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1.
Comput Intell Neurosci ; 2022: 2343181, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36110909

RESUMO

A relevant definition of big data technology has been released by relevant research institutes in China. Big data technology is defined as follows: big data technology is a digitally important productivity factor in the network era; big data technology is based on network technology, statistical technology, and mathematical technology; big data technology, as a carrier of network technology, should be integrated with various industries and technologies other than contemporary ones in order to achieve better informatization and industrialization. In the context of the new crown epidemic in 2020, China's big data technology continues to grow steadily, with a total value of 39.2 trillion yuan, accounting for 38.6% of GDP. This paper investigates the risk constraint in the context of big data and optimizes the benign interaction mechanism of insurance management based on distorted risk metrics in this context. The current situation of insurance risk is investigated through a profound discussion of theories in this paper and through research methods such as distortion risk metrics and SQL Server database management. It is found that the overall situation of insurance industry development in the era of digital economy is not optimistic and so on. And relevant suggestions are made in the conclusion.


Assuntos
Big Data , Seguro , China
2.
BMJ Open ; 12(9): e065600, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104129

RESUMO

OBJECTIVES: In people with a disability, or their caregivers, who reported suboptimal experiences, the objectives were to explore: (1) challenges with telehealth-delivered allied health services during the COVID-19 pandemic and (2) suggestions to improve such services. DESIGN: Qualitative study based on an interpretivist paradigm and a phenomenological approach. SETTING: Participants who accessed allied healthcare via telehealth during the pandemic. PARTICIPANTS: Data saturation was achieved after 12 interviews. The sample comprised three people with permanent or significant disabilities, and nine carers/partners/family members of people with permanent or significant disabilities, who were funded by the Australian National Disability Insurance Scheme and had suboptimal experiences with telehealth. Semistructured one-on-one interviews explored experiences with telehealth and suggestions on how such services could be improved. An inductive thematic analysis was performed. RESULTS: Six themes relating to the first study objective (challenges with telehealth) were developed: (1) evoked behavioural issues in children; (2) reliant on caregiver facilitation; (3) inhibits clinician feedback; (4) difficulty building rapport and trust; (5) lack of access to resources and (6) children disengaged/distracted. Five themes relating to the second study objective (suggestions to improve telehealth services) were developed: (1) establish expectations; (2) increase exposure to telehealth; (3) assess suitability of specific services; (4) access to support workers and (5) prepare for telehealth sessions. CONCLUSIONS: Some people with permanent and significant disabilities who accessed allied healthcare via telehealth during the pandemic experienced challenges, particularly children. These unique barriers to telehealth need customised solutions so that people with disabilities are not left behind when telehealth services become more mainstream. Increasing experience with telehealth, setting expectations before consultations, supplying resources for therapy and assessing the suitability of clients for telehealth may help overcome some of the challenges experienced.


Assuntos
COVID-19 , Pessoas com Deficiência , Seguro , Telemedicina , Austrália , COVID-19/epidemiologia , Criança , Atenção à Saúde , Serviços de Saúde , Humanos , Pandemias
3.
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
4.
Vet Rec ; 191(5): 201, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36083057
5.
Comput Intell Neurosci ; 2022: 5870893, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36093478

RESUMO

Since the turn of the twenty-first century, the issue of aging has gained international attention. Both developed and developing nations are currently dealing with this issue. To ensure the sustained and healthy growth of the economy and society in the face of an aging society, it is especially important to establish a scientific old-age insurance system and a reasonable retirement system. We are all aware that the key indicators for the state to control the old-age insurance system in the old-age insurance system are the income and expenditure balance of the old-age insurance pooling account and the analysis of the ideal retirement age. In this paper, a better machine algorithm is used. By independently learning the rules present in a large amount of data and gaining new experience and knowledge, machine learning (ML) can increase computer intelligence and give computers decision-making abilities comparable to those of humans. In general, a machine learning algorithm uses the laws it derives from data to predict unknown data after automatically analysing the data. This study's findings suggest that the ideal retirement age and life expectancy are positively correlated, with the ideal retirement age's growth rate 12.57 percent higher than that of life expectancy.


Assuntos
Seguro , Aposentadoria , Algoritmos , Gastos em Saúde , Humanos , Aprendizado de Máquina , Pensões
6.
Front Public Health ; 10: 950870, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36091537

RESUMO

This study examines the influences of grandchild care and medical insurance on childhood obesity. Nationally representative longitudinal data-from the China Family Panel Studies 2010-2020-of 26,902 school-age children and adolescents aged 6-16 years and China's new reference standard ("WS/T586-2018") are used to identify a child's obesity status. Using binary mixed-effects logistic regression models and the Blinder-Oaxaca decomposition method, this study explores the roots of obesity inequalities and finds that at least 15% of Chinese children aged 6-16 were obese in the 2010s. The logistic regression analysis results indicate that grandchild care, public medical insurance, and commercial medical insurance are key risk factors of child obesity. However, the influences are heterogeneous in different groups: Grandchild care and public medical insurance increase urban-rural obesity inequalities because of a distribution effect, and grandchild care may also exacerbate children obesity inequalities between left-behind and non-left-behind children owing to the event shock of parental absence. Inequalities in socioeconomic status (SES) factors such as income, education, and region also cause obesity inequalities. These results indicate that child obesity and its inequalities are rooted in multidimensional environmental inequalities, including medical protection policies and its benefit incidence; intergenerational behavior and family SES factors; and urban-rural and left-behind risk shocks. This study provides new evidence for the development of population-based interventions and equitable medical insurance policies to prevent the deterioration of child obesity among Chinese school-age children and adolescents.


Assuntos
Seguro , Obesidade Pediátrica , Adolescente , Criança , China/epidemiologia , Família , Humanos , Obesidade Pediátrica/epidemiologia , Fatores Socioeconômicos
7.
Front Endocrinol (Lausanne) ; 13: 967739, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36133311

RESUMO

In recent years, the incidence of infertility has been increasing gradually, while the natural rate of population growth is declining or even at zero growth. China is observed to enter a depth of aging society, leading to more severe infertility. Infertility patients face many predicaments, and many unreasonable behaviors existed in seeking medical diagnosis and treatment, of which the main influencing factor is economic condition. In China, Beijing has taken the lead in providing medical insurance for 16 assisted reproductive technology items. Assuming that all infertile couples with the option of assisted reproduction are treated, there would be a huge market gap. The reimbursement rate can be adjusted based on some factors within the affordable range of the medical insurance fund. Progress on infertility coverage in other countries was also reviewed. This paper cited the data of medical insurance funds in China in the recent 4 years as a reference. Based on the data, it is not currently able to cover all the costs of infertility diagnosis and treatment during the research period, but it is feasible to access selective reimbursement and subsidies for those in particular need as well as to develop some commercial insurances. There is a big gap in the application of assisted reproductive technology between China and developed countries. More comprehensive and constructive policies should be formulated countrywide to standardize the market. Assisted reproduction-related technologies and acceleration of the domestic medical apparatus and instrument replacement should be improved to reduce the cost.


Assuntos
Infertilidade , Seguro , China/epidemiologia , Estudos de Viabilidade , Humanos , Infertilidade/epidemiologia , Infertilidade/terapia , Técnicas de Reprodução Assistida
8.
PLoS One ; 17(9): e0273332, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36054196

RESUMO

In Germany, the incidence of cervical cancer, a disease caused by human papillomaviruses (HPV), is higher than in neighboring European countries. HPV vaccination has been recommended for girls since 2007. However, it continues to be significantly less well received than other childhood vaccines, so its potential for cancer prevention is not fully realized. To find new starting points for improving vaccination rates, we analyzed pseudonymized routine billing data from statutory health insurers in the PRÄZIS study (prevention of cervical carcinoma and its precursors in women in Saarland) in the federal state Saarland serving as a model region. We show that lowering the HPV vaccination age to 9 years led to more completed HPV vaccinations already in 2015. Since then, HPV vaccination rates and the proportion of 9- to 11-year-old girls among HPV-vaccinated females have steadily increased. However, HPV vaccination rates among 15-year-old girls in Saarland remained well below 50% in 2019. Pediatricians vaccinated the most girls overall, with a particularly high proportion at the recommended vaccination age of 9-14 years, while gynecologists provided more HPV catch-up vaccinations among 15-17-year-old girls, and general practitioners compensated for HPV vaccination in Saarland communities with fewer pediatricians or gynecologists. We also provide evidence for a significant association between attendance at the children´s medical check-ups "U11" or "J1" and HPV vaccination. In particular, participation in HPV vaccination is high on the day of U11. However, obstacles are that U11 is currently not financed by all statutory health insurers and there is a lack of invitation procedures for both U11 and J1, resulting in significantly lower participation rates than for the earlier U8 or U9 screenings, which are conducted exclusively with invitations and reminders. Based on our data, we propose to restructure U11 and J1 screening in Germany, with mandatory funding for U11 and organized invitations for HPV vaccination at U11 or J1 for both boys and girls.


Assuntos
Alphapapillomavirus , Seguro , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Adolescente , Criança , Feminino , Humanos , Masculino , Infecções por Papillomavirus/prevenção & controle , Vacinação
9.
BMC Public Health ; 22(1): 1677, 2022 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064378

RESUMO

BACKGROUND: Invasive pneumococcal disease (IPD) is a major cause of pediatric morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) were introduced in the US in 2000 (PCV7) and 2010 (PCV13). This study estimated the annual incidence rates (IRs) and time trends of IPD to quantify the burden of disease in children before and after the introduction of PCV7 and PCV13 in the US. METHODS: IPD episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using claims with International Classification of Diseases 9/10th Revision, Clinical Modification codes. Annual IRs were calculated as the number of IPD episodes/100,000 person-years (PYs) for children < 18 years and by age group (< 2, 2-4, and 5-17 years). National estimates of annual IPD IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were conducted to assess immediate and gradual changes in IPD IRs before and after introduction of PCV7 and PCV13. RESULTS: In commercially insured children, IPD IRs decreased from 9.4 to 2.8 episodes/100,000 PY between the pre-PCV7 (1998-1999) and late PCV13 period (2014-2018) overall, and from 65.6 to 11.6 episodes/100,000 PY in children < 2 years. In the Medicaid population, IPD IRs decreased from 11.3 to 4.2 episodes/100,000 PY between the early PCV7 (2001-2005) and late PCV13 period overall, and from 42.6 to 12.8 episodes/100,000 PY in children < 2 years. The trends of IRs for meningitis, bacteremia, and bacteremic pneumonia followed the patterns of overall IPD episodes. The ITS analyses indicated significant decreases in the early PCV7 period, increases in the late PCV7 and decreases in the early PCV13 period in commercially insured children overall. However, increases were also observed in the late PCV13 period in children < 2 years. The percentage of cases with underlying risk factors increased in both populations. CONCLUSIONS: IRs of IPD decreased from 1998 to 2018, following introduction of PCV7 and PCV13, with larger declines during the early PCV7 and early PCV13 periods, and among younger children. However, the residual burden of IPD remains substantial. The impact of future PCVs on IPD IRs will depend on the proportion of vaccine-type serotypes and vaccine effectiveness in children with underlying conditions.


Assuntos
Bacteriemia , Seguro , Infecções Pneumocócicas , Bacteriemia/epidemiologia , Criança , Vacina Pneumocócica Conjugada Heptavalente , Humanos , Incidência , Lactente , Medicaid , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico , Sorogrupo , Estados Unidos/epidemiologia , Vacinas Conjugadas
10.
Front Public Health ; 10: 910534, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937251

RESUMO

Based on China's provincial panel data from 2007 to 2019, this article discusses the impact of agricultural insurance on agricultural green development, and discusses the issue of regional heterogeneity. This article first studies the impact mechanism of agricultural insurance on agricultural green development, calculates the agricultural green development index, and empirically analyzes the impact of agricultural insurance on agricultural green development. The empirical results show that agricultural insurance has an inhibitory effect on agricultural green development, and that the impact of agricultural insurance on agricultural green development in the three functional areas is heterogeneous. Finally, it puts forward countermeasures and suggestions to build a low-carbon subsidy mechanism for agricultural insurance, enrich agricultural insurance products, improve the coverage of agricultural insurance, and build an agricultural production mode of internal planting and breeding combined with recycling through policy incentives.


Assuntos
Seguro , Desenvolvimento Sustentável , Agricultura
11.
J Patient Saf ; 18(5): 404-409, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35948289

RESUMO

OBJECTIVE: The aim of the study was to investigate the feasibility of using administrative data to screen adverse events in Korea. METHODS: We used a diagnosis-related groups claims data set and the information of the checklist of healthcare quality improvement (a part of the value incentive program) to verify adverse events in fiscal year 2018. Adverse events were identified using patient safety indicator (PSI) clusters and a present on admission indicator (POA). The PSIs consisted of 19 clusters representing subcategories of adverse events, such as hospital-acquired infection. Among the adverse events identified using PSI clusters, "POA = N," which means not present at the time of admission, was only deemed as the case in the final stage. We compared the agreement on the occurrence of adverse events from claims data with a reference standard data set (i.e., checklist of healthcare quality improvement) and presented them by PSI cluster and institution. RESULTS: The cases of global PSI for any adverse event numbered 27,320 (2.32%) among all diagnostic codes in 2018. In terms of institutional distribution, considerable variation was observed throughout the clusters. For example, only 13.2% of institutions (n = 387) reported any global PSI for any adverse event throughout the whole year. The agreement between the reference standard and the claims data was poor, in the range of 2.2% to 10.8%, in 3 types of adverse events. The current claims data system (i.e., diagnostic codes coupled to POA indicators) failed to capture a large majority of adverse events identified using the reference standard. CONCLUSIONS: Our results imply that the coding status of International Classification of Diseases, Tenth Revision, codes and POA indicators should be refined before using them as quality indicators.


Assuntos
Seguro , Classificação Internacional de Doenças , Estudos de Viabilidade , Humanos , Segurança do Paciente , Indicadores de Qualidade em Assistência à Saúde , Estados Unidos , United States Agency for Healthcare Research and Quality
13.
Am J Public Health ; 112(10): 1507-1514, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35981277

RESUMO

Objectives. To compare survival by gender and race among transgender and cisgender people enrolled in private insurance in the United States between 2011 and 2019. Methods. We examined Optum's Clinformatics Data Mart Database. We identified transgender enrollees using claims related to gender-affirming care. Our analytic sample included those we identified as transgender and a 10% random sample of cisgender enrollees. We limited our sample to those 18 years or older who were non-Hispanic Black or White. We identified 18 033 transgender and more than 4 million cisgender enrollees. We fit Kaplan-Meier survival curves and calculated standardized mortality ratios while adjusting for census region. Results. Black transfeminine and nonbinary people assigned male sex at birth were 2.73 times more likely to die than other Black transgender people and 2.38 and 3.34 times more likely than Black cisgender men and women, respectively; similar results were found when White transfeminine and nonbinary people assigned male sex at birth were compared with White cisgender cohorts. Conclusions. Our findings highlight glaring inequities in mortality risks among Black transfeminine and nonbinary people assigned male sex at birth and underscore the need to monitor mortality risks in transgender populations and address the social conditions that increase these risks. (Am J Public Health. 2022;112(10):1507-1514. https://doi.org/10.2105/AJPH.2022.306963).


Assuntos
Seguro , Pessoas Transgênero , Transexualidade , Negros , Feminino , Identidade de Gênero , Humanos , Recém-Nascido , Masculino , Estados Unidos/epidemiologia
14.
PLoS One ; 17(8): e0272940, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35969622

RESUMO

Under climate change, the sea surface temperature and salinity change greatly, which poses a considerable threat to sustainable food security. Sea surface temperature and salinity (SST/SSS) are selected to examine the annual output of swimming crab in 24 cities along the eastern China. The Copula-based function was used to construct the probability distribution model of the swimming crab yield with SST and SSS. The pure premium rate of the swimming crab production in these 24 cities are also examined. The results show that 1) There is significant positive correlations between the yield of swimming crab with temperature and salinity over the study area. The only exception is that the correlation between yield of swimming crab and salinity is not significant in the south of study area. 2) The span of the pure insurance premium rate of swimming crab in 24 cities increases rapidly with the increase of the protection level, the maximum span up to 2.04%, and the minimum span is only 1.6%. 3) The distribution of the swimming crab insurance premium rate is various in space. The insurance premium rate of 8 cities in the south of Taizhou is low with the highest premium rate at 5.6%. The insurance premium rate of 16 cities in north of Taizhou is relatively high with the rate between 6%-22%. The research can provide a theoretical basis for the pricing of insurance products for swimming crab in 24 cities in the typical aquaculture areas in eastern China.


Assuntos
Braquiúros , Cubomedusas , Seguro , Animais , Salinidade , Natação , Temperatura
15.
Medicine (Baltimore) ; 101(33): e29736, 2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35984132

RESUMO

BACKGROUND: With technological advances, radiotherapy has progressed from simple irradiation to robotic arm-based stereotactic radiosurgery systems (SRS, in this case, CyberKnife®). This equipment is high-priced and might be cost-effective or not. The National Health Insurance (NHI) in Taiwan has a premedical claims review process for approving CyberKnife® treatment; however, patients might have to pay for the procedure themselves if the NHI rejects the practice. Under the high treatment cost and such an insurance system, a sketch of patients treated by these high-cost machines and whether the prereview of insurance for reimbursement is reasonable without hindering the patient's right to undergo treatment should be investigated. In this study, the patients of CyberKnife® radiotherapy in our institute were investigated as an example for this purpose. METHODS: Patients who underwent CyberKnife® radiotherapy in our department were investigated retrospectively. Their demographic characteristics, disease patterns, and treatment sites were analyzed. Survivals were compared according to clinical features, and treatment expenses were reimbursed after prereview or out-of-pocket. RESULTS: From October 19, 2014, to January 30, 2018, there were 331 patients included in this study, 205 (55.3%) of whom underwent CyberKnife® radiotherapy at their own expense, while 166 (44.7%) had their expenses approved for reimbursement after prereview by NHI. Most patients were treated for metastatic tumors (37.5%), and the brain was the most frequent treatment site (46.1%). The 1-year overall survival was 67.1%, and the 2-year overall survival was 56.3% after CyberKinfe® radiotherapy. The best survival rate (96.8% at 1 year) was for patients with brain tumors. In patient's characteristics, A better Eastern Cooperative Oncology Group (ECOG) performance status, treatment for primary tumors, and outpatient treatment were independent factors for superior survival after CyberKnife® radiotherapy. The survivals for patients whose treatment expenses were approved for reimbursement after prereview by NHI were also better than out-of-pocket. CONCLUSIONS: Besides the patients' characteristics, the treatment expense could be approved or rejected for reimbursement by the NHI prereview was an independent factor for survival in CyberKnife® radiotherapy. Prereview to reimburse expensive treatment is not an unreasonable requirement.


Assuntos
Neoplasias Encefálicas , Seguro , Radiocirurgia , Neoplasias Encefálicas/radioterapia , Gastos em Saúde , Humanos , Radiocirurgia/métodos , Estudos Retrospectivos , Taiwan
16.
Science ; 377(6607): 714-716, 2022 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-35951687

RESUMO

Risk transfer can facilitate nature-positive investments.


Assuntos
Biodiversidade , Extinção Biológica , Seguro , Investimentos em Saúde , Seguro/economia , Risco
17.
BMJ Open ; 12(8): e053166, 2022 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948379

RESUMO

BACKGROUND: Atrial fibrillation (AF) is a complex disease. The management of AF requires continuous patient engagement and integrative healthcare. OBJECTIVES: To explore the association between adverse AF-related clinical outcomes and the following two sociodemographic factors: educational attainment and insurance plan. DESIGN: A nationwide, prospective, multicenter, cohort trial. SETTING: National registry of 3402 patients with non-valvular AF in Thailand. PARTICIPANTS: All patients enrolled in the registry, except those with missing information on educational attainment or insurance plan. Finally, data from 3026 patients (mean age 67 years, SD 11.3; 59% male sex) were analysed. PRIMARY OUTCOMES: Incidences of all-cause mortality, ischaemic stroke and major bleeding during the 36-month follow-up period. Survival analysis was performed using restricted mean survival time (RMST) and adjusted for multiple covariates. The levels of the educational attainment were as follows: no formal education, elementary (grade 1-6), secondary (grade 7-12) and higher education (tertiary education). RESULTS: The educational attainment of the majority of patients was elementary (N=1739, 57.4%). The predominant health insurance plans were the Civil Servant Medical Benefit Scheme (N=1397, 46.2%) and the Universal Coverage Scheme (N=1333, 44.1%). After 36 months of follow-up, 248 patients died (8.2%), 95 had ischaemic stroke (3.1%) and 136 had major bleeding (4.5%). Patients without formal education died 1.78 months earlier (adjusted RMST difference -1.78; 95% CI, -3.25 to -0.30; p=0.02) and developed ischaemic stroke 1.04 months sooner (adjusted RMST difference -1.04; 95% CI, -2.03 to -0.04; p=0.04) than those attained a level of higher education. There were no significant differences in RMSTs for all three clinical outcomes when considering the type of health insurance plan. CONCLUSION: Educational attainment was independently associated with all-cause mortality and ischaemic stroke in patients with AF, but adverse clinical outcomes were not related to the types of health insurance in Thailand. TRIAL REGISTRATION NUMBER: Thai Clinical Trial Registration; Study ID: TCTR20160113002.


Assuntos
Fibrilação Atrial , Isquemia Encefálica , Seguro , AVC Isquêmico , Acidente Vascular Cerebral , Idoso , Anticoagulantes/efeitos adversos , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/terapia , Isquemia Encefálica/complicações , Feminino , Hemorragia/epidemiologia , Humanos , Masculino , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Acidente Vascular Cerebral/complicações
19.
Front Public Health ; 10: 907005, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35859770

RESUMO

This study explored the willingness and purchase of travel insurance during the COVID-19 pandemic amongst working adults to ensure their safety and welfare through the lens of the theory of planned behavior. Primary data were gathered from 1,118 working adults across Malaysia and analyzed using the partial least squares structural equation modeling. The study outcomes revealed that attitude toward travel insurance was significantly influenced by insurance literacy, perceived health risk, and health consciousness. The willingness of working adults to purchase travel insurance was highly influenced by attitudes, subjective norms, and perceived behavioral controls but unaffected by perceived product risks. The purchase of travel insurance was positively influenced by the willingness to purchase travel insurance. In fact, travel insurance literacy and perceived health risk should be emphasized amongst working adults to encourage them to purchase travel insurance policies for traveling abroad.


Assuntos
COVID-19 , Seguro , Adulto , Comportamento do Consumidor , Humanos , Pandemias , Viagem
20.
J Assist Reprod Genet ; 39(8): 1951-1958, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35776369

RESUMO

PURPOSE: The high cost of in vitro fertilization (IVF) procedures coupled with public availability of success rates may influence IVF practice patterns and success rates but may be mitigated by mandated insurance coverage for IVF procedures. This study examined associations of competition with IVF practice patterns and success rates by insurance mandate status. METHODS: We used publicly available 2018 National Assisted Reproductive Technology Surveillance System data from the CDC. We defined competition as distance to nearest clinic and number of clinics within certain radii. We used linear regression to explore associations of competition, insurance mandate status, and interactions between competition and mandate status with clinical practice patterns (e.g., percentage of cycles among patients < 35 years, percentage of cycles using ICSI, average number of embryos transferred) and IVF success rates (e.g., live birth rates). We also assessed the percentage of variation in outcomes explained by our models, R2. RESULTS: For practice patterns, the largest R2 value was 0.3518, meaning only 35.18% of the variability in the practice pattern variable was explained by competition and insurance mandate status. In most cases, the R2 values were less than 0.20, indicating little to no association. Less than 10% of the variability in success rates was explained by competition and insurance mandate status. CONCLUSION: The multiple regression analyses all yielded low R2 values, indicating weak associations. These encouraging results coincide with previous studies, suggesting that competition, even by insurance mandate status, does not have a strong association with IVF practice patterns or success rates.


Assuntos
Seguro , Nascimento Prematuro , Feminino , Fertilização In Vitro , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Vigilância da População , Gravidez , Resultado da Gravidez , Gravidez Múltipla , Nascimento Prematuro/epidemiologia , Técnicas de Reprodução Assistida
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