Impact of Various Insurance Types on Level and Appropriateness of Health Care Consumption

The goal of this study was to examine the extent to which insurance type, or method of care management, impact the appropriate delivery of health care. Previous studies indicate a relationship between insurance type and patterns of consumption but do not directly link the incentives or disincentives inherent in each plan with trends inconsumption of health care. This study explores how different types of health insurance coverage affect the location, the degree, and the frequency of health care consumption in order to gain insight into which plans promote appropriate delivery and consumption ofcare.

Temporomandibular disorders/myoarthropathy of the masticatory system. Costs of dental treatment and reimbursement by Swiss federal insurance agencies according to the Health Care Benefits Ordinance (KLV)

The goal of the study was to calculate the direct costs of therapy for patients with MAP. This retrospective study included 242 MAP patients treated at the Department of Prosthodontics of the University of Bern between 2003 and 2006. The following parameters were collected from the clinical charts: chief complaint, diagnosis, treatment modalities, total costs, costs of the dental technician, number of appointments, average cost per appointment, length of treatment, and services reimbursed by health insurance agencies. The average age of the patients was 40.4 ± 17.3 years (76.4% women, 23.6% men). The chief complaint was pain in 91.3% of the cases, TMJ noises (61.2%) or limitation of mandibular mobility (53.3%). Tendomyopathy (22.3%), disc displacement (22.4%), or a combination of the two (37.6%) were more often diagnosed than arthropathy alone (7.4%). Furthermore, 10.3% of the MAP patients had another primary diagnosis (tumor, trauma, etc.). Patients were treated with counseling and exercises (36.0%), physiotherapy (23.6%), or occlusal splints (32.6%). The cost of treatment reached 644 Swiss francs for four appointments spread over an average of 21 weeks. In the great majority of cases, patients can be treated with inexpensive modalities. 99.9% of the MAP cases submitted to the insurance agencies were reimbursed by them, in accordance with Article 17d1-3 of the Swiss Health Care Benefits Ordinance (KLV) and Article 25 of the Federal Health Insurance Act (KVG). The costs of treatment performed by dentists remain modest. The more time-consuming services, such as providing information, counseling and instructions, are poorly remunerated. This aspect should be re-evaluated in a future revision of the tariff schedule.

THE RESONATE-AND-FIRE NEURON: TIME DEPENDENT AND FREQUENCY SELECTIVE NEURONS IN NEURAL NETWORKS

The means through which the nervous system perceives its environment is one of the most fascinating questions in contemporary science. Our endeavors to comprehend the principles of neural science provide an instance of how biological processes may inspire novel methods in mathematical modeling and engineering. The application ofmathematical models towards understanding neural signals and systems represents a vibrant field of research that has spanned over half a century. During this period, multiple approaches to neuronal modeling have been adopted, and each approach is adept at elucidating a specific aspect of nervous system function. Thus while bio-physical models have strived to comprehend the dynamics of actual physical processes occurring within a nerve cell, the phenomenological approach has conceived models that relate the ionic properties of nerve cells to transitions in neural activity. Further-more, the field of neural networks has endeavored to explore how distributed parallel processing systems may become capable of storing memory. Through this project, we strive to explore how some of the insights gained from biophysical neuronal modeling may be incorporated within the field of neural net-works. We specifically study the capabilities of a simple neural model, the Resonate-and-Fire (RAF) neuron, whose derivation is inspired by biophysical neural modeling. While reflecting further biological plausibility, the RAF neuron is also analytically tractable, and thus may be implemented within neural networks. In the following thesis, we provide a brief overview of the different approaches that have been adopted towards comprehending the properties of nerve cells, along with the framework under which our specific neuron model relates to the field of neuronal modeling. Subsequently, we explore some of the time-dependent neurocomputational capabilities of the RAF neuron, and we utilize the model to classify logic gates, and solve the classic XOR problem. Finally we explore how the resonate-and-fire neuron may be implemented within neural networks, and how such a network could be adapted through the temporal backpropagation algorithm.

Health insurance coverage of Hispanic adults: An assessment of subgroup difference and the impact of immigration

This research explores the health insurance coverage of various Hispanic subgroups in comparison to non-Hispanic whites and blacks. The impact of immigration status is also considered as we hypothesize that nativity, duration, and naturalization tap a possible process of structural acculturation that increases access to insurance coverage for Hispanic groups. We find that the immigration variables impact the type of insurance reported. However, race/ethnic disparities continue to exist, with the various Hispanic subgroups more likely to report miscellaneous government health insurance or no health insurance coverage as compared to non-Hispanic whites.

Atlantic hurricanes and associated insurance loss potentials in future climate scenarios: limitations of high-resolution AGCM simulations

Potential future changes in tropical cyclone (TC) characteristics are among the more serious regional threats of global climate change. Therefore, a better understanding of how anthropogenic climate change may affect TCs and how these changes translate in socio-economic impacts is required. Here, we apply a TC detection and tracking method that was developed for ERA-40 data to time-slice experiments of two atmospheric general circulation models, namely the fifth version of the European Centre model of Hamburg model (MPI, Hamburg, Germany, T213) and the Japan Meteorological Agency/ Meteorological research Institute model (MRI, Tsukuba city, Japan, TL959). For each model, two climate simulations are available: a control simulation for present-day conditions to evaluate the model against observations, and a scenario simulation to assess future changes. The evaluation of the control simulations shows that the number of intense storms is underestimated due to the model resolution. To overcome this deficiency, simulated cyclone intensities are scaled to the best track data leading to a better representation of the TC intensities. Both models project an increased number of major hurricanes and modified trajectories in their scenario simulations. These changes have an effect on the projected loss potentials. However, these state-of-the-art models still yield contradicting results, and therefore they are not yet suitable to provide robust estimates of losses due to uncertainties in simulated hurricane intensity, location and frequency.

Extent and structure of health insurance expenditures for complementary and alternative medicine in Swiss primary care

BACKGROUND: The study is part of a nationwide evaluation of complementary and alternative medicine (CAM) in primary care in Switzerland. The goal was to evaluate the extent and structure of basic health insurance expenditures for complementary and alternative medicine in Swiss primary care. METHODS: The study was designed as a cross-sectional evaluation of Swiss primary care providers and included 262 certified CAM physicians, 151 noncertified CAM physicians and 172 conventional physicians. The study was based on data from a mailed questionnaire and on reimbursement information obtained from health insurers. It was therefore purely observational, without interference into diagnostic and therapeutic procedures applied or prescribed by physicians. Main outcome measures included average reimbursed costs per patient, structured into consultation- and medication-related costs, and referred costs. RESULTS: Total average reimbursed cost per patient did not differ between CAM physicians and conventional practitioners, but considerable differences were observed in cost structure. The proportions of reimbursed costs for consultation time were 56% for certified CAM, 41% for noncertified CAM physicians and 40% for conventional physicians; medication costs--including expenditures for prescriptions and directly dispensed drugs--respectively accounted for 35%, 18%, and 51% of costs. CONCLUSION: The results indicate no significant difference for overall treatment cost per patient between CAM and COM primary care in Switzerland. However, CAM physicians treat lower numbers of patients and a more cost-favourable patient population than conventional physicians. Differences in cost structure reflect more patient-centred and individualized treatment modalities of CAM physicians.