Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia

Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

Using Agents for Mining Maintenance Data while interacting in 3D Objectoriented Virtual Environments

This report demonstrates the development of: (a) object-oriented representation to provide 3D interactive environment using data provided by Woods Bagot; (b) establishing basis of agent technology for mining building maintenance data, and (C) 3D interaction in virtual environments using object-oriented representation. Applying data mining over industry maintenance database has been demonstrated in the previous report.

Developing Software Agents for Data Mining : [AIMM] Agents for Improving Maintenance Management

This report demonstrates the development of: • Development of software agents for data mining • Link data mining to building model in virtual environments • Link knowledge development with building model in virtual environments • Demonstration of software agents for data mining • Populate with maintenance data

Demonstration of Software Agents Prototype System : [AIMM] Agents for Improving Maintenance Management

This report presents the demonstration of software agents prototype system for improving maintenance management [AIMM] including: • Developing and implementing a user focused approach for mining the maintenance data of buildings. This report presents the demonstration of software agents prototype system for improving maintenance management [AIMM] including: • Developing and implementing a user focused approach for mining the maintenance data of buildings. • Refining the development of a multi agent system for data mining in virtual environments (Active Worlds) by developing and implementing a filtering agent on the results obtained from applying data mining techniques on the maintenance data. • Integrating the filtering agent within the multi agents system in an interactive networked multi-user 3D virtual environment. • Populating maintenance data and discovering new rules of knowledge.

Knowledge discovery for adaptive negotiation agents in e-marketplaces

Intelligent software agents are promising in improving the effectiveness of e-marketplaces for e-commerce. Although a large amount of research has been conducted to develop negotiation protocols and mechanisms for e-marketplaces, existing negotiation mechanisms are weak in dealing with complex and dynamic negotiation spaces often found in e-commerce. This paper illustrates a novel knowledge discovery method and a probabilistic negotiation decision making mechanism to improve the performance of negotiation agents. Our preliminary experiments show that the probabilistic negotiation agents empowered by knowledge discovery mechanisms are more effective and efficient than the Pareto optimal negotiation agents in simulated e-marketplaces.