Evaluating borrowers' default risk with a spatial probit model reflecting the distance in their relational network.

Potential relationship among loan applicants can provide valuable information for evaluating default risk. However, most of the existing credit scoring models either ignore this relationship or consider a simple connection information. This study assesses the applicants' relation in terms of their distance estimated based on their characteristics. This information is then utilized in a proposed spatial probit model to reflect the different degree of borrowers' relation on the default prediction of loan applicant. We apply this method to peer-to-peer Lending Club Loan data. Empirical results show that the consideration of information on the spatial autocorrelation among loan applicants can provide high predictive power for defaults.

Loan default prediction of Chinese P2P market: a machine learning methodology.

Repayment failures of borrowers have greatly affected the sustainable development of the peer-to-peer (P2P) lending industry. The latest literature reveals that existing risk evaluation systems may ignore important signals and risk factors affecting P2P repayment. In our study, we applied four machine learning methods (random forest (RF), extreme gradient boosting tree (XGBT), gradient boosting model (GBM), and neural network (NN)) to predict important factors affecting repayment by utilizing data from Renrendai.com in China from Thursday, January 1, 2015, to Tuesday, June 30, 2015. The results showed that borrowers who have passed video, mobile phone, job, residence or education level verification are more likely to default on loan repayment, whereas those who have passed identity and asset certification are less likely to default on loans. The accuracy and kappa value of the four methods all exceed 90%, and RF is superior to the other classification models. Our findings demonstrate important techniques for borrower screening by P2P companies and risk regulation by regulatory agencies. Our methodology and findings will help regulators, banks and creditors combat current financial disasters caused by the coronavirus disease 2019 (COVID-19) pandemic by addressing various financial risks and translating credit scoring improvements.

A Multicenter Curricular Intervention to Address Resident Knowledge and Perceptions of Personal Finance.

OBJECTIVES: We evaluated internal medicine residents' confidence and knowledge of personal finance, perceptions of burnout, and relations between these issues before and after an educational intervention. METHODS: We surveyed internal medicine residents at two university-based training programs in 2018. We developed and implemented a curriculum at both sites, covering topics of budgeting, saving for retirement, investment options, and the costs of investing. Each site used the same content but different strategies for dissemination. One used a condensed-form lecture series (two 1-hour sessions) and the other used a microlecture series (four 30-minute sessions) series. Residents were resurveyed following the intervention for comparison. RESULTS: The preintervention survey response rate was 41.2% (122/296) and the postintervention response rate was 44.3% (120/271). Postintervention mean scores for personal finance knowledge improved for basic concepts (52.6% vs 39.4%, P < 0.001), mutual fund elements (30.8% vs 19.7%, P < 0.001), investment plans (68.5% vs. 49.2%, P < 0.001), and overall knowledge (50.1% vs 36.1%, P < 0.001). A significantly smaller proportion of residents reported feelings of burnout following the intervention (23.3% vs 36.9%, P = 0.022). CONCLUSIONS: Our findings show that residents want to learn about finances. Our brief educational intervention is a practical way to improve overall knowledge. Our intervention suggests that improving knowledge of finance may be associated with decreased feelings of burnout.

Impacts on employment, finances, and lifestyle for working age people facing an expected premature death: A systematic review.

ABSTRACTObjective:The working ages (25-65 years) are a period when most people have significant work, financial, and family responsibilities. A small proportion of working age people will face an expected premature death from cancer or other life-limiting illness. Understanding the impact an expected premature death has on this population is important for informing support. The current study set out to summarize research describing the effects that facing an expected premature death has on employment, financial, and lifestyle of working age people and their families. METHOD: A systematic review using narrative synthesis approach. Four electronic databases were searched in July 2016 for peer-reviewed, English language studies focusing on the financial, employment, and lifestyle concerns of working age adults living with an advanced life-limiting illness and/or their carers and/or children. RESULTS: Fifteen quantitative and 12 qualitative studies were included. Two-thirds (n = 18) were focused on cancer. All studies identified adverse effects on workforce participation, finances, and lifestyle. Many patients were forced to work less or give up work/retire early because of symptoms and reduced functioning. In addition to treatment costs, patients and families were also faced with child care, travel, and home/car modification costs. Being younger was associated with greater employment and financial burden, whereas having children was associated with lower functional well-being. Changes in family roles were identified as challenging regardless of diagnosis, whereas maintaining normalcy and creating stability was seen as a priority by parents with advanced cancer. This review is limited by the smaller number of studies focussing on the needs of working age people with nonmalignant disease. SIGNIFICANCE OF RESULTS: Working age people facing an expected premature death and their families have significant unmet financial, employment, and lifestyle needs. Comparing and contrasting their severity, timing, and priority for people with nonmalignant conditions is required to better understand their unique needs.

Choice Experiments to Quantify Preferences for Health and Healthcare: State of the Practice.

Stated-preference methods increasingly are used to quantify preferences in health economics, health technology assessment, benefit-risk analysis and health services research. The objective of stated-preference studies is to acquire information about trade-off preferences among treatment outcomes, prioritization of clinical decision criteria, likely uptake or adherence to healthcare products and acceptability of healthcare services or policies. A widely accepted approach to eliciting preferences is discrete-choice experiments. Patient, physician, insurant or general-public respondents choose among constructed, experimentally controlled alternatives described by decision-relevant features or attributes. Attributes can represent complete health states, sets of treatment outcomes or characteristics of a healthcare system. The observed pattern of choice reveals how different respondents or groups of respondents implicitly weigh, value and assess different characteristics of treatments, products or services. An important advantage of choice experiments is their foundation in microeconomic utility theory. This conceptual framework provides tests of internal validity, guidance for statistical analysis of latent preference structures, and testable behavioural hypotheses. Choice experiments require expertise in survey-research methods, random-utility theory, experimental design and advanced statistical analysis. This paper should be understood as an introduction to setting up a basic experiment rather than an exhaustive critique of the latest findings and procedures. Where appropriate, we have identified topics of active research where a broad consensus has not yet been established.

Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients: Evidence From the Up-Tech Study.

BACKGROUND: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs. METHOD: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers). RESULTS: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW. DISCUSSION: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.

Determinants of Default in P2P Lending.

This paper studies P2P lending and the factors explaining loan default. This is an important issue because in P2P lending individual investors bear the credit risk, instead of financial institutions, which are experts in dealing with this risk. P2P lenders suffer a severe problem of information asymmetry, because they are at a disadvantage facing the borrower. For this reason, P2P lending sites provide potential lenders with information about borrowers and their loan purpose. They also assign a grade to each loan. The empirical study is based on loans' data collected from Lending Club (N = 24,449) from 2008 to 2014 that are first analyzed by using univariate means tests and survival analysis. Factors explaining default are loan purpose, annual income, current housing situation, credit history and indebtedness. Secondly, a logistic regression model is developed to predict defaults. The grade assigned by the P2P lending site is the most predictive factor of default, but the accuracy of the model is improved by adding other information, especially the borrower's debt level.

The random card sort method and respondent certainty in contingent valuation: an exploratory investigation of range bias.

Willingness to pay (WTP) values derived from contingent valuation surveys are prone to a number of biases. Range bias occurs when the range of money values presented to respondents in a payment card affects their stated WTP values. This paper reports the results of an exploratory study whose aim was to investigate whether the effects of range bias can be reduced through the use of an alternative to the standard payment card method, namely, a random card sort method. The results suggest that the random card sort method is prone to range bias but that this bias may be mitigated by restricting the analysis to the WTP values of those respondents who indicate they are 'definitely sure' they would pay their stated WTP.

Person-centeredness in home- and community-based long-term care: current challenges and new directions.

Person-centered care (PCC) has demonstrated to be a viable and preferred model of providing health and institutionalized long-term care services. However, the concept of PCC has not been fully extended to home- and community-based long-term care services (HCBS) for older adults with chronic conditions. This review highlights the need for PCC in HCBS and suggests that social workers may play a role in overcoming cultural and structural barriers to extending PCC to HCBS that include: the fragmentation of the industry, financial structures, regulation of services, and paternalism in policy and practice. Recommendations for practice, policy, and research are provided.

Testing procedural invariance in the context of health.

Violations of procedural invariance, epitomised by 'classic' preference reversals, have been observed for more than 40 years, and yet the study of this phenomenon in health remains nascent. This is an oversight because such violations pose a challenge to health economics, where choice and valuation methodologies often are used interchangeably. This article reports two experiments that aim to test for preference reversals over outcomes defined by health status, using both 'open' and 'assisted' valuation procedures. Although systematic preference reversals in the direction generally reported in the literature were not observed, the rates of non-systematic reversal were substantial, measuring 35-40%. By analysing the respondents' explanations for their answers, it is clear that many of them used heuristics to answer the questions, and they may have good reasons to do so, which undermines the notion that preferences are always fixed and stable. These results, and others like it, pose a challenge to those who unquestioningly assume procedural invariance and maintain that population preferences should be used to inform health policy.

Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam.

BACKGROUND: The proportion of people in Vietnam who are 60 years and over has increased rapidly. The emigration of young people and impact of other socioeconomic changes leave more elderly on their own and with less family support. This study assesses the willingness to use and pay for different models of care for community-dwelling elderly in rural Vietnam. METHODS: In 2007, people aged 60 and older and their family representatives, living in 2,240 households, were randomly selected from the FilaBavi Demographic Surveillance Site. They were interviewed using structured questionnaires to assess dependence in activities of daily living (ADLs), willingness to use and to pay for day care centres, mobile care teams, and nursing centres. Respondent socioeconomic characteristics were extracted from the FilaBavi repeated census. Percentages of those willing to use models and the average amount (with 95% confidence intervals) they are willing to pay were estimated. Multivariate analyses were performed to measure the relationship of willingness to use services with ADL index and socioeconomic factors. Four focus group discussions were conducted to explore people's perspectives on the use of services. The first discussion group was with the elderly. The second discussion group was with their household members. Two other discussion groups included community association representatives, one at the communal level and another at the village level. RESULTS: Use of mobile team care is the most requested service. The fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than do the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require that services be free-of-charge is two to three times higher than the proportion willing to pay full cost. Households are willing to pay more than the elderly for day care and nursing centres. The elderly are more willing to pay for mobile teams than are their households. Age group, sex, literacy, marital status, living arrangement, living area, working status, poverty, household wealth and dependence in ADLs are factors related to willingness to use services. CONCLUSIONS: Community-centric elderly care will be used and partly paid for by individuals if it is provided by the government or associations. Capacity building for health professional networks and informal caregivers is essential for developing formal care models. Additional support is needed for the most vulnerable elderly to access services.

What is affordable health insurance? The reasonable tradeoff account of affordability.

The reform of the health care system will include a mandate: Individuals are required to purchase health insurance provided that affordable options are available. But what is affordable health insurance? Three accounts of affordability of health coverage have been advanced. The first two accounts are empirical. The third account is needs-based. All three accounts are inadequate. I propose a fourth, the reasonable tradeoff account, according to which individuals should only be required to make reasonable tradeoffs in order to pay for their health coverage. That is, health insurance is affordable if in order to pay for it one does not to have to sacrifice other benefit(s) that are comparable in importance to the benefits of health coverage.

Development of a Money Mismanagement Measure and cross-validation due to suspected range restriction.

A measure of the tendency to mismanage money was developed in an evaluation of a representative payee program for individuals with serious mental illnesses. A conceptual model was composed to guide item development, and items were tested, revised, added, and rejected in three waves of data collection. Rasch analyses were used to examine measurement properties. The resulting Money Mismanagement Measure (M3) consisted of 28 items with a Rasch person reliability at .72. Restriction of range was likely responsible for the low Rasch reliability. Validity analyses supported the construct validity of the M3. Subsequently, a cross-validation study was conducted on an untreated sample not as susceptible to range restriction. The M3 produced a Rasch person reliability = .85 with good validity. The M3 fills a gap that can facilitate research in the understudied area of money mismanagement.

What's it worth?

Patients without effective coverage frequently must pay charges for medical services that are higher than the hospital's contracted rates. A national survey of hospitals shows great variation in how charges are set and accommodations made for patients with low income. The government is taking a more active role in examining charging practices. Hospitals can take several steps to help stave off government intervention.