Статті в журналах: "Behavioral health insurance"

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Baicker, Katherine, Sendhil Mullainathan, and Joshua Schwartzstein. "Behavioral Hazard in Health Insurance *." Quarterly Journal of Economics 130, no. 4 (July 15, 2015): 1623–67. http://dx.doi.org/10.1093/qje/qjv029.

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Abstract A fundamental implication of standard moral hazard models is overuse of low-value medical care because copays are lower than costs. In these models, the demand curve alone can be used to make welfare statements, a fact relied on by much empirical work. There is ample evidence, though, that people misuse care for a different reason: mistakes, or “behavioral hazard.” Much high-value care is underused even when patient costs are low, and some useless care is bought even when patients face the full cost. In the presence of behavioral hazard, welfare calculations using only the demand curve can be off by orders of magnitude or even be the wrong sign. We derive optimal copay formulas that incorporate both moral and behavioral hazard, providing a theoretical foundation for value-based insurance design and a way to interpret behavioral “nudges.” Once behavioral hazard is taken into account, health insurance can do more than just provide financial protection—it can also improve health care efficiency.

2

Colloff, Edwin. "Behavioral Economics and Health Insurance Reform." JAMA 318, no. 10 (September 12, 2017): 964. http://dx.doi.org/10.1001/jama.2017.10548.

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Goldman, Howard H., Richard G. Frank, M. Audrey Burnam, Haiden A. Huskamp, M. Susan Ridgely, Sharon-Lise T. Normand, Alexander S. Young, et al. "Behavioral Health Insurance Parity for Federal Employees." New England Journal of Medicine 354, no. 13 (March 30, 2006): 1378–86. http://dx.doi.org/10.1056/nejmsa053737.

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Skinner, Jonathan, and Kevin G. Volpp. "Behavioral Economics and Health Insurance Reform—Reply." JAMA 318, no. 10 (September 12, 2017): 965. http://dx.doi.org/10.1001/jama.2017.10556.

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Mamun, Abdullah Al, Muhammad Khalilur Rahman, Uma Thevi Munikrishnan, and P. Yukthamarani Permarupan. "Predicting the Intention and Purchase of Health Insurance Among Malaysian Working Adults." SAGE Open 11, no. 4 (October 2021): 215824402110613. http://dx.doi.org/10.1177/21582440211061373.

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This study explored the effects of insurance literacy, perceived usefulness, attitude toward health insurance, subjective norm, and perceived behavioral control on the intention to purchase and the actual purchase of health insurance among working adults in Malaysia. This quantitative study adopted the cross-sectional design with data gathered from 1,308 working adults through a Google form link shared in social media. Upon analysis, the outcomes revealed that insurance literacy, perceived usefulness, attitude toward health insurance, subjective norm, and perceived behavioral control exerted a significantly positive effect on the intention to purchase health insurance. Intention to purchase health insurance exhibited a significantly positive impact on actual purchase of health insurance. Empirically, intention to purchase health insurance yielded a significantly positive mediating effect. Based on the multi-group analysis (MGA), the perceived behavioral control was significantly stronger among rural respondents than urban respondents, as well as among respondents with a bachelor degree than those with secondary school certificate. Referring to the retrieved empirical outputs, financial and health management policymakers, as well as insurance companies in Malaysia should concentrate more on the positive attributes of health insurance in order to improve the attitude of Malaysian working adults toward insurance and insurance literacy.

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Sree Hari Rao, V., and Murthy V. Jonnalagedda. "Insurance Dynamics – A Data Mining Approach for Customer Retention in Health Care Insurance Industry." Cybernetics and Information Technologies 12, no. 1 (March 1, 2012): 49–60. http://dx.doi.org/10.2478/cait-2012-0004.

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Abstract Extraction of customer behavioral patterns is a complex task and widely studied for various industrial applications under different heading viz., customer retention management, business intelligence and data mining. In this paper, authors experimented to extract the behavioral patterns for customer retention in Health care insurance. Initially, the customers are classified into three general categories - stable, unstable and oscillatory. To extract the patterns the concept of Novel index tree (a variant of K-d tree) clubbed with K-Nearest Neighbor algorithm is proposed for efficient classification of data, as well as outliers and the concept of insurance dynamics is proposed for analyzing customer behavioral patterns

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Loewenstein, George, David Hagmann, Janet Schwartz, Keith Ericson, Judd B. Kessler, Saurabh Bhargava, Jennifer Blumenthal-Barby, et al. "A Behavioral Blueprint for Improving Health Care Policy." Behavioral Science & Policy 3, no. 1 (April 2017): 53–66. http://dx.doi.org/10.1177/237946151700300106.

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Behavioral policy to improve health and health care often relies on interventions, such as nudges, which target individual behaviors. But the most promising applications of behavioral insights in this area involve more far-reaching and systemic interventions. In this article, we propose a series of policies inspired by behavioral research that we believe offer the greatest potential for success. These include interventions to improve health-related behaviors, health insurance access, decisions about insurance plans, end-of-life care, and rates of medical (for example, organ and blood) donation. We conclude with a discussion of new technologies, such as electronic medical records and web- or mobile-based decision apps, which can enhance doctor and patient adherence to best medical practices. These technologies, however, also pose new challenges that can undermine the effectiveness of medical care delivery.

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Barrett, Kirsten, and Jeffrey Legg. "Demographic and Health Factors Associated with Mammography Utilization." American Journal of Health Promotion 19, no. 6 (July 2005): 401–5. http://dx.doi.org/10.4278/0890-1171-19.6.401.

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Purpose. The purpose of this study was to determine the frequency of mammography utilization among women in 2002 and to compare it with Healthy People 2010 targets. Relationships between demographic and health factors and utilization were explored. Methods. This study used data from 93,657 women completing the 2002 Behavioral Risk Factor Surveillance Survey, a population-based telephone survey measuring behavioral risk factors. Relationships between demographic and health factors and mammography utilization were explored by bivariate and logistic regression analyses. Results. Seventy-six percent of women reported having had a mammogram within the past 2 years. Utilization was significantly associated with age; ethnicity; race; education; income; employment; perceived health; health insurance coverage; access to physicians; and receipt of basic, preventive health care services. When controlling for other factors, women who had a personal doctor, had health insurance, had higher incomes, and were older had the greatest odds of having received a mammogram within the past 2 years. Conclusions. This assessment indicates that, overall, the Healthy People 2010 mammography utilization target is being met. However, though utilization is improving for some at-risk groups, women without health insurance; women without a personal doctor; and women not receiving basic, preventive care fall short of the Healthy People 2010 target.

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Baillon, Aurélien, Aleli Kraft, Owen O’Donnell, and Kim van Wilgenburg. "A behavioral decomposition of willingness to pay for health insurance." Journal of Risk and Uncertainty 64, no. 1 (February 2022): 43–87. http://dx.doi.org/10.1007/s11166-022-09371-2.

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AbstractDespite widespread exposure to substantial medical expenditure risk in low-income populations, health insurance enrollment is typically low. This is puzzling from the perspective of expected utility theory. To help explain it, this paper introduces a decomposition of the stated willingness to pay (WTP) for insurance into its fair price and three behavioral deviations from that price due to risk perception and risk attitude consistent with prospect theory, plus a residual. To apply this approach, we elicit WTP, subjective distributions of medical expenditures and risk attitude (utility curvature and probability weighting) from Filipino households in a nationwide survey. We find that the mean stated WTP of the uninsured is less than both the actuarially fair price and the subsidized price at which public insurance is offered. This is not explained by downwardly biased beliefs: both the mean and the median subjective expectation are greater than the subsidized price. Convex utility in the domain of losses pushes mean WTP below the fair price and the subsidized price, and the transformation of probabilities into decision weights depresses the mean further, at least using one of two specific decompositions. WTP is reduced further by factors other than risk perception and attitude.

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Lin, Shen (Lamson). "Inequities in Access: The Impact of a Segmented Health Insurance System on Physician Visits and Hospital Admissions Among Older Adults in the 2014 China Family Panel Studies." International Journal of Health Services 50, no. 2 (August 14, 2019): 184–98. http://dx.doi.org/10.1177/0020731419867529.

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The fragmentation of job-based and community-based insurance plans inevitably undermines health care accessibility in China’s market-oriented health system, especially for uninsured and rural residents. Based on the 2014 China Family Panel Studies, this secondary data analysis examined whether socioeconomic indicators, health-related determinants, and particularly social health insurance status affect physician visits in the past 2 weeks and hospital admissions in the past 12 months among a representative sample of older adults (n = 6,570). Grounded in Andersen’s behavioral framework, 2 series of logistic regression analyses were performed: one was built in a hierarchical manner, assessing blocks of predisposing, enabling, health-need, and lifestyle-behavioral factors; the other was conducted in a cross-referencing manner, comparing uninsured populations with job-based and community-based insurance enrollees. Results show that, after full adjustment, the odds of physician visits were lower among urban insurance enrollees (OR = 0.67, 95% CI: 0.47–0.97) than rural residents. For hospital admissions, both uninsured elders (OR = 0.65, 95% CI: 0.48–0.87) and community-based insurance enrollees (OR = 0.67, 95% CI: 0.47–0.97) had lower use of inpatient care than job-based insurance enrollees, demonstrating inequitable access. This study suggests that policy efforts should unify the social health insurance system to combat existing insurance-related inequities in health care use for underserved aging populations.

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BAICKER, KATHERINE, WILLIAM J. CONGDON, and SENDHIL MULLAINATHAN. "Health Insurance Coverage and Take-Up: Lessons from Behavioral Economics." Milbank Quarterly 90, no. 1 (March 2012): 107–34. http://dx.doi.org/10.1111/j.1468-0009.2011.00656.x.

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Song, Xinshan, and Yuxiao Zheng. "Analysis of Demand for China’s Commercial Health Insurance from the Perspective of Loss Aversion." Highlights in Business, Economics and Management 11 (May 9, 2023): 252–59. http://dx.doi.org/10.54097/hbem.v11i.8107.

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China's health insurance industry has been developing continuously since its emergence in the 1980s, but at this stage, China's social security system is still at a relatively low level of development, and people's expenses incurred in a variety of medical needs cannot be given by the current social security system, while commercial health insurance has made a good supplement to this, ensuring people's practical interests, and is also its biggest competitive advantage. This paper lays out an overview of its market size, product structure and security degree, followed by effective suggestions of improvement in relation to the behavioral economical concept of loss aversion. The irrational misunderstanding of health insurance and the resulting problems of lack of insurance, insufficient coverage, excess insurance and double insurance have been puzzling the sustainable and healthy development of health insurance, which is also a hot issue of general concern at home and abroad. According to analysis of possible improvement measures about the effect of loss aversion on citizens, optimizing claims and modifying health service models in a desirable way will mitigate the loss aversion effects when purchasing commercial health insurance.

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Einav, Liran, Amy Finkelstein, Stephen P. Ryan, Paul Schrimpf, and Mark R. Cullen. "Selection on Moral Hazard in Health Insurance." American Economic Review 103, no. 1 (February 1, 2013): 178–219. http://dx.doi.org/10.1257/aer.103.1.178.

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We use employee-level panel data from a single firm to explore the possibility that individuals may select insurance coverage in part based on their anticipated behavioral (“moral hazard”) response to insurance, a phenomenon we label “selection on moral hazard.” Using a model of plan choice and medical utilization, we present evidence of heterogenous moral hazard as well as selection on it, and explore some of its implications. For example, we show that, at least in our context, abstracting from selection on moral hazard could lead to overestimates of the spending reduction associated with introducing a high-deductible health insurance option. (JEL D82, G22, I13, J32)

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O'Connor, Genevieve Elizabeth. "The impact of insurance coverage on consumer utilization of health services." International Journal of Bank Marketing 33, no. 3 (May 18, 2015): 276–97. http://dx.doi.org/10.1108/ijbm-05-2014-0061.

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Purpose – The purpose of this paper is to identify how need for service, enabling factors and pre-disposing characteristics influences access to service. In addition, the authors seek to examine the moderating influence of pre-disposing variables on the relationship between insurance and health services utilization. Design/methodology/approach – The authors utilize data from a major metropolitan hospital in the USA to test and extend the behavioral model of health care. Findings – Results indicate that insurance and pre-disposing variables have a direct impact on type of health service utilization. However, the insurance effect is found to vary by demographic factors. Research limitations/implications – This paper is limited to secondary data. Future work can incorporate both attitudinal and behavioral measures to obtain a more comprehensive evaluation of services access. Practical implications – The research offers a tactical framework for management to segment consumer markets more effectively. Social implications – Through the framework, management will have the requisite knowledge to target segmented populations based on need, insurance, and pre-disposing variables which will help improve access to services and clinical outcome. Originality/value – The findings of this paper will serve as a basis for future research exploring the influence of insurance on access to services.

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Kino, Shiho, and Ichiro Kawachi. "Can Health Literacy Boost Health Services Utilization in the Context of Expanded Access to Health Insurance?" Health Education & Behavior 47, no. 1 (October 8, 2019): 134–42. http://dx.doi.org/10.1177/1090198119875998.

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Background. Health insurance access and health literacy are critical components of “enabling resources” to encourage uptake of services. We sought to test whether health literacy boosts health services utilization in the context of expanded access to health insurance stemming from the Affordable Care Act. Method. We used individual-level data from 11 states included in the Behavioral Risk Factor Surveillance System 2016. We conducted a two-stage least squares instrumental variables analysis. We instrumented improved access to health insurance stemming from Affordable Care Act Medicaid expansion. As outcome variables, we examined cost as a barrier to needed care, having a personal doctor and receipt of routine health checkups, flu shots, Pap tests, mammograms, sigmoidoscopy/colonoscopy, and dental visits in the past year. We then tested whether the relation between improved health insurance access and health services utilization was moderated by health literacy. Health literacy was measured by a dichotomized scale comprising three items: difficulties obtaining advice or information about health, difficulties understating information from health professionals, and difficulties understanding written health information. Results. We found that improving health insurance access increased the likelihood of reporting a personal doctor while reducing the likelihood of reporting cost as a barrier to care. We also found an interaction effect between health insurance and health literacy on dental visits. However, there was no significant interaction effect between insurance access and health literacy for preventive services utilization. Conclusion. Health literacy did not explain why people fail to access preventive services even when they obtain access to insurance, with the sole possible exception of dental visits among individuals with high literacy.

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Alatawy, Khald S. "Consumers’ Purchase Intention Toward Online Health Insurance in Saudi Arabia." International Journal of Marketing Studies 14, no. 2 (November 23, 2022): 121. http://dx.doi.org/10.5539/ijms.v14n2p121.

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Literature reported a dearth of research on Online Health Insurance in Saudi Arabia. The purpose of this paper thus is to understand the antecedents of Consumers’ Purchase Intention toward Online Health Insurance in Saudi Arabia. The paper drew data from 355 Saudi Arabian internet buying communities. The paper used Smart-PLS 3 to analyze the data. The findings show that attitude, perceived behavioral control, subjective norms and perceived trust have significant positive influences on purchase intention toward online health insurance in Saudi Arabia. However, the relationship between religiosity and purchase intention toward online health insurance was not supported. Various theoretical and managerial implications of these findings were discussed.

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Madden, Jeanne M., Matthew D. Lakoma, Donna Rusinak, Christine Y. Lu, and Stephen B. Soumerai. "Missing clinical and behavioral health data in a large electronic health record (EHR) system." Journal of the American Medical Informatics Association 23, no. 6 (April 14, 2016): 1143–49. http://dx.doi.org/10.1093/jamia/ocw021.

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Abstract Objective Recent massive investment in electronic health records (EHRs) was predicated on the assumption of improved patient safety, research capacity, and cost savings. However, most US health systems and health records are fragmented and do not share patient information. Our study compared information available in a typical EHR with more complete data from insurance claims, focusing on diagnoses, visits, and hospital care for depression and bipolar disorder. Methods We included insurance plan members aged 12 and over, assigned throughout 2009 to a large multispecialty medical practice in Massachusetts, with diagnoses of depression ( N = 5140) or bipolar disorder ( N = 462). We extracted insurance claims and EHR data from the primary care site and compared diagnoses of interest, outpatient visits, and acute hospital events (overall and behavioral) between the 2 sources. Results Patients with depression and bipolar disorder, respectively, averaged 8.4 and 14.0 days of outpatient behavioral care per year; 60% and 54% of these, respectively, were missing from the EHR because they occurred offsite. Total outpatient care days were 20.5 for those with depression and 25.0 for those with bipolar disorder, with 45% and 46% missing, respectively, from the EHR. The EHR missed 89% of acute psychiatric services. Study diagnoses were missing from the EHR’s structured event data for 27.3% and 27.7% of patients. Conclusion EHRs inadequately capture mental health diagnoses, visits, specialty care, hospitalizations, and medications. Missing clinical information raises concerns about medical errors and research integrity. Given the fragmentation of health care and poor EHR interoperability, information exchange, and usability, priorities for further investment in health IT will need thoughtful reconsideration.

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Terry Sharrer, G. "Extending Health Expectancy." Molecular Frontiers Journal 03, no. 02 (September 30, 2019): 147–65. http://dx.doi.org/10.1142/s252973251940011x.

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All health-related issues exist in a context of extending health expectancy. Behavioral risk factors, diagnostic ”omics,” disparities, insurance, tissue engineering, and climate can shorten life expectancy, but before that, health expectancy. Longer life can bring decades of disability; longer health can mean dying healthy after brief incapacity. Because health precedes other accomplishments, extending average health expectancy into the ninth decade during the [Formula: see text] century would have an impact comparable to doubling life expectancy in the [Formula: see text] century.

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Rochefort, David A. "The Affordable Care Act and the Faltering Revolution in Behavioral Health Care." International Journal of Health Services 48, no. 2 (March 29, 2018): 223–46. http://dx.doi.org/10.1177/0020731417753674.

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Often described in such terms as a “revolution” and a “game-changer” for the behavioral health sector in the United States, the Affordable Care Act has helped to enhance coverage for mental health and substance use disorders while encouraging service system innovations at the organizational level. However, tens of millions of Americans still lack health insurance, insurance companies are resisting the implementation of parity coverage rules, and inequalities in the financing and organization of care continue to worsen in key respects. This article examines these difficulties and their political-economic nature, highlighting the need for a single-payer framework if the task of reform is to be fulfilled.

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Nurhayati, Siti, and Nurul Hidayat. "Acceptance Measurement of Health Insurance Information System Based on Technology Acceptance Model." Jurnal Kesehatan Masyarakat 14, no. 2 (November 5, 2018): 254–63. http://dx.doi.org/10.15294/kemas.v14i2.11374.

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The objective of this research is to evaluate P-Care BPJS information system based on Technology Acceptance Model (TAM). The type of research is analytical, cross sectional approach. Number of respondents 206 P-Care BPJS users at primary health care. Data analysis using linear regression. Based on correlation test external variables with percieved usefulness, showed high correlation = 0.6 (p <0.001); external variables with percieved ease of use showed moderate correlation = 0.4 (p <0.001); perceived ease of use with attitude showed moderate correlation = 0.5 (p <0.001); percieved usefulness with attitude showed high correlation = 0.7 (p <0.001); perceived usefulness with actual use showed moderate correlation = 0.5 (p <0.001); behavioral intention to use with percieved usefulness showed moderate correlation = 0.5 (p <0.001); attitude with behavioral intention to use showed high correlation = 0.6 (p <0.001); behavioral intention to use with actual use showed high correlation = 0.7 (p <0.001).

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Apriani, Maya, and Haerawati Idris. "Farmers’ Intention to Apply for National Health Insurance." Unnes Journal of Public Health 11, no. 2 (September 27, 2021): 125–30. http://dx.doi.org/10.15294/ujph.v11i2.44899.

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The number of people who worked as farmers is big enough to challenge the Healthcare Social Security Agency (BPJS Kesehatan) to achieve these targets. This study aims to determine the variables associated by the intention of farmers to apply for National Health Insurance in the working area of Sungai Rambutan Integrated Independent City Community Health Center in Ogan Ilir Regency. The type of this research is descriptive analytical research with a cross-sectional design. The samples used farmers in the work area of Sungai Rambutan public health center. 104 samples were selected by cluster random sampling. 57.7 % of the farmers have the intention to apply for national health insurance. There are five variables related to the intention of farmers to apply for national health insurance. Those variables are the behavioral beliefs, the outcome evaluation, motivation to comply, control beliefs, and perceived power. The outcome evaluation was the most dominant variable associated with the intention to apply for national health insurance since it controlled the other variables. To increase the number of national health insurance members, approaching local stakeholders to introduce and educate all people to apply and inform the benefit of national health insurance is required

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Chen, Zhiling, Xinghong Dai, and Zhigang Tan. "Artificial Intelligence Analysis of Outdoor Sports Risk Self-Assessment on Insurance Psychology." International Journal of Environmental Research and Public Health 20, no. 4 (February 10, 2023): 3140. http://dx.doi.org/10.3390/ijerph20043140.

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The development potential of China’s medical insurance market is huge, and the research on medical insurance demand has always been the focus of academic discussions. As a result, the discipline of behavioral economics is derived, which aims to explain the decision-making behavior of individual insurance consumption. Among them, the focus of this study was to investigate the influence of individual psychological characteristics and cognitive level on insurance behavior under the difference of reference points. This paper combined behavioral insurance, actuarial mathematics and the econometrics knowledge system, comprehensive theoretical analysis, and empirical tests and analyzed the impact mechanism of individual frame effect on medical insurance demand under different reference points at multiple levels. At the same time, based on the risk self-assessment of outdoor sports, the artificial intelligence of insurance psychology was analyzed. Based on the correlation vector machine algorithm and the theoretical basis combined with the dual perspective of insurance products, the expected utility model was established under the “guarantee framework”, and the prospect theoretical model was established under the “profit and loss framework”. The framing effect was used to measure the relative size of “guarantee utility” and “profit and loss utility”, and a high-insurance-rate model and a low-insurance-rate model were established. The theoretical model analysis found that under the high insurance rate, because the “profit and loss utility” is positive, the size of the individual frame effect is positively correlated with the willingness to insure. Under the low insurance rate, because the “profit and loss utility” is negative, the size of the individual frame effect is negatively correlated with the willingness to insure. The research results of this paper show that insurance is an important beginning of insurance consumption behavior, which includes the complex mentality and emotion of consumers on insurance activities. The insurance demand of policyholders is formed by the joint action of external and internal incentives. Many factors such as income level and education level play an important role in insurance consumption decision making.

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Hagen, Patrick C., Daniel W. Nuss, Michael Ellis, and George D. Lyons. "Health Care Crisis: The Head and Neck Cancer Patient and Affordable Health Insurance." Ear, Nose & Throat Journal 72, no. 5 (May 1993): 334–40. http://dx.doi.org/10.1177/014556139307200507.

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In an evaluation of 30 patients with head and neck cancer, we found that 14 (46%) were uninsured at the time of diagnosis and 15 (50%) had yearly incomes below the poverty level. Tobacco and alcohol were identified as risk factors in 25 (83%) of the patients. These patients spent an average of $2,781 on carcinogenic agents yearly, increasing the risk of cancer 55 times that of the unexposed population, whereas the cost of a health insurance policy was $2,321 per year. To remedy the disparities and incongruities of this situation, we advocate patient education to influence behavioral change in these high-risk groups, a lowering of insurance rates, legal reform, and continued physician activism toward managing the current health care crisis.

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Zakaria, Nora I., Parisa Tehranifar, Blandine Laferrère, and Sandra S. Albrecht. "Racial and Ethnic Disparities in Glycemic Control Among Insured US Adults." JAMA Network Open 6, no. 10 (October 5, 2023): e2336307. http://dx.doi.org/10.1001/jamanetworkopen.2023.36307.

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ImportancePoor access to care and lack of health insurance are important contributors to disparities in glycemic control. However expanding health insurance coverage may not be enough to fully address the high burden of poor glycemic control for some groups.ObjectiveTo characterize racial and ethnic disparities in glycemic control among adults with private and public insurance in the US over a 15-year timeframe and to evaluate whether social, health care, and behavioral or health status factors attenuate estimates of disparities.Design, Setting, and ParticipantsThis cross-sectional study used data from the National Health and Nutrition Examination Survey from 2003 to 2018. Participants included Hispanic or Latino, non-Hispanic Black, and non-Hispanic White adults aged 25 to 80 years with self-reported diabetes and health insurance. Data were analyzed from January 15 to August 23, 2023.ExposureParticipants self-identified as Hispanic or Latino, non-Hispanic Black, or non-Hispanic White.Main Outcomes and MeasuresThe main outcome, poor glycemic control, was defined as glycated hemoglobin A1c (HbA1c) of 7.0% or greater. Information about social (education, food security, and nativity), health care (insurance type, routine place for health care, insurance gap in past year, and use of diabetes medications), and behavioral or health status (years with diabetes, waist circumference, and smoking) factors were collected via questionnaires.ResultsA total of 4070 individuals (weighted mean [SE] age, 61.4 [0.27] years; 1970 [weighted proportion, 49.3%] were women) were included, representing 16 337 362 US adults, including 1146 Hispanic or Latino individuals (weighted proportion, 13.2%), 1196 non-Hispanic Black individuals (weighted proportion, 15.7%), and 1728 non-Hispanic White individuals (weighted proportion, 71.1%). In models adjusted for age, sex, and survey year, Hispanic or Latino and non-Hispanic Black individuals had significantly higher odds of poor glycemic control than non-Hispanic White individuals (Hispanic or Latino: odds ratio [OR], 1.46; 95% CI, 1.16-1.83; Black: OR, 1.28; 95% CI, 1.04-1.57). There was some attenuation after adjustment for social factors, especially food security (Hispanic or Latino: OR, 1.39; 95% CI, 1.08-1.81); Black: OR, 1.39; 95% CI, 1.08-1.81). However, accounting for health care and behavioral or health status factors increased disparities, especially for Hispanic or Latino individuals (OR, 1.63; 95% CI, 1.24-2.16), with racial and ethnic disparities persisting even among those with private insurance (OR, 1.66; 95% CI, 1.10-2.52).Conclusions and RelevanceIn this cross-sectional study of insured adults with diabetes in the US, disparities in poor glycemic control persisted despite adjustment for social, health care, and behavioral factors. Research is needed to identify the barriers contributing to poor control even in populations with access to care.

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Azzone, Vanessa, Richard G. Frank, Juliana R. Pakes, Craig C. Earle, and Michael J. Hassett. "Behavioral Health Services for Women Who Have Breast Cancer." Journal of Clinical Oncology 27, no. 5 (February 10, 2009): 706–12. http://dx.doi.org/10.1200/jco.2008.16.3006.

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Purpose To explore whether the use of behavioral health services (BHS) among women with breast cancer is influenced by how insurance plans administer these services, we compared utilization of psychotherapy and psychotherapeutic medications among women with breast cancer who received BHS coverage through a carve-out versus integrated arrangement. Patients and Methods We analyzed insurance claims, enrollment data, and benefit design data from the MarketScan Commercial Claims & Encounters Research Database for the years 1998 to 2002 for women ≤ 63 years old with newly diagnosed breast cancer. We compared the probability of receiving psychotherapy, the likelihood of receiving antidepressant/antianxiety/hypnotic medications, and the number of psychotherapy sessions used during the year after a breast cancer diagnosis among women whose behavioral health services were provided through carve-out versus integrated arrangements. Results Women enrolled in carve-outs were significantly less likely to receive any psychotherapy visits compared with women in integrated arrangements (odds ratio, 0.68; P < .01). Conditional on having received psychotherapy, however, women in carve-out arrangements used more psychotherapy visits than women in integrated arrangements. The use of antianxiety/hypnotic drugs was significantly higher for women in carve-out arrangements versus women in integrated arrangements (36.1% v 32.6%, P < .05). Moreover, women who received psychotherapy were significantly more likely to received antidepressants and antianxiety/hypnotic medications (five and three times more likely, respectively). Conclusion The type of BHS arrangement was associated with the utilization of psychotherapy and psychotherapeutic medications among women with breast cancer.

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Auerbach, David, Janet Holtzblatt, Paul Jacobs, Alexandra Minicozzi, Pamela Moomau, and Chapin White. "Will Health Insurance Mandates Increase Coverage, Synthesizing Perspectives from Health, Tax, and Behavioral Economics." National Tax Journal 63, no. 4, Part 1 (December 2010): 659–79. http://dx.doi.org/10.17310/ntj.2010.4.03.

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Wonda, Frengky Lani, Agus Zainuri, Arius Togodly, Rosmin M. Tingginehe, Yacob Ruru, and Septevanus Rantetoding. "Behavioral Analysis of Health Service use of the Ilaga Community Health Center, Puncak Regency Central Papua Province." Formosa Journal of Science and Technology 3, no. 2 (February 15, 2024): 275–88. http://dx.doi.org/10.55927/fjst.v3i2.8107.

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The aim of this research is to analyze utilization behavior service health, Ilaga District Community Health Center, Puncak Regency, Central Papua Province. The type of research used is descriptive qualitative. Data was obtained using interviews and analyzed qualitatively. The results of the research showed that people seeking treatment in the Ilaga District used the Community Health Center as a place for treatment and as a referral place to other health service institutions (referrals) so that the community was enthusiastic in utilizing the Community Health Center services. Not all people have health insurance due to low knowledge and lack of support from health workers in assisting health services in arranging membership for the National Health Insurance Social Security Administering Body (BPJS). Security disturbances disrupt the accessibility of community health services in the event of conflict, especially from armed criminal groups.

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Rudenko, Lesia A., Vladyslav A. Smiianov, and Olha I. Smiianova. "BASIC PRINCIPLES OF BEHAVIORAL ECONOMICS AND PROSPECTS FOR THEIR APPLICATION IN THE PUBLIC HEALTH SYSTEM." Wiadomości Lekarskie 73, no. 9 (2020): 2026–30. http://dx.doi.org/10.36740/wlek202009225.

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Behavioral economics is a branch of economic theory that studies the influence of psychological factors on people’s decisions in various life situations. At the same time, much attention is paid to situations where people behave differently than predicted by classical economic theory with its assumption of rationality and selfishness. Interesting possibility of application of behavioral economic in various spheres of human life and society, for example, reforms introducing, insurance system, public health and medicine (healthy living, disease prevention, following-up to the doctor’s recommendations, improving the quality of care, etc.).

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Shaul, James A., Susan V. Eisen, Vickie L. Stringfellow, Brian R. Clarridge, Richard C. Hermann, Deborah Nelson, Eric Anderson, Alan I. Kubrin, H. Stephen Leff, and Paul D. Cleary. "Use of Consumer Ratings for Quality Improvement in Behavioral Health Insurance Plans." Joint Commission Journal on Quality Improvement 27, no. 4 (April 2001): 216–29. http://dx.doi.org/10.1016/s1070-3241(01)27019-9.

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Nguyen, Kevin H., Timothy W. Levengood, Heidi L. Allen, and Gilbert Gonzales. "Health Insurance Coverage and Access to Care by Sexual Orientation During the COVID-19 Pandemic: United States, January 2021–February 2022." American Journal of Public Health 114, no. 1 (January 2024): 118–28. http://dx.doi.org/10.2105/ajph.2023.307446.

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Objectives. To compare health insurance coverage and access to care by sex and sexual minority status during the COVID-19 pandemic and assess whether lack of insurance hindered access to care by sexual minority status. Methods. Using Behavioral Risk Factor Surveillance System data (January 2021–February 2022), we examined differences by sex and sexual orientation among 158 722 adults aged 18 to 64 years living in 34 states. Outcomes were health insurance coverage type and 3 access to care measures. Results. Sexual minority women were significantly more likely to be uninsured than were heterosexual women, and lack of insurance widened the magnitude of disparity by sexual minority status in all measures of access. Compared with heterosexual men with health insurance, sexual minority men with health insurance were significantly more likely to report being unable to afford necessary care. Conclusions. During the pandemic, 1 in 8 sexual minority adults living in 34 study states were uninsured. Among sexual minority women, lack of insurance widened inequities in access to care. There were inequities among sexual minority men with health insurance. Public Health Implications. Sexual minority adults may be disproportionately affected by the unwinding of the COVID-19 public health emergency and may require tailored efforts to mitigate insurance coverage loss. (Am J Public Health. 2024;114(1):118–128. https://doi.org/10.2105/AJPH.2023.307446 )

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Cheng, Tyrone C., and Celia C. Lo. "Factors Associated with Insured Children’s Use of Physician Visits, Dentist Visits, Hospital Care, and Prescribed Medications in the United States: An Application of Behavioral Model of Health-Services Use." International Journal of Environmental Research and Public Health 21, no. 4 (March 31, 2024): 427. http://dx.doi.org/10.3390/ijerph21040427.

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This study is the first to examine factors in the utilization of physician services, dentist services, hospital care, and prescribed medications focusing exclusively on insured children in the United States. Data describing 48,660 insured children were extracted from the 2021 National Survey of Children’s Health. Children in the present sample were covered by private health insurance, public health insurance, or other health insurance. Logistic regression results showed self-reported health to be negatively associated with physician visits, hospital-care use, and prescription use, but teeth condition to be positively associated with dentist visits. Physician visits were associated negatively with age, Hispanic ethnicity, Asian ethnicity, family income at or below 200% of the federal poverty level, and other health insurance, but positively with parental education and metropolitan residency. Dentist visits were associated positively with girls, age, and parental education, but negatively with Asian ethnicity and public health insurance. Use of hospital care was associated negatively with age and Asian ethnicity, but positively with parental education and public health insurance. Use of prescriptions was associated positively with age, Black ethnicity, parental education, and public health insurance, but negatively with Hispanic ethnicity, Asian ethnicity, and family income at or below 200% of the federal poverty level. Implications included the expansion of public health insurance, promotion of awareness of medicine discount programs, and understanding of racial/ethnic minorities’ cultural beliefs in health and treatment.

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Ismail, Ishak, Hasnah Haron, Shaikh Hamzah Abdul Razak, Nurul Khair Ishak, and Nor Azah Abdul Jalil. "Unethical Behavior—What Influences Salesperson to Do So? The Case of Malaysia." Advanced Science Letters 21, no. 4 (April 1, 2015): 918–21. http://dx.doi.org/10.1166/asl.2015.5934.

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This paper contributes to existing research on ethical behavior by identifying the factors that leads to the intention to commit the unethical behavior. The study used a questionnaire method that was sent to 1,200 insurance agents across peninsular Malaysia, 300 copies were returned of which only 246 were useful. Results of the study exhibited that there is a significant relationship between attitudes, perceived behavioral control, and subjective norm among insurance agents on the intention to commit unethical behavior. Attitude and moral obligation provide a positive relationship, while perceived behavioral control and norm provide a negative relationship. It also reflected that agents committing the unethical behavior are being influence by attitudes, moral obligation then perceived behavioral control and subjective norm. The study also reflected that ethics among insurance agents in Malaysia are low due to the fact that there is no documented evidence of any form of severe punishment meted out for unethical behavioral intention. While the results in this study are by no means conclusive, it is felt that this study has contributed to the research done in identifying unethical behavioral intention of insurance agents in Malaysia.

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Williams, Courtney P., Maria Pisu, Andres Azuero, Kelly M. Kenzik, Ryan D. Nipp, Monica S. Aswani, Stephen T. Mennemeyer, Jennifer Y. Pierce, and Gabrielle B. Rocque. "Health Insurance Literacy and Financial Hardship in Women Living With Metastatic Breast Cancer." JCO Oncology Practice 16, no. 6 (June 2020): e529-e537. http://dx.doi.org/10.1200/jop.19.00563.

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PURPOSE: In patients with metastatic breast cancer (MBC), low health insurance literacy may be associated with adverse material conditions, psychological response, and coping behaviors because of financial hardship (FH). This study explored the relationship between health insurance literacy and FH in women with MBC. METHODS: This cross-sectional study used data collected from 84 women receiving MBC treatment at 2 southeastern cancer centers. Low health insurance literacy was defined as not knowing premium or deductible costs. FH was defined by lifestyle changes as a result of medical expenses, financial toxicity, and medical care modifications attributable to cost. Mean differences were calculated using Cramer’s V. Associations between health insurance literacy and FH were estimated with adjusted linear models. RESULTS: Half of the surveyed patients had low health insurance literacy, 26% were underinsured, 45% had private insurance, 39% had Medicare, and 15% had Medicaid. Patients with low health insurance literacy more often reported borrowing money (19% v 4%; V = 0.35); an inability to pay for basic necessities like food, heat, or rent (10% v 4%; V = 0.18); and skipping a procedure (8% v 1%; V = 0.21), medical test (7% v 0%; V = 0.30), or treatment (4% v 0%; V = 0.20) compared with patients with high health insurance literacy. Median Comprehensive Score for Financial Toxicity was 23 (interquartile range, 17-29). In adjusted models, health insurance literacy was not associated with financial toxicity. CONCLUSION: Low health insurance literacy was common in women receiving MBC treatment. Additional research to increase health insurance literacy could lessen undesirable material FH and unnecessary behavioral FH associated with cancer-related care.

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Baggé, Sarah. "Using Behavioral Economics to Understand Premium Tax Credit Reconciliation." Policy Perspectives 23 (May 2, 2016): 1. http://dx.doi.org/10.4079/pp.v23i0.16239.

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The Affordable Care Act provides advanced premium tax credits to millions of Americans to help with the cost of purchasing private health insurance on the new health insurance marketplaces. The amount of subsidy a family qualifies for is based on their projected income for the year ahead. However, since income is fairly unpredictable, some families end up qualifying for a larger tax credit when they do their taxes, while others end up with a smaller credit and must repay what they received throughout the year. In the first year of this reconciliation process, half of those who received advanced premium tax credits had to pay at least a part back. This outcome is consistent with recent literature in behavioral economics, which explores psychological, social, and cognitive influences on decision-making. This paper explores the reconciliation problem and possible approaches to reducing or eliminating it.

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Yanos, Philip T., Weli Lu, Shula Minsky, and Gerard L. Kiely. "Correlates of Health Insurance Among Persons With Schizophrenia in a Statewide Behavioral Health Care System." Psychiatric Services 55, no. 1 (January 2004): 79–82. http://dx.doi.org/10.1176/appi.ps.55.1.79.

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Park, J. M. "The Determinants of Long-Term Care Utilization and Equity of Access to Care among Older Adults in Dong-Ku of Incheon Metropolitan City, South Korea." Asia Pacific Journal of Public Health 17, no. 2 (July 2005): 104–9. http://dx.doi.org/10.1177/101053950501700208.

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Under the current health care system, around three percent of the elderly remain uninsured. Based on the 2003 Dong-Ku Health Status Survey and the Aday and Andersen Access Framework, the present study examined the social and behavioral determinants of long-term care utilization and the extent to which equity in the use of long-term care services for the elderly has been achieved. The results indicate that universal health insurance system has not yielded a fully equitable distribution of services. Type of coverage and resource availability do not remain predictors of long-term care utilization. The data suggest that a universal health insurance system exists in South Korea with significant access problems for the population without insurance. Access differences also arise from obstacles in expanding the scope and level of plan benefits due to financial disparity among insurers. Health policy reforms must continue to concentrate on extending insurance coverage to the uninsured and establishing long-term insurance system for the elderly. Asia Pac J Public Health 2005; 17(2): 104-109.

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Anderson, Andrew C., Ellesse Akre, and Jie Chen. "Exploring national trends of patient- and family-centered care among US children." Journal of Child Health Care 23, no. 2 (July 17, 2018): 200–212. http://dx.doi.org/10.1177/1367493518786015.

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We explored national trends in the receipt of high-quality patient–physician communication and patient empowerment through behavioral health counseling among children in the United States. We used data from the Medical Expenditure Panel Survey from 2010 to 2014. We employed two measures of patient- and family-centered care (PFCC): (1) a composite measure of high-quality patient–physician communication ( n = 34,629) and (2) patient empowerment through behavioral health counseling about healthy eating ( n = 36,527) and exercise ( n = 38,318). We used multivariate logistic regression models to estimate the variation of receiving PFCC by social determinants of health over time. Rates of receiving behavioral health counseling about healthy eating (53–60%) and exercise (37–42%) were lower than the rate of receiving high-quality physician–patient communication (92–93%). Parents were significantly more likely to report receiving high-quality physician–patient communication in 2014 than in 2010 (odds ratio 1.37, confidence interval 1.08–1.67); however, no association was found for empowerment through behavioral health counseling. Low income and parental educational attainment, and lack of insurance were associated with lower odds of receiving behavioral health counseling. Results showed significant variation of physician–patient communication and empowerment by social and demographic factors. The results suggest more providers need to empower parents and their children to self-care through behavioral health counseling.

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Das, Jishnu, and Quy-Toan Do. "The Prices in the Crises: What We Are Learning from 20 Years of Health Insurance in Low- and Middle-Income Countries." Journal of Economic Perspectives 37, no. 2 (May 1, 2023): 123–52. http://dx.doi.org/10.1257/jep.37.2.123.

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Governments in many low- and middle-income countries are developing health insurance products as a complement to tax-funded, subsidized provision of healthcare through publicly-operated facilities. We discuss two rationales for this transition. First, health insurance would boost fiscal revenues for healthcare, as post-treatment out-of-pocket payments to providers would be replaced by pre-treatment insurance premia to health ministries. Second, increased patient choice and carefully designed physician reimbursements would increase quality in the healthcare sector. Our essay shows that, at best, these objectives have only been partially met. Despite evidence that health insurance has provided financial protection, consumers are not willing to pay for unsubsidized premia. Health outcomes have not improved despite an increase in utilization. We argue that this is not because there was no room to improve the quality of care but because behavioral responses among healthcare providers have systematically undermined the objectives of these insurance schemes.

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Kazaure, Mansur Ahmed, and Addul Rashid Abdullah. "THE MICROENTERPRISING SIZE AND ACCEPTANCE OF ISLAMIC HEALTH INSURANCE (TAKAFUL) IN NORTHWESTERN NIGERIA." Journal of Islamic Monetary Economics and Finance 5, no. 3 (November 1, 2019): 541–58. http://dx.doi.org/10.21098/jimf.v5i3.1153.

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Application of Theory of Planned Behavior (TPB) in Islamic Health Insurance(takaful) acceptance revealed mixed findings. Hence, the need for a moderatingvariable to explain the conflicting results. This paper examines the moderating roleof size of microenterprise among the TPB variables. To achieve this end, quantitativemethodology adopted through distribution of research questionnaires among theparticipants of the study. Results indicate that attitude, social influence, perceivedbehavioral control and size of microenterprises significantly influence Islamic HealthInsurance (takaful) acceptance intention among microenterprises in northwesternNigeria. The findings also revealed that size of microenterprise moderates the effectof social influence on Islamic Health Insurance acceptance intention, but it failed tomoderate the influence of attitude and perceived behavioral control on Islamic HealthInsurance acceptance intention in same context. It implied that size of microenterprisesdoes not matter most in Islamic Health Insurance acceptance; nonetheless, the findingcontributes to the Theories of Reasoned Action and Planned Behavior as it providesevidence on the significant moderating role of size on the effect social influence onIslamic Health Insurance acceptance intention among microenterprises.

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James, Nigel, and Yubraj Acharya. "Increasing Health Insurance Enrollment in Low- and Middle-Income Countries: What Works, What Does Not, and Research Gaps: A Scoping Review." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 59 (January 2022): 004695802210903. http://dx.doi.org/10.1177/00469580221090396.

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Health insurance programs have the potential to shield individuals in low- and middle-income countries from catastrophic health expenses and reduce their vulnerability to poverty. However, the uptake of insurance programs remains low in these countries. We reviewed existing evidence from experimental studies on approaches that researchers have tested in order to raise the uptake. In the 12 studies we synthesized, educational programs and subsidies were the dominant interventions. Consistent with findings from previous studies on other health products, subsidies were effective in raising the uptake of insurance programs in many contexts. Conversely, education interventions—in their current forms—were largely ineffective, although they bolstered the effect of subsidies. Other strategies, such as the use of microfinance institutions and social networks for outreach and enrollment, showed mixed results. Additional research is needed on effective approaches to raise the uptake of insurance programs, including tools from behavioral economics that have shown promise in other areas of health behavior.

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Domurat, Richard, Isaac Menashe, and Wesley Yin. "The Role of Behavioral Frictions in Health Insurance Marketplace Enrollment and Risk: Evidence from a Field Experiment." American Economic Review 111, no. 5 (May 1, 2021): 1549–74. http://dx.doi.org/10.1257/aer.20190823.

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We experimentally varied information mailed to 87,000 households in California’s health insurance marketplace to study the role of frictions in insurance take-up. Reminders about the enrollment deadline raised enrollment by 1.3 pp (16 percent) in this typically low take-up population. Heterogeneous effects of personalized subsidy information indicate misperceptions about program benefits. Consistent with an adverse selection model with frictional enrollment costs, the intervention lowered average spending risk by 5.1 percent, implying that marginal respondents were 37 percent less costly than inframarginal consumers. We observe the largest positive selection among low income consumers, who exhibit the largest frictions in enrollment. Finally, we estimate the implied value of the letter intervention to be $25 to $53 per month in subsidy dollars. These results suggest that frictions may partially explain low take-up for marketplace insurance, and that interventions reducing them can improve enrollment and market risk in exchanges. (JEL C93, G22, G52, H75, I13)

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Vuong, Ngoc, and Nikki Keene Woods. "On the Relationship Between Stakeholder Affiliation and Attitudes Toward Behavioral Health Reform in Kansas." Kansas Journal of Medicine 16, no. 1 (February 21, 2023): 28–34. http://dx.doi.org/10.17161/kjm.vol16.18542.

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Introduction. The lack of access to behavioral health care, trends in behavioral health issues, and the impact of social determinants of health underlie the need for behavioral health reform in Kansas. However, stakeholders may affect progress toward behavioral health reform. This study examined stakeholders’ attitudes toward behavioral health reform. Methods. This study analyzed data from a survey administered to elected officials, members of health advocacy groups, state employees, and payers in Kansas. Main outcome measures included attitudes toward primary care and behavioral health integration; the perceived benefit of certain behavioral health and social determinants of health policies; and the perceived performance of the primary care and behavioral health care systems in Kansas. Results. Although stakeholders supported most policies that facilitate primary care and behavioral health integration, elected officials and payers were less likely to support financial incentives for primary care practitioners who treat gender dysphoria than health advocates and state employees. Payers perceived legislation to improve insurance coverage for behavioral health issues as less beneficial than state employees and health advocates. And elected officials perceived legislation to address various social determinants of health as less beneficial than health advocates. Conclusions. Preliminary findings indicate may reflect both the barriers and facilitators to behavioral health reform in Kansas. However, several limitations undermined the generalizability of these findings. Future studies should consider more representative sample sizes, additional variables in behavioral health and social determinants of health policies, and more comprehensive, validated measures.

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Breslau, Joshua, Bradley D. Stein, Bing Han, Shoshanna Shelton, and Hao Yu. "Impact of the Affordable Care Act’s Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?" Medical Care Research and Review 75, no. 2 (January 5, 2017): 131–52. http://dx.doi.org/10.1177/1077558716682171.

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The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders’ children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

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Enos, Gary. "Collaborative seeks consistency in use of quality measures." Mental Health Weekly 33, no. 37 (September 22, 2023): 3–4. http://dx.doi.org/10.1002/mhw.33792.

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A public‐private partnership between the Centers for Medicare & Medicaid Services (CMS) and America's Health Insurance Plans (AHIP) has updated a series of voluntary performance measures to guide value‐based payment for services, including a set of outpatient behavioral health measures.

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Levit, Katharine R., Tami L. Mark, Rosanna M. Coffey, Sasha Frankel, Patricia Santora, Rita Vandivort-Warren, and Kevin Malone. "Federal Spending On Behavioral Health Accelerated During Recession As Individuals Lost Employer Insurance." Health Affairs 32, no. 5 (May 2013): 952–62. http://dx.doi.org/10.1377/hlthaff.2012.1065.

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Goldman, Howard H. "Maintaining ACA’s Gains in Insurance Coverage and Improving Access to Behavioral Health Care." Psychiatric Services 68, no. 6 (June 2017): 529. http://dx.doi.org/10.1176/appi.ps.68601.

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Ha, Neung Soo, and Joseph Sedransk. "Assessing health insurance coverage in Florida using the behavioral risk factor surveillance system." Statistics in Medicine 38, no. 13 (March 5, 2019): 2332–52. http://dx.doi.org/10.1002/sim.8108.

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Kim, Yu-Rin, and Hyun-Kyung Kang. "Changes in Oral Health Behavior According to Dental Calculus Removal Health Insurance in Korea." Behavioral Sciences 13, no. 4 (April 6, 2023): 315. http://dx.doi.org/10.3390/bs13040315.

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Background: Periodontal disease is a chronic disease that is increasing year by year. Korea also recognizes the seriousness of periodontal disease and has been applying preventive scaling in the National Health Insurance since 2013 to prevent it. Studies confirming the effectiveness of such insurance coverage are very scarce. Therefore, this study intended to confirm the effect of such policy by comparing and analyzing the oral health characteristics and oral health behavior of the South Koreans before and after the scaling insurance. Methods: For all the analyses, complex sampling analysis with the stratification variable, clustering variable, and weight was applied. For a total of 40,945 people, the demographic characteristics, oral health characteristics, dental clinic use, brushing, and use of oral care supplies were compared through chi-square tests. Results: Scaling insurance showed a positive effect (p < 0.05) on the unemployed and elderly people, who had lost their previous economic status; on smoking and willingness to quit smoking as well as on consultation on drinking problems; on dental-clinic use and oral examination in terms of utilization of dental clinics; and on brushing after lunch, before breakfast, and before sleeping. Conclusions: The study results showed that the scaling rate was universalized, and there was a positive effect on willingness to quit smoking and undergo oral examination. An active reimbursement policy for oral health education is needed, however, if a substantial change in oral health behavior is to be achieved.

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Lent, Adrienne B., Carlos O. Garrido, Emily H. Baird, Ruta Viela, and Robin B. Harris. "Racial/Ethnic Disparities in Health and Life Insurance Denial Due to Cancer among Cancer Survivors." International Journal of Environmental Research and Public Health 19, no. 4 (February 15, 2022): 2166. http://dx.doi.org/10.3390/ijerph19042166.

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This study examined racial/ethnic differences in health/life insurance denial due to cancer among cancer survivors after the passage of the Affordable Care Act (ACA). Behavioral Risk Factor Surveillance System data were obtained from 2012–2020. The dependent variable asked: “Were you ever denied health insurance or life insurance coverage because of your cancer?” Cancer survivors were included if they were diagnosed with cancer after the Affordable Care Act (N = 14,815). Unadjusted and adjusted logistic regressions for age, sex, income, and employment provided odds ratios of insurance denial due to cancer across racial/ethnic groups: Non-Hispanic White, Black, and Other/mixed race; and Hispanic. Statistically significant differences (p < 0.05) were found between those who were denied or not denied insurance across sex, age, race/ethnicity, income, and employment. Adjusted regressions found significantly higher odds ratios of insurance denial for Blacks (OR: 3.00, 95% CI: 1.77, 5.08), Other/mixed race (OR: 2.16, 95% CI: 1.16, 4.02), and Hispanics (OR: 2.13, 95% CI: 1.02, 4.42) compared to Whites. Differences were observed across sex, income, and employment. Cancer survivors report racial/ethnic disparities in health and life insurance denial due to their cancer despite policy changes. This may be harmful for those who are already financially vulnerable due to their cancer diagnosis and exacerbate racial/ethnic cancer disparities.

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Hussain Al-Hashimy, Hisham Noori, Tariq Tawfeeq Yousif Alabdullah, Essia Ries Ahmed, Muath Asmar, Mohamed Ibrahim Nor, and Kanaan Abdulkarim M. Jamal. "The Impact of Financial Management Elements and Behavioral Intention on the Financial Performance." International Journal of Scientific and Management Research 05, no. 12 (2022): 117–49. http://dx.doi.org/10.37502/ijsmr.2022.51210.

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To better understand how behavioural intention (BI) and financial management elements (FME) affect insurance companies' financial performance (FP), this study will examine the relationship. Two hundred seventy-seven insurance (277) firms in Iraq were questioned for this cross-sectional study. Using principal component analysis, we were able to minimise the number of variables and pinpoint the key parts that best represented the FME, BI, financial health and performance of insurance businesses. Apart from that, we proposed and evaluated two hypotheses regarding the significance of the association between these three insurance company characteristics. PLS-SEM, or partial least squares-structural equation modeling, was utilised to analyse the data. Note that a better financial success of insurance firms is correlated with robust FME. The results strongly correlate with the insurance companies' FP and BI. Additionally, it has been discovered that BI and FP have a strong positive link. The results proved that BI possess a mediating impact on the relationship between FP and FME. Despite the abundance of material on FP, FME, and BI, there is a dearth of work on effective conceptualisation. This could have impacted how the study was conceptualised and the vague notion of BI. As a result, we do not assert very sophisticated measuring notions in this study. In addition, while many of the studies that are now available have examined FP statistically, fundamentally qualitative process elements can better account for variations in the financial success concept. Hence, more research is required to hone the qualitative notions used in this study. The adoption of FME that give insurance businesses a persistent BI advantage over their rivals must coincide with management efforts to improve FP at insurance companies. This study demonstrates the importance of determining the role of BI in the association between FME and FP to understand the FP of insurance companies. It draws on social economics, management, and accounting strands. While many of the studies that are currently in existence have used quantitative methods to assess FP, process elements or antecedents that are fundamentally qualitative can be used to explain variations in the FP notion. Therefore, this study recommends improving the notion of FP and endogeneity accounting.

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