Trauma epidemiology in Puerto Rico: in-hospital morbidity and mortality from 2002 to 2011

This study aimed to describe the distribution of injury mechanisms and to assess the impact of those mechanisms on the morbidity and mortality of trauma. All patients admitted to Puerto Rico Trauma Hospital (2002–2011) for road-traffic collisions (RTCs, 5,371), gunshot wounds (GSWs, 2,946), falls (2,319), pedestrian accidents (1,652), and stab wounds (SWs, 1,073) were selected. Gunshot victims were 1.19 (95%CI: 1.07–1.33) times as likely as road-traffic victims to have an ISS ≥25. Pedestrians were 1.76 (95%CI: 1.49–2.09) times more likely to have a GCS ≤8 than road-traffic victims were. The risk of dying was 2.64 (95%CI: 2.20–3.16) times higher for gunshot victims and 1.51 (95%CI: 1.23–1.86) times higher for pedestrians compared to patients who had had RTCs. Gunshot victims and pedestrians had the worst clinical outcomes. Accordingly, these patients should receive the most aggressive clinical management. Furthermore, it is imperative to develop public health campaigns on trauma prevention.     

Health and political regimes: Evidence from quantile regression

This study investigates how political regimes affect health conditions such as infant and child mortality rates and life expectancy using data from 180 countries observed between 1960 and 2013. Panel quantile regression is used to examine the effects at different intervals throughout the distribution of health outcomes. The estimation results indicate that democracy has significant positive effects on health outcomes and that its impacts are greater when health outcomes are worse. These results are robust to different democracy and health indices. The effects of different types of democracies and dictatorships are also considered, that is parliamentary, mixed (semi-presidential) and presidential democracies, and civilian, military and royal dictatorships. The parliamentary form of democracy has the largest positive impact on health outcomes at the worst quantile of health outcomes, although the difference in the impacts of the three types of democracies is not necessarily large. Furthermore, all types of dictatorships have a negative impact on health outcomes, with military dictatorship having the worst outcome when health outcomes are worse. Finally, the effects of democratization on health outcomes are significantly positive when the health outcomes are worse.     

医疗卫生资源、新型冠状病毒肺炎死亡率与资源优化配置

新冠肺炎疫情发生后，湖北省一直是疫情的重灾区与抗疫的焦点地区，患者死亡率远远高于全国平均水平。本文构建纳入医疗资源条件的新冠肺炎传播的SIER模型进行机制分析和模拟研究，发现改善卫生资源条件会降低疫情的死亡率。针对湖北省疫情数据，使用最小二乘方法进行实证研究后发现,无论是增加医院或者卫生系统内的床位数，还是增加医护人员数，均可显著地降低疫情死亡率。进一步通过时变效应和断点回归模型考察重大突发公共卫生事件一级响应政策效应和外援医疗团队效应，实证结果也佐证了上述推断。结合研究结论和湖北省防疫经验，本文提出先整合医院内部医疗资源，打破医院内部各科室之间分割，再整合地区内医疗卫生系统的资源，同时实施医疗系统外部资源三管齐下的医疗资源配置建议措施，以期为国内外疫情防控贡献中国智慧。     

极端死亡率债券的运行机制与定价模型

极端死亡率债券是票息或面值与极端死亡概率相关的债券,能够将寿险公司所面临的极端死亡率风险转移到资本市场。本文阐述了极端死亡率债券的市场发展,包括发行规模、触发机制、债券期限、债券分层、债券评级等,分析了以 Tartan 债券为代表的本金赔付累积型极端死亡率债券的运行机制,并给出了考虑极端死亡率风险的跳跃性特征下的本金赔付累积型极端死亡率债券 Wang 转换定价的解析式。     

Exploring the widening food gap: an international perspective

Using data for a long panel of 90 developed and developing countries, this article explores the effects of research and development (R&D) and fixed capital stock on agricultural land productivity over the period 1961–2012. Instruments are used for R&D to deal with feedback effects and measurement errors. The results show very high social returns to investment in R&D and to fixed capital stock, suggesting that increasing investment in these factors are promising ways of arresting the increasing food prices due to increasing demand for animal protein, population growth, desertification, salinization, soil erosion, climate change, and decreasing growth in land productivity.     

死亡率免疫理论及其在长寿风险对冲中的应用

基于死亡率免疫理论探讨保险公司长寿风险的自然对冲问题,研究年龄、性别与保险期限等因素与保单久期和凸性之间的关系,发现保险公司欲达到长寿风险的完全对冲,其寿险业务和年金业务必须达到的最小ρ比例应该等于年金和寿险保单的久期之比,表明保险公司可以通过选择调整寿险和年金业务的比例来对冲长寿风险的影响。     

A practical solution to the problem of ultimate ruin probability

Abstract

It was the Swiss actuary Chr. Moser who, in lectures at Bern University at the turn of the century, gave the name “self-renewing aggregate” to what Vajda (1947) has called the “unstationary community” of lives, namely where deaths at any epoch are immediately replaced by an equivalent number of births. It was Moser too (1926) who coined the expression “steady state” for the stationary community in which the age distribution at any time follows the life table (King, 1887). With such a distinguished actuarial history, excellently summarized by Saxer (1958, Ch. IV), it behoves every actuary to know at least the definitions and modus operandi of today's so-called renewal (point), or recurrent event, processes.     

MEASURING VARIATIONS IN LIFETIME WELFARE EX ANTE AND EX POST: SOME EXPLORATORY CALCULATIONS

Whereas longevity‐adjusted consumption measures have become increasingly used as indicators of lifetime standards of living, it remained unnoticed that those measures, by relying on period – rather than cohort – life tables, constitute indicators of expected – rather than actual – lifetime standards of living. In order to estimate the actual gap between ex ante and ex post measures of lifetime welfare, this paper computes, for 19th‐century European economies, longevity‐adjusted consumption measures based on period and cohort life tables. It is shown that the gap between ex ante and ex post measures is statistically significant, and that attempts to reduce it are likely to be unsuccessful, because standards of living tend to exhibit, over temporal horizons as long as a human life, structural breaks, which make the ex ante measurement of lifetime welfare highly speculative.