浅析病案信息在保险理赔中的利用

病案资料在保险理赔中具有重要的作用,分析病案信息资料在保险理赔利用过程中存在的问题,探讨通过提高保险理赔人员的医学素质、职业责任感、促进医疗机构与保险机构合作,可以加强病案信息的利用,提升保险理赔水平。     

A new solution to the problem of adjudicating conflicting claims

Summary. For the problem of adjudicating conflicting claims, we consider the requirement that each agent should receive at least 1/n his claim truncated at the amount to divide, where n is the number of claimants (Moreno-Ternero and Villar, 2004a). We identify two families of rules satisfying this bound. We then formulate the requirement that for each problem, the awards vector should be obtainable in two equivalent ways, (i) directly or (ii) in two steps, first assigning to each claimant his lower bound and then applying the rule to the appropriately revised problem. We show that there is only one rule satisfying this requirement. We name it the “ rule”, as it is obtained by a recursion. We then undertake a systematic investigation of the properties of the rule.Received: 7 September 2004, Revised: 21 April 2005, JEL Classification Numbers: C79, D63, D74.William Thomson: Correspondence toWe thank Christopher Chambers, Youngsub Chun, Tarík Kara, Çağatay Kayí, Juan Moreno-Ternero, Toyotaka Sakai, and Michel Truchon for their comments. We also thank a referee for useful comments. This paper was presented at Columbia University, CORE, Bilkent University, Sabancí University, Université Laval, and Caltech, and at the Mallorca Review of Economic Design meeting. Thomson acknowledges support from the NSF under grant SES-0214691.     

索赔与反索赔的内涵界定

索赔与反索赔是工程建设合同管理的一个重要内容，章对国内和国外的现状加以分析，讨论了索赔与反索赔的概念，澄清目前的一些关于索赔管理中的模糊认识，希望按照国际惯例界定我国的索赔与反索赔的内涵，从而适应开放的市场经济的要求，提高我国企业合同管理水平。     

素心傲骨气韵流香——谈《林声自题画诗》

林声凝神观照松、竹、梅、菊、牡丹、鹤等多种艺术对象,其自题画诗是对绘画意境的点题与延伸、深化与升华,是审美情感运动的延续与上扬,表现创造主体素心傲骨、气韵留香的书画人生。素心傲骨,是指题画诗在审美内质的静态特征;气韵留香,是题画诗在审美内蕴中的动态特征,是一种动态之美。林声的题画诗是其人格力量与生命情韵的集中显现,是形式美与内蕴美的统一。     

On the existence of consistent rules to adjudicate conflicting claims: a constructive geometric approach

For the problem of adjudicating conflicting claims, a rule is consistent if the choice it makes for each problem is always in agreement with the choice it makes for each “reduced problem” obtained by imagining that some claimants leave with their awards and reassessing the situation from the viewpoint of the remaining claimants. We develop a general technique to determine whether a given two-claimant rule admits a consistent extension to general populations, and to identify this extension if it exists. We apply the technique to a succession of examples. I gratefully acknowledge support from NSF under grant SBR-9731431 and SES 0214691, and the comments of Carmen Bevia, Rodrigo Velez, Chun-Hsien Yeh, and a referee.     

Patterns of relapse and associated cost burden in schizophrenia patients receiving atypical antipsychotics

Abstract

Objective:

To identify relapse in schizophrenia and the main cost drivers of relapse using a cost-based algorithm.

Methods:

Multi-state Medicaid data (1997–2010) were used to identify adults with schizophrenia receiving atypical antipsychotics (AP). The first schizophrenia diagnosis following AP initiation was defined as the index date. Relapse episodes were identified based on (1) weeks during the ≥2 years post-index associated with high cost increase from baseline (12 months before the index date) and (2) high absolute weekly cost. A compound score was then calculated based on these two metrics, where the 54% of patients associated with higher cost increase from baseline and higher absolute weekly cost were considered relapsers. Resource use and costs of relapsers during baseline and relapse episodes were compared using incidence rate ratios (IRRs) and bootstrap methods.

Results:

In total, 9793 relapsers were identified with a mean of nine relapse episodes per patient. Duration of relapse episodes decreased over time (mean [median]; first episode: 34 [4] weeks; remaining episodes: 8 [1] weeks). Compared with baseline, resource utilization during relapse episodes was significantly greater in pharmacy, outpatient, and institutional visits (hospitalizations, emergency department visits), with IRRs ranging from 1.9–2.4 (all p?<?0.0001). Correspondingly, relapse was associated with a mean (95% CI) incremental cost increase of $2459 ($2384–$2539) per week, with institutional visits representing 53% of the increase.

Limitations:

Relapsers and relapse episodes were identified using a cost-based algorithm, as opposed to a more clinical definition of relapse. In addition, their identification was based on the assumption from literature that ～54% of schizophrenia patients will experience at least one relapse episode over a 2-year period.

Conclusions:

Significant cost increases were observed with relapse in schizophrenia, driven mainly by institutional visits.     

信息一致性对消费者态度的影响——基于营养标签信息的实证研究

全文选取营养成分表作为基本研究对象,得出高感知风险因素能够比低感知风险因素引起更大的受众态度变化范围;对于产品包装上营养成分表和营养声称、营养成分功能声称不一致的情形,具有较高感知风险因素的信息不一致将引起更大的受众态度变化。     

一种延长机械产品使用寿命的新措施

从配合间隙 (或过盈 )的角度用概率统计法分析孔、轴尺寸分布对机械产品使用寿命的影响 ,并提出了改进措施——改变相配件的非基准件的基本偏差 ,从而适当减小配合件的初始间隙 ,使零件的磨损储备量增加 ,以达到延长机械产品使用寿命的目的     

跨境金融:驱动因素、结构特征与未来路径

跨境金融的驱动因素和结构特征是理论界和实务界关注的重要话题。在当前复杂的国际经济金融形势下,厘清全球跨境金融的规律特征,对我国更好地利用“两个市场、两种资源”,防范外部金融风险具有重要意义。2008年国际金融危机以来,在经济周期、全球流动性、金融结构和监管政策等驱动因素的影响下,全球跨境金融活动呈现规模下降、结构调整、流向分化、主体切换和风险变化等特征。同时,银行跨境业务呈现综合化趋势,数字化转型提速,经营稳健性明显增强。我国跨境金融规模稳步增长,对国际收支的影响持续增强,在全球资金循环中的份额不断提高。未来,随着我国经济转型和对外开放步伐的加快,跨境金融的规模和结构还将发生深刻变化,风险日趋复杂。应引导形成与我国经济金融发展特征相匹配的跨境资金结构,平衡扩大开放与风险防控的关系,充分发挥银行业在跨境金融领域的“比较优势”。