Transitional and Long-Term Care System in Japan and Current Challenges for Stroke Patient Rehabilitation

In Japan, the national medical insurance system and long-term care insurance (LTCI) system cover rehabilitation therapy for patients with acute, convalescent, and chronic stroke. Medical insurance covers early and multidisciplinary rehabilitation therapy during acute phase hospitalizations. Patients requiring assistance in their activities of daily living (ADL) after hospitalization are transferred to kaifukuki (convalescent) rehabilitation wards (KRW), which the medical insurance system has also covered. In these wards, patients can receive intensive and multidisciplinary rehabilitation therapy to improve their ADL and transition to a smooth home discharge. After discharge from these hospitals, elderly patients with stroke can receive outpatient (day-care) rehabilitation and home-based rehabilitation using the LTCI system. The Japanese government has proposed building a community-based integrated care system by 2025 to provide comprehensive medical services, long-term care, preventive care, housing, and livelihood support for patients. This policy aims to promote smooth coordination between medical insurance services and LTCI providers. Accordingly, the medical insurance system allows hospitals to receive additional fees by providing patient information to rehabilitation service providers in the LTCI system. A comprehensive database on acute, convalescent, and chronic phase stroke patients and seamless cooperation between the medical care system and LTCI system is expected to be established in the future. There are only 2,613 board-certified physiatrists in Japan, and many medical schools lack a department for rehabilitation medicine; establishing such a department at each school is encouraged to teach students efficient medical care procedures, to conduct research, and to facilitate the training of personnel in comprehensive stroke rehabilitation.

A FEW REMARKS ON THE APPOINTMENT OF THE PRESIDENT OF THE ZUS (SOCIAL INSURANCE INSTITUTION)

The subject of the article is to discuss the evolution of legal regulations regarding the appointment of the President of the Social Insurance Institution included in the Act of 13 October 1998 on the social insurance system and an assessment whether an employment relationship is established between ZUS and its President on the basis of the appointment.

INSURANCE MARKET TRANSFORMATION DURING PANDEMIC PERIOD

The article is devoted to the research analysis of the current patterns of development of the insurance system during the pandemic. Insurance is an integral part of the life of every person and enterprise. In this paper, studies of insurance as part of the economy in a pandemic are carried out. The problems of the work of insurance organizations in the conditions of a pandemic are identified, as well as ways to solve them are outlined. Summing up, we can say what big changes have taken place not only on the economy market as a whole, but also on insurance.

“Single System, Single-Standard” vs. “Single System, Multi-Standard”—The Impact of the Financing Method of Chinese Urban-Rural Integrated Medical Insurance System on the Rate of Joining Insurance for Middle-Aged and Elderly People

Basic Chinese medical insurance has achieved full coverage, but the inequality between urban and rural areas is still outstanding. Under this background, the government proposed the urban-rural Integrated Medical Insurance System which proposes two kinds of financing modes. Based on the decision-making theory of medical insurance and the logit regression model, this paper studies the influence of two kinds of financing modes on middle-aged and elderly people’s decisions to participate in integrated medical insurance in China. The two financing modes are “single-standard” and “multi-standard”. The results show that the two kinds of financing methods have positive and significant effects, and the incentive effect of “multi-standard” on the integrated medical insurance is greater than that of “single-standard”. Having an urban household registration promotes the development of the “multi-standard”. However, there are some central provinces are not eable to improve the integrated medical insurance participation rate through “multi-standard”. Improving the participation rate of integrated medical insurance can promote the balanced allocation of resources between urban and rural areas, as well as different income groups and regions. Moreover, it can ensure a smooth transition of medical insurance policies. We should hold and boost the financing method of “multi-standard” to guarantee medical insurance integration’s rapid and steady progress in China.

Development of Takaful in the Russian insurance system

Subject. We consider the specifics and trends in takaful development in the conditions of the modern Russian insurance market. Objectives. The aim is to show the possibilities of takaful in the Russian insurance system, provide a brief analysis of limitations, problems and prospects for its functioning Methods. The study rests on analysis, comparison, induction and deduction, logical method, and others. Results. The need for the development of takaful in our country resulted from the fact that there is an increase in the number of Muslims, making up more than 20 percent of the population. This is indicative of prospects for growth. Furthermore, a positive trend contributing to the development of takaful is the significant volume of the property and personal insurance market in Russia, as these types of insurance are implemented in takaful in accordance with Sharia, or Islamic law. The findings can be useful for ministries and departments, management of insurance organizations and development institutions, investment, microfinance, leasing and consulting companies, financial and industrial groups, and large banks interested in providing insurance services and attracting or placing capital in accordance with Islamic financial principles. Conclusions. Thanks to takaful, the individuals of the Islamic faith have the opportunity to meet such financial needs as insurance, thereby complementing the insurance market as a whole.

Exploring Interactions in the Sickness Insurance System in Terms of Power and Trust

Purpose Activation policies and efforts to reduce sick leave rates has influenced sickness insurance systems in Western countries, which has led to social security being more connected with work and attempts to expose malingering among the sickness absent. The aim of this study was to explore how power and trust are expressed by clients and stakeholders within the Swedish sickness insurance system. Methods This was a longitudinal qualitative study based on semi structured interviews and case files from 31 clients on sick leave in Sweden. Data was analyzed using a thematic analysis. Results The main theme ‘Acts of power and distrust’ illustrates how stakeholders’ express suspicions towards each other, and how clients need to demonstrate desire and efforts to return to work which other stakeholders verified. Conclusions The clients desire to prove themselves able to contribute to society was prominent in this study and power relations need to be acknowledged, in particular between client and the SIA. Further, to preserve citizens trust in the system, the system needs to demonstrate trust also in the clients.