Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.109
Filtrar
1.
BMJ Open ; 12(12): e066289, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36456029

RESUMO

OBJECTIVES: This study assesses effective coverage of diabetes and hypertension in Thailand during 2016-2019. DESIGN: Mixed method, analysis of National health insurance database 2016-2019 and in-depth interviews. SETTING: Beneficiaries of Universal Coverage Scheme residing outside Bangkok. PARTICIPANTS: Quantitative analysis was performed by acquiring individual patient data of diabetes and hypertension cases in the Universal Coverage Scheme residing outside bangkok in 2016-2019. Qualitative analysis was conducted by in-depth interview of 85 multi-stakeholder key informants to identify challenges. OUTCOMES: Estimate three indicators: detected need (diagnosed/total estimated cases), crude coverage (received health services/total estimated cases) and effective coverage (controlled/total estimated cases) were compared. Controlled diabetes was defined as haemoglobin A1C (HbA1C) below 7% and controlled hypertension as blood pressure below 140/90 mm Hg. RESULTS: Estimated cases were 3.1-3.2 million for diabetes and 8.7-9.2 million for hypertension. For diabetes, all indicators have shown slow improvement between 2016 and 2019 (67.4%, 69.9%, 71.9% and 74.7% for detected need; 38.7%, 43.1%, 45.1% and 49.8% for crude coverage and 8.1%, 10.5%, 11.8% and 11.7% for effective coverage). For hypertension, the performance was poorer for detection (48.9%, 50.3%, 51.8% and 53.3%) and crude coverage (22.3%, 24.7%, 26.5% and 29.2%) but was better for effective coverage (11.3%, 13.2%, 15.1% and 15.7%) than diabetes. Results were better for the women and older age groups in both diseases. Complex interplays between supply and demand side were a key challenge. Database challenges also hamper regular assessment of effective coverage. Sensitivity analysis when using at least three annual visits shows slight improvement of effective coverage. CONCLUSION: Effective coverage was low for both diseases, though improving in 2016-2019, especially among men and ัyounger populations. The increasing rate of effective coverage was significantly smaller than crude coverage. Health information systems limitation is a major barrier to comprehensive measurement. To maximise effective coverage, long-term actions should address primary prevention of non-communicable disease risk factors, while short-term actions focus on improving Chronic Care Model.


Assuntos
Diabetes Mellitus , Hipertensão , Seguro , Masculino , Feminino , Humanos , Idoso , Tailândia/epidemiologia , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Bases de Dados Factuais
2.
Artigo em Inglês | MEDLINE | ID: mdl-36361192

RESUMO

China has been piloting the catastrophic medical insurance (CMI) program since 2012 and rolled it out nationally in 2016 to reduce the incidence of catastrophic health expenditure among Chinese residents. Few studies have been conducted to determine its effect on healthcare expenditures, particularly among the elderly. The purpose of this study is to examine the effect of CMI on healthcare expenditures among China's elderly population. The data for this study were derived from 4 waves of the Chinese Longitudinal Healthy Longevity Survey, which included 344 and 1199 individuals in the treatment and control groups, respectively. To examine the effect of CMI on healthcare expenditures among the elderly, we used difference-in-differences and fixed-effects models. Additionally, a heterogeneity analysis was used to examine the differences in the impact of CMI on different groups. Finally, we confirmed the robustness of the results using robustness and placebo tests. CMI increased total health and out-of-pocket expenditures significantly, as well as inpatient and corresponding out-of-pocket expenditures. The reassults of the heterogeneity analysis indicated that CMI had a greater impact on elderly residents of rural areas. Economic burden protection has been enhanced for low-income groups and patients with serious diseases over the last two years. Our research indicated that CMI can promote the use of inpatient medical services for the elderly to a certain extent. Targeted measures such as expanding the CMI compensation list, establishing a more precise compensation scheme, and specific diseases associated with high healthcare expenditures can be considered in the practice of CMI implementation.


Assuntos
Gastos em Saúde , Seguro , Humanos , Idoso , China/epidemiologia , Atenção à Saúde , Pobreza , Seguro Saúde
3.
Artigo em Inglês | MEDLINE | ID: mdl-36360638

RESUMO

BACKGROUND: Self-medication has become a common phenomenon. Economic factors are important factors that affect the self-medication of residents. This study aimed to investigate the current status of self-medication behaviors in China and explored the related factors affecting considerations associated with medical insurance reimbursement or drug price in self-medication. METHODS: A national cross-sectional investigation was conducted among Chinese people over 18 years old under a multi-stage sampling method through a questionnaire, which includes demographic sociological characteristics, self-medication behaviors and scales. The Chi-square test was used to analyze whether the respondents consider medical insurance reimbursement or drug price as an important factor when purchasing over-the-counter (OTC) drugs. Logistic regression was used to examine the associated factors of considering medical insurance reimbursement or drug price. RESULTS: In total, 9256 respondents were included in this study; 37.52% of the respondents regarded drug prices as an important consideration, and 28.53% of the respondents attached great importance to medical insurance reimbursement. Elderly respondents who lived in the central region, had medical insurance, and had lower levels of health literacy were more likely to consider the medical insurance reimbursement, while respondents with high monthly family income as well as students were less likely to consider the same issue (p < 0.05). Respondents settled in the central and western regions, students, those without fixed occupations, those who suffered from chronic diseases, or those with lower health literacy were more likely to consider drug prices, while the respondents with bachelor degrees, urban population and high per capita monthly income were less likely to consider the drug prices (p < 0.05). CONCLUSION: Self-medication behaviors with OTC drugs were prevalent in China, and consideration factors of medical insurance reimbursement or drug prices were related to socio-demographic characteristics and health literacy. There is a need to take measures to reduce the economic burden of self-medication, improve the health literacy of residents and strengthen public health education.


Assuntos
Seguro , Automedicação , Humanos , Idoso , Adolescente , Estudos Transversais , Medicamentos sem Prescrição , China/epidemiologia
5.
Front Public Health ; 10: 1032758, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36330115

RESUMO

The purpose of this paper is to promote the construction of digital healthy cities and improve the living standards of urban residents. Based on this, this paper analyzes the development of healthy cities, and studies community public health safety emergency management and nursing insurance service optimization methods for healthy urban environment construction. First, the concept of digital healthy urban environment construction is discussed. Then, the role of environmental health is discussed. Finally, two methods are designed to study the emergency management of public health safety and nursing insurance services in urban communities under the condition of environmental health. The results show that in the environmental health score of the city, the scores of X1 (the urban air quality excellent rate) and X6 (citizens' satisfaction with the environmental quality) were relatively low between 2016 and 2018, below 0.5 points. The scores for the remaining 3 years were relatively high, above 0.5. The scores of X2 (green coverage rate of built-up area), X3 (average grade sound effect of environmental noise in urban area), X4 (harmless treatment rate of domestic waste) and X5 (centralized treatment rate of domestic sewage) were relatively high from 2016 to 2018, above 0.5 points, and relatively low in the remaining 3 years, below 0.5 points. Meanwhile, residents are very satisfied with information collection and information management in public health and safety emergency management, and the number of very satisfied people is basically more than 40%. Satisfaction with resource allocation and privacy management is high, and the number of very satisfied people is basically above 30%. However, the satisfaction with risk perception and management measures is very low, and the number of very satisfied people is basically below 20%. It shows that the current construction of the community's public health and safety emergency management system is relatively poor in terms of X2-X5, while the development of X1 and X6 is relatively mature. The research not only provides a reference for the construction and improvement of a digital healthy city, but also contributes to the improvement of the healthy life of urban residents.


Assuntos
Poluição do Ar , Seguro , Humanos , Saúde Pública , Cidades , Meio Ambiente
6.
J Am Dent Assoc ; 153(12): 1171-1178, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36441087

RESUMO

BACKGROUND: The purpose of this study was to identify differences in usage trends for 2 specific pulpal therapy treatments in pediatric patients during an 11-year period from January 1, 2010, through December 31, 2020. METHODS: Insurance data claims for children aged 2 through 12 years undergoing a pulpotomy or a pulpectomy performed by a general dentist (GD) or pediatric dentist (PD) from 2010 through 2020 were extracted from a dental data warehouse. The state where the provider was located was included in the extracted claim. RESULTS: Rates of undergoing a pulpotomy or pulpectomy declined from 2010 through 2020 (odds ratio [OR], 0.978 or 0.946, respectively; P < .001). PDs were more likely to perform pulpotomies than GDs (OR, 1.393; P < .001), but PDs were less likely to perform pulpectomies than GDs (OR, 0.225; P < .001). Younger patient age was a significant predictor for undergoing pulpotomy treatment for both GDs and PDs (ORs, 0.850 and 0.892, respectively; P < .001). With increasing patient age, PDs had increased odds of performing a pulpectomy (OR, 1.030; P < .001) and GDs had decreased odds of performing a pulpectomy (OR, 0.995; P = .04). When examining effects according to American Academy of Pediatric Dentistry national membership districts, the trends remained consistent with those above. CONCLUSIONS: The percentage of children undergoing pulpotomy and pulpectomy therapy declined from 2010 through 2020 among both GDs and PDs. PRACTICAL IMPLICATIONS: These changes in pulpal therapy practice might indicate a teaching change in pulpal therapy guidelines, suggesting that less invasive pulpal therapy can be used rather than pulpotomies or pulpectomies.


Assuntos
Assistência Odontológica , Revisão da Utilização de Seguros , Seguro , Criança , Humanos , Odontólogos , Razão de Chances , Odontopediatria , Pulpotomia
7.
Front Public Health ; 10: 1005257, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36438206

RESUMO

The number of older adults is rising rapidly in China. Various concerns such as chronic diseases, financial inadequacy, and a feeling of loneliness have adversely affected the mental health of older adults, and this has become an important public health and social issue. To realize healthy aging, the Nineteenth National People's Congress of China put forth the Healthy China strategy, speeding up the promotion activities of mental health and pension measures, carrying out public welfare pension insurance for the entire population, and contributing to the mental health of older adults. This study used data from China Family Panel Studies. This study mainly uses the random effect estimation method (random effect, RE) and the feasible generalized least squares estimation method (FGLS) to control for heterogeneity to explore the impact of social and commercial pension insurance on the mental health of older adults, the moderating effect of social capital on pension insurance, and the mental health of older adults. The results showed that social pension insurance is proportional to the mental health of older adults, whereas commercial pension insurance is inversely proportional to mental health. Social capital had a significant moderating effect on pension insurance. When a country develops an aging economy, the emphasis on social capital helps make targeted industrial development suggestions. The government's expansion of insurance coverage is crucial for improving the mental health of older adults.


Assuntos
Seguro , Capital Social , Humanos , Idoso , Saúde Mental , China/epidemiologia , Pensões
8.
Front Public Health ; 10: 1037763, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36438289

RESUMO

Background: Rural residents' participation in medical insurance has a significant relationship to the affordability of their medical care. This study aims to investigate the willingness of rural residents to participate in basic medical insurance for urban and rural residents and its determinants so as to enhance their willingness to participate in medical insurance. Methods: Data were obtained from 1,077 validated questionnaires from rural residents. Chi-square test and multiple logistic regression analysis were adopted to analyze determinants of rural residents' willingness to participate in basic medical insurance for urban and rural residents. Results: 94.3% of respondents were willing to participate in basic medical insurance for urban and rural residents and this was associated with the familiarity with the medical insurance policies [OR = 2.136, 95% CI (1.143, 3.989)], the reasonability of medical insurance premiums [OR = 2.326, 95% CI (0.998, 5.418)], the normality of doctors' treatment behavior [OR = 3.245, 95% CI (1.339, 7.867)] and the medical insurance's effectiveness in reducing the economic burden of disease [OR = 5.630, 95% CI (2.861, 11.079)]. Conclusion: Even though most respondents were willing to participate in basic medical insurance for urban and rural residents, some aspects need to be improved. The focus should be on promoting and regulating the behavior of medical staff. Financing policies and reimbursement of treatment costs need to be more scientifically developed. A comprehensive basic healthcare system needs to be optimized around the core function of "hedging financial risks".


Assuntos
Seguro , População Rural , Humanos , China , Inquéritos e Questionários
9.
BMC Public Health ; 22(1): 1847, 2022 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-36192708

RESUMO

BACKGROUND: Many Western countries have scaled back social and health expenditure, including decreases in the generosity and coverage of unemployment insurance, resulting in negative effects on general health and well-being at the aggregate level. Yet, research has not sufficiently looked into heterogeneity of such effects across different subgroups of the population. In Sweden, the 2006 unemployment insurance reform, implemented on the 1st of January 2007, encompassed a drastic increase of insurance fund membership fees, reduced benefit levels, and stricter eligibility requirements. As this particularly affected already socioeconomically disadvantaged groups in society, such as foreign-born and low-educated individuals, the current study hypothesise that the reform would also have a greater impact on health outcomes in these groups. METHODS: Based on register data for the total population, we utilise a quasi-experimental approach to investigate heterogeneous health effects of the reform across ethnic background, educational level, employment status, and sex. Due to behaviourally caused diseases having a relatively shorter lag time from exposure, hospitalisation due to alcohol-related disorders serves as the health outcome. A series of regression discontinuity models are used to analyse monthly incidence rates of hospitalisation due to alcohol-related disorders among individuals aged 30-60 during the study period (2001-2012), with the threshold set to the 1st of January 2007. RESULTS: The results suggest that, in general, there was no adverse effect of the reform on incidence rates of hospitalisation due to alcohol-related disorders. A significant increase is nonetheless detected among the unemployed, largely driven by Swedish-born individuals with Swedish-born or foreign-born parents, low-educated individuals, and men. CONCLUSIONS: We conclude that the Swedish 2006 unemployment insurance reform generally resulted in increasing incidence rates of hospitalisation due to alcohol-related disorders among unemployed population subgroups known to have higher levels of alcohol consumption.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Seguro , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Emprego , Hospitalização , Humanos , Incidência , Masculino , Suécia/epidemiologia , Desemprego
10.
JAMA Health Forum ; 3(9): e222919, 2022 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-36218926

RESUMO

Importance: Given higher reimbursement rates, hospitals primarily serving privately insured patients may invest more in intensive coding than hospitals serving publicly insured patients. This may lead these hospitals to code more diagnoses for all patients. Objective: To estimate whether, for the same Medicaid enrollee with multiple hospitalizations, a hospital's share of privately insured patients is associated with the number of diagnoses on claims. Design, Setting, and Participants: This cross-sectional study used patient-level fixed effects regression models on inpatient Medicaid claims from Medicaid enrollees with at least 2 admissions in at least 2 different hospitals in New York State between 2010 and 2017. Analyses were conducted from 2019 to 2021. Exposures: The annual share of privately insured patients at the admitting hospital. Main Outcomes and Measures: Number of diagnostic codes per admission. Probability of diagnoses being from a list of conditions shown to be intensely coded in response to payment incentives. Results: This analysis included 1 614 630 hospitalizations for Medicaid-insured patients (mean [SD] age, 48.2 [20.1] years; 829 684 [51.4%] women and 784 946 [48.6%] men). Overall, 74 998 were Asian (4.6%), 462 259 Black (28.6%), 375 591 Hispanic (23.3%), 486 313 White (30.1%), 128 896 unknown (8.0%), and 86 573 other (5.4%). When the same patient was seen in a hospital with a higher share of privately insured patients, more diagnoses were recorded (0.03 diagnoses per percentage point [pp] increase in share of privately insured; 95% CI, 0.02-0.05; P < .001). Patients discharged from hospitals in the bottom quartile of privately insured patient share received 1.37 more diagnoses when they were subsequently discharged from hospitals in the top quartile, relative to patients whose admissions were both in the bottom quartile (95% CI, 1.21-1.53; P < .001). Those going from hospitals in the top quartile to the bottom had 1.67 fewer diagnoses (95% CI, -1.84 to -1.50; P < .001). Diagnoses in hospitals with a higher private payer share were more likely to be for conditions sensitive to payment incentives (0.08 pp increase for each pp increase in private share; 95% CI, 0.06-0.10; P < .001). These findings were replicated in 2016 to 2017 data. Conclusions and Relevance: In this cross-sectional study of Medicaid enrollees, admission to a hospital with a higher private payer share was associated with more diagnoses on Medicaid claims. This suggests payment policy may drive differential investments in infrastructure to document diagnoses. This may create a feedback loop that exacerbates resource inequity.


Assuntos
Hospitais Estaduais , Seguro , Codificação Clínica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New York/epidemiologia , Estados Unidos
11.
PLoS One ; 17(10): e0274047, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36215253

RESUMO

This paper aims to test whether agricultural insurance significantly impacts farmers' income increase or not. We have used the ordinary least squares method (OLS), panel fixed effects, and system generalized moment estimation (GMM) for the test. The results show that the increase in agricultural insurance density and the increase in agricultural insurance per capita compensation positively impact farmers' income growth significantly. Agricultural insurance density and per capita compensation are the indicators used in this article to measure agricultural insurance development. Therefore, it can be considered that the development of agricultural insurance in Guangdong Province (China) can effectively increase the income level of farmers. Based on the results of theoretical and empirical analysis, combined with the current situation of agricultural insurance development in Guangdong Province, this paper finally puts forward relevant countermeasures and suggestions. It provides some ideas for giving full play to the role of agricultural insurance in promoting farmers' income from the perspectives of pertinent system design, subsidy methods, insurance innovation, service level, and publicity.


Assuntos
Fazendeiros , Seguro , Agricultura/métodos , China , Humanos , Renda
12.
Front Public Health ; 10: 975459, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36211697

RESUMO

Objectives: Based on incentive theory of motivation, this paper aims to estimate China's basic pension insurance's annual efficiency and inter-period efficiency changes from 2015 to 2019 and further examine the relationship between official tenure and basic pension insurance governance performance. Methods: The DEA-BCC model was used to evaluate the operating efficiency of basic pension insurance in 31 provinces of China. And four panel Tobit models were constructed to examine the heterogeneous linkages between officials' tenure and governance efficiency in different regions of China. Results: The results showed that there was an inverted U-shaped relationship between the official tenure and the governance efficiency of basic pension insurance. The younger an official was in his current position, the more apparent the inverted U-shaped relationship between the tenure of an official and the governance efficiency of basic pension insurance. We also found that localized government officials showed better governance efficiency of basic pension insurance. However, as the term of office of officials increased, the governance efficiency of non-localized officials showed a steeper negative effect. Conclusion: This study firstly reveals a significant relationship between the characteristics of officials and the operation of China's basic pension insurance system, which is a complement to the study of China's basic pension systems.


Assuntos
Seguro , Pensões , China
13.
Comput Math Methods Med ; 2022: 3135149, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36188108

RESUMO

This work establishes the SE-IR model of dissemination of online public opinions and control decisions. The model is developed by sorting out the development process of dissemination of the online public opinion model, analysing the mechanism of public opinion evolution in emergencies, drawing on the construction idea of the SEIR contagion model, and combining the characteristics of the online public opinion dissemination with the role mechanism of government intervention. Using this model, we determine the equilibrium point and stability of public opinion dissemination. Using the data of public opinion on an incident of fraudulent insurance claims in China, we explore the influence of different government decisions on public opinion dissemination. The results show that government actions in that case achieved the purpose of minimising the risk of harmful public opinion dissemination.


Assuntos
Seguro , Opinião Pública , China , Pesquisa Empírica , Fraude , Humanos , Revisão da Utilização de Seguros
14.
Front Public Health ; 10: 1009207, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36262233

RESUMO

Population aging is the most serious challenge facing the pension insurance system in China in the next few decades. Compared with the employees of civil servants and enterprises and institutions, urban and rural residents are unstable vulnerable groups with less income. In order to deal with the pension risks caused by the growing aging population and solve the security problems of urban and rural residents, our government has carried out a series of constructive works in the pension insurance system: in view of the rural and urban residents, new rural social endowment insurance system and the social endowment insurance system for urban residents have been set up and combined into a unified basic old-age insurance system for urban and rural residents in 2014. With the continuous expansion in the scale of income and expenditure of urban and rural living insurance funds and the size of the insured number, it is of great necessity to evaluate the efficiency of this system. The operational efficiency evaluation of urban and rural residents' basic pension insurance systems is viewed as multi-attribute group decision-making (MAGDM). In this paper, we propose an approach by combining the traditional Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) with cumulative prospect theory (CPT) which can be widely used with vague information. Thus, the main contribution of this study is as follows: (1) the TOPSIS method is extended by picture fuzzy sets (PFSs) with unknown weight information; (2) entropy method to obtain the original weights of attributes; (3) the picture fuzzy-CPT-TOPSIS (PF-CPT-TOPSIS) method is used to deal with the MAGDM problems under PFSs; (4) a numerical instance for operational efficiency evaluation of urban and rural residents' basic pension insurance systems is proposed to testify the effectiveness of new method; and (5) some comparative studies are provided to give effect to the rationality of PF-CPT-TOPSIS approach.


Assuntos
Seguro , População Rural , Humanos , Idoso , China , Pensões , Tomada de Decisões
15.
J Manag Care Spec Pharm ; 28(11): 1272-1281, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36282930

RESUMO

BACKGROUND: Migraineurs may be categorized as having episodic migraine (EM: < 15 headache days/month) or chronic migraine (CM: ≥ 15 days/month for > 3 months with ≥ 8 days/month having features of migraine). Opioid use has been linked to progression from EM to CM. OBJECTIVE: To describe the utilization of opioid prescriptions among patients with migraine, to determine the association between opioid use and migraine progression, and to explore demographic and clinical risk factors for migraine progression. METHODS: This retrospective cohort study used Optum's deidentified Clinformatics Data Mart Database from January 2015 to December 2018. Adult patients with a migraine diagnosis and continuous health plan enrollment were included. Opioid use was measured by average daily morphine equivalent dose, also known as morphine milligram equivalent (MME). Descriptive statistics were used to summarize the opioid use by patient demographic and clinical characteristics. A Cox proportional hazards model with stepwise selection was used to determine the risk factors of new-onset CM. RESULTS: Overall, 35% of patients with migraine (27,331 of 78,134) received prescription opioids (> 0 MME/day) during the 12-month follow-up period. Higher opioid dosage was found in patients who had CM and comorbidities of interest. Compared with patients with EM, patients with CM were twice as likely to receive at least 20 MME/day (CM 3.8% vs EM 1.9%) and had a higher median opioid day supply (CM 20 vs EM 10) during follow-up. About 7% of patients with CM with at least 1 opioid prescription had at least 50 MME/day in any 90-day period during follow-up. A significant association was found between MME level and the likelihood of new-onset CM. Additional significant risk factors of migraine progression included younger age, female sex, South and West regions, and having a diagnosis of medication overuse headache, depression, back pain, or fibromyalgia (all P < 0.05). CONCLUSIONS: Despite guidelines and the availability of more migraine-specific treatments, opioids are still commonly prescribed to patients with migraines in real-world practice, especially for those with CM. In this study population, a higher risk of new-onset CM was associated with receiving higher opioid doses.


Assuntos
Seguro , Transtornos de Enxaqueca , Transtornos Relacionados ao Uso de Opioides , Adulto , Humanos , Feminino , Analgésicos Opioides/efeitos adversos , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia , Fatores de Risco , Derivados da Morfina/uso terapêutico
16.
Artigo em Inglês | MEDLINE | ID: mdl-36293638

RESUMO

Based on the theories of welfare economics, this paper analyzed the mechanism of agricultural insurance (AI) affecting agricultural economic growth (AEG), theoretically, and carried out an empirical analysis by using the random effects model and thirteen years of panel data, which included the annual data of 11 cities in Zhejiang Province, China, from 2007 to 2019. The gross output value of agriculture, forestry, animal husbandry, and fishery (GOVA) of 11 cities in Zhejiang Province is selected as the explained variable, agricultural insurance premium income (AIPI) as an explanatory variable. We selected area of waterlogging removal (AWR), rural electricity consumption (REC), total power of agricultural machinery (TPAM), and crop-sown area (CSA) as control variables. The study shows that: (1) the AIPI has a significant positive impact on the growth of GOVA. When other conditions remain unchanged, a 1% increase in AIPI increases the GOVA by 0.166%, accordingly; (2) The control variables of REC, TPAM, and CSA are statistically significant for the growth of the GOVA. The elasticity coefficient of REC is 0.325, the elastic coefficient of the TPAM is 0.287, and the elasticity coefficient of CSA is -0.281.


Assuntos
Desenvolvimento Econômico , Seguro , Agricultura , China , Agricultura Florestal , Criação de Animais Domésticos
18.
Int J Drug Policy ; 109: 103853, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36202041

RESUMO

BACKGROUND: The use of opioids is increasing globally, but data from low- and middle-income countries on opioid-related mental and behavioural disorders (hereafter referred to as opioid-related disorders) are scarce. This study examines the incidence of opioid-related disorders, opioid agonist use, and excess mortality among persons with opioid-related disorders in South Africa's private healthcare sector. METHODS: We analysed longitudinal data of beneficiaries (≥ 11 years) of a South African medical insurance scheme using reimbursement claims from Jan 1, 2011, to Jul 1, 2020. Beneficiaries were classified as having an opioid-related disorder if they received an opioid agonist (buprenorphine or methadone) or an ICD-10 diagnosis for harmful opioid use (F11.1), opioid dependence or withdrawal (F11.2-4), or an unspecified or other opioid-related disorder (F11.0, F11.5-9). We calculated adjusted hazard ratios (aHR) for factors associated with opioid-related disorders, estimated the cumulative incidence of opioid agonist use after receiving an ICD-10 diagnosis for opioid dependence or withdrawal, and examined excess mortality among beneficiaries with opioid-related disorders. RESULTS: Of 1,251,458 beneficiaries, 1286 (0.1%) had opioid-related disorders. Between 2011 and 2020, the incidence of opioid-related disorders increased by 12% (95% CI 9%-15%) per year. Men, young adults in their twenties, and beneficiaries with co-morbid mental health or other substance use disorders were at increased risk of opioid-related disorders. The cumulative incidence of opioid agonist use among beneficiaries who received an ICD-10 diagnosis for opioid dependence or withdrawal was 18.0% (95% CI 14.0-22.4) 3 years after diagnosis. After adjusting for age, sex, year, medical insurance coverage, and population group, opioid-related disorders were associated with an increased risk of mortality (aHR 2.28, 95% CI 1.84-2.82). Opioid-related disorders were associated with a 7.8-year shorter life expectancy. CONCLUSIONS: The incidence of people diagnosed with or treated for an opioid-related disorder in the private sector is increasing rapidly. People with opioid-related disorders are a vulnerable population with substantial psychiatric comorbidity who often die prematurely. Evidence-based management of opioid-related disorders is urgently needed to improve the health outcomes of people with opioid-related disorders.


Assuntos
Buprenorfina , Seguro , Transtornos Relacionados ao Uso de Opioides , Adulto Jovem , Masculino , Humanos , Analgésicos Opioides/efeitos adversos , África do Sul/epidemiologia , Estudos de Coortes , Setor Privado , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/complicações , Buprenorfina/uso terapêutico , Metadona/uso terapêutico
19.
Gan To Kagaku Ryoho ; 49(9): 1011-1013, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36156029

RESUMO

Precision medicine, which provides personalized treatments based on individual genomic profiles, has made remarkable progress especially in the oncology area, since when 2 types of comprehensive genomic profiling(CGP)tests, FoundationOne CDx and OncoGuide NCC Oncopanel have been reimbursed by national insurance system in June 2019. However, the application of CGP as a companion diagnostics(CDx)in addition to the single and the multi-CDx tests is now complicated. In this session, problems of the personalized treatment system based on the results of the cancer genomic test will be discussed.


Assuntos
Seguro , Neoplasias , Medicina Genômica , Humanos , Oncologia , Neoplasias/genética , Neoplasias/terapia , Medicina de Precisão/métodos
20.
J Environ Manage ; 322: 116079, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36063696

RESUMO

This study addresses the role of natural hazard insurance in two European countries with different insurance markets and socioeconomic conditions: Sweden and Portugal. The analyses were conducted at the national, regional (Southern Sweden and Lisbon Metropolitan Area - LMA), and local (Malmö and Lisbon cities) scales. Most damage caused by weather and climate-related (WCR) hazards during the 1980-2019 period was not covered by insurance companies in Sweden (71%) and Portugal (91%). An insurance affordability analysis was performed using income for the national and regional scales. Unaffordability is higher in Southern Sweden than in LMA, implying that better socioeconomic conditions do not necessarily mean a higher average capacity to pay for insurance. At the local scale, urban flooding was analysed for Malmö (1996-2019) and Lisbon (2000-2011) using insurance databases, in which the most relevant 21st century rainfall events for each city are included (2014 and 2008, respectively). The influence of terrain features on flooding claims and payouts was determined using Geographic Information Systems (GIS) spatial analyses. The flat Malmö favours ponding and extensive flooding, while the distance to the drainage network and flow accumulation are key factors to promote flooding along valley bottoms in the hilly Lisbon. Flooding hotspots tend to result from a combination of higher depths/lower velocities (accumulation of floodwaters and ponding) and not from a pattern of lower depths/higher velocities (shallow overland flow). More detailed data on insurance, flooding, and socioeconomic conditions, at regional and mainly local scales, is needed to improve affordability and urban flooding risk assessments.


Assuntos
Inundações , Seguro , Cidades , Portugal , Suécia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...