Understanding out-of-pocket spending and financial hardship among patients who succumb to cancer and their caregivers

Background In most countries, including those with national health insurance or comprehensive public insurance, some expenses for cancer treatment are borne by the ill and their families. Objectives This study aims to identify the areas of out-of-pocket (OOP) spending in the last half-year of the lives of cancer patients and examine the extent of that spending; to examine the probability of OOP spending according to patients’ characteristics; and to examine the financial burden on patients’ families. Methods 491 first-degree relatives of cancer patients (average age: 70) who died 3–6 months before the study were interviewed by telephone. They were asked about their OOP payments during the last-half year of the patient's life, the nature of each payment, and whether it had imposed a financial burden on them. A logistic regression and ordered logit models were used to estimate the probability of OOP expenditure and the probability of financial burden, respectively. Results Some 84% of cancer patients and their relatives incurred OOP expenses during the last half-year of the patient’s life. The average levels of expenditure were US$5800on medicines, $8000 on private caregivers, and $2800 on private nurses. The probability of paying OOP for medication was significantly higher among patients who were unable to remain alone at home and those who were less able to make ends meet. The probability of spending OOP on a private caregiver or private nurse was significantly higher among those who were incapacitated, unable to remain alone, had neither medical nor nursing-care insurance, and were older. The probability of a financial burden due to OOP was higher among those unable to remain alone, the incapacitated, and those without insurance, and lower among those with above-average income, those with better education, and patients who died at home. Conclusions The study yields three main insights. First, it is crucial that oncology services provide cancer patients with detailed information about their entitlements and refer them to the National Insurance Institute so that they can exercise those rights. Second, oncologists should relate to the financial burden associated with OOP care at end of life. Finally, it is important to sustain the annual increase in budgeting for technologies and pharmaceuticals in Israel and to allocate a significant proportion of those funds to the addition new cancer treatments to the benefits package; this can alleviate the financial burden on patients who need such treatments and their families.

A Proposed Methodology for Modelling the Solvency of a National Pension Scheme

The main aim of this study is to fit a model for predicting pension liability. The study proposed a stochastic population model to determine the status of a pension scheme. By categorizing the members of the Social Security and National Insurance Trust (SSNIT) pension scheme of Ghana into five groups, the birth and death process with emigration and the pure death process coupled with assumption of the Yule’s process, were combined to successfully formulate a model for forecasting the surplus of SSNIT to be used as a proxy for assessing the solvency status of the scheme. The reliability of the proposed model was corroborated by very high coverage probabilities of the estimates of expected surpluses produced. The study demonstrated how easy it is to use the proposed model to carry out sensitivity analysis which allows the exploration of various scenarios leading to formulation and implementation of policies to enhance the solvency of the scheme. One major advantage of the proposed model is that, it uses more information (variables) compared to others proposed elsewhere for the same purpose. This contributes to the precision of estimates from the model. A key finding of the study is that SSNIT would have still been solvent had she increased pension by 50%.

An Analytical Study of Ship Hull Insurance in the Liquidity and Profitability of the National Insurance Company

The sea is of paramount importance in the life of man and peoples. Since ancient times, it has represented a tool for communication between nations, a link for civilizational meeting between them, and a source of sustenance. Man’s need and interest in exploiting this wealth moves his curiosity and ambitions to think and search for means that contribute and help in expanding the scope of maritime exploitation and consolidating relations between countries more and more. The maritime field was among the important areas touched by industrial and technological development, especially in the field of maritime transport, which led to the emergence of giant ships capable of embarking on sea voyages and thus moving foreign trade in a positive way. The aim of the research is to know the extent to which ship hull insurance is related to the liquidity and profitability of the National Insurance Company, and where the main research problem is manifested in the extent to which ship hull insurance is linked to the liquidity and profitability of the National Insurance Company. Only the research relied on the questionnaire as a tool for all data and information from the sample of 64 and those who have responsibility are (General Director, Department Director, Division Officer, Unit Officer) and the statistical program was used spss 21 in the calculation standard deviation, simple linear regression, testF ) R² (. The conclusions reached by the research are the evaluation of the degree of risk surrounding the ship and the evaluation of the degree of classification in the classification record is based on which the insurance price for the structures of marine vessels is determined, which shows that the degree of risk varies up and down according to the type of ship, origin, shipping lines, and the experience of the crew and the master. The results of the study also showed the existence of a strong correlation between the liquidity variable and profitability in the respondents' response to the research sample in the National Insurance Company, as there is no profitability without the presence of liquidity and good liquidity expresses the company's ability to meet the payment of its obligations. (*) An extracted thesis, which is part of the requirements for obtaining a higher diploma equivalent to a master’s degree. There are also a number of recommendations, including; Adoption of a unified plan for all insurance branches. To measure the liquidity risk in order to ensure that the company is protected from bankruptcy or its exit from the insurance market in the event of a financial crisis again.

Population-Based Distribution of Mycobacterium avium and Mycobacterium intracellulare in Japan

This study aimed to clarify the population-based distributions of Mycobacterium avium and Mycobacterium intracellulare in Japan. We conducted a combined analysis of the national insurance claim and microbiological databases. The incidence rates of M. avium by province were similar throughout the country, with some exceptions, such as in Okinawa, probably because the bathing customs are different from those in mainland Japan. In contrast, M. intracellulare showed a gradual increase from the central part of the country to the southwestern region, with precise gradation, which may indicate infection sources in the natural environment. This study found that assessment of the infection route of M. intracellulare in the natural environment, which is similar to the distribution of M. intracellular patients, is warranted. In conclusion, improvement of the household environment could decrease the incidence of M. avium, while environmental countermeasures will be required to decrease the incidence of M. intracellulare.

THE ROLE OF KNOWLEDGE MANAGEMENT IN RAISING THE EFFICIENCY OF EMPLOYEES :APPLIED STUDY IN THE NATIONAL INSURANCE COMPANY

The issue of raising the efficiency of workers has gained great importance for business organizations, especially in light of the challenges facing institutions today and their ability to adapt to technological changes. The knowledge economy is also one of the most important means that raise the efficiency of workers and increase their productivity. Therefore, the researcher found that insurance companies suffer from not giving importance to the concept of knowledge management and how to take advantage of knowledge to improve the performance level of workers and raise the efficiency and productivity of the worker, which will be reflected on the performance of the bank as a whole. In order to find out the causes of the problem and develop solutions to it, a sample of 40 managers in the National Insurance Company was selected, which included general managers, heads of departments, and directors of departments and branches to test the research hypothesis, which stipulated (there is a moral relationship with statistical significance between knowledge management and raising the efficiency of workers’ performance). The aim of the research is to clarify the role of knowledge management in raising the efficiency of workers and increase their productivity and to reach proposals that try to help the bank in question to improve the concept of knowledge management and how to apply it. The research also reached a number of recommendations, the most prominent of which is that insurance companies try to draw a clear path for the application and development of knowledge management and how to benefit from it in raising the efficiency of workers, and the bank should work permanently to generate knowledge and try to apply it to individuals working in the bank.

DIGITALIZATION OF THE INSURANCE MARKET AS A FACTOR IN INCREASING ITS COMPETITIVENESS

Approaches to the definition of «competitiveness» are systematized. The problems of the national insurance market and the main directions of its sustainable development in the conditions of digital transformation of the economy are identified. Factors affecting the competitiveness of an insurance company are identified. The author offers a classification of factors of insurers' competitiveness, including the main factors (reliability factors), support factors and stress factors. Digitalization is defined as the most important factor in the competitiveness of the insurance market in the digital economy. Competitive advantages of insurers based on digitalization are justified. Business imperatives of insurers in the conditions of digitalization are revealed. The recommendations can become a powerful driver for increasing the competitiveness of the insurance market.

Experience of Korea in setting up an insurance database system and proposed solutions for Vietnam

Clause 1, Article 33, Decree 03/2021/NĐ-CP dated January 15, 2021, on compulsory civil liability insurance of motor vehicle owners, clearly regulate the responsibility of insurance companies in developing and operating information technology system to guarantee statistical affairs and update the implementation of compulsory civil liability insurance of motor vehicle owners to ensure the connection to database on compulsory civil liability insurance of motor vehicle ownersas well as responsibility for insurance companies to provide minimum information on the system. However, in reality, insurance companies use their own database systems and hesitate to share information on the common database,thus causing difficulties for management. This issue leads to difficulties in data management and sharing. A cause of this situation is that insurance companies worry about the risk of losing customers when information is public. In order to resolve this issue, the paper will analyse a model that has been successfully deployed in Korea, from which, proposes several recommendations to contribute to the early realisation of the national insurance databases in Vietnam.