CI): 0.75–0.78) for receipt of any endoscopy; 0.72: (CI: 0.70–0.74) for ‘screening’ endoscopy; and 0.86: (CI: 0.84–0.88) for mammography. Conclusion: Even

  5. Health Insurance

    Science.gov (United States)

    Health insurance helps protect you from high medical care costs. It is a contract between you and your ... Many people in the United States get a health insurance policy through their employers. In most cases, the ...

  6. Pharmaceutical market in Serbia

    Directory of Open Access Journals (Sweden)

    Veselin Tima Dickov

    2012-02-01

    Full Text Available Marketing concept formed around the focus on the consumers, their needs, wants and demands, evolves in the case of pharmaceutical into a care of the complex interest of constituents generating demand on this market and #8211; pres scribers whose role is to select therapies, pharmacists who dispense drugs within a specialized distribution channel to the final consumer -patient, alongside the payers and #8211; the state and or insurance companies refund a part of or total costs of the pharmaceutical product. A special challenge that the subject raises is the existence of controversy generated from two sources. Marketing controversy stems from criticism leveled at the effectiveness and efficiency of marketing activities and the debatable ethical code of conduct. [J Intercult Ethnopharmacol 2012; 1(1.000: 44-51

  7. Insurance crisis

    International Nuclear Information System (INIS)

    Williams, P.L.

    1996-01-01

    The article discusses the effects of financing and technology advances on the availability of insurance for independent power producers operating gas turbines. Combined cycle units which require new materials and processes make it difficult to assess risk. Insurers are denying coverage, or raising prices and deductibles. Many lenders, however, are requiring insurance prior to financing. Some solutions proposed include information sharing by industry participants and insurers and increased risk acceptance by plant owners/operators

  8. 3. Radioactive pharmaceutical medications

    International Nuclear Information System (INIS)

    2006-01-01

    In the chapter common definitions of for radio-pharmacy are given. Radio-pharmacy medications are pharmacy medications which contain minor amount of one or several radionuclides (radioactive tracers), those radiation ability is applying in diagnostic or therapeutic purposes. At the same time radionuclides with more short life time, which are ether gamma-radiators or beta-radiators are applying. The following items for such radioisotopes production; radionuclides applying in nuclear medicine; radio-pharmaceutics; radio-toxicity; quality insurance; order for 18 F-PDG production; radionuclide analysis are considered

  9. Probabilistic Insurance

    NARCIS (Netherlands)

    Wakker, P.P.; Thaler, R.H.; Tversky, A.

    1997-01-01

    Probabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in premium to compensate for a 1% default risk. These observations cannot be

  10. Probabilistic Insurance

    NARCIS (Netherlands)

    P.P. Wakker (Peter); R.H. Thaler (Richard); A. Tversky (Amos)

    1997-01-01

    textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these

  11. Pharmaceutical policy reform in Canada: lessons from history.

    Science.gov (United States)

    Boothe, Katherine

    2018-07-01

    Canada is the only country with a broad public health system that does not include universal, nationwide coverage for pharmaceuticals. This omission causes real hardship to those Canadians who are not well-served by the existing patchwork of limited provincial plans and private insurance. It also represents significant forgone benefits in terms of governments' ability to negotiate drug prices, make expensive new drugs available to patients on an equitable basis, and provide integrated health services regardless of therapy type or location. This paper examines Canada's historical failure to adopt universal pharmaceutical insurance on a national basis, with particular emphasis on the role of public and elite ideas about its supposed lack of affordability. This legacy provides novel lessons about the barriers to reform and potential methods for overcoming them. The paper argues that reform is most likely to be successful if it explicitly addresses entrenched ideas about pharmacare's affordability and its place in the health system. Reform is also more likely to achieve universal coverage if it is radical, addressing various components of an effective pharmaceutical program simultaneously. In this case, an incremental approach is likely to fail because it will not allow governments to contain costs and realize the social benefits that come along with a universal program, and because it means forgoing the current promising conditions for achieving real change.

  12. An empirical investigation on factors influencing customer loyalty and their relationships with quality of services: A case study of insurance firm

    Directory of Open Access Journals (Sweden)

    Rostam Pourrahidi

    2014-01-01

    Full Text Available In this paper, we present an empirical investigation to study the effect of various factors influencing customer loyalty and quality of services on customer satisfaction and customer loyalty. The proposed study is implemented in one of Iranian insurance firms by choosing a sample of 171 randomly selected customers of this insurance firm. We use SERVQUAL standard questionnaire to measure customer satisfaction. The study examines three hypotheses associated with the proposed study using one-way t-student as well as path analysis, and the results have confirmed all three hypotheses. The study also uses Freedman test to rank the most important factors and detects that value was the most important issue followed by trust, customer satisfaction, empathy, value and resistance to change.

  13. [Incidence and prevalence of disabled rheumatic patients. A socio-epidemiological study on the services of the disability insurance system in the canton of Berne].

    Science.gov (United States)

    Blatter, L A; Cloetta, B

    1985-06-01

    The incidence and prevalence of patients with musculoskeletal disorders benefiting from the Swiss invalidity insurance system in the Canton of Berne, Switzerland, are studied. During a 5-year period 1252 such patients (393 women) first received either payments or were supported by rehabilitation measures (incidence). The correlation of this incidence with sociodemographic factors such as sex, age, disease pattern, place of residence and occupation, as well as the type of service delivered, are analyzed and discussed. At a given date (March 1982) 2754 patients with musculoskeletal disorders were receiving insurance pension (prevalence). By relating these figures to census data (total population), a 1.37% 5-year benefit incidence and a 3.02% pension prevalence can be calculated.

  14. 77 FR 16264 - Manufacturer of Controlled Substances, Notice of Registration; Johnson Matthey Pharmaceutical...

    Science.gov (United States)

    2012-03-20

    ..., Notice of Registration; Johnson Matthey Pharmaceutical Materials Inc. By Notice dated November 18, 2011... Pharmaceutical Materials Inc., Pharmaceutical Service, 25 Patton Road, Devens, Massachusetts 01434, made... Matthey Pharmaceutical Materials Inc. to manufacture the listed basic classes of controlled substances is...

  15. Effect of having private health insurance on the use of health care services: the case of Spain

    Directory of Open Access Journals (Sweden)

    David Cantarero-Prieto

    2017-11-01

    Full Text Available Abstract Background Several stakeholders have undertaken initiatives to propose solutions towards a more sustainable health system and Spain, as an example of a European country affected by austerity measures, is looking for ways to cut healthcare budgets. Methods The aim of this paper is to study the effect of private health insurance on health care utilization using the latest micro-data from the European Community Household Panel (ECHP, the Spanish National Health Survey (SNHS and the European Union Statistics on Income and Living Conditions (EU-SILC. We use matching techniques based on propensity score methods: single match, four matches, bias-adjustment and allowing for heteroskedasticity. Results The results demonstrate that people with a private health insurance, use the public health system less than individuals without double health insurance coverage. Conclusions Our conclusions are useful when policy makers design public-private partnership policies.

  16. Has the free maternal health policy eliminated out of pocket payments for maternal health services? Views of women, health providers and insurance managers in Northern Ghana.

    Directory of Open Access Journals (Sweden)

    Philip Ayizem Dalinjong

    Full Text Available The free maternal health policy was implemented in Ghana in 2008 under the National Health Insurance Scheme (NHIS. The policy sought to eliminate out of pocket (OOP payments and enhance the utilisation of maternal health services. It is unclear whether the policy had altered OOP payments for services. The study explored views on costs and actual OOP payments during pregnancy. The source of funding for payments was also explored.A convergent parallel mixed methods design, involving quantitative and qualitative data collection approaches. The study was set in the Kassena-Nankana municipality, a rural area in Ghana. Women (n = 406 who utilised services during pregnancy were surveyed. Also, 10 focus groups discussions (FGDs were held with women who used services during pregnancy as well as 28 in-depth interviews (IDIs with midwives/nurses (n = 25 and insurance managers/directors (n = 3. The survey was analysed using descriptive statistics, focussing on costs from the women's perspective. Qualitative data were audio recorded, transcribed and translated verbatim into English where necessary. The transcripts were read and coded into themes and sub-themes.The NHIS did not cover all expenses in relation to maternal health services. The overall mean for OOP cost during pregnancy was GH¢17.50 (US$8.60. Both FGDs and IDIs showed that women especially paid for drugs and ultrasound scan services. Sixty-five percent of the women used savings, whilst twenty-two percent sold assets to meet the OOP cost. Some women were unable to afford payments due to poverty and had to forgo treatment. Participants called for payments to be eliminated and for the NHIS to absorb the cost of emergency referrals. All participants admitted the benefits of the policy.Women needed to make payments despite the policy. Measures should be put in place to eliminate payments to enable all women to receive services and promote universal health coverage.

  17. Simulation Of Premi Calculation Claims Insurance Base On Web; Case Study PT. Sinarmas Insurance Padang

    OpenAIRE

    Rohendi, Keukeu; Putra, Ilham Eka

    2016-01-01

    Sinarmas currently has several insurance services featured. To perform its function as a good insurance company is need for reform in terms of services in the process of calculating insurance premiums of insurance carried by marketing to use a calculator which interferes with the activities of marketing activities, slow printing insurance policies, automobile claims process that requires the customer to come to the office ASM, slow printing of Work Order (SPK) and the difficulty recap custome...

  18. The Impact of Community Based Health Insurance in Enhancing Better Accessibility and Lowering the Chance of Having Financial Catastrophe Due to Health Service Utilization: A Case Study of Savannakhet Province, Laos.

    Science.gov (United States)

    Bodhisane, Somdeth; Pongpanich, Sathirakorn

    2017-07-01

    The Lao population mostly relies on out-of-pocket expenditures for health care services. This study aims to determine the role of community-based health insurance in making health care services accessible and in preventing financial catastrophe resulting from personal payment for inpatient services. A cross-sectional study design was applied. Data collection involved 126 insured and 126 uninsured households in identical study sites. Two logistic regression models were used to predict and compare the probability of hospitalization and financial catastrophe that occurred in both insured and uninsured households within the previous year. The findings show that insurance status does not significantly improve accessibility and financial protection against catastrophic expenditure. The reason is relatively simple, as catastrophic health expenditure refers to a total out-of-pocket payment equal to or more than 40% of household income minus subsistence. When household income declines as a result of inability to work due to illness, the 40% threshold is quickly reached. Despite this, results suggest that insured households are not significantly better off under community-based health insurance. However, compared to uninsured households, insured households do have better accessibility and a lower probability of reaching the financial catastrophe threshold.

  19. Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults.

    Science.gov (United States)

    Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex

    2017-01-01

    The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options. However, most published research on this population does not systematically look at effects before and after full implementation of the ACA. As the US Congress considers new health policy reforms, current and accurate data on this vulnerable population are essential. Weighted estimates, trend analyses and analytic models were conducted using the 1998-2016 National Health Interview Surveys (NHIS) and the 2014 Medical Expenditure Panel Survey. Compared with working-age adults without disabilities, those with disabilities are less likely to work, more likely to earn below the federal poverty level, and more likely to use public insurance. Average health costs for this population are 3 to 7 times higher, and access problems are far more common. Repeal of key features of the ACA, like Medicaid expansion and marketplace subsidies, would likely diminish health care access for working-age adults with disabilities.

  20. Building intentions with the Theory of Planned Behaviour: the mediating role of knowledge and expectations in implementing new pharmaceutical services in Malaysia.

    Science.gov (United States)

    Tan, Christine L; Gan, Vincent B; Saleem, Fahad; Hassali, Mohamed A

    2016-01-01

    Pharmacy value added services (PVAS) was introduced as a matter of public health policy by Malaysia's Ministry of Health to improve health outcomes through public healthcare services. For example, drive through pharmacy services is a major policy implementation of the Ministry. However, adoption rates are low and therefore hampering the achievement of national health policy goals. Our objective is to explore the key determinants and mediators of successful implementation of new public pharmaceutical services by investigating the cognitive perspectives of patients' intentions to adopt with the Theory of Planned Behavior as the theoretical framework. A two phase mixed methodology involving first a qualitative exploration and the second a quantitative phase was conducted in public health facilities in Negeri Sembilan, Malaysia. Multiple regression and mediation analysis were performed. Subjective norms, perceived behavioural control, knowledge and expectations are found to be significant predictors of intentions to adopt PVAS. Knowledge and expectations are found to exert significant indirect effects on intentions. Overall, we suggest that patient knowledge be enhanced through appropriate channels and expectations of service quality be met to increase intentions.

  1. Building intentions with the Theory of Planned Behaviour: the mediating role of knowledge and expectations in implementing new pharmaceutical services in Malaysia

    Directory of Open Access Journals (Sweden)

    Tan CL

    2016-12-01

    Full Text Available Background: Pharmacy value added services (PVAS was introduced as a matter of public health policy by Malaysia’s Ministry of Health to improve health outcomes through public healthcare services. For example, drive through pharmacy services is a major policy implementation of the Ministry. However, adoption rates are low and therefore hampering the achievement of national health policy goals. Objective: Our objective is to explore the key determinants and mediators of successful implementation of new public pharmaceutical services by investigating the cognitive perspectives of patients’ intentions to adopt with the Theory of Planned Behavior as the theoretical framework. Methods: A two phase mixed methodology involving first a qualitative exploration and the second a quantitative phase was conducted in public health facilities in Negeri Sembilan, Malaysia. Multiple regression and mediation analysis were performed. Results: Subjective norms, perceived behavioural control, knowledge and expectations are found to be significant predictors of intentions to adopt PVAS. Knowledge and expectations are found to exert significant indirect effects on intentions. Conclusion: Overall, we suggest that patient knowledge be enhanced through appropriate channels and expectations of service quality be met to increase intentions.

  2. Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service

    Directory of Open Access Journals (Sweden)

    Yong-ho Lee

    2016-02-01

    Full Text Available In 2014, the National Health Insurance Service (NHIS signed a memorandum of understanding with the Korean Diabetes Association to provide limited open access to its databases for investigating the past and current status of diabetes and its management. NHIS databases include the entire Korean population; therefore, it can be used as a population-based nationwide study for various diseases, including diabetes and its complications. This report presents how we established the analytic system of nation-wide population-based studies using the NHIS database as follows: the selection of database study population and its distribution and operational definition of diabetes and patients of currently ongoing collaboration projects.

  3. 77 FR 30377 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2012-05-23

    ... Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations relating to the health insurance premium tax... categories of immigrants described in the Children's Health Insurance Program Reauthorization Act. One...

  4. Nuclear insurance

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The yearbook contains among others the figures of the nuclear insurance line. According to these these the DKVG (German nuclear power plant insurance association) has 102 member insurance companies all registered in the Federal Republic of Germany. By using reinsurance capacities of the other pools at present property insurance amounts to 1.5 billion DM and liability insurance to 200 million DM. In 1991 the damage charges on account of DKV amounted to 3.1 (1990 : 4.3) million DM. From these 0.6 million DM are apportioned to payments and 2.5 million DM to reserves. One large damage would cost a maximum gross sum of 2.2 billion DM property and liability insurance; on account of DKVG 750 million DM. (orig./HSCH) [de

  5. Probabilistic insurance

    OpenAIRE

    Wakker, P.P.; Thaler, R.H.; Tversky, A.

    1997-01-01

    textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these preferences are intuitively appealing they are difficult to reconcile with expected utility theory. Under highly plausible assumptions about the utility function, willingness to pay for probabilistic i...

  6. Utilization of Service Delivery Insurance (Jampersal for Maternal and Child Health Services in 12 Districts/Cities: Eliminate the Socio-cultural Obstacle on Safe Delivery

    Directory of Open Access Journals (Sweden)

    Lestari Handayani

    2014-08-01

    Full Text Available Background: The Government launched Jampersal as one of efforts to suppress the number of Maternal and Infant Mortality Ratio (MMR & IMR as well as a booster to achieve the MDGs by 2015. Delivery assistance seek are influencedby many factors including a socio-cultural factor. This research aimed to provide a study on the socio-cultural role inimproving the utilization of Service Delivery Insurance (Jampersal. Methods: Data about Jampersal was collected throughin-depth interviews, focus group discussion to community leaders, traditional birth attendants, midwives and head of thehealth center. In addition, as a supporting data, a quantitative survey to mothers who gave birth in the last year was alsoconducted. The research was located in 6 province in Indonesia. Each covered one health center in a rural area and one in a urban area. Results: The result of this research showed a strong evidence that rituals or traditions were still mostlyconducted. So the role of traditional birth attendants were still needed. Lack of transportation was to be the main obstacleto acces health facilities. Mean while, social interaction in rural area and a well-developed infrastructure in urban areawere important to enable the accessibility to access health facilities. Midwives were well-accepted by the people who hada good knowledge on health despite having less formal education both in rural or urban area. Labor financing by utilizingJampersal are good but not maximized or tend to be low in certain urban areas. Conclusions: People prefered to chosemidwives as birth attendants financed by Jampersal although some delivered at home. TBAs are still needed for maternal and baby care as well as to assist the implementation of rituals. Midwife-TBAs partnerships already on the right track butthe labor financing by Jampersal only support health care practitioner. Recommendation: Jampersal also support social and cultural-related financing, such as honorarium for TBAs who

  7. Health Insurance Marketplace Public Use Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — A set of seven (7) public use files containing information on health insurance issuers participating in the Health Insurance Marketplace and certified qualified...

  8. Healthcare.gov Insurance Finder Tool

    Data.gov (United States)

    U.S. Department of Health & Human Services — This tool will help you find the health insurance best suited to your needs, whether its private insurance for individuals, families, and small businesses, or public...

  9. Pre-Existing Condition Insurance Plan Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act created the new Pre-Existing Condition Insurance Plan (PCIP) program to make health insurance available to Americans denied coverage by...

  10. Consumer in insurance law

    Directory of Open Access Journals (Sweden)

    Čorkalo Milena

    2016-01-01

    Full Text Available The paper analyses the notion of consumer in the European Union law, and, in particular, the notion of consumer in insurance law. The author highligts the differences between the notion of consumer is in aquis communautaire and in insurance law, discussing whether the consumer can be defined in both field in the same way, concerning that insurance services differ a lot from other kind of services. Having regarded unequal position of contracting parties and information and technical disadvantages of a weaker party, author pleads for broad definition of consumer in insurance law. In Serbian law, the consumer is not defined in consistent way. That applies on Serbian insurance law as well. Therefore, the necessity of precise and broad definition of consumes is underlined, in order to delimit the circle of subject who are in need for protection. The author holds that the issue of determination of the circle of persons entitled to extended protection as consumers is of vital importance for further development of insurance market in Serbia.

  11. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  12. Pharmaceutical penetration of new drug and pharmaceutical market structure in Taiwan: hospital-level prescription of thiazolidinediones for diabetes.

    Science.gov (United States)

    Tsai, Yi-Wen; Wen, Yu-Wen; Huang, Weng-Foung; Kuo, Ken N; Chen, Pei-Fen; Shih, Hsin-Wei; Lee, Yue-Chune

    2010-06-01

    This study used Taiwan's National Health Insurance claim database (years 2000-2005) to examine how thiazolidinediones (TZD), a new class of drugs for diabetes, penetrated into Taiwan's hospitals, and its association with the concentration of all diabetes drugs at the hospital level. We collected 72 monthly summaries of diabetes prescriptions from all hospitals in Taiwan. Hospital-level pharmaceutical concentration was measured by penetration of TZD, defined as monthly market share of TZD in each hospital. Concentration of diabetes drugs was measured by Herfindahl-Hirschman indices. We found a negative association (coefficient = -0.3610) between TZD penetration and concentration of diabetes drug but a positive association between penetration of TZD and the volume of prescribed diabetes drugs (coefficient = 0.4088). In conclusion, hospital characteristics and volume of services determined the concentration of pharmaceuticals at the institution level, reflecting the heterogeneous competition between pharmaceutical companies within each hospital. Institution-level pharmaceutical concentration influences the adoption and penetration of new drugs.

  13. 48 CFR 28.308 - Self-insurance.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS BONDS AND INSURANCE Insurance 28.308 Self-insurance. (a) When it is anticipated that 50 percent or... risks, limits of coverage, assignments of safety and loss control, and legal service responsibilities... projected average loss; and (10) A disclosure of all captive insurance company and re-insurance agreements...

  14. Medical Progress and Supplementary Private Health Insurance

    OpenAIRE

    Reiner Leidl

    2003-01-01

    In many welfare states, tightening financial constraints suggest excluding some medical services, including new ones, from social security coverage. This may create opportunities for private health insurance. This study analyses the performance of supplementary private health insurance (SPHI) in markets for excluded services in terms of population covered, risk selection and insurer profits. Using a utility-based simulation model, the insurance market is described as a composite of sub-market...

  15. School Insurance.

    Science.gov (United States)

    1964

    The importance of insurance in the school budget is the theme of this comprehensive bulletin on the practices and policies for Texas school districts. Also considered is the development of desirable school board policies in purchasing insurance and operating the program. Areas of discussion are: risks to be covered, amount of coverage, values,…

  16. The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study.

    Science.gov (United States)

    Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

    2016-06-07

    In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.

  17. The impact of the healthcare system in Barbados (provision of health insurance and the benefit service scheme) on the use of herbal remedies by Christian churchgoers.

    Science.gov (United States)

    Cohall, D H; Scantlebury-Manning, T; Cadogan-McLean, C; Lallement, A; Willis-O'Connor, S

    2012-06-01

    To determine the impact of health insurance and the government's Benefit Service Scheme, a system that provides free drugs to treat mostly chronic illnesses to persons aged 16 to 65 years, on the use of herbal remedies by Christian churchgoers in Barbados. The eleven parishes of Barbados were sampled over a six-week period using a survey instrument developed and tested over a four-week period prior to administration. Persons were asked to participate and after written informed consent, they were interviewed by the research team. The data were analysed by the use of IBM SPSS version 19. The data were all nominal, so descriptive statistics including counts, the frequencies, odds ratios and percentages were calculated. More than half of the participants (59.2%) were female, a little less than a third (29.9%) were male, and one tenth of the participants (10.9%) did not indicate their gender The majority of the participants were between the ages of 41 and 70 years, with the age range of 51-60 years comprising 26.1% of the sample interviewed. Almost all of the participants were born in Barbados (92.5%). Approximately 33% of the respondents indicated that they used herbal remedies to treat various ailments including chronic conditions. The odds ratio of persons using herbal remedies and having health insurance to persons not using herbal remedies and having health insurance is 1.01 (95% CI 0.621, 1.632). There was an increase in the numbers of respondents using herbal remedies as age increased. This trend continued until the age group 71-80 years which showed a reduction in the use of herbal remedies, 32.6% of respondents compared with 38.3% of respondents in the 61-70-year category. The data demonstrated that only a third of the study population is using herbal remedies for ailments. Health insurance was not an indicator neither did it influence the use of herbal remedies by respondents. The use of herbal remedies may not be associated with affluence. The reduction in

  18. Leadership and change commitment in the life insurance service context in Taiwan: the mediating-moderating role of job satisfaction.

    Science.gov (United States)

    Yang, Yi-Feng

    2011-06-01

    The effects of transformational leadership and satisfaction were studied along with their interconnected effects (mediation and moderation) on commitment to change in the life insurance industry in two samples, sales managers and salespersons. A multiple mediated-moderated regression approach showed mediation and moderation to have statistically significant main effects on change commitment. Transformational leadership and satisfaction made a more important contribution to change commitment while job satisfaction had a mediating and moderating role that could enhance the relationships between leadership and change commitment. This information is of importance in building successful change commitment associations with customers.

  19. Distribution system choice in a service industry: An analysis of international insurance firms operating in the United States

    NARCIS (Netherlands)

    Parente, R.; Choi, B.P.; Slangen, A.H.L.; Ketkar, S.

    2010-01-01

    Service firms play an increasingly important role in the global economy. However, the internationalization strategies of such firms, and especially their distribution system choices, have been underexplored in the international management literature. One specific service industry that has

  20. The economics of health insurance.

    Science.gov (United States)

    Jha, Saurabh; Baker, Tom

    2012-12-01

    Insurance plays an important role in the United States, most importantly in but not limited to medical care. The authors introduce basic economic concepts that make medical care and health insurance different from other goods and services traded in the market. They emphasize that competitive pricing in the marketplace for insurance leads, quite rationally, to risk classification, market segmentation, and market failure. The article serves as a springboard for understanding the basis of the reforms that regulate the health insurance market in the Patient Protection and Affordable Care Act. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. The relationship between leadership style and provision of the first Danish publicly reimbursed cognitive pharmaceutical service--a qualitative multicase study.

    Science.gov (United States)

    Kaae, Susanne; Søndergaard, Birthe; Haugbølle, Lotte Stig; Traulsen, Janine Morgall

    2011-06-01

    Evidence suggests that leadership style is important to the sustainability of cognitive pharmaceutical services, yet only scarce literature on the relationship exists. Support of the sustainability of the first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS), was ascertained through a qualitative study to explore how leadership style shapes the implementation process of the service. Sustainability in this project was defined as the state where those asthma patients whose symptom status is negatively clinically affected (as defined by Global Initiative for Asthma guidelines) by inappropriate inhalation technique are identified and offered the service by pharmacy staff. The study was an exploratory qualitative multicase study that used triangulation of both data sources and methods. A theoretical framework of Bolman and Deal inspired the analysis of how leadership style influenced the local process of implementation of the ITAS. Four pharmacies were selected for the analysis because they differed in terms of leadership actions in their implementation process and achievement of ITAS sustainability. The analysis was inductive and linked factors that influence ITAS provision as perceived by employees with the interpreted leadership style of the owner. Three main themes emerged: (1) the alignment of the owner and staff values, (2) whether owners perceived ITAS development as being under their own control, and (3) whether owners explicated the responsibilities of employees in the implementation process. The themes were interrelated. Pharmacy owner's leadership style was significant to sustainability of the ITAS. A strong wish by the owner to have ITAS implemented was important, followed by aligning the owner's values and visions with those of the employees. The widespread perception by owners that experienced users are not interested in the ITAS needs to be addressed to achieve sustainability. Copyright © 2011 Elsevier

  2. [Pharmaceutical logistic in turnover of pharmaceutical products of Azerbaijan].

    Science.gov (United States)

    Dzhalilova, K I

    2009-11-01

    Development of pharmaceutical logistic system model promotes optimal strategy for pharmaceutical functioning. The goal of such systems is organization of pharmaceutical product's turnover in required quantity and assortment, at preset time and place, at a highest possible degree of consumption readiness with minimal expenses and qualitative service. Organization of the optimal turnover chain in the region is offered to start from approximate classification of medicaments by logistic characteristics. Supplier selection was performed by evaluation of timeliness of delivery, quality of delivered products (according to the minimum acceptable level of quality) and time-keeping of time spending for orders delivery.

  3. Insurance dictionary

    International Nuclear Information System (INIS)

    Mueller-Lutz, H.L.

    1984-01-01

    Special technical terms used in the world of insurance can hardly be found in general dictionaries. This is a gap which the 'Insurance dictionary' now presented is designed to fill. In view of its supplementary function, the number of terms covered is limited to 1200. To make this dictionary especially convenient for ready reference, only the most commonly used translations are given for each key word in any of the four languages. This dictionary is subdivided into four parts, each containing the translation of the selected terms in the three other languages. To further facilitate the use of the booklet, paper of different colours was used for the printing of the German, English, French and Greek sections. The present volume was developed from a Swedish insurance dictionary (Fickordbok Foersaekring), published in 1967, which - with Swedish as the key language- offers English, French and German translations of the basic insurance terms. (orig./HP) [de

  4. 78 FR 14034 - Health Insurance Providers Fee

    Science.gov (United States)

    2013-03-04

    ... Health Insurance Providers Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... insurance for United States health risks. This fee is imposed by section 9010 of the Patient Protection and... insurance for United States health risks. DATES: Written or electronic comments must be received by June 3...

  5. 3 CFR - State Children's Health Insurance Program

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false State Children's Health Insurance Program... Insurance Program Memorandum for the Secretary of Health and Human Services The State Children's Health Insurance Program (SCHIP) encourages States to provide health coverage for uninsured children in families...

  6. 17 CFR 256.924 - Property insurance.

    Science.gov (United States)

    2010-04-01

    ... insurance premiums to protect the service company against losses and damages to owned or leased property... covered, and the applicable premiums. Any dividends distributed by mutual insurance companies shall be credited to the accounts to which the insurance premiums were charged. ...

  7. Connecting pills and people: an ethnography of the pharmaceutical nexus in Odisha, India.

    Science.gov (United States)

    Seeberg, Jens

    2012-06-01

    This article explores the impact of intensive competition within the pharmaceutical industry and among private providers on health care in an Indian city. In-depth interviewing and clinical observation were used over a period of 18 months. Private practitioners and chemists who provided regular services to inhabitants of a poor neighborhood in central Bhubaneswar were included. Fierce competition in private health in Odisha, India, reduced quality of care for the poor. The pharmaceutical industry exploited weak links in the health system to push drugs aggressively, including through illegal channels. The private health market is organized in small "network molecules" that maximize profit at the cost of health. The large private share of health care in India and stiff competition are detrimental for primary care in urban India. Free government services are urgently needed and a planned health insurance scheme should be linked to quality control measures.

  8. Burns in South Korea: An analysis of nationwide data from the Health Insurance Review and Assessment Service.

    Science.gov (United States)

    Oh, Hyunjin; Boo, Sunjoo

    2016-05-01

    The purpose of the study was to identify and describe the incidence of burn injuries in patients seen and treated in South Korea. Characteristics of inpatients and outpatients with burns were analyzed according to gender, age, burn site, and burn severity. This retrospective study examined the characteristics of a stratified sample of burn patients seen and treated in South Korea during the calendar year 2011. The sample was drawn from the national patient database Health Insurance Review and Assessment (HIRA). Approximately 1.71% of the total patients in the Patient Sample of HIRA for 2011 were burn-injured patients. The numbers of patients treated for burns were 913/10(5) males (n=8009) and 1454/10(5) females (n=11,881). Nearly all of these patients (94.1%) were covered by national health insurance and the majority of these patients (80.6%) were treated as outpatients. Nearly half of the burn injuries were of the upper extremities (43.5%), and most of these injuries (71.5%) were rated as second-degree burns. A review of the national data on patients seen and treated for burns in 2011 revealed that people in South Korea may experience higher numbers and more severe cases of burns and burn-related injuries than found in other countries. General burn prevention programs as well as gender- and age-specific prevention strategies are needed to reduce the risk of burns in this population. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  9. CLINICAL AND EPIDEMIOLOGICAL PROFILE OF ELDERLY PATIENTS WITH CHAGAS DISEASE FOLLOWED BETWEEN 2005-2013 BY PHARMACEUTICAL CARE SERVICE IN CEARÁ STATE, NORTHEASTERN BRAZIL

    Directory of Open Access Journals (Sweden)

    Laíse dos Santos PEREIRA

    2015-04-01

    Full Text Available By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%; mean age of 67 years; retired (54.6%; married (51.6 %; high illiteracy rate (40.2%; and family income equal to the minimum wage (51.5%. The predominant clinical forms of Chagas disease were cardiac (65.3% and indeterminate (14.7%. The main electrocardiographic changes were the right bundle branch block (41.0%, associated or not with the anterosuperior left bundle branch block (27.4%. The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%. It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.

  10. Preparation of intravenous cytostatic mixtures: one-year work experience at the Pharmaceutical Service of the Nacional Institute of Oncology and Radiobiology

    International Nuclear Information System (INIS)

    Arbesu Michelena, Antonieta; Jimenez Rodriguez, Deise; Guzman Descondido, Anisley; Masso Maulin, Kenia

    2008-01-01

    From October 2006 to September 2007, which marked the beginning of the preparation of intravenous cytostatic mixtures by the Pharmaceutical Service of the National Institute of Oncology and Radiobiology, a number of results were achieved and then considered for analysis in this paper. The selected indicators included the number of detected and/or avoided medication errors, cytostatics consumption, therapies recovered through centralized preparation and the implementation of Good Practices of Preparation and Pharmacy. The results were compared with those of similar periods of time in previous years. It was observed that the involvement of the pharmacist in the oncological chemotherapy team contributed to recovering costly therapies such as 80 mg Docetaxel, 300 mg Paclitaxel and 150 mg Transtuzomab ampules. One hundred and twenty one patients could potentially benefit from these therapies, mainly those suffering breast cancer. The consumption of cytostatic drugs such as 1 mg Vincristine and 15 mg Bleomycin ampules decreased; the application of technical and economic control evidenced an increased use of 200 mg Cyclophosphamide and 10 mg Cisplatine ampules. Besides, 1,3% medication errors in prescription was detected and avoided, although this is still a high figure. It was concluded that the involvement of a pharmacist in the medical team improves the quality of service in those hospitals that care for oncological patients. It was suggested that a pharmacist should be incorporated into the medical teams of other hospital centers throughout the country since this encourages the implementation of Good Practices of Preparation and contributes to minimizing medication errors. (Author)

  11. 42 CFR 457.618 - Ten percent limit on certain Children's Health Insurance Program expenditures.

    Science.gov (United States)

    2010-10-01

    ... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...

  12. Pharmaceutical Cocrystals

    OpenAIRE

    Korotkova, Elena I.; Kratochvíl, B.

    2014-01-01

    Cocrystals are very interesting and useful product. In this paper the main information about cocrystals is presented. It is shown that cocrystals are solid substances, which consist of few components mixed together. There are a lot of ways of cocrystals production and application. It is shown that cocrystals can be applied in medicine and pharmaceutical industry for improving different properties such as dissolution rate, melting point, solubility, chemical stability etc. Another way of cocry...

  13. The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data.

    Science.gov (United States)

    Kim, JinHee; Rhee, Chin Kook; Yoo, Kwang Ha; Kim, Young Sam; Lee, Sei Won; Park, Yong Bum; Lee, Jin Hwa; Oh, YeonMok; Lee, Sang Do; Kim, Yuri; Kim, KyungJoo; Yoon, HyoungKyu

    2013-01-01

    Patients with high grade chronic pulmonary obstructive disease (COPD) account for much of the COPD-related mortality and incur excessive financial burdens and medical care utilization. We aimed to determine the characteristics and medical care use of such patients using nationwide data from the Korean Health Insurance Review and Assessment Service in 2009. Patients with COPD were identified by searching with the International Classification of Diseases-10th Revision for those using medication. Patients with high grade COPD were selected based on their patterns of tertiary institute visits and medication use. The numbers of patients with high grade COPD increased rapidly in Korea during the study period, and they showed a high prevalence of comorbid disease. The total medical costs were over three times higher in patients with high grade COPD compared with those without it ($3,744 versus $1,183; P system in Korea. Prevention of progression to high grade COPD is important, both clinically and economically.

  14. Pharmaceutical virtue.

    Science.gov (United States)

    Martin, Emily

    2006-06-01

    In the early history of psychopharmacology, the prospect of developing technologically sophisticated drugs to alleviate human ills was surrounded with a fervor that could be described as religious. This paper explores the subsequent history of the development of psychopharmacological agents, focusing on the ambivalent position of both the industry and its employees. Based on interviews with retired pharmaceutical employees who were active in the industry in the 1950s and 1960s when the major breakthroughs were made in the development of MAOIs and SSRIs, the paper explores the initial development of educational materials for use in sales campaigns. In addition, based on interviews with current employees in pharmaceutical sales and marketing, the paper describes the complex perspective of contemporary pharmaceutical employees who must live surrounded by the growing public vilification of the industry as rapacious and profit hungry and yet find ways to make their jobs meaningful and dignified. The paper will contribute to the understudied problem of how individuals function in positions that require them to be part of processes that on one description constitute a social evil, but on another, constitute a social good.

  15. Financial Planning and the Life Insurance Agency

    OpenAIRE

    Robert Puelz

    1992-01-01

    In this article, the effects of fee-for-service personal financial planning on the decision making of a profit-maximizing life insurance general agent are examined. Three refutable propositions are developed which implicate the movements of the general agent who must adjust to a new optimal profit-maximizing allocation of financial planning, personal insurance sales, and agent insurance sales when there is a change in one of the fee or commission rate parameters. It is demonstrated that insur...

  16. Costs and Trends in Utilization of Low-value Services Among Older Adults With Commercial Insurance or Medicare Advantage.

    Science.gov (United States)

    Carter, Elizabeth A; Morin, Pamela E; Lind, Keith D

    2017-11-01

    Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse. Adults 50 and older enrolled in commercial plans and adults 65 and older enrolled in MA plans between 2009 and 2014. Costs and utilization of 16 low-value services in the following categories: cancer screening, imaging, and invasive procedures. The most commonly performed low-value service was imaging of the head for syncope, at rates of 33%-39% in commercial enrollees and 45% in MA enrollees. The least common service was peripheral artery stenting (value service utilization. Greater consistency would facilitate monitoring use of low-value services and changing clinical practice patterns over time.

  17. Group Life Insurance

    CERN Multimedia

    2013-01-01

    The CERN Administration would like to remind you that staff members and fellows have the possibility to take out a life insurance contract on favourable terms through a Group Life Insurance.   This insurance is provided by the company Helvetia and is available to you on a voluntary basis. The premium, which varies depending on the age and gender of the person insured, is calculated on the basis of the amount of the death benefit chosen by the staff member/fellow and can be purchased in slices of 10,000 CHF.    The contract normally ends at the retirement age (65/67 years) or when the staff member/fellow leaves the Organization. The premium is deducted monthly from the payroll.   Upon retirement, the staff member can opt to maintain his membership under certain conditions.   More information about Group Life Insurance can be found at: Regulations (in French) Table of premiums The Pension Fund Benefit Service &...

  18. Nuclear insurance

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The German Nuclear Power Plant Insurance (DKVG) Association was able to increase its net capacity in property insurance to 637 million marks in 1993 (1992: 589 million). The reinsurance capacity of the other pools included, the total amount covered now amounts to 2 billion marks in property incurance and 200 million marks in liability incurance. As in the year before the pool can reckon with a stable gross premium yield around 175 million marks. The revival of the US dollar has played a decisive role in this development. In 1993 in the domestic market, the DKVG offered policies for 22 types of property risk and 43 types to third-party risk, operating with a gross target premium of 65 million marks and 16 million marks, respectively. The DKVG also participated in 540 foreign insurance contracts. (orig./HSCH) [de

  19. Comparing pharmaceutical pricing and reimbursement policies in Croatia to the European Union Member States

    Science.gov (United States)

    Vogler, Sabine; Habl, Claudia; Bogut, Martina; Vončina, Luka

    2011-01-01

    Aim To perform a comparative analysis of the pharmaceutical pricing and reimbursement systems in Croatia and the 27 European Union (EU) Member States. Methods Knowledge about the pharmaceutical systems in Croatia and the 27 EU Member States was acquired by literature review and primary research with stakeholders. Results Pharmaceutical prices are controlled at all levels in Croatia, which is also the case in 21 EU Member States. Like many EU countries, Croatia also applies external price referencing, ie, compares prices with other countries. While the wholesale remuneration by a statutorily regulated linear mark-up is applied in Croatia and in several EU countries, the pharmacy compensation for dispensing reimbursable medicines in the form of a flat rate service fee in Croatia is rare among EU countries, which usually apply a linear or regressive pharmacy mark-up scheme. Like in most EU countries, the Croatian Social Insurance reimburses specific medicines at 100%, whereas patients are charged co-payments for other reimbursable medicines. Criteria for reimbursement include the medicine’s importance from the public health perspective, its therapeutic value, and relative effectiveness. In Croatia and in many EU Member States, reimbursement is based on a reference price system. Conclusion The Croatian pharmaceutical system is similar to those in the EU Member States. Key policies, like external price referencing and reference price systems, which have increasingly been introduced in EU countries are also applied in Croatia and serve the same purpose: to ensure access to medicines while containing public pharmaceutical expenditure. PMID:21495202

  20. Comparing pharmaceutical pricing and reimbursement policies in Croatia to the European Union Member States.

    Science.gov (United States)

    Vogler, Sabine; Habl, Claudia; Bogut, Martina; Voncina, Luka

    2011-04-15

    To perform a comparative analysis of the pharmaceutical pricing and reimbursement systems in Croatia and the 27 European Union (EU) Member States. Knowledge about the pharmaceutical systems in Croatia and the 27 EU Member States was acquired by literature review and primary research with stakeholders. Pharmaceutical prices are controlled at all levels in Croatia, which is also the case in 21 EU Member States. Like many EU countries, Croatia also applies external price referencing, i.e., compares prices with other countries. While the wholesale remuneration by a statutorily regulated linear mark-up is applied in Croatia and in several EU countries, the pharmacy compensation for dispensing reimbursable medicines in the form of a flat rate service fee in Croatia is rare among EU countries, which usually apply a linear or regressive pharmacy mark-up scheme. Like in most EU countries, the Croatian Social Insurance reimburses specific medicines at 100%, whereas patients are charged co-payments for other reimbursable medicines. Criteria for reimbursement include the medicine's importance from the public health perspective, its therapeutic value, and relative effectiveness. In Croatia and in many EU Member States, reimbursement is based on a reference price system. The Croatian pharmaceutical system is similar to those in the EU Member States. Key policies, like external price referencing and reference price systems, which have increasingly been introduced in EU countries are also applied in Croatia and serve the same purpose: to ensure access to medicines while containing public pharmaceutical expenditure.

  1. THE ROLE OF THE WORLD INSURANCE MARKET INFRASTRUCTURE

    Directory of Open Access Journals (Sweden)

    Antonina Sholoiko

    2017-09-01

    Full Text Available The purpose is to define a role and significance of elements of the world insurance market infrastructure. Tasks of the study are the next: to consider the dynamics of development of the world insurance market from 2012 to 2016; to define groups of elements of the world insurance market infrastructure; to characterize elements of the world insurance market infrastructure. Methodology. These tasks are done because of using such methods as: grouping of elements of the world insurance market infrastructure; a collection of information about elements of the world insurance market infrastructure; generalization to define role and significance of elements of the world insurance market infrastructure. Results. World insurance premiums were increasing and decreasing from 2012 to 2016 and did not exceed 6.3% of Gross Domestic Product. Lots of factors influence global insurance premium volume as an indicator of the development of world insurance market. One of them is an activity of the elements of the world insurance market infrastructure. It is necessary to divide them into some groups: A International insurance associations (associations of organizations connected with insurance but members of such associations do not provide insurance services – International Association of Insurance Supervisors, International Association of Insurance Fraud Agencies, Global Federation of Insurance Associations, International Insurance Foundation; B International associations of insurers (includes associations of insurers and other organizations in a certain area of insurance – International Association of Deposit Insurers, International Union of Credit and Investment Insurers, International Association of Agricultural Production Insurers, International Group of P&I Clubs, International Union of Aerospace Insurers, International Union of Marine Insurance, International Association of Engineering Insurers; C International associations of insurance experts

  2. Inflation Insurance

    OpenAIRE

    Zvi Bodie

    1989-01-01

    A contract to insure $1 against inflation is equivalent to a European call option on the consumer price index. When there is no deductible this call option is equivalent to a forward contract on the CPI. Its price is the difference between the prices of a zero coupon real bond and a zero coupon nominal bond, both free of default risk. Provided that the risk-free real rate of interest is positive, the price of such an inflation insurance policy first rises and then falls with time to maturity....

  3. [The significance of a large number of health insurance funds and fusions for health services research with statutory health insurance data in Germany - experiences of the lidA study].

    Science.gov (United States)

    March, S; Powietzka, J; Stallmann, C; Swart, E

    2015-02-01

    Since 1970 the health insurance system in Germany has shrunk by more than 90% to 132 statutory health insurance funds (SHI) at present. For studies using data from different SHI, this development means a reduction of contacts and a higher workload when requesting data. The latter is due to the fact that fusions bind resources in the health insurance funds. In order to avoid selection in studies among the insured, all SHI must be contacted. Additionally, 15 controlling institutions on the state and national level have to agree as determined in § 75 of the German Social Code number 10. The lidA study - a German cohort study on work, age and health intends to link primary and secondary data from all SHI of those insured who have given their agreement for participation. Since the beginning of the study in 2009 the number of SHI has been reduced by 70. Of the 6 585 interviews in 2011 approximately half of the interviewees agreed in written form that their individual health insurance data can be linked. This portion of the insured is dispersed among 95 SHI. At this point, 11 contracts with SHI are realised (approximately 50% of the insured) and 8 data controlling authorities have been contacted. The problems involved in the fusion of SHI and its meaning for research are explained in this article. The fusion of SHI makes sense for the long term. It will lead to a reduction of contacts and contracts that researchers have to establish in order to analyse the data. Therefore, this article also discusses the alternative of creating a meta-data set of all the data from the different SHI combined. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Features of insurance evolution in the Internet expansion

    Directory of Open Access Journals (Sweden)

    A.Yu. Polchanov

    2015-03-01

    Full Text Available The article investigates the features of the development of insurance in the Internet expansion. Increasing the number of mobile subscribers, Internet users and social networking, as well as owners of smartphones changes the decision-making process on insurance, marketing of insurance services, the mechanism of interaction between participants of insurance relations. As a result, insurance companies and intermediaries should adjust strategies and innovate to maintain their competitive advantage. The research examined the functioning of the foreign experience of P2P insurance (for example «Friendsurance», microinsurance using mobile payment instruments (for example «Kilimo Salama», cyber-risks insurance (for example «AIG», and the possibility of using digital currencies in insurance in particular Bitcoin. According to the results of investigation the question asked to clarify a number of basic insurance terms, including money payment, the order of payment of insurance premiums, the insurance event and risk, the insurance intermediary.

  5. Impact of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany.

    Science.gov (United States)

    Claassen, Kevin; Jäger, Pia

    2018-04-25

    Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence regarding its actual impact on the use of medical services. The aim of the study is to examine this impact on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). Study Design: For this purpose, a standardized survey was conducted with 260 asylum seekers in different municipalities, some of which have introduced the EHIC for asylum seekers, while others have not. Methods: The period prevalence was compared between the groups “with EHIC” and “without EHIC” using a two-sided t -test. Multivariate analysis was done using a linear OLS regression model. Results: Asylum seekers in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Conclusions: The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers.

  6. 75 FR 54232 - Proposed Collection; Comment Request for Report of Covered Pharmaceutical Manufacturers and...

    Science.gov (United States)

    2010-09-03

    ... Report of Covered Pharmaceutical Manufacturers and Importers (Form-8947) AGENCY: Internal Revenue Service...)). Currently, the IRS is soliciting comments concerning Form-8947, Report of Covered Pharmaceutical...: Title: Report of Covered Pharmaceutical Manufacturers and Importers. OMB Number: 1545-XXXX. Form Number...

  7. 78 FR 19017 - Manufacturer of Controlled Substances; Notice of Application; Johnson Matthey Pharmaceutical...

    Science.gov (United States)

    2013-03-28

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration Manufacturer of Controlled Substances; Notice of Application; Johnson Matthey Pharmaceutical Materials, Inc. Pursuant to Sec. 1301.33(a), Title... Matthey Pharmaceutical Materials, Inc., Pharmaceutical Service, 25 Patton Road, Devens, Massachusetts...

  8. SIMULATION OF THE INSURANCE COMPANY’S MARKETING STRATEGY

    Directory of Open Access Journals (Sweden)

    О. Klepikova

    2013-05-01

    Full Text Available The article is devoted the development of marketing strategy of the insurance company with using of mathematical modeling of structures. The algorithm was developed for calculating the coefficient of “probability of insurance policy acquisition” which accumulates the influence of factors related to the feature of providing insurance services and financial activities of the insurance company.

  9. The role of the State Security Service (Stasi) in the context of international clinical trials conducted by western pharmaceutical companies in Eastern Germany (1961-1990).

    Science.gov (United States)

    Erices, Rainer; Frewer, Andreas; Gumz, Antje

    2018-01-01

    After the building of the Berlin Wall in the 1960s, a number of international pharmaceutical manufacturers from the West had their drugs tested in Eastern Germany (GDR). So far, the extensive collection of documents on the subject stored in the archives of the GDR State Security Service (Stasi, MfS) has not been systematically analysed. Until now, the role of the Stasi with respect to the surveillance of the trials has been unclear. A keyword search within the database of the Stasi files was conducted. All available files were screened in order to identify institutions, companies and personnel involved in the clinical trials. On this basis, further files were requested. A total of 259 files were available for analysis. Relevant data was derived from 160 of these files. A contextualised approach was applied, which critically explored the origin, content, and impact of the data. In addition, an approach guided by the central steps of document analysis was applied. At least 400 clinical trials were conducted during the GDR period. The exact number remains speculative. According to references found in the Stasi files, it might have been considerably higher. Initially, the main goal of the trials was for the GDR authorities to decide whether to import certain Western drugs. By 1983, this intention had changed. Now, the primary aim of the trials was the procurement of foreign currency. The Stasi feared that the pharmaceutical companies could have a significant influence on GDR Health System. Stasi spies were holding positions in the responsible medical committees, universities, and hospitals. Constant surveillance by the Stasi served the purpose of monitoring any contact between people from the West and the East. Unknowingly, representatives of Western companies were surveilled by the Stasi. The studied documents also point to the fact that a number of clinical trials conducted during the GDR period did not comply with GDR regulations, and were therefore deemed illegal

  10. 77 FR 47573 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Science.gov (United States)

    2012-08-09

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 40 and 46 [REG-136008-11] RIN 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... on issuers of certain health insurance policies and plan sponsors of certain self-insured health...

  11. How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?

    Science.gov (United States)

    Trish, Erin E; Herring, Bradley J

    2015-07-01

    The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Financiamento da assistência farmacêutica no sistema único de saúde Financing of pharmaceutical services in Brazilian public health system

    Directory of Open Access Journals (Sweden)

    Fabiola Sulpino Vieira

    2013-03-01

    Full Text Available Objetivos. Descrever e discutir a evolução do financiamento da assistência farmacêutica no Sistema Único de Saúde - SUS. Métodos. Foram identificados os valores alocados para aquisição de medicamentos, para o Programa Farmácia Popular e para estruturação de serviços farmacêuticos públicos. Os valores referentes ao financiamento da União, por meio do Ministério da Saúde, foram obtidos do sistema Siga Brasil e, dos Estados, do Distrito Federal e dos municípios, do Sistema de Informações sobre Orçamentos Públicos em Saúde - SIOPS. Resultados. Entre 2005 e 2009 houve aumento de 65,3% nos recursos financeiros da União para aquisição de medicamentos. No mesmo período, ampliou-se o volume de transferências feitas às esferas subnacionais. Verificou-se que os Estados e o Distrito Federal aumentaram em 112,4% o volume de recursos próprios alocados no financiamento de medicamentos e que para os municípios este crescimento foi de 22,7%. Em 2008, a participação das despesas com medicamentos em relação às despesas com saúde foi de 7,8%. O gasto total com medicamentos em 2009 foi de 8,9 bilhões de reais. Observou-se aumento de 20,6 vezes no valor alocado no Programa Farmácia Popular e, no caso dos recursos destinados à estruturação de serviços, crescimento de 41,6%, chegando a 10,1 milhões de reais em 2009. Conclusão: Houve ampliação do financiamento de medicamentos no SUS entre 2005 e 2009.Objectives. To describe and discuss developments in the financing of pharmaceutical services in the Brazilian public health system - SUS. Methods. The amounts allocated for drug procurement, for the Farmácia Popular Program and for structuring of public pharmaceutical services were identified. The values regarding the financing of the Federal government were obtained from the Siga Brasil database. Data regarding states, Federal District and municipalities were obtained from Information System on Public Health Budget - SIOPS

  13. CUSTOMER COST - SECOND IMPORTANT FACTOR FOR IMAGE GAP ANALYSIS OF LIFE INSURANCE SERVICES - BASED ON THE DATA COLLECTION FROM GUWAHATI

    OpenAIRE

    Pankaj Bihani; Prof. Amalesh Bhowal

    2017-01-01

    The concept of Customer Cost was developed by Lauterborn (1990) while developing the customer oriented Marketing Mix- the 4C concept. 4C model replaces the earlier 4Ps of Marketing Mix, here the focus is on customer and the current chapter is all about the second C of this model i.e. Customer Cost or Price in earlier 4P model. The Customer Cost concept is based on the fact that customers are more concerned with the total cost of acquiring a solution of their problem (Product or Service) rathe...

  14. Crop insurance: Risks and models of insurance

    Directory of Open Access Journals (Sweden)

    Čolović Vladimir

    2014-01-01

    Full Text Available The issue of crop protection is very important because of a variety of risks that could cause difficult consequences. One type of risk protection is insurance. The author in the paper states various models of insurance in some EU countries and the systems of subsidizing of insurance premiums by state. The author also gives a picture of crop insurance in the U.S., noting that in this country pays great attention to this matter. As for crop insurance in Serbia, it is not at a high level. The main problem with crop insurance is not only the risks but also the way of protection through insurance. The basic question that arises not only in the EU is the question is who will insure and protect crops. There are three possibilities: insurance companies under state control, insurance companies that are public-private partnerships or private insurance companies on a purely commercial basis.

  15. Internet pharmaceutical sales: attributes, concerns, and future forecast.

    Science.gov (United States)

    Bruckel, Katy; Capozzoli, Ernest A

    2003-01-01

    Internet pharmaceutical sales continue to skyrocket as healthcare providers and consumers are increasingly relying on the efficiencies and convenience that is available via such transactions. Managed care companies, increasing demands to reduce healthcare inefficiencies while maximizing the quality of patient care is a significant contributing factor to the expanding utilization and success of online pharmaceutical sales. However, with the expansion of Internet pharmaceutical sales, healthcare providers, pharmacy benefit management and insurance companies, and consumers realize new opportunities and risks. This paper will review the attributes and concerns associated with online pharmaceutical sales, discussing current and pending legislation intended to more effectively manage these parameters.

  16. HEALTH INSURANCE

    CERN Multimedia

    Division HR

    2000-01-01

    Change of name for AUSTRIA As of October 1, the AUSTRIA Assurances S.A. company will change its name to: UNIQA Assurances S.A. It inherits the same name as its parent Austrian company, which adopted it towards the end of 1999. This change has no effect on the contract which binds it to CERN for the administration of our Health Insurance Scheme. New insurance cards will be sent to you by UNIQA and the printed forms and envelopes will gradually be updated with the new name. Postal and phone addresses remain unaffected by the change. You should address your postal mail to: UNIQA Assurances rue des Eaux Vives 94 case postale 6402 1211 Genève 6 You may telephone your usual contact persons at the same numbers as before and send e-mails to the UNIQA office at CERN at: UNIQA.Assurances@cern.ch

  17. Pharmaceutical powder compaction technology

    National Research Council Canada - National Science Library

    Çelik, Metin

    2011-01-01

    "Revised to reflect modern pharmaceutical compacting techniques, this Second Edition guides pharmaceutical engineers, formulation scientists, and product development and quality assurance personnel...

  18. HEALTH INSURANCE

    CERN Multimedia

    2000-01-01

    The CERN-AUSTRIA Agreement, which implemented CERN's health insurance scheme, expired on 31 December 1999.In accordance with CERN's rules, a call for tenders for the management of the health insurance scheme was issued and the contract was once again awarded to AUSTRIA. In June 1999, the Finance Committee thus authorised the Management to conclude a new contract with AUSTRIA, which came into force on 1st January 2000.Continuity is thus assured on favourable conditions and the transition from one contract to the other will entail no substantial changes in the system for those insured at CERN except for a few minor and purely formal amendmentsWHAT REMAINS UNCHANGEDThe list of benefits, i.e. the 'cover' provided by the system, is not changed;Neither is the reimbursement procedure.AUSTRIA's office at CERN and its opening hours as well as its city headquarters remain the same. The envelopes containing requests for reimbursement have had to be sent (since the end of 1998) to :Rue des Eaux-Vives 94Case postale 64021...

  19. Trends in the prevalence of metabolic syndrome and its components in South Korea: Findings from the Korean National Health Insurance Service Database (2009–2013)

    Science.gov (United States)

    Lee, Seung Eun; Han, Kyungdo; Kang, Yu Mi; Kim, Seon-Ok; Cho, Yun Kyung; Ko, Kyung Soo; Park, Joong-Yeol; Lee, Ki-Up

    2018-01-01

    Background The prevalence of metabolic syndrome has markedly increased worldwide. However, studies in the United States show that it has remained stable or slightly declined in recent years. Whether this applies to other countries is presently unclear. Objectives We examined the trends in the prevalence of metabolic syndrome and its components in Korea. Methods The prevalence of metabolic syndrome and its components was estimated in adults aged >30 years from the Korean National Health Insurance Service data from 2009 to 2013. The revised National Cholesterol Education Program criteria were used to define metabolic syndrome. Results Approximately 10 million individuals were analyzed annually. The age-adjusted prevalence of metabolic syndrome increased from 28.84% to 30.52%, and the increasing trend was more prominent in men. Prevalence of hypertriglyceridemia, low HDL-cholesterol, and impaired fasting plasma glucose significantly increased. However, the prevalence of hypertension decreased in both genders. The prevalence of abdominal obesity decreased in women over 50 years-of-age but significantly increased in young women and men (metabolic syndrome is still increasing in Korea. Trends in each component of metabolic syndrome are disparate according to the gender, or age groups. Notably, abdominal obesity among young adults increased significantly; thus, interventional strategies should be implemented particularly for this age group. PMID:29566051

  20. The prevalence of Behçet's disease in Korea: data from Health Insurance Review and Assessment Service from 2011 to 2015.

    Science.gov (United States)

    Kim, Ji Na; Kwak, Sang Gyu; Choe, Jung-Yoon; Kim, Seong-Kyu

    2017-01-01

    The aim of this study is to identify the prevalence of Behçet's disease (BD) from data in the Healthcare Bigdata Hub of the Health Insurance Review & Assessment (HIRA) Service from 2011 to 2015 in Korea. This study collected information on primary and auxiliary diagnoses of BD (M352) by physicians according to the Korean Standard Classification of Diseases (KCD) codes. The prevalence of BD was assessed on the basis of age, sex, and geographical distribution. We used time series analysis, using the ARIMA model for the expected prevalence of BD from 2016 to 2025. The overall prevalence of BD was gradually increased, ranging from 32.8 to 35.7 per 100,000 population over the study period. The male to female ratio of BD ranged from 0.54:1 to 0.56:1, revealing a female predominance from 2011 to 2015. Among five districts in Korea, the prevalence in the Seoul Metropolitan district was the highest, with a slowly increasing trend for the study period, accounting for about 60.3% of total BD patients. The expected prevalence of BD patients was estimated to range from 36.9 (95% CI 35.0 - 39.0) to 44.7 (95% CI 40.2 - 49.6) between 2016 and 2025. This study found that the overall prevalence of BD is estimated to be approximately 35.0 per 100,000 population, with female predominance, and predicts gradually increased prevalence of BD in Korea.

  1. Conversion of National Health Insurance Service-National Sample Cohort (NHIS-NSC) Database into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM).

    Science.gov (United States)

    You, Seng Chan; Lee, Seongwon; Cho, Soo-Yeon; Park, Hojun; Jung, Sungjae; Cho, Jaehyeong; Yoon, Dukyong; Park, Rae Woong

    2017-01-01

    It is increasingly necessary to generate medical evidence applicable to Asian people compared to those in Western countries. Observational Health Data Sciences a Informatics (OHDSI) is an international collaborative which aims to facilitate generating high-quality evidence via creating and applying open-source data analytic solutions to a large network of health databases across countries. We aimed to incorporate Korean nationwide cohort data into the OHDSI network by converting the national sample cohort into Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM). The data of 1.13 million subjects was converted to OMOP-CDM, resulting in average 99.1% conversion rate. The ACHILLES, open-source OMOP-CDM-based data profiling tool, was conducted on the converted database to visualize data-driven characterization and access the quality of data. The OMOP-CDM version of National Health Insurance Service-National Sample Cohort (NHIS-NSC) can be a valuable tool for multiple aspects of medical research by incorporation into the OHDSI research network.

  2. Diabetes, Frequency of Exercise, and Mortality Over 12 Years: Analysis of the National Health Insurance Service-Health Screening (NHIS-HEALS) Database.

    Science.gov (United States)

    Shin, Woo Young; Lee, Taehee; Jeon, Da Hye; Kim, Hyeon Chang

    2018-02-19

    The goal of this study was to analyze the relationship between exercise frequency and all-cause mortality for individuals diagnosed with and without diabetes mellitus (DM). We analyzed data for 505,677 participants (53.9% men) in the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort. The study endpoint variable was all-cause mortality. Frequency of exercise and covariates including age, sex, smoking status, household income, blood pressure, fasting glucose, body mass index, total cholesterol, and Charlson comorbidity index were determined at baseline. Cox proportional hazard regression models were developed to assess the effects of exercise frequency (0, 1-2, 3-4, 5-6, and 7 days per week) on mortality, separately in individuals with and without DM. We found a U-shaped association between exercise frequency and mortality in individuals with and without DM. However, the frequency of exercise associated with the lowest risk of all-cause mortality was 3-4 times per week (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.65-0.73) in individuals without DM, and 5-6 times per week in those with DM (HR, 0.93; 95% CI, 0.78-1.10). A moderate frequency of exercise may reduce mortality regardless of the presence or absence of DM; however, when compared to those without the condition, people with DM may need to exercise more often. © 2018 The Korean Academy of Medical Sciences.

  3. MARKETING CHARACTERISTICS OF INSURANCE MARKET IN UKRAINE

    Directory of Open Access Journals (Sweden)

    А. Sabirova

    2014-03-01

    Full Text Available The current state of the insurance market of Ukraine in the post-crisis period, by comparison with the pre-crisis was investigated in the paper. The insurance market in the pre-crisis period grew rapidly, but was unable to withstand the economic crisis and suffered a crushing blow. The economic crisis of 2008-2009 led to a decrease of the demand for financial services in general and insurance services in particular. The lack of development of the insurance market created high barriers for responding and adapting to changes that occurred during the crisis.

  4. Structural changes in the German pharmaceutical market: price setting mechanisms based on the early benefit evaluation.

    Science.gov (United States)

    Henschke, Cornelia; Sundmacher, Leonie; Busse, Reinhard

    2013-03-01

    In the past, free price setting mechanisms in Germany led to high prices of patented pharmaceuticals and to increasing expenditures in the pharmaceutical sector. In order to control patented pharmaceutical prices and to curb increasing pharmaceutical spending, the Act for Restructuring the Pharmaceutical Market in Statutory Health Insurance (AMNOG) came into effect on 1st January 2011. In a structured dossier, pharmaceutical manufacturers have to demonstrate the additional therapeutic benefit of the newly approved pharmaceutical compared to its appropriate comparator. According to the level of additional benefit, pharmaceuticals will be subject to price negotiations between the Federal Association of Statutory Health Insurance Funds and the pharmaceutical company concerned (or assigned to a reference price group in case of no additional benefit). Therefore, the health care reform is a first step to decision making based on "value for money". The process of price setting based on early benefit evaluation has an impact on the German as well as the European pharmaceutical markets. Therefore, these structural changes in Germany are of importance for pricing decisions in many European countries both from a political point of view and for strategic planning for pharmaceutical manufacturers, which may have an effect on insured patients' access to pharmaceuticals. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Considerations on Albanian Life Insurance Market

    Directory of Open Access Journals (Sweden)

    Gentiana Sharku

    2011-03-01

    Full Text Available The life insurance sector is an important sector of the economy all over the world. Life insurance provides the economy and the individuals as well, a variety of fundamental financial services.Regardless the importance it has all around the world, life insurance market in Albania is still underdeveloped comparing not only to the Western European countries, but to the region countries as well. The comparative analysis of insurance market is carried out by means of two indexes: insurance density and penetration index. The life insurance market in Albania is facing several problems which will be further explained in the paper, together with some recommendations to be taken in account by Albanian insurance companies and the Albanian government as well.

  6. The development and implementation of stroke risk prediction model in National Health Insurance Service's personal health record.

    Science.gov (United States)

    Lee, Jae-Woo; Lim, Hyun-Sun; Kim, Dong-Wook; Shin, Soon-Ae; Kim, Jinkwon; Yoo, Bora; Cho, Kyung-Hee

    2018-01-01

    The purpose of this study was to build a 10-year stroke prediction model and categorize a probability of stroke using the Korean national health examination data. Then it intended to develop the algorithm to provide a personalized warning on the basis of each user's level of stroke risk and a lifestyle correction message about the stroke risk factors. Subject to national health examinees in 2002-2003, the stroke prediction model identified when stroke was first diagnosed by following-up the cohort until 2013 and estimated a 10-year probability of stroke. It sorted the user's individual probability of stroke into five categories - normal, slightly high, high, risky, very risky, according to the five ranges of average probability of stroke in comparison to total population - less than 50 percentile, 50-70, 70-90, 90-99.9, more than 99.9 percentile, and constructed the personalized warning and lifestyle correction messages by each category. Risk factors in stroke risk model include the age, BMI, cholesterol, hypertension, diabetes, smoking status and intensity, physical activity, alcohol drinking, past history (hypertension, coronary heart disease) and family history (stroke, coronary heart disease). The AUC values of stroke risk prediction model from the external validation data set were 0.83 in men and 0.82 in women, which showed a high predictive power. The probability of stroke within 10 years for men in normal group (less than 50 percentile) was less than 3.92% and those in very risky group (top 0.01 percentile) was 66.2% and over. The women's probability of stroke within 10 years was less than 3.77% in normal group (less than 50 percentile) and 55.24% and over in very risky group. This study developed the stroke risk prediction model and the personalized warning and the lifestyle correction message based on the national health examination data and uploaded them to the personal health record service called My Health Bank in the health information website - Health

  7. Basic pharmaceutical technology

    OpenAIRE

    Angelovska, Bistra; Drakalska, Elena

    2017-01-01

    The lecture deals with basics of pharmaceutical technology as applied discipline of pharmaceutical science, whose main subject of study is formulation and manufacture of drugs. In a broad sense, pharmaceutical technology is science of formulation, preparation, stabilization and determination of the quality of medicines prepared in the pharmacy or in pharmaceutical industry

  8. 22 CFR 228.23 - Eligibility of marine insurance.

    Science.gov (United States)

    2010-04-01

    ...-Related Services for USAID Financing § 228.23 Eligibility of marine insurance. The eligibility of marine... commodities procured with USAID funds be insured in the United States against marine loss. The decision of any...

  9. Nuclear insurance problems in Spain

    International Nuclear Information System (INIS)

    Gomez del Campo, Julian.

    1977-01-01

    The purpose of this paper is to study the problems raised in Spain by third party liability insurance for nuclear damage. National law in this field is based on the Paris Convention on nuclear third party liability and defines the conditions of liability of operators of nuclear installations. The insurance contract requirements must comply with the regulations on cover for nuclear risks, under the control of the Finance Ministry's competent services. Certain exceptional nuclear risks which cannot be covered entirely by ordinary insurance policies, are taken over by the Consorcio de Compensacion de Seguros which belongs to this Ministry. From the insurance viewpoint, the regulations make a distinction between nuclear and radioactive installations and nuclear transport. (NEA) [fr

  10. Rational Use of Medicines in Relation to Pharmaceutical Supply ...

    African Journals Online (AJOL)

    Pharmaceutical management involves a set of practices aiming at ensuring timely availability and appropriate use of safe, effective and quality pharmaceuticals and services in any health care setting. Rational use of medicines is often associated with efficiency of pharmaceutical supply system that operates in the health ...

  11. Relationships among Components of Insurance Companies and Services’ Quality

    Directory of Open Access Journals (Sweden)

    Šebjan Urban

    2014-11-01

    Full Text Available Background and Purpose: An increasing number of insurance companies and the intensity of competition in this field require research on customer perceptions of the components of insurance services and insurance company. The objective of this study was to examine the conceptual model and to study the relationships between customer perceptions of the innovation, reputation, adequacy of premium, and adequacy of information about the coverage of insurance services.

  12. A proposal for an evaluation model of pharmaceutical services for malaria Uma proposta de modelo de avaliação para a assistência farmacêutica na malária

    Directory of Open Access Journals (Sweden)

    Claudia Garcia Serpa Osorio-de-Castro

    2009-09-01

    Full Text Available Malaria is a serious public health problem in over 90 countries worldwide. In Brazil the disease is prevalent in the Amazon and the control rationale is based on early diagnosis and treatment. Quality pharmaceutical services are considered a key element for control. A proposal for evaluating pharmaceutical services for malaria is presented here. A theoretical outline composed of a logical model and an indicator framework is discussed and strives to establish a basis for assessment and judgment of the way in which these services are actually delivered. The aim is to contribute to the understanding of pharmaceutical services for malaria and other endemic diseases, complying with the directives of the Brazilian National Medicines Policy.A malária é um grave problema de saúde pública em cerca de 90 países. No Brasil, a Amazônia congrega o maior número de casos. No país, o racional de enfrentamento se baseia em diagnóstico precoce e tratamento. A assistência farmacêutica de qualidade é considerada elemento-chave para o controle da doença. Apresenta-se uma proposta de avaliação da assistência farmacêutica, composta por um modelo lógico e uma grade de indicadores, discutidos de modo a estabelecer uma base de comparação e julgamento da forma na qual os serviços são ofertados. O objetivo é contribuir para o entendimento da assistência farmacêutica na malária e em outras endemias, atendendo às diretrizes da Política Nacional de Medicamentos.

  13. Implementing Automotive Telematics for Fleet Insurance

    Directory of Open Access Journals (Sweden)

    Marika Azzopardi

    2013-12-01

    Full Text Available The advantages of Usage-Based Insurance for automotive covers over conventional rating methods have been discussed in literature for over four decades. Notwithstanding their adoption in insurance markets has been slow. This paper seeks to establish the viability of introducing fleet Telematics-Based Insurance by investigating the perceptions of insurance operators, tracking service providers and corporate fleet owners. At its core, the study involves a SWOT-analysis to appraise Telematics-Based Insurance against conventional premium rating systems. Twenty five key stakeholders in Malta, a country with an insurance industry that represents others in microcosm, were interviewed to develop our analysis. We assert that local insurers have interests in such insurance schemes as enhanced fleet management and monitoring translate into an improved insurance risk. The findings presented here have implications for all stakeholders as we argue that telematics enhance fleet management, TBI improves risk management for insurers and adoption of this technology is dependent on telematics providers increasing the perceived control by insurers over managing this technology.

  14. [Prognostic prediction of the functional capacity and effectiveness of functional improvement program of the musculoskeletal system among users of preventive care service under long-term care insurance].

    Science.gov (United States)

    Sone, Toshimasa; Nakaya, Naoki; Tomata, Yasutake; Aida, Jun; Okubo, Ichiro; Ohara, Satoko; Obuchi, Shuichi; Sugiyama, Michiko; Yasumura, Seiji; Suzuki, Takao; Tsuji, Ichiro

    2013-01-01

    The purpose of this study was to examine the effectiveness of the Functional Improvement Program of the Musculoskeletal System among users of Preventive Care Service under Long-Term Care Insurance. A total of 3,073 subjects were analyzed. We used the prediction formula to estimate the predicted value of the Kihon Checklist after one year, and calculated the measured value minus the predicted value. The subjects were divided into two groups according to the measured value minus predicted value tertiles: the lowest and middle tertile (good-to-fair measured value) and the highest tertile (poor measured value). We used a multiple logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) of the good-to-fair measured values of the Kihon Checklist after one year, according to the Functional Improvement Program of the Musculoskeletal System. In potentially dependent elderly, the multivariate adjusted ORs (95% CI) of the good-to-fair measured values were 2.4 (1.3-4.4) for those who attended the program eight times or more in a month (vs those who attended it three times or less in a month), 1.3 (1.0-1.8) for those who engaged in strength training using machines (vs those who did not train), and 1.4 (1.0-1.9) for those who engaged in endurance training. In this study, among potentially dependent elderly, those who attended the program eight times or more in a month and those who engaged in strength training using machines or endurance training showed a significant improvement of their functional capacity.

  15. Data Analytic Process of a Nationwide Population-Based Study on Obesity Using the National Health Information Database Presented by the National Health Insurance Service 2006-2015

    Directory of Open Access Journals (Sweden)

    Yang-Hyun Kim

    2017-03-01

    Full Text Available Background : In Korea, the prevalence of obesity has steadily increased, and the socioeconomic burden of obesity has increased along with it. In 2015, the National Health Insurance Service (NHIS signed a memorandum of understanding with the Korean Society for the Study of Obesity (KSSO, providing limited open access to its databases so that the status of obesity and obesity management could be investigated. Methods : Using NHIS databases, we analyzed nationwide population-based studies for obesity using the definition of obesity (body mass index ≥25 kg/m² in subjects over the age of 20. Age and sex standardization were used for all data. Results : The KSSO released the ‘Obesity Fact Sheet 2016’ using the 2006-2015 NHIS Health Checkup database. The prevalence of obesity steadily increased from 28.7% in 2006 to 32.4% in 2015, and the prevalence of abdominal obesity also steadily increased from 18.4% in 2009 to 20.8% in 2015. The prevalence of class II obesity steadily increased from 2006 to 2015, such that the total prevalence was 4.8% in 2015 (5.6% in men and 4.0% in women. The highest prevalence of obesity was found in Jeju Island, while the lowest prevalence was found in Daegu City. The highest prevalence of abdominal obesity was also found in Jeju Island, while the lowest prevalence was found in Gwangju City. Conclusion : Based on the Obesity Fact Sheet 2016, a strategy for reducing the prevalence of obesity is needed, especially in Korean men.

  16. Development of a Korean Fracture Risk Score (KFRS for Predicting Osteoporotic Fracture Risk: Analysis of Data from the Korean National Health Insurance Service.

    Directory of Open Access Journals (Sweden)

    Ha Young Kim

    Full Text Available Asian-specific prediction models for estimating individual risk of osteoporotic fractures are rare. We developed a Korean fracture risk prediction model using clinical risk factors and assessed validity of the final model.A total of 718,306 Korean men and women aged 50-90 years were followed for 7 years in a national system-based cohort study. In total, 50% of the subjects were assigned randomly to the development dataset and 50% were assigned to the validation dataset. Clinical risk factors for osteoporotic fracture were assessed at the biennial health check. Data on osteoporotic fractures during the follow-up period were identified by ICD-10 codes and the nationwide database of the National Health Insurance Service (NHIS.During the follow-up period, 19,840 osteoporotic fractures were reported (4,889 in men and 14,951 in women in the development dataset. The assessment tool called the Korean Fracture Risk Score (KFRS is comprised of a set of nine variables, including age, body mass index, recent fragility fracture, current smoking, high alcohol intake, lack of regular exercise, recent use of oral glucocorticoid, rheumatoid arthritis, and other causes of secondary osteoporosis. The KFRS predicted osteoporotic fractures over the 7 years. This score was validated using an independent dataset. A close relationship with overall fracture rate was observed when we compared the mean predicted scores after applying the KFRS with the observed risks after 7 years within each 10th of predicted risk.We developed a Korean specific prediction model for osteoporotic fractures. The KFRS was able to predict risk of fracture in the primary population without bone mineral density testing and is therefore suitable for use in both clinical setting and self-assessment. The website is available at http://www.nhis.or.kr.

  17. INSURANCE MARKET. GENERAL CONSIDERATIONS OF INSURANCES IN ROMANIA

    Directory of Open Access Journals (Sweden)

    MARINEL NEDELUŢ

    2013-10-01

    Full Text Available Insurance is a contract made by a company or society, or by the state, to provide a guarantee for loss, damage, illness, death etc in return for regular payments. In other words it is a means by which one pays a relatively small known cost for protection against an uncertain and much larger cost. Still, this contract (insurance policy makes it possible for the insured to cover only losses that are measurable in terms of money and caused strictly by hazardous events, independent from own doing. If no such events should happen, the benefits won’t exist in a tangible, material form, but will take the shape of security against ruin. Since the insurance industry has developed more during the last decade due to the powerful players that have entered the market, the services provided by the insurance companies, and not only their products have evolved a lot in order to meet the requirements of the consumers, and to make them familiar with this type of investments. Therefore all the means of advertising became essential in this process of implementation and familiarization with this area of activity: mass-media advertising, insurance brokerage companies, the internet are all parts of this process.

  18. Biological age as a health index for mortality and major age-related disease incidence in Koreans: National Health Insurance Service – Health screening 11-year follow-up study

    Directory of Open Access Journals (Sweden)

    Kang YG

    2018-03-01

    Full Text Available Young Gon Kang,1 Eunkyung Suh,2 Jae-woo Lee,3 Dong Wook Kim,4 Kyung Hee Cho,5 Chul-Young Bae1 1Department of R&D, MediAge Research Center, Seongnam, Republic of South Korea; 2Department of Family Medicine, College of Medicine, CHA University, Chaum, Seoul, Republic of South Korea; 3Department of Family Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of South Korea; 4Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Republic of South Korea; 5Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of South KoreaPurpose: A comprehensive health index is needed to measure an individual’s overall health and aging status and predict the risk of death and age-related disease incidence, and evaluate the effect of a health management program. The purpose of this study is to demonstrate the validity of estimated biological age (BA in relation to all-cause mortality and age-related disease incidence based on National Sample Cohort database.Patients and methods: This study was based on National Sample Cohort database of the National Health Insurance Service – Eligibility database and the National Health Insurance Service – Medical and Health Examination database of the year 2002 through 2013. BA model was developed based on the National Health Insurance Service – National Sample Cohort (NHIS – NSC database and Cox proportional hazard analysis was done for mortality and major age-related disease incidence.Results: For every 1 year increase of the calculated BA and chronological age difference, the hazard ratio for mortality significantly increased by 1.6% (1.5% in men and 2.0% in women and also for hypertension, diabetes mellitus, heart disease, stroke, and cancer incidence by 2.5%, 4.2%, 1.3%, 1.6%, and 0.4%, respectively (p<0.001.Conclusion: Estimated BA by the developed BA model based on NHIS – NSC database is expected to be

  19. The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data

    Directory of Open Access Journals (Sweden)

    Kim JH

    2013-11-01

    Full Text Available JinHee Kim,1 Chin Kook Rhee,2 Kwang Ha Yoo,3 Young Sam Kim,4 Sei Won Lee,5 Yong Bum Park,6 Jin Hwa Lee,7 YeonMok Oh,5 Sang Do Lee,5 Yuri Kim,8 KyungJoo Kim,8 HyoungKyu Yoon9 1Office of Health Service Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea; 2Department of Internal Medicine, Seoul St Mary’s Hospital, Catholic University of Korea College of Medicine, Seoul, Korea; 3Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea; 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; 5Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 6Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea; 7Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea; 8Department of Clinical Research Support, National Strategic Coordinating Center for Clinical Research, Seoul, Korea; 9Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary’s Hospital, Catholic University of Korea College of Medicine, Seoul, Korea Background: Patients with high grade chronic pulmonary obstructive disease (COPD account for much of the COPD-related mortality and incur excessive financial burdens and medical care utilization. We aimed to determine the characteristics and medical care use of such patients using nationwide data from the Korean Health Insurance Review and Assessment Service in 2009. Materials and methods: Patients with COPD were identified by searching with the International Classification of Diseases–10th Revision for those using medication. Patients with high grade COPD were selected based on their patterns of tertiary institute visits and medication use. Results: The numbers of patients with high grade COPD increased rapidly

  20. Federal Deposit Insurance Corporation (FDIC) Insured Banks

    Data.gov (United States)

    Department of Homeland Security — The Summary of Deposits (SOD) is the annual survey of branch office deposits for all FDIC-insured institutions including insured U.S. branches of foreign banks. Data...

  1. Unemployment Insurance Query (UIQ)

    Data.gov (United States)

    Social Security Administration — The Unemployment Insurance Query (UIQ) provides State Unemployment Insurance agencies real-time online access to SSA data. This includes SSN verification and Title...

  2. 38 CFR 8.4 - Deduction of insurance premiums from compensation, retirement pay, or pension.

    Science.gov (United States)

    2010-07-01

    ...' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Premiums § 8.4 Deduction of insurance premiums from compensation, retirement pay, or pension. The insured under a National Service life insurance policy which is not lapsed may authorize the monthly deduction of premiums from disability...

  3. Pharmaceutical Advertising and Medicare Part D

    Science.gov (United States)

    Lakdawalla, Darius; Sood, Neeraj; Gu, Qian

    2013-01-01

    We explore how and to what extent prescription drug insurance expansions affects incentives for pharmaceutical advertising. When insurance expansions make markets more profitable, firms respond by boosting advertising. Theory suggests this effect will be magnified in the least competitive drug classes, where firms internalize a larger share of the benefits from advertising. Empirically, we find that the implementation of Part D coincides with a 14% to 19% increase in total advertising expenditures. This effect is indeed concentrated in the least competitive drug classes. The additional advertising raised utilization among non-elderly patients outside the Part D program by about 3.6%. This is roughly half of the direct utilization effect of Part D on elderly beneficiaries. The results suggest the presence of considerable spillover effects from publicly subsidized prescription drug insurance on the utilization and welfare of consumers outside the program. PMID:24308884

  4. Pharmaceutical advertising and Medicare Part D.

    Science.gov (United States)

    Lakdawalla, Darius; Sood, Neeraj; Gu, Qian

    2013-12-01

    We explore how and to what extent prescription drug insurance expansions affect incentives for pharmaceutical advertising. When insurance expansions make markets more profitable, firms respond by boosting advertising. Theory suggests this effect will be magnified in the least competitive drug classes, where firms internalize a larger share of the benefits from advertising. Empirically, we find that the implementation of Part D coincides with a 14-19% increase in total advertising expenditures. This effect is indeed concentrated in the least competitive drug classes. The additional advertising raised utilization among non-elderly patients outside the Part D program by about 3.6%. This is roughly half of the direct utilization effect of Part D on elderly beneficiaries. The results suggest the presence of considerable spillover effects from publicly subsidized prescription drug insurance on the utilization and welfare of consumers outside the program. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Pharmaceutical care in smoking cessation.

    Science.gov (United States)

    Marín Armero, Alicia; Calleja Hernandez, Miguel A; Perez-Vicente, Sabina; Martinez-Martinez, Fernando

    2015-01-01

    As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients' access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre-post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy's smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation.

  6. NEW VECTORS OF THE MOTOR INSURANCE DEVELOPMENT IN UKRAINE

    Directory of Open Access Journals (Sweden)

    N. Prikazyuk

    2015-04-01

    Full Text Available The essence and features of different forms of motor insurance are studied. As investigated, the motor insurance is one of the most popular types of insurance in many countries, and continues its further quality development. It is stated that the following new vectors of development has been recently observed in developed countries: Internet sales are getting significantly prevalent along with the traditional channels of insurance distribution; insurers’ websites provide a wide range of online features in motor insurance; innovations in motor insurance based on the use of telematics, particularly the usage-based insurance, are widely spread. Basic types of motor insurance, which represent the domestic market, are analyzed. It was found that the share of motor insurance in the insurance market of Ukraine is significant. As established, the proportion of net premiums of motor insurance is decreasing, because its development is significantly influenced by economic factors. Measures, applied by insurance companies in the domestic market of motor insurance to attract new customers and retain the existing ones, are defined. In particular, insurers are trying to develop the implementation of insurance services online, and use possibilities offered by mobile technologies. It was found that the domestic market of motor insurance is characterized by a high level of fraud, that is why some innovative measures in the domestic and international motor insurance agreements are taken to decrease it, such as the introduction of mandatory registration of insurance agents, who have the right to perform mediatory activity in compulsory civil liability insurance of owners of motor vehicles (CCLIOMV, and procedures for contracting the international insurance “Green Card” agreements with simultaneous entering the information on concluded agreement into a unified centralized database of Motor (transport insurance bureau of Ukraine using the “Green Card online

  7. Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines-Stroke.

    Science.gov (United States)

    Medford-Davis, Laura N; Fonarow, Gregg C; Bhatt, Deepak L; Xu, Haolin; Smith, Eric E; Suter, Robert; Peterson, Eric D; Xian, Ying; Matsouaka, Roland A; Schwamm, Lee H

    2016-11-14

    Insurance status affects access to care, which may affect health outcomes. The objective was to determine whether patients without insurance or with government-sponsored insurance had worse quality of care or in-hospital outcomes in acute ischemic stroke. Multivariable logistic regressions with generalized estimating equations stratified by age under or at least 65 years were adjusted for patient demographics and comorbidities, presenting factors, and hospital characteristics to determine differences in in-hospital mortality and postdischarge destination. We included 589 320 ischemic stroke patients treated at 1604 US hospitals participating in the Get With The Guidelines-Stroke program between 2012 and 2015. Uninsured patients with hypertension, high cholesterol, or diabetes mellitus were less likely to be taking appropriate control medications prior to stroke, to use an ambulance to arrive to the ED, or to arrive early after symptom onset. Even after adjustment, the uninsured were more likely than the privately insured to die in the hospital (rehab (stroke, time to presentation for acute treatment, access to rehabilitation, and in-hospital mortality differ by patient insurance status. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  8. Cyber Insurance - Managing Cyber Risk

    Science.gov (United States)

    2015-04-01

    disaster response plans, how employees and others access data systems, and at a minimum, the antivirus and anti- malware software used by the business, the...a policy for insuring data stored in the cloud.[5] Typically, businesses that install or ser- vice software or networks or provide IT consulting for...security, and privacy. Errors and omissions covers claims related to performance of services such as software development or consulting services

  9. [Monitoring of a protocol for the adequacy of the pharmaceutical form of the oral medication to the degree of dysphagia in patients hospitalized in an internal medicine service].

    Science.gov (United States)

    García Aparicio, J; Herrero Herrero, J I; Moreno Gómez, A Ma; Martínez Sotelo, J; González del Valle, E; Fernández de la Fuente, Ma A

    2011-01-01

    The oral route is the most convenient way of administering medication, although it may not be safe. Dysphagia is one of the factors rendering difficult a proper feeding and administration of medication. to improve the administration of oral medication in patients with dysphagia by changing the pharmaceutical formulation of the principles prescribed to tolerable textures. Pilot project for the application of a dysphagia protocol that included the patients admitted to the Internal Medicine Unit at Los Montalvos Center for 4 months. After detecting the suspicion of dysphagia, a dysphagia-viscosity test was applied to know the tolerated textures. Then, the pharmaceutical formulations were adapted and the manipulation instructions for the drugs were indicated for their proper administration. 23 out of 627 admitted patients were included, with a mean age of 85 years (σ±7.4). The pathologies implicated in dysphagia were: dementia (65.2%); cerebrovascular disease (30.4%), and Parkinson's disease (4.4%). The best texture for drug intake was a "pudding" in 48.0%. 43 active ingredients were reviewed and 134 interventions were performed: in 41% of the cases, swallowing was made easier by mixing the drug with the food and in 59% water and a thickener were used. 94% of the recommendations were considered to be appropriate. the adaptation of the pharmaceutical formulations to the degree of dysphagia impacts on the improvement of healthcare quality by implementing safety in drug prescription and administration processes.

  10. Insure Kids Now (IKN) (Dental Care Providers)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Insure Kids Now (IKN) Dental Care Providers in Your State locator provides profile information for oral health providers participating in Medicaid and Children's...

  11. Health Insurance Rate Review Fact Sheet

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act is bringing an unprecedented level of scrutiny and transparency to health insurance rate increases. The Act ensures that, in any State, any...

  12. Women's Health Insurance Coverage

    Science.gov (United States)

    ... Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Published: Oct 31, 2017 Facebook Twitter LinkedIn ... that many women continue to face. Sources of Health Insurance Coverage Employer-Sponsored Insurance: Approximately 57.9 million ...

  13. Alternative health insurance schemes

    DEFF Research Database (Denmark)

    Keiding, Hans; Hansen, Bodil O.

    2002-01-01

    In this paper, we present a simple model of health insurance with asymmetric information, where we compare two alternative ways of organizing the insurance market. Either as a competitive insurance market, where some risks remain uninsured, or as a compulsory scheme, where however, the level...... competitive insurance; this situation turns out to be at least as good as either of the alternatives...

  14. Health Insurance Basics

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

  15. Expanding Access to Insurance by the Poor : Policy, Regulation and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Expanding Access to Insurance by the Poor : Policy, Regulation and Supervision of Micro Insurance. This project aims to facilitate poor people's access to insurance products and services as a means of addressing their vulnerability to risk. It will do so by carrying out case studies in five countries. Potential candidates ...

  16. 76 FR 50931 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2011-08-17

    ... Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care... be able to purchase private health insurance through State-based competitive marketplaces called...

  17. Assessing Early Implementation of State Autism Insurance Mandates

    Science.gov (United States)

    Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

  18. 77 FR 26698 - Allocation of Mortgage Insurance Premiums

    Science.gov (United States)

    2012-05-07

    ... Allocation of Mortgage Insurance Premiums AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final... explain how to allocate prepaid qualified mortgage insurance premiums to determine the amount of the... Act of 2010. The regulations affect taxpayers who pay prepaid qualified mortgage insurance premiums...

  19. 78 FR 70856 - Information Reporting of Mortgage Insurance Premiums

    Science.gov (United States)

    2013-11-27

    ... Information Reporting of Mortgage Insurance Premiums AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... regulations that require information reporting by persons who receive mortgage insurance premiums, including... reporting requirements that result from the extension of the treatment of mortgage insurance premiums made...

  20. 77 FR 18883 - Surety Companies Acceptable on Federal Bonds-Termination and Merger; Pioneer General Insurance...

    Science.gov (United States)

    2012-03-28

    .... Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety... Carrico, Director, Financial Accounting and Services Division, Financial Management Service. [FR Doc. 2012...--Termination and Merger; Pioneer General Insurance Company AGENCY: Financial Management Service, Fiscal Service...

  1. 76 FR 37891 - Surety Companies Acceptable on Federal Bonds; Termination; Western Insurance Company

    Science.gov (United States)

    2011-06-28

    ... the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and Services.... Laura Carrico, Director, Financial Accounting and Services Division, Financial Management Service. [FR...; Termination; Western Insurance Company AGENCY: Financial Management Service, Fiscal Service, Department of the...

  2. Pharmaceutical care in smoking cessation

    Directory of Open Access Journals (Sweden)

    Marín Armero A

    2015-01-01

    Full Text Available Alicia Marín Armero,1 Miguel A Calleja Hernandez,2 Sabina Perez-Vicente,3 Fernando Martinez-Martinez4 1Community Pharmacy, Murcia, Spain; 2Hospital Pharmacy, University Hospital Virgen de las Nieves, Granada, Spain; 3Result Evaluation Unit, Institute of Biomedicine, Sevilla, Spain; 4Research Unit in Pharmaceutical Care, University of Granada, Granada, Spain Abstract: As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients’ access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre–post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy’s smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation. Keywords: community pharmacy, health campaign, tobacco cessation, nicotine replacement therapy

  3. 78 FR 72089 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2013-12-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6051-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... period entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening...

  4. Biological age as a health index for mortality and major age-related disease incidence in Koreans: National Health Insurance Service – Health screening 11-year follow-up study

    OpenAIRE

    Kang,Young Gon; Suh,Eunkyung; Lee,Jae-woo; Kim,Dong Wook; Cho,Kyung Hee; Bae,Chul-Young

    2018-01-01

    Young Gon Kang,1 Eunkyung Suh,2 Jae-woo Lee,3 Dong Wook Kim,4 Kyung Hee Cho,5 Chul-Young Bae1 1Department of R&D, MediAge Research Center, Seongnam, Republic of South Korea; 2Department of Family Medicine, College of Medicine, CHA University, Chaum, Seoul, Republic of South Korea; 3Department of Family Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of South Korea; 4Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital...

  5. Pet insurance--essential option?

    Science.gov (United States)

    Stowe, J D

    2000-08-01

    As Hawn (2) says, "insurance is about risk and peace of mind." She reports that the American Humane Society supports pet insurance because companion animals are able to be treated for disease or accidents that are life-threatening where, otherwise, they would have been euthanized. For veterinarians, she suggests that pet insurance allows them to practice veterinary medicine "as if it were free." It is inevitable that pet insurance will grow as a recourse for veterinary fees. This may be a savior to some families whose budget is stretched to the limit at a critical moment in the health care of their cherished pet. We in the veterinary profession have an advantage over other professions. We have seen the good, the bad, and the ugly of insurance, as it applies to human health and dental care. If we work hand-in-hand with our own industries, collectively we may be able to develop a system that wins for everyone, with fees that allow practice to thrive and growth strategies that accommodate new treatment and diagnostic modalities, as well as consistent and exemplary customer service. The path ahead is always fraught with bumps and potholes. We can be a passive passenger and become a victim of the times or an active driver to steer the profession to a clearer route. Pet insurance is but one of the solutions for the profession; the others are a careful assessment of our fees--charging what we are worth, not what we think the client will pay; business management; customer service; leadership of our health care team; lifelong learning; and more efficient delivery systems. Let us stop being a victim, stop shooting ourselves in the professional foot, and seize the day!

  6. ECONOMIC AND MANAGERIAL APPROACH OF HEALTH INSURANCES

    Directory of Open Access Journals (Sweden)

    Georgeta Dragomir

    2007-05-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizesthe necessity and the opportunity of creating in Romania a medical service market based on the competingsystem. In Romania, the social insurances for health care are at their very beginning. The development of thedomain of the private insurances for health care is prevented even by its legislation, due to the lack of anormative act that may regulate the management of the private insurances for health care. The establishment ofthe legislation related to the optional insurances for health care might lead to some activity norms for thecompanies which carry out optional insurances for health care. The change of the legislation is made in order tocreate normative and financial opportunities for the development of the optional medical insurances. Thischange, as part of the social protection of people, will positively influence the development of the medicalinsurance system. The extension of the segment of the optional insurances into the medical insurance segmentincreases the health protection budget with the value of the financial sources which do not belong to thebudgetary funds.

  7. Insurance of nuclear risk

    International Nuclear Information System (INIS)

    Lacroix, M.

    1976-01-01

    Insurance for large nuclear installations covers mainly four types of risk: third party liability which in accordance with the nuclear conventions, is borne by a nuclear operator following an incident occurring in his installation or during transport of nuclear substances; material damage to the installation itself, which precisely is not covered by third party liability insurance; machinery breakdown, i.e. accidental damage or interruption of operation. Only the first category must be insured. In view of the magnitude of the risk, nuclear insurance resorts to co-insurance and reinsurance techniques which results in a special organisation of the nuclear insurance market, based on national nuclear insurance pools and on the Standing Committee on Atomic Risk of the European Insurance Committee. Conferences of the chairmen of nuclear insurance pools are convened regularly at a worldwide level. (NEA) [fr

  8. Communications Centre Model in Insurance Business

    Directory of Open Access Journals (Sweden)

    Danijel Bara

    2013-07-01

    Full Text Available The aim of this paper is to define a communications centre model in an insurance company that essentially has two objectives. The first objective is focused on providing quality support with the sales process thereby creating a strategic advantage over the competition while the second objective is focused on improving the link between internal organizational units whose behaviour can often render decision-making at all levels difficult. The function of sales is fundamental for an insurance company. Whether an insurance company will fulfil its basic function, which is transfer of risk from the insured party to the insurer who agrees tonreimburse incidental damages to the damaged party and distribute them among all members of the risk group on the principles of reciprocity and solidarity, depends on successful sales and billing (Andrijašević & Petranović, 1999. For an insurance company to operate successfully in a demanding market, it is necessary to meet the needs of potential clients who then must be at the centre of all the activities of the insurer. A satisfied policy holder, who is respected by the insurer as a partner, is a guarantee that the sales of insurance services will be successful and that the insured party will come back to the same insurance company. In the era of globalization and all-pervading new technologies and modes of communication, policy holders need to be able to communicate with insurance company employees. Quality communication is a good foundation for a sales conversation. A fast flow of all types of information within an organisation using a single communication module makes decision-making at all levels quicker and easier.

  9. FEATURES OF PROFESSIONAL LIABILITY INSURANCE REALIZATION IN UKRAINE

    Directory of Open Access Journals (Sweden)

    О. Lobova

    2015-04-01

    Full Text Available The signs of professional liability insurance are generalized in the article. It is the presence of losses, additional costs that require mechanisms and sources of compensation. The essence of the professional responsibility concept is determined and it is characterized like specialists material liability of different professions, lack of qualifications, errors and omissions are due to carelessness or negligence may cause harm to the client The main elements of the professional liability insurance contract, such as insurance objects, insurance compensation, insurance risks are described. The types of professional liability insurance are characterized. There are such types of the professional liability insurance: professional liability insurance of architect, lawyer, auditor (accountant, appraiser, notary, customs broker and doctor. It is determined, that the most widespread in Ukraine is the professional liability insurance of lawyer and customs broker because the policy is purchased for the sole purpose to obtain a license. The size of insurance rates in the provision of professional liability insurance in different insurance companies of Ukraine are analyzed. It is established that insurance rate depends on the type of professional activity, scope of service, qualifications and the other factors. The development impulse can only provide judicial and legal definition of professions wide list that are subject under mandatory professional liability insurance.

  10. Effects of a consumer driven health plan on pharmaceutical spending and utilization.

    Science.gov (United States)

    Parente, Stephen T; Feldman, Roger; Chen, Song

    2008-10-01

    To compare pharmaceutical spending and utilization in a consumer driven health plan (CDHP) with a three-tier pharmacy benefit design, and to examine whether the CDHP creates incentives to reduce pharmaceutical spending and utilization for chronically ill patients, generic or brand name drugs, and mail-order drugs. Retrospective insurance claims analysis from a large employer that introduced a CDHP in 2001 in addition to a point of service (POS) plan and a preferred provider organization (PPO), both of which used a three-tier pharmacy benefit. Difference-in-differences regression models were estimated for drug spending and utilization. Control variables included the employee's income, age, and gender, number of covered lives per contract, election of flexible spending account, health status, concurrent health shock, cohort, and time trend. Results. CDHP pharmaceutical expenditures were lower than those in the POS cohort in 1 year without differences in the use of brand name drugs. We find limited evidence of less drug consumption by CDHP enrollees with chronic illnesses, and some evidence of less generic drug use and more mail-order drug use among CDHP members. The CDHP is cost-neutral or cost-saving to both the employer and the employee compared with three-tier benefits with no differences in brand name drug use. © Health Research and Educational Trust.

  11. Insurance billing and coding.

    Science.gov (United States)

    Napier, Rebecca H; Bruelheide, Lori S; Demann, Eric T K; Haug, Richard H

    2008-07-01

    The purpose of this article is to highlight the importance of understanding various numeric and alpha-numeric codes for accurately billing dental and medically related services to private pay or third-party insurance carriers. In the United States, common dental terminology (CDT) codes are most commonly used by dentists to submit claims, whereas current procedural terminology (CPT) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD.9.CM) codes are more commonly used by physicians to bill for their services. The CPT and ICD.9.CM coding systems complement each other in that CPT codes provide the procedure and service information and ICD.9.CM codes provide the reason or rationale for a particular procedure or service. These codes are more commonly used for "medical necessity" determinations, and general dentists and specialists who routinely perform care, including trauma-related care, biopsies, and dental treatment as a result of or in anticipation of a cancer-related treatment, are likely to use these codes. Claim submissions for care provided can be completed electronically or by means of paper forms.

  12. Duty to provide pre-contractual information of crop insurance

    Directory of Open Access Journals (Sweden)

    Ivančević Katarina

    2016-01-01

    Full Text Available Crop insurance is one of the most important types of agricultural insurance. From the aspect of insurance technique, this insurance is very challenging and requires careful drafting of insurance terms and tariffs. This type of insurance can provide security to farmers in case of financial losses caused by numerous risks which they are exposed to. Insufficient knowledge of the opportunities that the insurance provides is caused in part by inaccurate and vague explanations that have been offered by insurers in negotiation stage to interested farmers. In this regard, an important novelty in Serbian law is the obligation of contractual information which was introduced by the new Insurance Law (IL. In this way, additional protection to users of the service of insurance in relation to the provisions of the obligation law is provided. The goal of this obligation is to allow a negotiator to gain a clear idea of the essential elements of the insurance contract, to consider the proposed coverage and make a reasonable decision whether to accept the conclusion of the insurance contract or not, i.e. under what conditions it should be concluded. Sanctions for failure in the obligation to inform act preventively and repressively on insurers. The aim of this study is analyse the legal and factual position of the service beneficiaries in terms of obligation of economically and experientially superior contractor of lawful and full information of a policyholder prior to the conclusion of an insurance contract in a very specific branch of insurance, such as crop insurance. The application of inductive-deductive and comparative-legal research method, points to certain doctrinal and normative solutions from other legal systems, legal provisions applicable in the law of the Republic of Serbia are critically set out, as well as the daily practice of insurance companies.

  13. Pharmaceutical care in community pharmacies: practice and research in the US.

    Science.gov (United States)

    Christensen, Dale B; Farris, Karen B

    2006-01-01

    To describe the state of community pharmacy, including patient care services, in the US. Chain pharmacies, including traditional chains, mass merchandisers, and supermarkets, comprise more than 50% of community pharmacies in the US. Dispensing of drugs remains the primary focus, yet the incidence of patients being counseled on medications appears to be increasing. More than 25% of independent community pharmacy owners report providing some patient clinical care services, such as medication counseling and chronic disease management. Most insurance programs pay pharmacists only for dispensing services, yet there are a growing number of public and private initiatives that reimburse pharmacists for cognitive services. Clinical care opportunities exist in the new Medicare prescription drug benefit plan, as it requires medication therapy management services for specific enrollees. The private market approach to healthcare delivery in the US, including pharmacy services, precludes national and statewide strategies to change the basic business model. To date, most pharmacies remain focused on dispensing prescriptions. With lower dispensing fees and higher operating costs, community pharmacies are focused on increasing productivity and efficiency through technology and technicians. Pharmacists remain challenged to establish the value of their nondispensing-related pharmaceutical care services in the private sector. As the cost of suboptimal drug therapy becomes more evident, medication therapy management may become a required pharmacy benefit in private drug insurance plans. Pharmacy school curricula, as well as national and state pharmacy associations, continually work to train and promote community pharmacists for these roles. Practice research is driven primarily by interested academics and, to a lesser degree, by pharmacy associations. Efficient dispensing of prescriptions is the primary focus of community pharmacies in the US. Some well designed practice-based research

  14. Does brand differentiate pharmaceuticals?

    Science.gov (United States)

    Bednarik, Josef

    2005-12-01

    Role of marketing in pharmaceutical industry is increasing and inspiration by successful brands known from consumer goods market influenced pharmaceutical companies enough to switch their attention to branding initiatives. Still there is little evidence that pharmaceutical brands represent anything more than product only. This study aims to explore the area of branding in pharmaceutical industry. Central hypothesis of the research has been that brand and its emotional content differentiate pharmaceuticals as well as rational data derived from clinical studies. It has been tested by extensive review of available literature as well as by primary research focused on drivers of physicians' attitudes towards products and their influence on prescribing behavior. The research has been conducted in the sample of psychiatrists in the Czech Republic. No evidence about pharmaceutical brand exceeding value of product has been found in reviewed literature. Nevertheless, the primary research conducted in the sample of Czech psychiatrists indicates that emotional brand in pharmaceutical industry exists and enables author to draw a model of Customer/product life cycle that describes likely impact of functional, emotional and self-expressive benefits throughout pharmaceutical product's market presence. Pharmaceutical brand is likely to develop differently than the same of consumer goods products--it seems to be built predominantly on long-term positive experience. Marketing role in this process should lie in finding relevant product position and building brand identity compliant with real product capabilities.

  15. Disability Income Insurance

    OpenAIRE

    Hayhoe, Celia Ray; Smith, Mike, CPF

    2009-01-01

    The purpose of disability income insurance is to partially replace your income if you are unable to work because of sickness or an accident. This guide reviews the types of disability insurance, important terms and concepts and employer provided benefits.

  16. Understanding health insurance plans

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  17. 76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2011-08-03

    ... Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services... regulations published July 19, 2010 with respect to group health plans and health insurance coverage offered... plans, and health insurance issuers providing group health insurance coverage. The text of those...

  18. 45 CFR 148.122 - Guaranteed renewability of individual health insurance coverage.

    Science.gov (United States)

    2010-10-01

    ... insurance coverage. 148.122 Section 148.122 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE INDIVIDUAL HEALTH INSURANCE MARKET... health insurance coverage. (a) Applicability. This section applies to all health insurance coverage in...

  19. Dental insurance: A systematic review.

    Science.gov (United States)

    Garla, Bharath Kumar; Satish, G; Divya, K T

    2014-12-01

    To review uses of finance in dentistry. A search of 25 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Insurance has come of ages and has become the mainstay of payment in many developed countries. So much so that all the alternative forms of payment which originated as an alternative to fee for service now depend on insurance at one point or the other. Fee for service is still the major form of payment in many developing countries including India. It is preferred in many instances since the payment is made immediately.

  20. 24 CFR 266.602 - Mortgage insurance premium: Insured advances.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

  1. State insurance exchanges face challenges in offering standardized choices alongside innovative value-based insurance.

    Science.gov (United States)

    Corlette, Sabrina; Downs, David; Monahan, Christine H; Yondorf, Barbara

    2013-02-01

    Value-based insurance is a relatively new approach to health insurance in which financial barriers, such as copayments, are lowered for clinical services that are considered high value, while consumer cost sharing may be increased for services considered to be of uncertain value. Such plans are complex and do not easily fit into the simplified, consumer-friendly comparison tools that many state health insurance exchanges are formulating for use in 2014. Nevertheless some states and plans are attempting to strike the right balance between a streamlined health exchange shopping experience and innovative, albeit complex, benefit design that promotes value. For example, agencies administering exchanges in Vermont and Oregon are contemplating offering value-based insurance plans as an option in addition to a set of standardized plans. In the postreform environment, policy makers must find ways to present complex value-based insurance plans in a way that consumers and employers can more readily understand.

  2. Farmers Insures Success

    Science.gov (United States)

    Freifeld, Lorri

    2012-01-01

    Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…

  3. Economic and Managerial Approach of Health Insurances

    Directory of Open Access Journals (Sweden)

    Marinela BOBOC

    2005-10-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizes the necessity and the opportunity ofcreating in Romania a medical service market based on the competing system. In Romania, the social insurances for health care are at their verybeginning. The development of the domain of the private insurances for health care is prevented even by its legislation, due to the lack of a normativeact that may regulate the management of the private insurances for health care. The establishment of the legislation related to the optional insurancesfor health care might lead to some activity norms for the companies which carry out optional insurances for health care. The change of the legislationis made in order to create normative and financial opportunities for the development of the optional medical insurances. This change, as part of thesocial protection of people, will positively influence the development of the medical insurance system. The extension of the segment of the optionalinsurances into the medical insurance segment increases the health protection budget with the value of the financial sources which do not belong tothe budgetary funds.

  4. INTEGRATION OF ROMANIAN INSURANCES MARKET IN EU

    Directory of Open Access Journals (Sweden)

    Gheorghe MOROŞAN

    2015-08-01

    Full Text Available One of the most important phenomena of the last decade has been the convergence of the financial services industry, especially the capital and insurance markets. The convergence in the insurance industry was determined by the increased frequency and the severity of catastrophic risks, market inefficiency in the past, and the new technologies in IT and communications. These globally developments can be observed much better at EU level, one of the most integrated areas of the world, which aimed the convergence of financial market, including an important component such as insurance market. As part of the EU, Romania also aims to financial market convergence with the EU countries. The article offers an overview and an analysis of the insurance market in the EU and Romania. Through a wide series of indicators such as: the amount of insurance premiums, degree of penetration, number of employees or number of insurance companies, it will analyze the evolution of this market convergence, as per all EU countries and Romania. It will identify the stage in which the insurance market in Romania is, regarding the requirements of full integration. Finally, there will be identified factors encouraging and particularly those who are impediments to insurance market convergence in Romania.

  5. 78 FR 7264 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2013-02-01

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [TD 9611] RIN 1545-BL49 Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations relating to the health insurance premium tax credit...

  6. 77 FR 41048 - Health Insurance Premium Tax Credit; Correction

    Science.gov (United States)

    2012-07-12

    ... the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [TD 9590] RIN 1545-BJ82 Health Insurance Premium Tax Credit; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  7. Logic models from an evaluability assessment of pharmaceutical services for people living with HIV/AIDS Modelos lógicos provenientes de estudo de avaliabilidade da assistência farmacêutica para pessoas vivendo com HIV/Aids

    Directory of Open Access Journals (Sweden)

    Angela Esher

    2011-12-01

    Full Text Available Brazil was the first developing country to provide people living with HIV/AIDS (PLWA with comprehensive, universal, free access to antiretroviral medicines (ARV. Pharmaceutical services are considered a strategic action that has the goal of providing access to rational use of quality medicines while also promoting user satisfaction. User satisfaction is a complex concept, and evaluation models for pharmaceutical services for PLWA were not found in the literature. Therefore, an evaluation approach to help assess this issue had to be developed. This article seeks to describe a theoretical evaluation model of user satisfaction with the dispensing of ARV, developed as part of an Evaluability Assessment (EA. It presents a brief review of the EA and user satisfaction and describes the development of models created during the EA. The lessons learned in the process are presented as a conclusion.O Brasil foi o primeiro país em desenvolvimento a fornecer medicamentos antiretrovirais (ARV de forma integral, universal e gratuita às pessoas vivendo com HIV/Aids (PVHA. A Assistência Farmacêutica é considerada uma ação estratégica e busca prover acesso a medicamentos de qualidade, com uso racional, promovendo a satisfação dos usuários. Satisfação do usuá-rio é um conceito complexo e modelos para avaliarem serviços farmacêuticos para PVHA não são encontrados na literatura. Este artigo objetiva descrever o desenvolvimento de três modelos criados em um Estudo de Avaliabilidade (EA. É apresentada uma breve revisão dos conceitos de EA e de Satisfação do Usuário. As lições apreendidas no processo são apresentadas como conclusão.

  8. ANALYSIS OF THE CURRENT STATE OF INSURANCE MARKET IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Melnyk Olga

    2018-03-01

    need to take foreign insurance experience and change their own operating models, in particular: to improve the mechanism of state regulation of the activity of insurance companies; to adapt the insurance legislation to the world standards; to implement the latest insurance technologies and the latest standards of service quality in this area, etc.

  9. Risks and nuclear insurance

    International Nuclear Information System (INIS)

    Debaets, M.; Springett, G.D.; Luotonen, K.; Virole, J.

    1988-01-01

    When analysing the nuclear insurance market, three elements must be taken into account: the nuclear operator's liability is regulated by national laws and/or international Conventions, such operators pay large premiums to insure their nuclear installations against property damage and finally, the nuclear insurance market is made up of pools and is mainly a monopoly. This report describes the different types of insurance coverage, the system governing nuclear third party liability under the Paris Convention and the Brussels Supplementary Convention and several national laws in that field. The last part of the report deals with liability and insurance aspects of international transport of nuclear materials [fr

  10. Employee Responses to Health Insurance Premium Increases

    OpenAIRE

    Goldman, Dana; Leibowitz, Arleen; Robalino, David

    2004-01-01

    Objective: To determine the sensitivity of employees’ health insurance decisions—including the decision to not choose health maintenance organization or fee-for-service coverage—during periods of rapidly escalating healthcare costs. Study Design: A retrospective cohort study of employee plan choices at a single large firm with a “cafeteria-style” benefits plan wherein employees paid all the additional cost of purchasing more generous insurance. Methods: We modeled the probabil...

  11. Do cost-sharing and entry deregulation curb pharmaceutical innovation?

    Science.gov (United States)

    Grossmann, Volker

    2013-09-01

    This paper examines the role of both cost-sharing schemes in health insurance systems and the regulation of entry into the pharmaceutical sector for pharmaceutical R&D expenditure and drug prices. The analysis suggests that both an increase in the coinsurance rate and stricter price regulations adversely affect R&D spending in the pharmaceutical sector. In contrast, entry deregulation may lead to higher R&D spending of pharmaceutical companies. The relationship between R&D spending per firm and the number of firms may be hump-shaped. In this case, the number of rivals which maximizes R&D expenditure per firm is decreasing in the coinsurance rate and increasing in labor productivity. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Pharmaceuticals: pharmaceutical cost controls--2005. End of Year Issue Brief.

    Science.gov (United States)

    Seay, Melicia; Varma, Priya

    2005-12-31

    The enactment of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90) gave states the option of offering pharmaceutical benefits within their Medicaid programs. But the law placed restrictions on states' flexibility to control what prescriptions they would cover and required the states to reimburse outpatient prescription drugs from manufacturers that signed rebate agreements with the U.S. Department of Health and Human Services. Forty-nine states--Arizona is excluded, based on its program structure--and the District of Columbia currently offer prescription drug coverage under the Medicaid Drug Rebate Program. During the past four years, states all over the country have been plagued with revenue shortfalls in their state Medicaid budgets. While the fiscal situation improved for most states in the 2004 legislative session, many states still face budget pressures in 2005. Compounding existing budget pressures are threats from the Bush Administration to shift increased costs of the Medicaid program on to the states. All things considered, the economic pressure of funding Medicaid is at the top of legislative agendas in 2005. As in previous years, states are attempting to reduce costs to their Medicaid programs by seeking savings in their pharmaceutical programs. Prescription drug costs are highly attributed as a contributing factor to the fiscal climate of state Medicaid programs. Currently, prescription drug spending outpaces that of every other category of health care and drug prices are rising faster than inflation. In response, states are instituting a variety of pharmaceutical cost control measures such as creating preferred drug lists (PDLs), negotiating supplemental rebates, forming bulk purchasing pools, promoting generic drug substitution and implementing price controls. As prescription drug cost containment tools have gained acceptance and momentum, they continue to be controversial. This issue brief explores the debate, history, methodology, utilization

  13. Does health insurance reduce out-of-pocket expenditure? Heterogeneity among China's middle-aged and elderly.

    Science.gov (United States)

    Zhang, Anwen; Nikoloski, Zlatko; Mossialos, Elias

    2017-10-01

    China's recent healthcare reforms aim to provide fair and affordable health services for its huge population. In this paper, we investigate the association between China's health insurance and out-of-pocket (OOP) healthcare expenditure. We further explore the heterogeneity in this association. Using data of 32,387 middle-aged and elderly individuals drawn from the 2011 and 2013 waves of China Health and Retirement Longitudinal Study (CHARLS), we report five findings. First, having health insurance increases the likelihood of utilizing healthcare and reduces inpatient OOP expenditure. Second, healthcare benefits are distributed unevenly: while low- and medium-income individuals are the main beneficiaries with reduced OOP expenditure, those faced with very high medical bills are still at risk, owing to limited and shallow coverage in certain aspects. Third, rural migrants hardly benefit from having health insurance, suggesting that institutional barriers are still in place. Fourth, health insurance does not increase patient visits to primary care facilities; hospitals are still the main provider of healthcare. Nonetheless, there is some evidence that patients shift from higher-tier to lower-tier hospitals. Last, OOP spending on pharmaceuticals is reduced for inpatient care but not for outpatient care, suggesting that people rely on inpatient care to obtain reimbursable drugs, putting further pressure on the already overcrowded hospitals. Our findings suggest that China's health insurance system has been effective in boosting healthcare utilization and lowering OOP hospitalization expenditure, but there still remain challenges due to the less generous rural scheme, shallow outpatient care coverage, lack of insurance portability, and an underdeveloped primary healthcare system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Public Insurance and Equality

    DEFF Research Database (Denmark)

    Landes, Xavier; Néron, Pierre-Yves

    2015-01-01

    Heath (among other political theorists) considers that the principle of efficiency provides a better normative explanation and justification of public insurance than the egalitarian account. According to this view, the fact that the state is involved in the provision of specific insurance (primarily......Public insurance is commonly assimilated with redistributive tools mobilized by the welfare state in the pursuit of an egalitarian ideal. This view contains some truth, since the result of insurance, at a given moment, is the redistribution of resources from the lucky to unlucky. However, Joseph...... surrounding public insurance as a redistributive tool, advancing the idea that public insurance may be a relational egalitarian tool. It then presents a number of relational arguments in favor of the involvement of the state in the provision of specific forms of insurance, arguments that have been overlooked...

  15. THE MODEL OF INTERACTION BETWEEN INSURANCE INTERMEDIARIES AND INSURANCE COMPANIES IN THE ASSURANCE OF SUSTAINABLE DEVELOPMENT OF THE INSURANCE MARKET

    Directory of Open Access Journals (Sweden)

    Nataliia Kudriavska

    2017-11-01

    Full Text Available The purpose of this paper is the investigation of the model of interaction between insurance intermediaries and insurance companies in the assurance of sustainable development of the insurance market. The methodology is based on the new studies and books. It is underlined the importance of potency and effectiveness of this model, its influence on the insurance market stability. It is analysed the European experience and specific of Ukrainian insurance market. The main ways for improving its model and ways of its practical realization are characterized. Results. The problems that exist in the broker market in general are connected with an ineffective state policy. In particular, we can say about the absence of many laws, acts, resolutions, which explain what a broker have to do in case of different problems with insurance companies, another brokers and clients. At the same time, the problem of distrust to national brokers exists. It provokes a decline of the demand for their services and so on. However, it is possible to solve these problems. Practical implications. For this, it is necessary to do some acts. The first one is to implement resolutions that regulate relationships between insurance brokers and insurance companies, clearly regulate the model of its interaction. This model affects the stability of the insurance market in general. The second is to find methods of solving problems of the increase in insurance culture of the population (for example, by the way of advertisement. The third one is to solve problems connected with the appearance of foreign brokers in the insurance market of Ukraine. Actually, the Ukrainian market of insurance brokers is not developed enough. That is why it needs big changes and reforms. Value/originality. Among alternatives of the strategic development of insurance, the method of quick liberalization and gradual development is distinguished. According to the liberal way, it is possible to transfer to the

  16. The shaping of pharmaceutical governance: the Israeli case

    Science.gov (United States)

    2014-01-01

    This article focuses on governance of the pharmaceutical sector in Israel. It traces the relationships between the state, industry, and sick funds from before the establishment of National Health Insurance (NHI) in 1995 to the beginning of this decade, in particular as they have grappled with the challenge of making national formulary decisions in a rational manner. Subsequent to the introduction of NHI there have been shifts in the modes and mix of governance. This research shows empirically that a relatively complex mix of hierarchical and network modes of governance can be successfully established over an extended period of time when flexibility is maintained through the implementation process. The system for defining and updating a standard basket of health services has coped well with the challenge of managing a range of difficult and potentially volatile stakeholder relationships in the pharmaceutical sector and of distancing ministers from controversies of funding and listing decisions. Government has succeeded in containing drug costs whilst still maintaining a basket of reimbursable drugs that, from an international perspective, is comprehensive and technologically advanced. On the other hand, network arrangements appear to have delayed the introduction of suitable accountability relationships and hindered their development. The state has traditionally played an intermediary role between unavoidable corporate interests of industry and sick funds, with little transparency and to the detriment of more pluralistic access to decision making. Governance arrangements in Israel appear to limit the potential and incentive of the state and the sick funds to realize their potential countervailing powers in subsidy and pricing decisions. PMID:24914409

  17. Pharmaceutical expenditure changes in Serbia and Greece during the global economic recession

    Directory of Open Access Journals (Sweden)

    Mihajlo Jakovljevic

    2016-04-01

    Full Text Available Aim: Clarity on health expenditures is essential for the timely identification of risks that jeopardize the democratic provision of health services and the credibility of health insurance systems. Furthermore, observing health outcomes with geographical scope is essential for making multilateral associations. This study aimed at conveying information on the variability of important economic parameters of the health sector of Serbia and Greece from 2007 to 2012, when the most serious financial crisis in the post-war economic history hit the global economy. Methods: Exchange rates, purchase-power-parities (PPP and price indices were used for the bilateral review of health and pharmaceutical expenditure dynamics during 2007-2012. Prescription and dispensing changes were also studied taking into account the anatomical therapeutic chemical (ATC structure of drugs consumed. Results: Greece was forced to cut down its total health care and pharmaceutical expenditure and mainly its out-of-pocket payments were more seriously affected by the recession. Surprisingly, emerging market of Serbia, although severely damaged by global recession, succeeded to maintain 19% growth of its per capita health expenditure and even 25% increase of its per capita spending on pharmaceuticals. Innovative pharmaceuticals showed an upward trend in both countries. Conclusions: These two countries might serve as an example of two distinct pathways of mature and emerging health care markets during financial constraints caused by global recession. Our findings show that producing disease-based feedback, in the long run, may empower the assessment of the return on investment on medical technology and healthcare systems’ cost-effectiveness.

  18. Main Determinants of Supplementary Health Insurance Demand: (Case of Iran)

    Science.gov (United States)

    Motlagh, Soraya Nouraei; Gorji, Hassan Abolghasem; Mahdavi, Ghadir; Ghaderi, Hossein

    2015-01-01

    Introduction: In the majority of developing countries, the volume of medical insurance services, provided by social insurance organizations is inadequate. Thus, supplementary medical insurance is proposed as a means to address inadequacy of medical insurance. Accordingly, in this article, we attempted to provide the context for expansion of this important branch of insurance through identification of essential factors affecting demand for supplementary medical insurance. Method: In this study, two methods were used to identify essential factors affecting choice of supplementary medical insurance including Classification and Regression Trees (CART) and Bayesian logit. To this end, Excel® software was used to refine data and R® software for estimation. The present study was conducted during 2012, covering all provinces in Iran. Sample size included 18,541 urban households, selected by Statistical Center of Iran using 3-stage cluster sampling approach. In this study, all data required were collected from the Statistical Center of Iran. Results: In 2012, an overall 8.04% of the Iranian population benefited from supplementary medical insurance. Demand for supplementary insurance is a concave function of age of the household head, and peaks in middle-age when savings and income are highest. The present study results showed greater likelihood of demand for supplementary medical insurance in households with better economic status, higher educated heads, female heads, and smaller households with greater expected medical expenses, and household income is the most important factor affecting demand for supplementary medical insurance. Conclusion: Since demand for supplementary medical insurance is hugely influenced by households’ economic status, policy-makers in the health sector should devise measures to improve households’ economic or financial access to supplementary insurance services, by identifying households in the lower economic deciles, and increasing their

  19. MARKETING STRATEGY OF COMMERCIAL HEALTH INSURANCE COMPANY

    Directory of Open Access Journals (Sweden)

    Cut Zaraswati

    2017-01-01

    Full Text Available The objectives of this research are to: 1 compare the effect of premium earnings products of health insurances after the launching of national social health insurance (JKN-BPJS (Badan Penyelenggara Jaminan Sosial for health; 2 analyze the internal and external factors of private/commercial health insurance companies; 3 formulate a marketing strategyy for health insurance product after the operation of JKN-BPJS for health.  It is a challenge for commercial health insurance to survive and thrive with the existence of JKN-BPJS for health which is compulsory to Indonesia’s citizens to be a member. The research begins by analyzing premium earnings of the commercial health insurance company one year before and after the implementation of JKN-BPJS for health, the intensive interviews and questionnaires to the chosen resource person (purposive samplings, the analysis on Internal Factor Evaluation (IFE, External Factor Evaluation (EFE, Matrix IE and SWOT are used in the research. Then it is continued by arranging a strategic priority using Analytical Hierarchy Process (AHP.  The result from the research is there is totally no decreasing premium earnings for the commercial health insurance company although the growth trend shows a slight drop.  The appropriate strategy for the health insurance company in the commercial sector is the differentiation where the implication is involving customer service quality improvement, product innovation, and technology and infrastructure development.      Keywords:  commercial health insurance company, Marketing Strategy, AHP Analysis, national social health insurance

  20. Public awareness of Pharmaceutical care availability in community ...

    African Journals Online (AJOL)

    Furthermore, the awareness of availability of pharmaceutical care services in community pharmacies was 3% while 75% of the respondents believed a community pharmacy was just a place drugs can be obtained. As the profession and pharmacists endeavour to improve knowledge and skill to deliver pharmaceutical care ...

  1. Impact of Economic Crisis on Credit Insurance Market in Romania

    Directory of Open Access Journals (Sweden)

    Florina VÎRLANUTA

    2012-11-01

    Full Text Available Bank Insurance phenomenon can not be attributed primarily or banks or insurance institutions. Near the two sectors was due to mutations occurring in supply and demand for financial services. Convergence bankers and insurers are determined by common platform for each country of local influence by supervisors and reforms at the central level. Credit insurance has emerged as a necessity stemming from the fact that most trade agreements concluded in circumstances in which payment is partially or completely after delivery of the goods or services covered by the agreement, so the payment delayed or selling on credit.

  2. The claims handling process of liability insurance in South Africa

    Directory of Open Access Journals (Sweden)

    Jacoline van Jaarsveld

    2015-04-01

    Full Text Available Liabilities play a very important financial role in business operations, professional service providers as well as in the personal lives of people. It is possible that a single claim may even lead to the bankruptcy of the defendant. The claims handling process of liability insurance by short-term insurers is therefore very important to these parties as it should be clear that liability claims may have enormous and far-reaching financial implications for them. The objective of this research paper embodies the improvement of financial decision-making by short-term insurers with regard to the claims handling process of liability insurance. Secondary data was initially studied which provided the basis to compile a questionnaire for the empirical survey. The leaders of liability insurance in the South African short-term insurance market that represented 69.5% of the annual gross written premiums received for liability insurance in South Africa were the respondents of the empirical study. The perceptions of these short-term insurers provided the primary data for the vital conclusions of this research. This paper pays special attention to the importance of the claims handling factors of liability insurance, how often the stipulations of liability insurance policies are adjusted by the short-term insurers to take the claims handling factors into consideration, as well as the problem areas which short-term insurers may experience during the claims handling process. Feasible solutions to address the problem areas are also discussed.

  3. 42 CFR 411.51 - Beneficiary's responsibility with respect to no-fault insurance.

    Science.gov (United States)

    2010-10-01

    ...-fault insurance. 411.51 Section 411.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PAYMENT Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance § 411.51 Beneficiary's responsibility with respect to no-fault insurance. (a) The beneficiary is...

  4. 75 FR 74863 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...

    Science.gov (United States)

    2010-12-01

    ... Part III Department of Health and Human Services 45 CFR Part 158 Health Insurance Issuers... 0950-AA06 Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient... health insurance issuers under the Public Health Service Act, as added by the Patient Protection and...

  5. 77 FR 28788 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the Patient Protection and...

    Science.gov (United States)

    2012-05-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 158 [CMS-9998-IFC3] Health Insurance Issuers..., entitled ``Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...) requirements for health insurance issuers under section 2718 of the Public Health Service Act, as added by the...

  6. Pharmaceutical cocrystals: an overview.

    Science.gov (United States)

    Qiao, Ning; Li, Mingzhong; Schlindwein, Walkiria; Malek, Nazneen; Davies, Angela; Trappitt, Gary

    2011-10-31

    Pharmaceutical cocrystals are emerging as a new class of solid drugs with improved physicochemical properties, which has attracted increased interests from both industrial and academic researchers. In this paper a brief and systematic overview of pharmaceutical cocrystals is provided, with particular focus on cocrystal design strategies, formation methods, physicochemical property studies, characterisation techniques, and recent theoretical developments in cocrystal screening and mechanisms of cocrystal formations. Examples of pharmaceutical cocrystals are also summarised in this paper. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Impacto de un servicio de seguimiento farmacoterapéutico implementado a pacientes con diabetes mellitus tipo 2 Impact of a pharmaceutical follow-up service implemented in type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    Yaily Lazo Roblejo

    2011-06-01

    Full Text Available Se evaluó el impacto de un servicio de seguimiento farmacoterapéutico implementado a 30 pacientes con diabetes mellitus tipo 2, dispensarizados en la Farmacia Principal Municipal Santiago de Cuba, según la metodología Dáder, en el período comprendido desde enero del 2009 hasta enero de 2010. El índice de impacto de la estabilidad clínica de los pacientes resultó moderado, mientras que en las intervenciones farmacéuticas aceptadas y el nivel de satisfacción de los pacientes, los índices de impacto obtenidos fueron elevados, por lo que el impacto global del servicio de seguimiento farmacoterapéutico implementado para la atención de estos fue considerado alto.The impact of a pharmacotherapy follow-up service was assessed in 30 patients dispensarized in municipal main drugstore of Santiago de Cuba according to Dáder's methodology from January, 2009 to January, 2010. The level of the clinical stability impact of patients was qualified as moderate, whereas in the accepted pharmaceutical interventions and at level of patient's satisfaction, the rates of impact achieved were high thus; the global above mentioned service repercussion was also qualified as high.

  8. Nuclear insurance fire risk

    International Nuclear Information System (INIS)

    Dressler, E.G.

    2001-01-01

    Nuclear facilities operate under the constant risk that radioactive materials could be accidentally released off-site and cause injuries to people or damages to the property of others. Management of this nuclear risk, therefore, is very important to nuclear operators, financial stakeholders and the general public. Operators of these facilities normally retain a portion of this risk and transfer the remainder to others through an insurance mechanism. Since the nuclear loss exposure could be very high, insurers usually assess their risk first-hand by sending insurance engineers to conduct a nuclear insurance inspection. Because a serious fire can greatly increase the probability of an off-site release of radiation, fire safety should be included in the nuclear insurance inspection. This paper reviews essential elements of a facility's fire safety program as a key factor in underwriting nuclear third-party liability insurance. (author)

  9. Pharmaceutical policies: effects of financial incentives for prescribers.

    Science.gov (United States)

    Rashidian, Arash; Omidvari, Amir-Houshang; Vali, Yasaman; Sturm, Heidrun; Oxman, Andrew D

    2015-08-04

    The proportion of total healthcare expenditures spent on drugs has continued to grow in countries of all income categories. Policy-makers are under pressure to control pharmaceutical expenditures without adversely affecting quality of care. Financial incentives seeking to influence prescribers' behaviour include budgetary arrangements at primary care and hospital settings (pharmaceutical budget caps or targets), financial rewards for target behaviours or outcomes (pay for performance interventions) and reduced benefit margin for prescribers based on medicine sales and prescriptions (pharmaceutical reimbursement rate reduction policies). This is the first update of the original version of this review. To determine the effects of pharmaceutical policies using financial incentives to influence prescribers' practices on drug use, healthcare utilisation, health outcomes and costs (expenditures). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (searched 29/01/2015); MEDLINE, Ovid SP (searched 29/01/2015); EMBASE, Ovid SP (searched 29/01/2015); International Network for Rational Use of Drugs (INRUD) Bibliography (searched 29/01/2015); National Health Service (NHS) Economic Evaluation Database (searched 29/01/2015); EconLit - ProQuest (searched 02/02/2015); and Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Knowledge (citation search for included studies searched 10/02/2015). We screened the reference lists of relevant reports and contacted study authors and organisations to identify additional studies. We included policies that intend to affect prescribing by means of financial incentives for prescribers. Included in this category are pharmaceutical budget caps or targets, pay for performance and drug reimbursement rate reductions and other financial policies, if they were specifically targeted at prescribing or drug utilisation. Policies in this review were defined as laws, rules

  10. 76 FR 37194 - Surety Companies Acceptable In Federal Bonds; Termination; Clearwater Insurance Company

    Science.gov (United States)

    2011-06-24

    ... to the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and...: June 16, 2011. Laura Carrico, Director, Financial Accounting and Services Division, Financial...; Termination; Clearwater Insurance Company AGENCY: Financial Management Service, Fiscal Service, Department of...

  11. Pharmaceutical costs of assisted reproduction in Spain.

    Science.gov (United States)

    Lorente, Maria-Reyes; Hernández, Juana; Antoñanzas, Fernando

    2013-11-01

    Assisted reproduction is one of the health services currently being considered for possible limitation or exclusion from the public health services portfolio in Spain. One of the main reasons claimed for this is the impact on the budget for pharmaceutical expenditure. The objective of this study was to assess the significance of the pharmaceutical costs of assisted reproduction in Spain. This study focused on medical practice in Spain, and is based on the opinions of experts in assisted reproduction and the results provided by professional societies' publications. The reference year is 2012 and the setting was secondary care. We have included all existing pharmaceutical modalities for assisted reproduction, as well as the most common drug for each modality. We have considered the pharmaceutical cost per cycle for artificial insemination, in vitro fertilisation with or without intracytoplasmic sperm injection (IVF_ICSI), and cryotransfer and donated fresh oocytes reception. In Spain, artificial insemination has a pharmaceutical cost per cycle of between €69.36 and €873.79. This amounts to an average cycle cost of €364.87 for partner's sperm and €327.10 for donor sperm. The pharmaceutical cost of IVF_ICSI ranges between €278.16 and €1,902.66, giving an average cost per cycle of €1,139.65. In the case of cryotransfer and donated fresh oocytes reception, the pharmaceutical cost per cycle is between €22.61 and €58.73, yielding an average cost of €40.67. The budgetary impact of pharmaceutical expenditure for assisted reproduction in Spain for the year 2012 was estimated at €98.7 million. In Spain, the total pharmaceutical cost of assisted reproduction is substantial. According to our results, we can say that about 29% of the total pharmaceutical expenditure for assisted reproduction techniques is funded by the National Health System and the rest represents 2.4% of the total annual out-of-pocket family expenditure on drugs.

  12. Nonlife Insurance Pricing:

    Science.gov (United States)

    Darooneh, Amir H.

    We consider the insurance company as a physical system which is immersed in its environment (the financial market). The insurer company interacts with the market by exchanging the money through the payments for loss claims and receiving the premium. Here, in the equilibrium state, we obtain the premium by using the canonical ensemble theory, and compare it with the Esscher principle, the well-known formula in actuary for premium calculation. We simulate the case of car insurance for quantitative comparison.

  13. Household perceptions and their implications for enrollment in the National Health Insurance Scheme in Ghana.

    NARCIS (Netherlands)

    Jehu-Appiah, C.; Aryeetey, G.C.; Agyepong, I.; Spaan, E.J.; Baltussen, R.M.

    2012-01-01

    OBJECTIVE: This paper identifies, ranks and compares perceptions of insured and uninsured households in Ghana on health care providers (quality of care, service delivery adequacy, staff attitudes), health insurance schemes (price, benefits and convenience) and community attributes (health 'beliefs

  14. EU pharmaceutical expenditure forecast

    OpenAIRE

    Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    Background and Objectives: With constant incentives for healthcare payers to contain their pharmaceutical budgets, forecasting has become critically important. Some countries have, for instance, developed pharmaceutical horizon scanning units. The objective of this project was to build a model to assess the net effect of the entrance of new patented medicinal products versus medicinal products going off-patent, with a defined forecast horizon, on selected European Union (EU) Member States’ ph...

  15. Catastrophic risks and insurance

    International Nuclear Information System (INIS)

    Deprimoz, J.

    1988-01-01

    This short communication deals with compensation for nuclear damage and compensation for environmental pollution through industrial activities and compress both systems and their insurance coverage [fr

  16. Prescriptions and Insurance Plans

    Science.gov (United States)

    ... contributed by: familydoctor.org editorial staff Categories: Healthcare Management, Insurance & Bills, Your Health ResourcesTags: brand name, co-pay, drug, formulary, generic, isurance, medicine, ...

  17. Uninsured vs. insured population

    DEFF Research Database (Denmark)

    Andersen, Z. J.; Lin, Chyongchiou J; Chang, Chung-Chou H

    2003-01-01

    analyzed. Approximately 74 percent of uninsured Americans are nonelderly Americans. Among the nonelderly Americans, about 17 percent are uninsured. Our findings show that insurance status varies significantly by region, age, race, gender, marital status, income, education, employment status, and health......This study identified the underlying demographic and socioeconomic factors associated with insurance status among nonelderly Americans (age 19-64), as well as compared health care utilization between insured and uninsured. Data from the Community Tracking Study 1996-1997 Household Survey were...... status. Also, the insured nonelderly Americans were found to have better access to health care than the uninsured nonelderly....

  18. Providing Universal Health Insurance Coverage in Nigeria.

    Science.gov (United States)

    Okebukola, Peter O; Brieger, William R

    2016-07-07

    Despite a stated goal of achieving universal coverage, the National Health Insurance Scheme of Nigeria had achieved only 4% coverage 12 years after it was launched. This study assessed the plans of the National Health Insurance Scheme to achieve universal health insurance coverage in Nigeria by 2015 and discusses the challenges facing the scheme in achieving insurance coverage. In-depth interviews from various levels of the health-care system in the country, including providers, were conducted. The results of the analysis suggest that challenges to extending coverage include the difficulty in convincing autonomous state governments to buy into the scheme and an inadequate health workforce that might not be able to meet increased demand. Recommendations for increasing the scheme's coverage include increasing decentralization and strengthening human resources for health in the service delivery systems. Strong political will is needed as a catalyst to achieving these goals. © The Author(s) 2016.

  19. Trends in diabetic retinopathy and related medical practices among type 2 diabetes patients: Results from the National Insurance Service Survey 2006-2013.

    Science.gov (United States)

    Song, Su Jeong; Han, Kyungdo; Choi, Kyung Seek; Ko, Seung-Hyun; Rhee, Eun-Jung; Park, Cheol-Young; Park, Joong-Yeol; Lee, Ki-Up; Ko, Kyung-Soo

    2018-01-01

    The present study aimed to analyze the temporal changes in the prevalence, screening rate, visual impairments and treatment patterns of diabetic retinopathy in the Korean population over 8 years. This was a retrospective population-based study of Korean national health insurance beneficiaries aged 30 years or older with type 2 diabetes, obtained from the Korean National Health Insurance Claims database from 2006 to 2013 (n = 1,655,495 in 2006 and 2,720,777 in 2013). The annual prevalence rates of diabetes, diabetic retinopathy, dilated fundus examinations, visual impairment, laser treatment and vitrectomy, as determined based on diagnostic and treatment codes, were analyzed. There was a steady increase in the prevalence of diabetic retinopathy, from 14.3% in 2006 to 15.9% in 2013. However, the incidence of new diabetic retinopathy cases decreased from 6.7/100 person-years in 2006 to 5.6 in 2013. Approximately 98% of patients underwent at least one dilated fundus examination during the follow-up period. The prevalence of diabetic retinopathy peaked in the 60-69 years age group. The prevalence of diabetic retinopathy was higher in female than in male diabetes patients. The proportion of patients who underwent an annual dilated fundus examination improved from 24.3% in 2006 to 30.0% in 2013. Among patients with diabetic retinopathy, constant decreases in the proportions of those who received laser treatment (11.4% in 2006 to 6.9% in 2013) and who underwent vitrectomy (2.4% in 2006 to 1.7% in 2013) were noted. Additionally, a decreasing trend in the prevalence of visual impairment was noted among the patients with diabetic retinopathy, from 2% (4,820/237,267) in 2006 to 0.08% (3,572/431,964) in 2013. Although there was a rapid increase in the prevalence of diabetes in the Korean population in the past decade, the prevalence of diabetic retinopathy remained stable during the study period. However, just three out of 10 patients with diabetes underwent regular annual

  20. A judicialização da saúde e os novos desafios da gestão da assistência farmacêutica Health litigation and new challenges in the management of pharmaceutical services

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Edais Pepe

    2010-08-01

    Full Text Available Os desafios para a gestão da assistência farmacêutica (AF provocados pelo fenômeno da judicialização da saúde vêm exigindo um tipo de atuação do gestor, administrativa e judicialmente diferenciada, no sentido de responder às ordens judiciais, evitar o crescimento de novas demandas, bem como preservar os princípios e as diretrizes do Sistema Único de Saúde (SUS. Este artigo se propõe a avançar na compreensão de um dos aspectos da judicialização da saúde, representado pelo intenso uso da via judicial para fornecimento de medicamentos, em especial, a relação deste mecanismo com a gestão da AF no SUS. A partir de revisão e análise das pesquisas disponíveis, realizadas em estados e municípios brasileiros, são abordados os principais elementos de interferência da "judicialização de medicamentos" no ciclo da AF, explicitando características comuns e divergentes desta demanda. Aponta, ao final, mecanismos possíveis de serem adotados na tomada de decisão neste âmbito, pelos gestores e profissionais do sistema de justiça, uma vez que a efetivação do direito à saúde só se realizará se no momento da tomada de decisão forem adotadas medidas, tanto por parte da gestão da AF como do Poder Judiciário, que certifiquem a segurança e a proteção dos usuários.Health litigation spurs many challenges in the management of pharmaceutical services. Performance of health managers and decisionmakers must be adjusted to new administrative and legal boundaries. Their actions must also be efficient in responding to ongoing lawsuits, as well as in avoiding additional litigation and in upholding principles and directives of the Brazilian Health System (SUS. This paper proposes to better understand one of the aspects of health litigation, namely the growing use of lawsuits demanding medicines, and the relationship between this phenomenon and pharmaceutical services management in SUS. Through review and analysis of available

  1. The Impact of Direct and Indirect of internal marketing on service quality and mediating role of OCB CASE: Iran Insurance Company

    OpenAIRE

    Hassan Ghorbani; Maedeh Mostafavi

    2013-01-01

    Internal Marketing is attracting, developing, motivating, and retaining qualified employees through job-products that satisfy their needs. Organizational citizenship behavior is conceptualized as synonymous with the concept of contextual performance, defined as ‘performance that supports the social and psychological environment in which task performance takes place. Service quality is defined as how well the service meets or exceeds the customers’ expectations on a consistent basis. The conce...

  2. Competitive Advantage in the Service Industry : The Importance of Strategic Congruence, Integrated Control and Coherent Organisational Structure – A Longitudinal Case Study of an Insurance Company

    OpenAIRE

    Poth, Susanna

    2014-01-01

    Competitive advantage has received considerable attention. Few studies have however chosen a holistic approach taking multiple aspects and organisational levels into consideration. This research has the goal of filling parts of this void. The aim is to deepen the understanding of competitive advantage in the service industry by analysing how alignment of strategy, control and organisation structure on multiple organisational levels impacts competitive advantage of a service company over a lon...

  3. The insurance of nuclear installations

    International Nuclear Information System (INIS)

    Francis, H.W.

    1977-01-01

    A brief account is given of the development of nuclear insurance. The subject is dealt with under the following headings: the need for nuclear insurance, nuclear insurance pools, international co-operation, nuclear installations which may be insured, international conventions relating to the liability of operators of nuclear installations, classes of nuclear insurance, nuclear reactor hazards and their assessment, future developments. (U.K.)

  4. An Evaluation of Takaful Insurance: Case of Pakistan

    OpenAIRE

    Hanif, Muhammad; Iqbal, Abdullah

    2014-01-01

    Islamic finance being a relatively new business segment, however, have shown promising results so far. In addition to banking services, Islamic finance has started penetrating in other sectors including capital markets and insurance. This study aims to evaluate the newly emerging Takaful sector in Pakistani market. The study covers an overview of insurance sector including Takaful; comparative financial analysis of Takaful industry with conventional insurance; an insight into the accounting a...

  5. Patients\\' Perception of the Benefits of Pharmaceutical Care ...

    African Journals Online (AJOL)

    Patients\\' Perception of the Benefits of Pharmaceutical Care Services in the Management of Hypertension in a Tertiary Health Care Facility in Benin City. ... effects, exercises, weight and blood pressure control were rated as “not beneficial”.

  6. The spillover effects of health insurance benefit mandates on public insurance coverage: Evidence from veterans.

    Science.gov (United States)

    Li, Xiaoxue; Ye, Jinqi

    2017-09-01

    This study examines how regulations in private health insurance markets affect coverage of public insurance. We focus on mental health parity laws, which mandate private health insurance to provide equal coverage for mental and physical health services. The implementation of mental health parity laws may improve a quality dimension of private health insurance but at increased costs. We graphically develop a conceptual framework and then empirically examine whether the regulations shift individuals from private to public insurance. We exploit state-by-year variation in policy implementation in 1999-2008 and focus on a sample of veterans, who have better access to public insurance than non-veterans. Using data from the Current Population Survey, we find that the parity laws reduce employer-sponsored insurance (ESI) coverage by 2.1% points. The drop in ESI is largely offset by enrollment gains in public insurance, namely through the Veterans Affairs (VA) benefit and Medicaid/Medicare programs. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. STATE AND PROBLEMS OF DEVELOPMENT OF INSURANCE MARKET OF UKRAINE

    Directory of Open Access Journals (Sweden)

    L. V. Martseniuk

    2016-04-01

    Full Text Available Purpose. The insurance market of Ukraine is still interesting for foreign investors. However, there is a range of negative factors. They are: 1 the old regulatory framework, public access and transparency of the insurance market for population; 2 low profitability of certain types of insurance; 3 low competitiveness of the insurance companies in comparison with commercial banks in attraction drive of free funds of legal entities and individuals; 4 insufficient state regulation and control does not allow the insurance market to develop effectively. Therefore, the purpose of the article is to analyze and identify the causes that hinder the development of insurance business in Ukraine, as well as to determine the directions of insurance market development. Methodology. To achieve this purpose the article determines the total number of insurance companies, composes the gross payment rating of the largest of them, presents the dynamics of net insurance premiums for basic insurance. This analysis allows you to identify problematic issues and activities of the insurance market. Findings. The analysis of the article revealed a number of factors that prevent successful development of insurance in Ukraine. The authors suggest priority areas for improving the situation in the insurance market. It was found that the main tasks of the development of insurance are: 1 legal framework reform; 2 improving competitiveness, investment attractiveness of the insurance companies; 3 development of modern infrastructure of the insurance market; 4 expanding the range of services and their compliance with international standards; 5 personnel development; 6 improvement of insurance activity licensing; 7 building of culture and public trust. At the same time the increase in the population solvency, economic and political stability in the country will contribute to the stabilization and intensive development of the insurance market. Originality. The article firstly

  8. 78 FR 46373 - Manufacturer of Controlled Substances; Notice of Registration; Johnson Matthey Pharmaceutical...

    Science.gov (United States)

    2013-07-31

    ...; Notice of Registration; Johnson Matthey Pharmaceutical Materials, Inc. By Notice dated March 20, 2013, and published in the Federal Register on March 28, 2013, 78 FR 19017, Johnson Matthey Pharmaceutical Materials, Inc., Pharmaceutical Services, 25 Patton Road, Devens, Massachusetts 01434, made application by...

  9. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Science.gov (United States)

    2010-01-01

    ...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE... is an insurer which is licensed in one state and is authorized, under the Products Liability Risk... insurance commission or regulatory agency challenges the legal authority of such group, FmHA or its...

  10. Insuring against Health Shocks: Health Insurance and Household Choices

    OpenAIRE

    Liu, Kai

    2015-01-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...

  11. On international cost-sharing of pharmaceutical R&D.

    Science.gov (United States)

    Barros, Pedro Pita; Martinez-Giralt, Xavier

    2008-12-01

    Ramsey pricing has been proposed in the pharmaceutical industry as a principle to price discriminate among markets while allowing to recover the (fixed) R&D cost. However, such analyses neglect the presence of insurance or the fund raising costs for most of drug reimbursement. By incorporating these new elements, we aim at providing some building blocks towards an economic theory incorporating Ramsey pricing and insurance coverage. We show how coinsurance affects the optimal prices to pay for the R&D investment. We also show that under certain conditions, there is no strategic incentive by governments to set coinsurance rates in order to shift the financial burden of R&D. This will have important implications to the application of Ramsey pricing principles to pharmaceutical products across countries.

  12. Nuclear energy and insurance

    International Nuclear Information System (INIS)

    Dow, J.C.

    1989-01-01

    It was the risk of contamination of ships from the Pacific atmospheric atomic bomb tests in the 1940's that seems first to have set insurers thinking that a limited amount of cover would be a practical possibility if not a commercially-attractive proposition. One Chapter of this book traces the early, hesitant steps towards the evolution of ''nuclear insurance'', as it is usually called; a term of convenience rather than exactitude because it seems to suggest an entirely new branch of insurance with a status of its own like that of Marine, Life or Motor insurance. Insurance in the field of nuclear energy is more correctly regarded as the application of the usual, well-established forms of cover to unusual kinds of industrial plant, materials and liabilities, characterised by the peculiar dangers of radioactivity which have no parallel among the common hazards of industry and commerce. It had, and still has, the feature that individual insurance underwriters are none too keen to look upon nuclear risks as a potential source of good business and profit. Only by joining together in Syndicates or Pools have the members of the national insurance markets been able to make proper provision for nuclear risks; only by close international collaboration among the national Pools have the insurers of the world been able to assemble adequate capacity - though still, even after thirty years, not sufficient to provide complete coverage for a large nuclear installation. (author)

  13. Social health insurance

    CERN Document Server

    International Labour Office. Geneva

    1997-01-01

    This manual provides an overview of social health insurance schemes and looks at the development of health care policies and feasibility issues. It also examines the design of health insurance schemes, health care benefits, financing and costs and considers the operational and strategic information requirements.

  14. Marketing in life insurance

    Directory of Open Access Journals (Sweden)

    Njegomir Vladimir

    2006-01-01

    Full Text Available Insurance industry has traditionally been oriented on sale of its products i.e. at the stage which from the aspect of marketing theory can be characterized as sales phase, phase which proceeds the marketing orientation. However, faced with numerous challenges of modern business environment such as globalization, deregulation and sophisticated information technology insurance companies must change their way of doing business. Competition is becoming fierce as insurance companies are faced with competition not only from insurance industry but also from other competitors, such as banks, that are in position to offer product substitutes for life insurance products. In this new environment information about customers and their education are becoming critical factors. Insurance companies must know their customers what influences their demand for life insurance, what is the amount of their income, what is inflation rate, their expenditures on other goods i.e. opportunity costs, etc. Those are factors that force insurance companies to concentrate more on present and potential buyers and their needs and force them to give their best to satisfy those needs in a way that will produce delighted customers.

  15. Unemployment Insurance and Inequality

    DEFF Research Database (Denmark)

    Larsen, Birthe; Waisman, Gisela

    This paper examines the impact of higher unemployment insurance on the fraction of the work force paying into an unemployment insurance fond, wage differences and therefore inquality and education letting worker initial wealth being important for the decisions and implied values. As usually higher...... educated workers receive a lower fraction of their wages as unemployment insurance, we consider how the impact on labour market performance and wage differences and thereby inequality differ dependent on whether educated or uneducated workers receive higher benefits. The model can help shed light...... on the the puzzle why only some workers, for given educational level, pay into an unemployment insurance fond, the lower wealth mobility than income mobility as well as the relative compressed wage structure in countries with generous social assistance as well as unemployment insurance for low income workers...

  16. Health insurance for "frontaliers"

    CERN Multimedia

    2013-01-01

    The French government has decided that, with effect from 1 June 2014, persons resident in France but working in Switzerland (hereinafter referred to as “frontaliers”) will no longer be entitled to opt for private French health insurance provision as their sole and principal health insurance.   The right of choice, which was granted by the Bilateral Agreement on the Free Movement of Persons between Switzerland and the European Union and which came into force on 1 June 2002, exempts “frontaliers” from the obligation to become a member of Switzerland’s compulsory health insurance scheme (LAMal) if they can prove that they have equivalent coverage in France, provided by either the French social security system (CMU) or a private French insurance provider. As the latter option of private health insurance as an alternative to membership of LAMal will be revoked under the new French legislation that will come into force on 1 June 2014, current “...

  17. WILLINGNESS TO TAKE AGRICULTURAL INSURANCE BY COCOA FARMERS IN NIGERIA

    Directory of Open Access Journals (Sweden)

    Abraham Falola

    2013-07-01

    Full Text Available This study examines willingness to take agricultural insurance by cocoa farmers in Nigeria. A three-stage sampling procedure was used to select 120 cocoa farm households and structured questionnaire was used to elicit data from the respondents. The data were analysed with descriptive statistics and probit regression model. Results showed that 77.5% of the farmers were aware of Agricultural Insurance but only 50% were willing to take it. The average willingness-to-pay (WTP for Agricultural Insurance by the respondents was N11,087.5/ha ($69.85/ha. The significant variables influencing willingness to take agricultural insurance by the farmers were age of household head, educational level, access to extension service and farm income. The study therefore recommends encouraging young well educated people to engage in cocoa farming, overhauling agricultural extension services as well as provision of insurance services to farmers at affordable rate.

  18. Terrorism Risk Insurance: An Overview

    National Research Council Canada - National Science Library

    Webel, Baird

    2005-01-01

    .... Addressing this problem, Congress enacted the Terrorism Risk Insurance Act of 2002 (TRIA) to create a temporary program to share future insured terrorism losses with the property-casualty insurance industry and policyholders...

  19. Insurance: Accounting, Regulation, Actuarial Science

    OpenAIRE

    Alain Tosetti; Thomas Behar; Michel Fromenteau; Stéphane Ménart

    2001-01-01

    We shall be examining the following topics: (i) basic frameworks for accounting and for statutory insurance rules; and (ii) actuarial principles of insurance; for both life and nonlife (i.e. casualty and property) insurance.Section 1 introduces insurance terminology, regarding what an operation must include in order to be an insurance operation (the legal, statistical, financial or economic aspects), and introduces the accounting and regulation frameworks and the two actuarial models of insur...

  20. Risk Management in Insurance Companies

    OpenAIRE

    Yang, Xufeng

    2006-01-01

    Insurance is the uncertain business in uncertain society. Today, insures face more complex and difficult risks. Efficient risk management mechanisms are essential for the insurers. The paper is set out initially to explore UK insurance companies risk management and risk disclosure by examining companies annual report after all the listed insurance companies are required to disclose risk information in their annual report, which seeks to reflect the recent development in UK insurance companies...

  1. Designing a reproductive health services package in the universal health insurance scheme in Thailand: match and mismatch of need, demand and supply.

    Science.gov (United States)

    Teerawattananon, Yot; Tangcharoensathien, Viroj

    2004-10-01

    In October 2001 Thailand introduced universal healthcare coverage (UC) financed by general tax revenue. This paper aims to assess the design and content of the UC benefit package, focusing on the part of the package concerned with sexual and reproductive health (SRH). The economic concept of need, demand and supply in the process of developing the SRH package was applied to the analysis. The analysis indicated that SRH constitutes a major part of the package, including the control of communicable and non-communicable diseases, the promotion and maintenance of reproductive health, and early detection and management of reproductive health problems. In addition, the authors identified seven areas within three overlapping spheres; namely need, demand and supply. The burden of disease on reproductive conditions was used as a proxy indicator of health needs in the population; the findings of a study of private obstetric practice in public hospitals as a proxy of patients' demands; and the SRH services offered in the UC package as a proxy of general healthcare supply. The authors recommend that in order to ensure that healthcare needs match consumer demand, the inclusion of SRH services not currently offered in the package (e.g. treatment of HIV infection, abortion services) should be considered, if additional resources can be made available. Where health needs exist but consumers do not express demand, and the appropriate SRH services would provide external benefits to society (e.g. the programme for prevention of sexual and gender-related violence), policymakers are encouraged to expand and offer these services. Efforts should be made to create consumer awareness and stimulate demand. Research can play an important role in identifying the services in which supply matches demand but does not necessarily reflect the health needs of the population (e.g. unnecessary investigations and prescriptions). Where only demand or supply exists (e.g. breast cosmetic procedures and

  2. Response to health insurance by previously uninsured rural children.

    Science.gov (United States)

    Tilford, J M; Robbins, J M; Shema, S J; Farmer, F L

    1999-08-01

    To examine the healthcare utilization and costs of previously uninsured rural children. Four years of claims data from a school-based health insurance program located in the Mississippi Delta. All children who were not Medicaid-eligible or were uninsured, were eligible for limited benefits under the program. The 1987 National Medical Expenditure Survey (NMES) was used to compare utilization of services. The study represents a natural experiment in the provision of insurance benefits to a previously uninsured population. Premiums for the claims cost were set with little or no information on expected use of services. Claims from the insurer were used to form a panel data set. Mixed model logistic and linear regressions were estimated to determine the response to insurance for several categories of health services. The use of services increased over time and approached the level of utilization in the NMES. Conditional medical expenditures also increased over time. Actuarial estimates of claims cost greatly exceeded actual claims cost. The provision of a limited medical, dental, and optical benefit package cost approximately $20-$24 per member per month in claims paid. An important uncertainty in providing health insurance to previously uninsured populations is whether a pent-up demand exists for health services. Evidence of a pent-up demand for medical services was not supported in this study of rural school-age children. States considering partnerships with private insurers to implement the State Children's Health Insurance Program could lower premium costs by assembling basic data on previously uninsured children.

  3. 77 FR 25788 - Request for Information Regarding Stop Loss Insurance

    Science.gov (United States)

    2012-05-01

    ... Health Plan Standards and Compliance Assistance, Employee Benefits Security Administration, Room N-5653... employee benefit plans to be insurance companies in order to regulate them under insurance laws.) \\6\\ As a... DEPARTMENT OF THE TREASURY Internal Revenue Service DEPARTMENT OF LABOR Employee Benefits Security...

  4. Preferences and choices for care and health insurance

    NARCIS (Netherlands)

    Berg, B. van den; Dommelen, P. van; Stam, P.; Laske-Aldershof, T.; Buchmueller, T.; Schut, F.T.

    2008-01-01

    Legislation that came into effect in 2006 has dramatically altered the health insurance system in the Netherlands, placing greater emphasis on consumer choice and competition among insurers. The potential for such competition depends largely on consumer preferences for price and quality of service

  5. 26 CFR 20.2042-1 - Proceeds of life insurance.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Proceeds of life insurance. 20.2042-1 Section 20.2042-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE... speaking, the term has reference to the right of the insured or his estate to the economic benefits of the...

  6. 78 FR 17612 - Health Insurance Providers Fee; Correction

    Science.gov (United States)

    2013-03-22

    ... Health Insurance Providers Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... guidance on the annual fee imposed on covered entities engaged in the business of providing health insurance for United States health risks. FOR FURTHER INFORMATION CONTACT: Charles J. Langley, Jr. at (202...

  7. 5 CFR 831.613 - Election of insurable interest annuity.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Election of insurable interest annuity... SERVICE REGULATIONS (CONTINUED) RETIREMENT Survivor Annuities Elections at the Time of Retirement § 831.613 Election of insurable interest annuity. (a) At the time of retirement, an employee or Member in...

  8. Insurance for replacement power costs

    International Nuclear Information System (INIS)

    Cleaver, A.

    1980-01-01

    Although careful consideration is given to insurance against physical damage to plant and equipment, little thought is given to the costs that will be incurred in replacing the power that is lost while a relatively efficient system is out of action. The results of an investigation carried out for a generating authority with an installed capacity of about 3000 MW is given. Replacement power costs for different cases of severity of damage range from Pound1.17m per month for damage to central services taking out all four units. (author)

  9. Institutional framework for integrated Pharmaceutical Benefits Management: results from a systematic review

    Directory of Open Access Journals (Sweden)

    Tomasz Roman Hermanowski

    2015-09-01

    Full Text Available Objectives: In this paper, we emphasised that effective management of health plans beneficiaries access to reimbursed medicines requires proper institutional set-up. The main objective was to identify and recommend an institutional framework of integrated pharmaceutical care providing effective, safe and equitable access to medicines. Method: The institutional framework of drug policy was derived on the basis of publications obtained by systematic reviews. A comparative analysis concerning adaptation of coordinated pharmaceutical care services in the USA, the UK, Poland, Italy, Denmark and Germany was performed. Results: While most European Union Member States promote the implementation of selected e-Health tools, like e-Prescribing, these efforts do not necessarily implement an integrated package. There is no single agent who would manage an insured patients’ access to medicines and health care in a coordinated manner, thereby increasing the efficiency and safety of drug policy. More attention should be paid by European Union Member States as to how to integrate various e-Health tools to enhance benefits to both individuals and societies. One solution could be to implement an integrated “pharmacy benefit management” model, which is well established in the USA and Canada and provides an integrated package of cost-containment methods, implemented within a transparent institutional framework and powered by strong motivation of the agent.

  10. [Fourcroy and pharmaceutical journals].

    Science.gov (United States)

    Bonnemain, Bruno

    2011-04-01

    Cadet de Gassicourt wrote a brief Eloge of Fourcroy in January 1810 as he died in December of 1809. Fourcroy had a major role concerning the new ideas on the place of pharmacy at the beginning of the 19th century. Fourcroy has had a key influence for the start of several pharmaceutical journals that wanted to emphasize the link between the new chemistry and pharmacy. None of these journals created with him will survive and one has to wait for 1909 to see the creation, without Fourcroy, of a new pharmaceutical journal, the "Journal de Pharmacie" that will become "Journal de Pharmacie et des Sciences accessoires", then "Journal de Pharmacie et de Chimie", before taking the name of"Annales Pharmaceutiques Françaises", the present official journal of the French Academy of Pharmacy. In spite of the essential role of Fourcroy at the start of pharmaceutical journals, Cadet did not even mention it in his Eloge of 1810.

  11. Rheology in Pharmaceutical Sciences

    DEFF Research Database (Denmark)

    Aho, Johanna; Hvidt, Søren; Baldursdottir, Stefania

    2016-01-01

    Rheology is the science of flow and deformation of matter. Particularly gels and non-Newtonian fluids, which exhibit complex flow behavior, are frequently encountered in pharmaceutical engineering and manufacturing, or when dealing with various in vivo fluids. Therefore understanding rheology......, together with the common measurement techniques and their practical applications. Examples of the use of rheological techniques in the pharmaceutical field, as well as other closely related fields such as food and polymer science, are also given....... is important, and the ability to use rheological characterization tools is of great importance for any pharmaceutical scientist involved in the field. Flow can be generated by shear or extensional deformations, or a combination of both. This chapter introduces the basics of both shear and extensional rheology...

  12. Conceptualizing Pharmaceutical Plants

    DEFF Research Database (Denmark)

    Larsen, Bent Dalgaard; Jensen, Klaes Ladeby; Gjøl, Mikkel

    2006-01-01

    In the conceptual design phase of pharmaceutical plants as much as 80%-90% of the total cost of a project is committed. It is therefore essential that the chosen concept is viable. In this design process configuration and 3D models can help validate the decisions made. Designing 3D models...... is a complex task and requires skilled users. We demonstrate that a simple 2D/3D configuration tool can support conceptualizing of pharmaceutical plants. Present paper reports on preliminary results from a full scale implementation project at a Danish engineering company....

  13. Health insurance basic actuarial models

    CERN Document Server

    Pitacco, Ermanno

    2014-01-01

    Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...

  14. Insurability of Terrorism Risks

    International Nuclear Information System (INIS)

    Harbruecker, D.

    2006-01-01

    Until 2001 losses caused by terrorist attacks have been covered under fire policies worldwide with two exceptions: Spain and UK where major and multiple losses caused by ETA and IRA had led to specific insurance solutions. The September 11, 2001 attacks on the World Trade Centre have changed the world in many aspects. This includes the insurance industry, which was compelled to exclude terrorism from coverage and to offer special solutions for extra premium. Nuclear power plants have been repeatedly called targets for terrorists as their destruction could cause a large catastrophe and more victims than the September 2001 attacks. How does the insurance industry respond? (author)

  15. Analysis of your professional liability insurance policy.

    Science.gov (United States)

    SADUSK, J F; HASSARD, H; WATERSON, R

    1958-01-01

    The most important lessons for the physician to learn in regard to his professional liability insurance coverage are the following:1. The physician should carefully read his professional liability policy and should secure the educated aid of his attorney and his insurance broker, if they are conversant with this field.2. He should particularly read the definition of coverage and carefully survey the exclusion clauses which may deny him coverage under certain circumstances.3. If the physician is in partnership or in a group, he should be certain that he has contingent partnership coverage.4. The physician should accept coverage only from an insurance carrier of sufficient size and stability that he can be sure his coverage will be guaranteed for "latent liability" claims as the years go along-certainly for his lifetime.5. The insurance carrier offering the professional liability policy should be prepared to offer coverages up to at least $100,000/$300,000.6. The physician should be assured that the insurance carrier has claims-handling personnel and legal counsel who are experienced and expert in the professional liability field and who are locally available for service.7. The physician is best protected by a local or state group program, next best by a national group program, and last, by individual coverage.8. The physician should look with suspicion on a cancellation clause in which his policy may be summarily cancelled on brief notice.9. The physician should not buy professional liability insurance on the basis of price alone; adequacy of coverage and service and a good insurance company for his protection should be the deciding factors.

  16. Resumed Publication of Pharmaceuticals in 2009

    Directory of Open Access Journals (Sweden)

    Shu-Kun Lin

    2009-04-01

    Full Text Available After a five year hiatus, we are pleased to announce the resumption of publication of the MDPI journal Pharmaceuticals (ISSN 1424-8247. First launched in 2004, few suitable papers were submitted and only one was published [1], before our limited editorial resources at the time led us to temporarily discontinue publication. Several things have changed since then. First, there has been an explosive growth in the number of manuscripts submitted and published in MDPI’s various current journals [2], whose topics clearly fall within the intended scope of Pharmaceuticals and we feel that these manuscripts merit a dedicated forum. Second, the expansion of MDPI, now with Editorial Offices and staff in Basel (Switzerland and Beijing (China, allows us to provide Pharmaceuticals’ authors with all the services they could desire and deserve: a simple manuscript submission process, rigorous peer review, quick revision turnaround, Open Access publication on a new and attractive platform and coverage by all the major abstracting services. In addition, a new Editorial Board comprised of noted academic and industry scientists has been set up for Pharmaceuticals. Finally, to better focus the subject matter published in Pharmaceuticals on molecular medicines, we have also set up a special section in International Journal of Molecular Sciences (IJMS, ISSN 1422-0067 for papers on nutraceuticals or chemopreventives. We look forward to receiving and publishing your papers and as always, we welcome your comments and suggestions.

  17. Survey of nuclear insurance - Parts 1 and 2

    International Nuclear Information System (INIS)

    Francis, H.W.

    1979-01-01

    The use of nuclear energy developed comparatively suddenly and introduced hazards with which insurers were quite unfamiliar as compared to conventional hazards such as fire or explosion. In addition to the possibility of severe contamination to property and serious injury to persons on a large scale, radiation damage may become apparent long after actual exposure to radiation. All these factors made nuclear insurance mandatory. In order to marshall the large insurance capacity needed, 23 nuclear insurance pools similar to the British Insurance Committee, were set up and are operating in some 22 countries. The insurance covers written by nuclear pools are related to material damage, liability, losses, machinery breakdown contingent liabilities of suppliers of goods and services and finally transport risks and nuclear-propelled ships. (NEA) [fr

  18. Depression among family caregivers of community-dwelling older people who used services under the Long Term Care Insurance program: a large-scale population-based study in Japan.

    Science.gov (United States)

    Arai, Yumiko; Kumamoto, Keigo; Mizuno, Yoko; Washio, Masakazu

    2014-01-01

    To identify predictors for depression among family caregivers of community-dwelling older people under the Long Term Care Insurance (LTCI) program in Japan through a large-scale population-based survey. All 5938 older people with disabilities, using domiciliary services under the LTCI in the city of Toyama, and their family caregivers participated in this study. Caregiver depression was defined as scores of ≥16 on the Center for Epidemiological Studies Depression Scale (CES-D). Other caregiver measures included age, sex, hours spent caregiving, relationship to the care recipient, income adequacy, living arrangement, self-rated health, and work status. Care recipient measures included age, sex, level of functional disability, and severity of dementia. The data from 4128 pairs of the care recipients and their family caregivers were eligible for further analyses. A multiple logistic regression analysis was used to examine the predictors associated with being at risk of clinical depression (CES-D of ≥16). Overall, 34.2% of caregivers scored ≥16 on the CES-D. The independent predictors for depression by logistic regression analysis were six caregiver characteristics (female, income inadequacy, longer hours spent caregiving, worse subjective health, and co-residence with the care recipient) and one care-recipient characteristic (moderate dementia). This is one of the first population-based examinations of caregivers of older people who are enrolled in a national service system that provides affordable access to services. The results highlighted the importance of monitoring caregivers who manifest the identified predictors to attenuate caregiver depression at the population level under the LTCI.

  19. Cancer insurance policies in Japan and the United States.

    Science.gov (United States)

    Bennett, C L; Weinberg, P D; Lieberman, J J

    1998-01-01

    Cancer care in the United States often results in financial hardship for patients and their families. Standard health insurance covers most medical costs, but nonmedical costs (such as lost wages, deductibles, copayments, and travel to and from caregivers) are paid out of pocket. Over the course of treatment, these costs can become substantial. Insurance companies have addressed the burden of these out-of-pocket costs by offering supplemental cancer insurance policies that, upon diagnosis of cancer, pay cash benefits for items that usually require out-of-pocket expenditures and are distinct from reimbursements made by traditional health insurance. Limitations associated with managed care have fostered increased consumer awareness and interest in the United States for cancer insurance and its ability to defray treatment expenditures that usually require out-of-pocket payments. Marketing campaigns are becoming more aggressive, and the number of cancer insurance policies sold has been steadily rising. While cancer insurance is only recently gaining popularity in the United States, it has been a successful product in Japan for over twenty years. In Japan, approximately one-quarter of the population own cancer insurance, and ten-year retention rates are estimated at 75%. As a result, individuals are afforded good access to nonmedical cancer services. Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States.

  20. Insuring against health shocks: Health insurance and household choices.

    Science.gov (United States)

    Liu, Kai

    2016-03-01

    This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Optimum amount of an insurance sum in life insurance

    Directory of Open Access Journals (Sweden)

    Janez Balkovec

    2001-01-01

    Full Text Available Personal insurance represents one of the sources of personal social security as a category of personal property. How to get a proper life insurance is a frequently asked question. When insuring material objects (car, house..., the problem is usually not in the amount of the taken insurance. With life insurance (abstract goods, problems as such occur. In this paper, we wish to present a model that, according to the financial situation and the anticipated future, makes it possible to calculate the optimum insurance sum in life insurance.

  2. Pharmaceutical packaging handbook

    National Research Council Canada - National Science Library

    Bauer, Edward J

    2009-01-01

    ... of the modern world. Pharmaceutical products and health care in developing countries and remote parts of the world seems like magic. Diseases that were once fatal and chronic conditions that destroyed lives have slowly been conquered by modern medicine. Views of the body, unimaginable for most of the last century with X rays, are now possible with new i...

  3. Doctors and pharmaceutical industry.

    Science.gov (United States)

    Beran, Roy G

    2009-09-01

    The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.

  4. The Effectiveness of Pharmaceutical Marketing

    NARCIS (Netherlands)

    E.R. Kappe

    2011-01-01

    textabstractPharmaceutical marketing effectiveness comprises the measurement of marketing efforts of pharmaceutical firms towards doctors and patients. These firms spend billions of dollars yearly to promote their prescription drugs. This dissertation provides empirical analyses and methods to

  5. Group life insurance

    CERN Multimedia

    2013-01-01

    The CERN Administration wishes to inform staff members and fellows having taken out optional life insurance under the group contract signed by CERN that the following changes to the rules and regulations entered into force on 1 January 2013:   The maximum age for an active member has been extended from 65 to 67 years. The beneficiary clause now allows insured persons to designate one or more persons of their choice to be their beneficiary(-ies), either at the time of taking out the insurance or at a later date, in which case the membership/modification form must be updated accordingly. Beneficiaries must be clearly identified (name, first name, date of birth, address).   The membership/modification form is available on the FP website: http://fp.web.cern.ch/helvetia-life-insurance For further information, please contact: Valentina Clavel (Tel. 73904) Peggy Pithioud (Tel. 72736)

  6. Vaccines as Epidemic Insurance.

    Science.gov (United States)

    Pauly, Mark V

    2017-10-27

    This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines) in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs) but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage). It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis.

  7. Vaccines as Epidemic Insurance

    Directory of Open Access Journals (Sweden)

    Mark V. Pauly

    2017-10-01

    Full Text Available This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage. It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis.

  8. M. Nuclear insurance

    International Nuclear Information System (INIS)

    1976-01-01

    Nuclear insurance and some of the features associated with it, such as the International Conventions and the operation of Atomic Risk Pools, are discussed both in general and with specific reference to the USA, Canada and the United Kingdom

  9. Building and Contents Insurance.

    Science.gov (United States)

    Freese, William C.

    Insurance coverage of school buildings and contents is becoming increasingly difficult to obtain, and increases of 50 percent or more in the premium are not uncommon. Methods of reducing premium increases are outlined in this speech. (MLF)

  10. HUD Insured Hospitals

    Data.gov (United States)

    Department of Housing and Urban Development — The Office of Healthcare Programs (OHP), previously known as the Office of Insured Health Care Facilities, is located within the Office of Housing and administers...

  11. Deductibles in health insurance

    Science.gov (United States)

    Dimitriyadis, I.; Öney, Ü. N.

    2009-11-01

    This study is an extension to a simulation study that has been developed to determine ruin probabilities in health insurance. The study concentrates on inpatient and outpatient benefits for customers of varying age bands. Loss distributions are modelled through the Allianz tool pack for different classes of insureds. Premiums at different levels of deductibles are derived in the simulation and ruin probabilities are computed assuming a linear loading on the premium. The increase in the probability of ruin at high levels of the deductible clearly shows the insufficiency of proportional loading in deductible premiums. The PH-transform pricing rule developed by Wang is analyzed as an alternative pricing rule. A simple case, where an insured is assumed to be an exponential utility decision maker while the insurer's pricing rule is a PH-transform is also treated.

  12. Insurance Coverage and Whither Thou Goest for Health Info

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Insurance Coverage and Whither Thou Goest for Health Information in 2012, recently published in Volume 4, Issue 4 of the Medicare and Medicaid Research...

  13. Insurance of professional responsibility at medical aid rendering

    Directory of Open Access Journals (Sweden)

    Abyzova N.V.

    2011-12-01

    Full Text Available The article discusses the necessity of adoption of professional responsibility insurance act into the public health service. It is considered as the basic mechanism of compensation in case of damage to a patient at medical aid rendering

  14. Prevention in insurance markets

    OpenAIRE

    Marie-Cécile FAGART; Bidénam KAMBIA-CHOPIN

    2006-01-01

    This paper considers a competitive insurance market under moral hazard and adverse selection, in which preventive efforts and self-protection costs are unobservable by insurance companies. Under reasonable assumptions, the conclusions of Rothschild and Stiglitz (1976) are preserved in our context even if it involves moral hazard. The riskier agents in equilibrium, who would also be the riskier agents under perfect information, receive their moral hazard contract. For other agents, adverse sel...

  15. 78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Science.gov (United States)

    2013-02-27

    ... Parts 144, 147, 150, et al. Patient Protection and Affordable Care Act; Health Insurance Market Rules... Insurance Market Rules; Rate Review AGENCY: Department of Health and Human Services. ACTION: Final rule. SUMMARY: This final rule implements provisions related to fair health insurance premiums, guaranteed...

  16. 42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

    Science.gov (United States)

    2010-10-01

    ... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...

  17. 78 FR 52719 - Tax Credit for Employee Health Insurance Expenses of Small Employers

    Science.gov (United States)

    2013-08-26

    ... Tax Credit for Employee Health Insurance Expenses of Small Employers AGENCY: Internal Revenue Service... Section 45R(a) provides for a health insurance tax credit in the case of an eligible small employer for... employee enrolled in health insurance coverage offered by the employer in an amount equal to a uniform...

  18. 42 CFR 457.80 - Current State child health insurance coverage and coordination.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

  19. 26 CFR 1.163-11T - Allocation of certain prepaid qualified mortgage insurance premiums (temporary).

    Science.gov (United States)

    2010-04-01

    ... insurance premiums (temporary). 1.163-11T Section 1.163-11T Internal Revenue INTERNAL REVENUE SERVICE... insurance premiums (temporary). (a) Allocation—(1) In general. As provided in section 163(h)(3)(E), premiums... section applies whether the qualified mortgage insurance premiums are paid in cash or are financed...

  20. 7 CFR 1962.29 - Payment of fees and insurance premiums.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Payment of fees and insurance premiums. 1962.29... Security § 1962.29 Payment of fees and insurance premiums. (a) Fees. (1) Security instruments. Borrowers... the service cannot be obtained without cost. (b) Insurance premiums. County Supervisors are authorized...

  1. Security Pricing as an Enabler of Cyber-Insurance: A First Look at Differentiated Pricing Markets

    OpenAIRE

    Pal, Ranjan; Golubchik, Leana; Psounis, Konstantinos; Hui, Pan

    2016-01-01

    Despite the promising potential of network risk management services (e.g., cyber-insurance) to improve information security, their deployment is relatively scarce, primarily due to such service companies being unable to guarantee profitability. As a novel approach to making cyber-insurance services more viable, we explore a symbiotic relationship between security vendors (e.g., Symantec) capable of price differentiating their clients, and cyber-insurance agencies having possession of informat...

  2. Tropical Journal of Pharmaceutical Research

    African Journals Online (AJOL)

    Journal Homepage Image. We seek to encourage pharmaceutical and allied research of tropical and international relevance and to foster multidisciplinary research and collaboration among scientists, the pharmaceutical industry and the healthcare professionals. We publish articles in pharmaceutical sciences and related ...

  3. Effects of Mental Health Parity on High Utilizers of Services: Pre-Post Evidence From a Large, Self-Insured Employer.

    Science.gov (United States)

    Grazier, Kyle L; Eisenberg, Daniel; Jedele, Jenefer M; Smiley, Mary L

    2016-04-01

    This study evaluated utilization of mental health and substance use services among enrollees at a large employee health plan following changes to benefit limits after passage in 2008 of federal mental health parity legislation. This study used a pre-post design. Benefits and claims data for 43,855 enrollees in the health plan in 2009 and 2010 were analyzed for utilization and costs after removal of a 30-visit cap on the number of covered mental health visits. There was a large increase in the proportion of health plan enrollees with more than 30 outpatient visits after the cap's removal, an increase of 255% among subscribers and 176% among dependents (pbenefit limit.

  4. Romanian Insurance Market Facing Globalization Process

    Directory of Open Access Journals (Sweden)

    Dumitru G. Badea

    2008-09-01

    Full Text Available The Romanian insurance market has passed through a permanent process of growth which ended up in 2004 to exceed the threshold of 1 billion Euros, in the frame of a small awareness and confidence of the population towards insurance, even now after 15 years. The globalization process of the financial markets affected also the Romanian market even before Romania became member of the European Union. The globalization brought about benefits (especially under the form of increase in the quality of the services provided to clients but also disadvantages for local companies (significant costs in logistics and training in order to cope with the international groups.

  5. 76 FR 37207 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Science.gov (United States)

    2011-06-24

    ... Department of Health and Human Services 45 CFR Part 147 Group Health Plans and Health Insurance Issuers... SERVICES [CMS-9993-IFC2] 45 CFR Part 147 RIN 0938-AQ66 Group Health Plans and Health Insurance Issuers... for group health plans and health insurance coverage in the group and individual markets under...

  6. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Science.gov (United States)

    2010-07-19

    ... Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive Services... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in...

  7. Evidence-Based Cutoff Threshold Values from Receiver Operating Characteristic Curve Analysis for Knee Osteoarthritis in the 50-Year-Old Korean Population: Analysis of Big Data from the National Health Insurance Sharing Service

    Directory of Open Access Journals (Sweden)

    Hyunseok Jee

    2018-01-01

    Full Text Available We aimed to investigate the characteristics of patients with osteoarthritis (OA, using the data of all Koreans registered in the National Health Insurance Sharing Service Database (NHISS DB, and to provide ideal alternative cutoff thresholds for alleviating OA symptoms. Patients with OA (codes M17 and M17.1–M17.9 in the Korean Standard Classification of Disease and Causes of Death were analyzed using SAS software. Optimal cutoff thresholds were determined using receiver operating characteristic curve analysis. The 50-year age group was the most OA pathogenic group (among 40~70 years, n=2088. All exercise types affected the change of body mass index (p<0.05 and the sex difference in blood pressure (BP (p<0.01. All types of exercise positively affected the loss of waist circumference and the balance test (standing time on one leg in seconds (p<0.01. The cutoff threshold for the time in seconds from standing up from a chair to walking 3 m and returning to the same chair was 8.25 (80% sensitivity and 100% specificity. By using the exercise modalities, categorized multiple variables, and the cutoff threshold, an optimal alternative exercise program can be designed for alleviating OA symptoms in the 50-year age group.

  8. EU pharmaceutical expenditure forecast.

    Science.gov (United States)

    Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    With constant incentives for healthcare payers to contain their pharmaceutical budgets, forecasting has become critically important. Some countries have, for instance, developed pharmaceutical horizon scanning units. The objective of this project was to build a model to assess the net effect of the entrance of new patented medicinal products versus medicinal products going off-patent, with a defined forecast horizon, on selected European Union (EU) Member States' pharmaceutical budgets. This model took into account population ageing, as well as current and future country-specific pricing, reimbursement, and market access policies (the project was performed for the European Commission; see http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). In order to have a representative heterogeneity of EU Member States, the following countries were selected for the analysis: France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. A forecasting period of 5 years (2012-2016) was chosen to assess the net pharmaceutical budget impact. A model for generics and biosimilars was developed for each country. The model estimated a separate and combined effect of the direct and indirect impacts of the patent cliff. A second model, estimating the sales development and the risk of development failure, was developed for new drugs. New drugs were reviewed individually to assess their clinical potential and translate it into commercial potential. The forecast was carried out according to three perspectives (healthcare public payer, society, and manufacturer), and several types of distribution chains (retail, hospital, and combined retail and hospital). Probabilistic and deterministic sensitivity analyses were carried out. According to the model, all countries experienced drug budget reductions except Poland (+€41 million). Savings were expected to be the highest in the United Kingdom (-€9,367 million), France (-€5,589 million), and, far behind them

  9. Pharmaceutical expenditure forecast model to support health policy decision making.

    Science.gov (United States)

    Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    generics had a major impact on savings. However, very aggressive pricing of generic and biosimilar products might make this market unattractive and can be counterproductive. Worth noting, delaying time to access innovative products was also identified as an effective leverage to increase savings but might not be a desirable policy for breakthrough products. Increasing patient financial contributions, either directly or indirectly via their private insurances, is a more likely scenario rather than expanding the national pharmaceutical expenditure coverage.

  10. Pharmaceutical expenditure forecast model to support health policy decision making

    Science.gov (United States)

    Rémuzat, Cécile; Urbinati, Duccio; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    , and distribution. Reducing, even slightly, the prices of generics had a major impact on savings. However, very aggressive pricing of generic and biosimilar products might make this market unattractive and can be counterproductive. Worth noting, delaying time to access innovative products was also identified as an effective leverage to increase savings but might not be a desirable policy for breakthrough products. Increasing patient financial contributions, either directly or indirectly via their private insurances, is a more likely scenario rather than expanding the national pharmaceutical expenditure coverage. PMID:27226830

  11. Marginal conditions for the insurance against fire events in waste incinerators; Randbedingungen fuer die Versicherung gegen Brandereignisse in Abfallverbrennungsanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Weschenbach, Harry [VMD-Prinas GmbH, Essen (Germany)

    2012-11-01

    Insurance companies represent not only damage compensation systems, but also a worldwide financial services operating compensation of damages against the insurance premium. The insurance industry has adapted itself to the industrial development. The comprehensive risk management was supplemented increasingly. Especially in the case of damage prevention and fire fighting, the insurance industry falls back on the comprehensive risk management. The fire insurance companies have learned to evaluate fire risks more technically and economically and to impact the design concepts of fire fighting. Under these conditions, in the case of major industrial risks the fire insurance companies are willing to provide an extensive insurance coverage.

  12. RISK CORRIDORS AND REINSURANCE IN HEALTH INSURANCE MARKETPLACES: Insurance for Insurers

    OpenAIRE

    LAYTON, TIMOTHY J.; MCGUIRE, THOMAS G.; SINAIKO, ANNA D.

    2016-01-01

    In order to encourage entry and lower prices, most regulated markets for health insurance include policies that seek to reduce the uncertainty faced by insurers. In addition to risk adjustment of premiums paid to plans, the Health Insurance Marketplaces established by the Affordable Care Act implement reinsurance and risk corridors. Reinsurance limits insurer costs associated with specific individuals, while risk corridors protect against aggregate losses. Both tighten the insurer's distribut...

  13. Pharmaceutical Research Strategies

    OpenAIRE

    Phlippen, Sandra; Vermeersch, Ad

    2008-01-01

    textabstractThis study analyses 1400 research projects of the top 20 R&D-spending pharmaceuticals to identify the determinants of successful research projects. We provide clear evidence that externally sourced projects and projects involving biotechnologies perform better than internal projects and chemical projects, respectively. Controlling for these effects, we find that big pharma should either build a critical mass of disease area knowledge or diversify projects over different DA’s in or...

  14. Medical and Pharmaceutical Information Service, inc

    Directory of Open Access Journals (Sweden)

    Facultad de Medicina Revista

    1954-05-01

    Full Text Available Recuentos sanguíneos mediante un sistema de televisión que acelera el proceso y reduce los errores: identificación de un síndrome de deficiencia de la Vitamina B•6; mediante un estudio se diferencia la etiología de dos tipos de obesidad; se encontró que el virus del mosaico del tabaco se sintetiza en el citoplasma; un antibiótico poco toxico desarrolla considerable actividad antitumoral.

  15. The pharmaceutical quality revolution

    Directory of Open Access Journals (Sweden)

    Jordi Botet

    2016-01-01

    Full Text Available Pharmaceutical products are patient-oriented. If they had a deficient quality they might put live at risk. Ensuring their quality is not, however, a straightforward task and this is why different approaches have been used along the way. This article analyzes them and shows how our present approach, if well implemented, is very effective in ensuring quality.Methods. This article analyzes the current pharmaceutical quality system as described by international guidances in the light of practical experience gathered by the author as an international GMP-consultant.Result. Nowadays we have come to understand that as quality is a global concept in terms of time and of requirements, it has to be assured in a global way too. This is why quality assurance is a permanent process that starts during the development of a product and goes on during its manufacturing life. Manufacturing should be performed within a pharmaceutical quality system which ensures GMP compliance. Decisions should be science and risk-based. Products and processes are monitored by means of critical variables.Conclusions. The approach followed in the 21st century for ensuring quality is very effective and allows for a progressive reduction of the level of quality risk. However, this quality system is either comprehensive or there is no quality

  16. Agricultural insurance under the Solvency II Directive

    Directory of Open Access Journals (Sweden)

    Njegomir Vladimir

    2014-01-01

    Full Text Available Solvency II Directive represents a new framework of unique solvency regulation of insurance and reinsurance companies in the European Union. Although it has not yet been implemented in national legislations, it can be concluded, based on the directive wording and conducted quantitative studies, that it will have implications on agricultural producers since they are the users of insurance services. The aim of the research presented in this paper is to analyse the implications of the new directive to agricultural producers since they are the insureds and the main actors of agribusiness. Firstly, the paper gives an overview of the basic features of the new regulatory framework and then it points at the issues and the needs for intensive application of Directive in order to improve the insurance business in Serbia. The process will direct the settlement of major claims, the ones that are typical of catastrophic risks in agriculture, towards the insurance, while the expectations from the government will be directed towards the regulation of the setting and economic measures (development and investment subsidies, cooperative movement. In addition, the paper points at the demands of the new regulation and analyses the implications of the new regulation regarding the settlement of claims resulting from major flood since it represents the example that proves the basic postulate.

  17. UK nuclear terrorism insurance arrangements: an overview

    International Nuclear Information System (INIS)

    Tetley, M. G.

    2004-01-01

    The risk of terrorism in the UK is not new, but since the New York World Trade Centre attacks in 2001, the potential scale of any terrorist attack has required a considerable reassessment. With UK foreign policy closely aligned to that of the USA, the UK security services now consider it is simply a matter of when and no longer if the UK is attacked. For insurers of any type this fact would cause concern; for insurers involved in high profile and potentially catastrophic loss targets such as nuclear power plants, any attack could have a severe impact on solvency and shareholder's funds. This paper's objective is to describe the terrorism insurance arrangements put in place in the U.K. both before and after the September 2001 attacks. These arrangements have been designed both to safeguard insurers' solvency and to ensure that the nuclear industry and general public can continue to be reassured by the availability of insurance should an attack ever occur.(author)

  18. Insurance Sector and Climate Changes in Serbia

    Directory of Open Access Journals (Sweden)

    Tatjana Piljan

    2017-06-01

    Full Text Available Climate changes have a strong negative impact on the insurance sector, which is reflected in the slow development of the insurance sector and in the transfer of the greater part of risk on the state and individuals. The difference between collected and paid premiums on the basis of incurred losses is rapidly decreasing, which leads to the fact that insurance market is less and less capable of absorbing the losses associated with climate changes, which then has negative repercussions on the availability of insurance services at an affordable premium. The question of establishing potential long and short-term effects of climate changes on business activities of insurance and reinsurance companies represents a priority and its ultimate objective is to find ways to minimize risks and losses. The problem of climate changes represents an important social problem in today’s civilization. At the same time, it is also an ecological problem, but also economic, political, social, cultural, health, etc. It is a global ecological problem, hence we can speak about global climate changes which affect states, nations, continents regardless of where they are and how responsible they are for creating and sustaining these changes.

  19. ENDOWMENT LIFE INSURANCE

    Directory of Open Access Journals (Sweden)

    Zeljko Sain

    2013-06-01

    Full Text Available The aim of the paper that treats the actuarial model of insurance in case of survival or early death is to show the actuarial methods and methodology for creating a model and an appropriate number of sub-models of the most popular form of life insurance in the world. The paper applies the scientific methodology of the deductive character based on scientific, theoretical knowledge and practical realities. Following the basic theoretical model’s determinants, which are at the beginning of the paper, the basic difference between models further in this paper was carried out according to the character of the premium to be paid. Finally, the financial repercussions of some models are presented at examples in insurance companies. The result of this paper is to show the spectrum of possible forms of capital endowment insurance which can be, without major problems, depending on the financial policy of the company, applied in actual practice. The conclusion of this paper shows the theoretical and the practical reality of this model, life insurance, and its quantitative and qualitative guidelines.

  20. Code of Ethics for Pharmacists – Pharmaceutical Chamber of Macedonia

    OpenAIRE

    Angelovska, Bistra

    2015-01-01

    Code of ethics represents the principles that form the fundamental basis of the roles and responsibilities of pharmacists in pharmaceutical practice. According to pharmacy practice, pharmacists are confirmed as healthcare professionals with unique knowledge, skills and responsibilities for safe and efficient medication therapy management in order to optimize therapeutic outcomes. The scope of pharmacy practice includes technical aspects of pharmaceutical services, the preparation of p...

  1. FEATURES OF ACCOUNTING AND AUDIT OF INSURANCE ORGANIZATIONS IN UKRAINE

    Directory of Open Access Journals (Sweden)

    А. Sholoiko

    2015-04-01

    Full Text Available Features of accounting and audit of insurance organizations in Ukraine that are based on the specific characteristics of the insurance activity and legislation are considered. The main of them are the next: the proper organization of accounting is a necessary condition of the activity of the financial institution; there are three groups of requirements to accounting of insurer, including: accounting of contracts; accounting of insurance reserves, formation financial reports in the Ukrainian insurance legislation; the use of IFRS instead of national accounting standards in preparing financial reports of insurance organizations in Ukraine is obligatory and despite of this compilation of primary documents and application of National Chart of Accounts by insurance organizations of Ukraine remains mandatory; it is necessary to follow the frequency of reporting according to national legislation; insurance companies are classified as institutions that must necessarily publish annual financial statements together with the auditor’s report about its accuracy, and this category of institutions are prohibited from using such form of organization of accounting and reporting as directly by the owner or the head of organization; audit of the annual financial statements and consolidated financial statements of insurance companies is mandatory and conducted in accordance with International quality control, auditing, review, other assurance, and related services pronouncements which adopted as national auditing standards by the Audit Chamber of Ukraine. These generalizations are done to make possible the further investigations of developing and improving in this field.

  2. Ways and means of insuring against nuclear risks

    International Nuclear Information System (INIS)

    Campbell Miles, A.

    1975-01-01

    Despite stringent safety requirements imposed upon nuclear installations, the need for adequate insurance cover is motivated by the consideration that a nuclear accident could lead to very grave consequences. To marshal the large insurance capacity required, national pools were formed in many countries, which may enter into arrangements with other similar national pools to increase their own capacity with a view to an appropriate spread of the risks involved. In the absence of a national nuclear pool, application for nuclear insurance would normally be made to the national insurance market association concerned. Virtually every type of nuclear risk is insurable; various forms of material damage and liability insurances are available. The financial liability of nuclear operators is established by national legislation on the basis of international conventions. Insurance coverage is linked to the operator's amount of liability established by law. A third party nuclear liability insurance policy usually consists of three parts: Part I covers the operator's liability under his domestic nuclear legislation; Part II provides non-nuclear power for accidents on the site up to a separate liability limit selected by the operator; and Part III provides cover for costs. Other types of insurance deal with damage to the site and the installation (material damage), consequential losses, contingent liabilities of suppliers of goods and services (products liability), nuclear material in transit and nuclear-propelled ships. (author)

  3. Serbian insurance market: Select issues

    Directory of Open Access Journals (Sweden)

    Obadović Mirjana M.

    2010-01-01

    Full Text Available Every day insurance companies face a number of risks arising from the insurance industry itself, as well as risks arising from insurance company operations. In this constant fight against risks insurance companies use different models and methods that help them better understand, have a more comprehensive view of, and develop greater tolerance towards risks, in order to reduce their exposure to these risks. The model presented in this paper has been developed for implementation in insurance risk management directly related to insurance company risk, i.e. it is a model that can reliably determine the manner and intensity with which deviations in the initial insurance risk assessment affect insurance company operations, in the form of changes in operational risks and consequently in insurance companies’ business strategies. Additionally we present the implementation of the model in the Serbian market for the period 2005-2010.

  4. Dental insurance! Are we ready?

    Directory of Open Access Journals (Sweden)

    Ravi SS Toor

    2011-01-01

    Full Text Available Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI bill which was put forward in the winter session of the Lok Sabha (2008 focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.

  5. CURRENT CHANGES ON INSURANCE MARKET

    Directory of Open Access Journals (Sweden)

    Madalina Giorgiana MANGRA

    2016-12-01

    Full Text Available The offer of insurance products is about the requirements and needs of the consumer who must always have information regarding: the type of insurance risk covered and the excluded risks, the sum insured, the payment of premiums and their duration. The accurate information of customer requires, from the commencement of contract and throughout its duration, that he or she is aware of the obligations throughout the contractual period. Most of the Romanians are turning their attention to one of the insurance companies found in the top 10 in 2016, supervised by F.S.A. (Financial Supervision Authority, preferring to have a policy of mandatory household and goods insurance, auto liability or life insurance, but are also interested in travel health insurance when going abroad, private health insurance or private pension insurance. Romanians' reluctance regarding the conclusion of an insurance comes from their distrust in insurance companies (see the situations of companies like Astra Insurance, Carpatica Insurance etc., their personal financial situation and the fear that they will not receive protection if the risk is covered but the insured sum is insufficient

  6. Insurance against nuclear risks

    International Nuclear Information System (INIS)

    Dow, J.C.

    1976-01-01

    Virtually any type of nuclear risk is insurable in principle, providing, of course, that the necessary standards of safety and control are met. Some of the risks are of a relatively minor character and no more hazardous than a simple conventional risk. But insurers would not consider as a minor risk anything which involves the use of nuclear fuel or other nuclear materials which are in a critical state or capable of releasing dangerous levels of radioactivity. These would include nuclear reactors or, indeed, any type of assembly which can not be regarded as subcritical. Most insurers would also regard installations involved in the manufacturing, processing and enriching of nuclear fuel, and certainly those concerned with the reprocessing of irradiated fuel and plutonium extraction, as major risks. (HP) [de

  7. Pharmaceutical care in community pharmacies: practice and research in Denmark

    DEFF Research Database (Denmark)

    Herborg, Hanne; Sørensen, Ellen Westh; Frøkjaer, Bente

    2007-01-01

    % offer inhalation counseling, a reimbursed service. Research in pharmacy practice is well established and conducted primarily at universities and at Pharmakon A/S, which is owned by the Danish Pharmaceutical Association. DISCUSSION: Extended services in clinical pharmacy are priorities for all Danish...

  8. Nuclear insurance and indemnity

    International Nuclear Information System (INIS)

    Kovan, D.

    1976-01-01

    A brief account is given of insurance protection in the nuclear industry, and the legislation involved. Aspects discussed are: third part liability and the role of government in setting the maximum amount of compensation; the development and concept of channelling the liability exclusively to the operator; the development of nuclear insurance facilities in Europe and the USA; and the emergence in Europe of international agreements on third party liability for protection of neighbouring countries in the event of a major accident. The development of liability law in the USA from the time of the Price Anderson Act of 1957 through subsequent legislation is described. (U.K.)

  9. American nuclear insurers

    International Nuclear Information System (INIS)

    Oliveira, R.A.

    1988-01-01

    Nuclear liability insurance covers liability for damages directly caused by the nuclear energy hazard. This coverage includes offsite bodily injury and property damage sustained by members of the general public, and bodily injury to onsite third party personnel. Recent nuclear liability claims allege bodily injury and property damage resulting from releases or radioactive materials to the environmental and occupational radiation worker exposures. Routine reactor operations involving radioactive waste have the potential to result in such claims. The nuclear insurance Pools believe that one way such claims can be minimized is through the implementation of an effective radioactive waste management program

  10. Lectures on insurance models

    CERN Document Server

    Ramasubramanian, S

    2009-01-01

    Insurance has become a necessary aspect of modern society. The mathematical basis of insurance modeling is best expressed in terms of continuous time stochastic processes. This introductory text on actuarial risk theory deals with the Cramer-Lundberg model and the renewal risk model. Their basic structure and properties, including the renewal theorems as well as the corresponding ruin problems, are studied. There is a detailed discussion of heavy tailed distributions, which have become increasingly relevant. The Lundberg risk process with investment in risky asset is also considered. This book will be useful to practitioners in the field and to graduate students interested in this important branch of applied probability.

  11. The argument for pharmaceutical policy.

    Science.gov (United States)

    Traulsen, Janine Morgall; Almarsdóttir, Anna Birna

    2005-02-01

    Pharmaceutical policy is a global concern. It has become a hot political topic in most countries--developed as well as developing--and can be found on the agenda of international organizations such as WHO, OECD, EU, WTO and even the World Bank. Pharmaceutical policy affects everyone in the world of pharmacy and it is therefore imperative that it be understood, discussed and debated within the pharmacy profession and included in the curriculum of schools of pharmacy. This, the first article in a series, argues for the importance of the academic discipline of pharmaceutical policy analysis and the involvement of pharmacists in this endeavour. The aim of the authors is to stimulate an informed and critical appreciation of this field. The authors begin with an introduction to the field of pharmaceutical policy, introducing several important concepts and current trends including: medicines regulation; how pharmaceutical policy is made; pharmaceutical policy as a dynamic process; and the new public health as a global issue. The article ends with a short description of the remaining five articles in the series which will deal with important aspects of pharmaceutical policy. The topics include: economic pressures on health care systems; drug utilization from the clinical viewpoint (rational use of medicines); the impact of pharmaceutical policy on patients and the patient impact on pharmaceutical policy; the professional perspective; and finally the last article which deals with studying and evaluating pharmaceutical policy.

  12. Disability Insurance and Health Insurance Reform: Evidence from Massachusetts

    OpenAIRE

    Nicole Maestas; Kathleen J. Mullen; Alexander Strand

    2014-01-01

    As health insurance becomes available outside of the employment relationship as a result of the Affordable Care Act (ACA), the cost of applying for Social Security Disability Insurance (SSDI)–potentially going without health insurance coverage during a waiting period totaling 29 months from disability onset–will decline for many people with employer-sponsored health insurance. At the same time, the value of SSDI and Supplemental Security Income (SSI) participation will decline for individuals...

  13. BUSINESS PROCESS MANAGEMENT IN INSURANCE CASE OF JADRANSKO INSURANCE COMPANY

    OpenAIRE

    Sanja Coric; Danijel Bara

    2014-01-01

    Selling insurance products in conditions of today’s modern technological solutions is faced with numerous challenges. Business processes in insurance as well as the results of these business processes are the real interface to policyholders. Modeling and analysis of business process in insurance ensure organizations to focus on the customer and increase the efficiency and quality of work. Managing critical business processes in every single organization, likewise in insurance is a key factor ...

  14. 78 FR 56583 - Deposit Insurance Regulations; Definition of Insured Deposit

    Science.gov (United States)

    2013-09-13

    ... as a potential global deposit insurer, preserve confidence in the FDIC deposit insurance system, and... the United States.\\2\\ The FDIC generally pays out deposit insurance on the next business day after a... since 2001 and total approximately $1 trillion today. In many cases, these branches do not engage in...

  15. 2001 Industry Studies: Services Industry

    National Research Council Canada - National Science Library

    Cervone, Michael

    2001-01-01

    .... has maintained its economic strength in traditional services industries such as transportation, tourism, public utilities, finance and insurance, accounting, engineering, architecture, medical, legal...

  16. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  17. Regulation of Pharmaceutical Prices

    DEFF Research Database (Denmark)

    Kaiser, Ulrich; Mendez, Susan J.; Rønde, Thomas

    On April 1, 2005, Denmark changed the way references prices, a main determinant of reimbursements for pharmaceutical purchases, are calculated. The previous reference prices, which were based on average EU prices, were substituted to minimum domestic prices. Novel to the literature, we estimate...... the joint eects of this reform on prices and quantities. Prices decreased more than 26 percent due to the reform, which reduced patient and government expenditures by 3.0 percent and 5.6 percent, respectively, and producer revenues by 5.0 percent. The prices of expensive products decreased more than...

  18. Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran.

    Science.gov (United States)

    Mohammadi, Effat; Raissi, Ahmad Reza; Barooni, Mohsen; Ferdoosi, Massoud; Nuhi, Mojtaba

    2014-01-01

    Health system reforms are the most strategic issue that has been seriously considered in healthcare systems in order to reduce costs and increase efficiency and effectiveness. The costs of health system finance in our country, lack of universal coverage in health insurance, and related issues necessitate reforms in our health system financing. The aim of this research was to prepare a structure of framework for social health insurance in Iran and conducting a comparative study in selected countries with social health insurance. This comparative descriptive study was conducted in three phases. The first phase of the study examined the structure of health social insurance in four countries - Germany, South Korea, Egypt, and Australia. The second phase was to develop an initial model, which was designed to determine the shared and distinguishing points of the investigated structures, for health insurance in Iran. The third phase was to validate the final research model. The developed model by the Delphi method was given to 20 professionals in financing of the health system, health economics and management of healthcare services. Their comments were collected in two stages and its validity was confirmed. The study of the structure of health insurance in the selected countries shows that health social insurance in different countries have different structures. Based on the findings of the present study, the current situation of the health system, and the conducted surveys, the following framework is suitable for the health social insurance system in Iran. The Health Social Insurance Organization has a unique service by having five funds of governmental employees, companies and NGOs, self-insured, villagers, and others, which serves as a nongovernmental organization under the supervision of public law and by decision- and policy-making of the Health Insurance Supreme Council. Membership in this organization is based on the nationality or residence, which the insured by

  19. Voluntary Public Unemployment Insurance

    DEFF Research Database (Denmark)

    O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene

    Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system...

  20. Insurance: Covering the bases

    International Nuclear Information System (INIS)

    Burr, M.T.

    1992-01-01

    This article addresses steps to take to improve the economics and risk profiles for independent power projects. The topics discussed in the article include the results of competition in the power industry, custom packages and the lack of competition among insurers in the power industry, mitigating risk through providing technical information, and developing programs

  1. Consumers’ Collision Insurance Decisions

    DEFF Research Database (Denmark)

    Austin, Laurel; Fischhoff, Baruch

    Using interviews with 74 drivers, we elicit and analyse how people think about collision coverage and, more generally, about insurance decisions. We compare the judgments and behaviours of these decision makers to the predictions of a range of theoretical models: (a) A model developed by Lee (200...

  2. Trends in pension insurance

    Directory of Open Access Journals (Sweden)

    D. Shterev

    2017-12-01

    Full Text Available This article deals with a topical for our country problem which is related to the State Social Insurance. It provides a review of the factors having an adverse effect onto the financial state of the Bulgarian pension system. Discussed are the basic parameters related to the economic incentives in connection with the optimal functioning of the pension system

  3. HOUSING INSURANCE IN ROMANIA

    Directory of Open Access Journals (Sweden)

    FLOREA IANC MARIA MIRABELA

    2014-12-01

    Full Text Available Last few years have shown that Romania is not protected from the consequences of climate change. It is clear that type flood events may cause social problems and losses is difficult financing from public resources, especially in the context of the existence of budget constraints. The only viable system to cope with such disasters is insurance system that has the ability to spread risks by reinsurance Natural disasters - earthquakes, floods, landslides - are just some of the risks that may threaten your home. And if natural disasters can seem distant danger, think as fires, floods caused by broken pipes or theft of household goods are trouble can happen anytime to anyone. To protect yourself in such unpleasant situations, whose frequency is unfortunately on the rise, it is necessary to be assured. Thus, you will be able to recover losses in the event that they occur. The house is undoubtedly one of the most important assets we own. Therefore, the Romans began to pay increasingly more attention to domestic insurance products. Since 2011, voluntary home insurance, life insurance with, were the most dynamic segments of the market.

  4. Business intelligence for insurance companies

    OpenAIRE

    IGNATIUK A.

    2016-01-01

    The current state and future trends for the world and domestic insurance markets are analyzed. The description of business intelligence methodology, tools and their practical implication for insurance companies are provided.

  5. BUSINESS INTELLIGENCE FOR INSURANCE COMPANIES

    Directory of Open Access Journals (Sweden)

    A. Ignatiuk

    2016-06-01

    Full Text Available The current state and future trends for the world and domestic insurance markets are analyzed. The description of business intelligence methodology, tools and their practical implication for insurance companies are provided.

  6. Electrochemical biosensors in pharmaceutical analysis

    OpenAIRE

    Gil, Eric de Souza; Melo, Giselle Rodrigues de

    2010-01-01

    Given the increasing demand for practical and low-cost analytical techniques, biosensors have attracted attention for use in the quality analysis of drugs, medicines, and other analytes of interest in the pharmaceutical area. Biosensors allow quantification not only of the active component in pharmaceutical formulations, but also the analysis of degradation products and metabolites in biological fluids. Thus, this article presents a brief review of biosensor use in pharmaceutical analysis, fo...

  7. Pharmaceuticals labelled with stable isotopes

    International Nuclear Information System (INIS)

    Krumbiegel, P.

    1986-11-01

    The relatively new field of pharmaceuticals labelled with stable isotopes is reviewed. Scientific, juridical, and ethical questions are discussed concerning the application of these pharmaceuticals in human medicine. 13 C, 15 N, and 2 H are the stable isotopes mainly utilized in metabolic function tests. Methodical contributions are given to the application of 2 H, 13 C, and 15 N pharmaceuticals showing new aspects and different states of development in the field under discussion. (author)

  8. Aviation or space policy: New challenges for the insurance sector to private human access to space

    Science.gov (United States)

    van Oijhuizen Galhego Rosa, Ana Cristina

    2013-12-01

    The phenomenon of private human access to space has introduced a new set of problems in the insurance sector. Orbital and suborbital space transportation will surely be unique commercial services for this new market. Discussions are under way regarding space insurance, in order to establish whether this new market ought to be regulated by aviation or space law. Alongside new definitions, infrastructures, legal frameworks and liability insurances, the insurance sector has also been introducing a new approach. In this paper, I aim to analyse some of the possibilities of new premiums, capacities, and policies (under aviation or space insurance rules), as well as the new insurance products related to vehicles, passengers and third party liability. This paper claims that a change toward new insurance regimes is crucial, due to the current stage in development of space tourism and the urgency to adapt insurance rules to support future development in this area.

  9. PREMIUMS CALCULATION FOR LIFE INSURANCE

    Directory of Open Access Journals (Sweden)

    ANA PREDA

    2012-10-01

    Full Text Available The paper presents the techniques and the formulas used on international practice for establishing the premiums for a life policy. The formulas are generally based on a series of indicators named mortality indicators which mainly point out the insured survival probability, the death probability and life expectancy at certain age. I determined, using a case study, the unique net premium, the annual net premium for a survival insurance, whole life insurance and mixed life insurance.

  10. Insurance - Piper Alpha ''et al''

    International Nuclear Information System (INIS)

    Hales, K.

    1995-01-01

    This paper opens with some brief information about the Piper Alpha loss, how the loss was handled and its final cost. More importantly, it discusses the effect of the Piper Alpha loss on the world insurance market including the oil insurance captives such as O.I.L Limited. Finally, the insurance market current status and prognosis for the future are considered. (Author)

  11. Willingness To Pay for Social Health Insurance in Iran

    Science.gov (United States)

    Nosratnejad, Shirin; Rashidian, Arash; Mehrara, Mohsen; Sari, Ali Akbari; Mahdavi, Ghadir; Moeini, Maryam

    2014-01-01

    Objective: The substantial level of out-of-pocket expenditure for health care by the population causes policy makers to draw particular attention to the proposal of a social health insurance for uninsured members of the community. Hence, it is essential to gather reliable information about the amount of Willingness To Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable social health insurance. Method: The study sample included 300 household heads in all Iranian provinces. The double bounded dichotomous choice approach was used to elicit the WTP. Result: The average WTP for social health insurance per person per month was 137 000 Rial (5.5 $US). Household heads with higher levels of education, income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. Conclusions: From a policy point of view, the WTP value can be used as a premium in a society. An important finding of this study is that although households’ Willingness To Pay is not more than the total insurance premium, households are willing to pay more than the premium they ought to pay for health insurance coverage. That is, total insurance premium is 150 000 Rials and households ought to pay approximately half of this sum. This can afford policy makers the ideal opportunity to provide good insurance coverage for medical services according to the need of society. PMID:25168979

  12. Premium Forecasting of an Insurance Company: Automobile Insurance

    OpenAIRE

    Fouladvand, M. Ebrahim; Darooneh, Amir H.

    2002-01-01

    We present an analytical study of an insurance company. We model the company's performance on a statistical basis and evaluate the predicted annual income of the company in terms of insurance parameters namely the premium, total number of the insured, average loss claims etc. We restrict ourselves to a single insurance class the so-called automobile insurance. We show the existence a crossover premium p_c below which the company is loss-making. Above p_c, we also give detailed statistical ana...

  13. Health insurance and the demand for medical care: Instrumental variable estimates using health insurer claims data.

    Science.gov (United States)

    Dunn, Abe

    2016-07-01

    This paper takes a different approach to estimating demand for medical care that uses the negotiated prices between insurers and providers as an instrument. The instrument is viewed as a textbook "cost shifting" instrument that impacts plan offerings, but is unobserved by consumers. The paper finds a price elasticity of demand of around -0.20, matching the elasticity found in the RAND Health Insurance Experiment. The paper also studies within-market variation in demand for prescription drugs and other medical care services and obtains comparable price elasticity estimates. Published by Elsevier B.V.

  14. Mental Health Insurance Parity and Provider Wages.

    Science.gov (United States)

    Golberstein, Ezra; Busch, Susan H

    2017-06-01

    Policymakers frequently mandate that employers or insurers provide insurance benefits deemed to be critical to individuals' well-being. However, in the presence of private market imperfections, mandates that increase demand for a service can lead to price increases for that service, without necessarily affecting the quantity being supplied. We test this idea empirically by looking at mental health parity mandates. This study evaluated whether implementation of parity laws was associated with changes in mental health provider wages. Quasi-experimental analysis of average wages by state and year for six mental health care-related occupations were considered: Clinical, Counseling, and School Psychologists; Substance Abuse and Behavioral Disorder Counselors; Marriage and Family Therapists; Mental Health Counselors; Mental Health and Substance Abuse Social Workers; and Psychiatrists. Data from 1999-2013 were used to estimate the association between the implementation of state mental health parity laws and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and average mental health provider wages. Mental health parity laws were associated with a significant increase in mental health care provider wages controlling for changes in mental health provider wages in states not exposed to parity (3.5 percent [95% CI: 0.3%, 6.6%]; pwages. Health insurance benefit expansions may lead to increased prices for health services when the private market that supplies the service is imperfect or constrained. In the context of mental health parity, this work suggests that part of the value of expanding insurance benefits for mental health coverage was captured by providers. Given historically low wage levels of mental health providers, this increase may be a first step in bringing mental health provider wages in line with parallel health professions, potentially reducing turnover rates and improving treatment quality.

  15. Public views of health insurance in Japan during the era of attaining universal health coverage: a secondary analysis of an opinion poll on health insurance in 1967

    Directory of Open Access Journals (Sweden)

    Ikuma Nozaki

    2017-07-01

    Full Text Available While Japan’s success in achieving universal health insurance over a short period with controlled healthcare costs has been studied from various perspectives, that of beneficiaries have been overlooked. We conducted a secondary analysis of an opinion poll on health insurance in 1967, immediately after reaching universal coverage. We found that people continued to face a slight barrier to healthcare access (26.8% felt medical expenses were a heavy burden and had high expectations for health insurance (60.5% were satisfied with insured medical services and 82.4% were willing to pay a premium. In our study, younger age, having children before school age, lower living standards, and the health insurance scheme were factors that were associated with a willingness to pay premiums. Involving high-income groups in public insurance is considered to be the key to ensuring universal coverage of social insurance.

  16. 77 FR 31499 - Medicaid and Children's Health Insurance Programs; Disallowance of Claims for FFP and Technical...

    Science.gov (United States)

    2012-05-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430, 433, 447, and 457 [CMS-2292-F] RIN 0938-AQ32 Medicaid and Children's Health Insurance Programs... Children's Health Insurance Program (CHIP) disallowance process to allow States the option to retain...

  17. 78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Science.gov (United States)

    2013-01-30

    ... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...

  18. 78 FR 56711 - Health Insurance Exchanges; Application by the Accreditation Association for Ambulatory Health...

    Science.gov (United States)

    2013-09-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9953-PN] Health Insurance Exchanges; Application by the Accreditation Association for Ambulatory Health Care To Be... Federal Register announcing the result of our determination. (Health Insurance Exchanges; Application by...

  19. 78 FR 77470 - Health Insurance Exchanges; Approval of an Application by the Accreditation Association for...

    Science.gov (United States)

    2013-12-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9953-FN] Health Insurance Exchanges; Approval of an Application by the Accreditation Association for Ambulatory...\\ Health Insurance Exchanges; Application by the Accreditation Association for Ambulatory Health Care To Be...

  20. A utility theory approach for insurance pricing

    Directory of Open Access Journals (Sweden)

    Mohsen Gharakhani

    2015-11-01

    Full Text Available Providing insurance contract with “deductible” is beneficial for both insurer and insured. In this paper, we provide a utility modeling approach to handle insurance pricing and evaluate the tradeoff between discount benefit and deductible level. We analyze four different pricing problems of no insurance, full insurance coverage, insurance with β% deductible and insurance with D-dollar deductible based on a given utility function. A numerical example is also used to illustrate some interesting results.