Chancen und herausforderungen der rückversicherung in der gesetzlichen krankenversicherung (Chances and challenges of reinsurance in the social health scheme)

In 2009 a so-called morbidity orientated risk structure equalization scheme was installed for the German statutory health insurance in order to minimize structural differences between different providers with respect to revenue and expenditures. Even with this mechanism some risks to the individual health insurance providers remain. Reinsurance could be a way to mitigate these risks, but so far only very few contracts have been signed. Moreover the existing reinsurance contracts only focus on the periphery of the statutory health insurance system such as travel health insurance. In this article we therefore analyse existing risks for individual health insurance providers and evaluate their (re-)insurability. Hereafter the potential for reinsurance solutions in the German statutory health insurance itself as well as in newer forms of healthcare provision (e.g. integrated health care and managed care) is discussed. We find that reinsurance may be a reasonable solution for many of the risks in the statutory health insurance scheme. But as research in this area is very young further analysis of the nature of risks is necessary.

Affective Computing to Enhance E-Learning in Segregated Societies

According to UN Women, to build stronger economies, it is essential to empower women to participate fully in economic life across all sectors. Increasing women and girls’ education enhances their chances to participate in the labor market. In certain cultures, like in Saudi Arabia, women contribution to the public economy growth is very limited. According to the World Bank, less than 20 percent of the female population participate in the labor force. This low participation rate has many reasons. One of them, is the educational level and educational quality for females. Although Saudi Arabia has about thirty three universities, opportunities are still limited for women because of the restrictions of access put upon them. A mixture of local norms, traditions, social beliefs, and principles preventing women from receiving full benefits from the educational system. Gender segregation is one of the challenges that limits the women access for education. It causes a problem due to the shortage of female faculty throughout the country. To overcome this problem, male faculty are allowed to teach female students under certain regulations and following a certain method of education delivery and interaction. However, most of these methods lack face-to-face communication between the teacher and students, which lowers the interactivity level and, accordingly, the students’ engagement, and increases the need for other alternatives. The e-learning model is one of high benefit for female students in such societies. Recognizing the students’ engagement is not straightforward in the e-learning model. To measure the level of engagement, the learner’s mood or emotions should be taken into consideration to help understanding and judging the level of engagement. This paper is to investigate the relationship between emotions and engagement in the e-learning environment, and how recognizing the learner’s emotions and change the content delivery accordingly can affect the efficiency of the e-learning process. The proposed experiment alluded to herein should help to find ways to increase the engagement of the learners, hence, enhance the efficiency of the learning process and the quality of learning, which will increase the chances and opportunities for women in such societies to participate more effectively in the labor market.

The troubling concept of class: reflecting on our ‘failure’ to encourage sociology students to re-cognise their classed locations using autobiographical methods

The troubling concept of class: reflecting on our ‘failure’ to encourage sociology students to re-cognise their classed locations using autobiographical methods Abstract This paper provides a narrative of the four authors‟ commitment to auto/biographical methods as teachers and researchers in „new‟ universities. As they went about their work, they observed that, whereas students engage with the gendered, sexualised and racialised processes when negotiating their identities, they are reluctant or unable to conceptualise „class-ifying‟ processes as key determinants of their life chances. This general inability puzzled the authors, given the students‟ predominantly working-class backgrounds. Through application of their own stories, the authors explore the sociological significance of this pedagogical „failure‟ to account for the troubling concept of class not only in the classroom but also in contemporary society.

Predictive Risk Modelling for Integrated Care: a Structured Review

If patients at risk of admission or readmission to hospital or other forms of care could be identified and offered suitable early interventions then their lives and long-term health may be improved by reducing the chances of future admission or readmission to care, and hopefully, their cost of care reduced. Considerable work has been carried out in this subject area especially in the USA and the UK. This has led for instance to the development of tools such as PARR, PARR-30, and the Combined Predictive Model for prediction of emergency readmission or admission to acute care. Here we perform a structured review the academic and grey literature on predictive risk tools for social care utilisation, as well as admission and readmission to general hospitals and psychiatric hospitals. This is the first phase of a project in partnership with Docobo Ltd and funded by Innovate UK,in which we seek to develop novel predictive risk tools and dashboards to assist commissioners in Clinical Commissioning Groups with the triangulation of the intelligence available from routinely collected data to optimise integrated care and better understand the complex needs of individuals.

Improving innovation and performance of Social Enterprises: Knowing what they know

Social Enterprises (SEs) are normally micro and small businesses that trade to tackle social problems, and to improve communities, people’s life chances, and the environment. Thus, their importance to society and economies is increasing. However, there is still a need for more understanding of how these organisations operate, perform, innovate and scale-up. This knowledge is crucial to design and provide accurate strategies to enhance the sector and increase its impact and coverage. Obtaining this understanding is the main driver of this paper, which follows the theoretical lens of the Knowledge-based View (KBV) theory to develop and assess empirically a novel model for knowledge management capabilities (KMCs) development that improves performance of SEs. The empirical assessment consisted of a quantitative study with 432 owners and senior members of SEs in UK, underpinned by 21 interviews. The findings demonstrate how particular organisational characteristics of SEs, the external conditions in which they operate, and informal knowledge management activities, have created overall improvements in their performance of up to 20%, based on a year-to-year comparison, including innovation and creation of social and environmental value. These findings elucidate new perspectives that can contribute not only to SEs and SE supporters, but also to other firms.