Asymmetric Information in Iranian's Health Insurance Market: Testing of Adverse Selection and Moral Hazard

BACKGROUND: Asymmetric information is one of the most important issues in insurance market which occurred due to inherent characteristics of one of the agents involved in insurance contracts; hence its management requires designing appropriate policies. This phenomenon can lead to the failure of insurance market via its two consequences, namely, adverse selection and moral hazard. OBJECTIVE: This study was aimed to evaluate the status of asymmetric information in Iran's health insurance market with respect to the demand for outpatient services. MATERIALS/PATIENTS AND METHODS: This research is a cross sectional study conducted on households living in Iran. The data of the research was extracted from the information on household's budget survey collected by the Statistical Center of Iran in 2012. In this study, the Generalized Method of Moment model was used and the status of adverse selection and moral hazard was evaluated through calculating the latent health status of individuals in each insurance category. To analyze the data, Excel, Eviews and stata11 software were used. RESULTS: The estimation of parameters of the utility function of the demand for outpatient services (visit, medicine, and Para-clinical services) showed that households were more risk averse in the use of outpatient care than other goods and services. After estimating the health status of households based on their health insurance categories, the results showed that rural-insured people had the best health status and people with supplementary insurance had the worst health status. In addition, the comparison of the conditional distribution of latent health status approved the phenomenon of adverse selection in all insurance groups, with the exception of rural insurance. Moreover, calculation of the elasticity of medical expenses to reimbursement rate confirmed the existence of moral hazard phenomenon. CONCLUSIONS: Due to the existence of the phenomena of adverse selection and moral hazard in most of health insurances categories, policymakers need to adjust contracts so that to reduce these phenomena. Given the importance of financing, the presence of such problems can lead to less coverage of health insurance provided by insurers, loss of contracts with health care institutions and service providers, and lower quality of health services

Experimental investigation of inlet distortion effect on performance of a micro gas turbine

An experimental study has been carried out to determine how inlet total-pressure distortion affects the performance of a micro gas turbine. An inlet simulator is designed and developed to produce and measure distortion patterns at the inlet to the gas turbine. An air jet distortion generator (AJDG) is used to produce nonuniform flow patterns and total pressure probes are installed to measure steady-state total-pressure distribution at the inlet. A set of wind tunnel tests have been performed to confirm the fidelity of distortion generator and measuring devices. Tests are carried out with the gas turbine exposed to inlet flow with 60¿deg, 120¿deg, and 180¿deg circumferential distortion patterns with different distortion intensities. The performance of the gas turbine has been measured and compared with that of clean inlet flow case. Results indicate that the gas turbine performance can be affected significantly facing with intense inlet distortions.Peer ReviewedPostprint (published version

Spectrofluorimetric Determination of Human Serum Albumin Using Terbium-Danofloxacin Probe

A spectrofluorimetric method is proposed for the determination of human serum albumin (HSA) and bovine serum albumin (BSA) using terbium-danofloxacin (Tb3+-Dano) as a fluorescent probe. These proteins remarkably enhance the fluorescence intensity of the Tb3+-Dano complex at 545 nm, and the enhanced fluorescence intensity of Tb3+-Dano is proportional to the concentration of proteins (HSA and BSA). Optimum conditions for the determination of HSA were investigated and found that the maximum response was observed at: pH = 7.8, [Tb3+] = 8.5 × 10−5 mol L−1, [Dano] = 1.5 × 10−4 mol L−1. The calibration graphs for standard solutions of BSA, HSA, and plasma samples of HSA were linear in the range of 0.2 × 10−6 − 1.3 × 10−6 mol L−1, 0.2 × 10−6 − 1.4 × 10−6 mol L−1, and 0.2 × 10−6 − 1 × 10−6 mol L−1, respectively. The detection limits (S/N = 3) for BSA, HSA, and plasma sample of HSA were 8.7 × 10−8 mol L−1, 6.2 × 10−8 mol L−1, and 8.1 × 10−8 mol L−1, respectively. The applicability of the method was checked using a number of real biological plasma samples and was compared with the UV spectrometric reference method. The results was showed that the method could be regarded as a simple, practical, and sensitive alternative method for determination of albumin in biological samples

A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel

Context: In spite of the high prevalence and consequences of much workplace violence against emergency medical services personnel, this phenomenon has been given insufficient attention. A systematic review can aid the development of guidelines to reduce violence. Objectives: The research question addressed by this paper is, “What are the characteristics and findings of studies on workplace violence against emergency medical services personnel”? Data Sources: A systematic literature review was conducted using online databases (PubMed, Scopus, Google Scholar, and Magiran) with the help of experienced librarians. Study Selection: Inclusion criteria comprised studies in the English or Persian language and researcher’s access to the full text. There was no limit to the entry of the study design. Exclusion criteria included lack of access to the full text of the article, studies published in unreliable journals or conferences, and studies in which the results were shared with other medical or relief groups and there was no possibility of breaking down the results. Data Extraction: A “Data extraction form” was designed by the researchers based on the goals of the study that included the title and author(s), study method (type, place of study, sample size, sampling method, and data collection/analysis tool), printing location, information related to the frequency of types of violence, characteristics of victims /perpetrators, and related factors. Results: The papers reviewed utilized a variety of locations and environments, methods, and instrument samplings. The majority of the studies were performed using the quantitative method. No intervention study was found. Most studies focused on the prevalence of violence, and their results indicated that exposure to violence was high. The results are presented in six major themes. Conclusions: Workplace violence and injuries incurred from it are extensive throughout the world. The important causes of violence include the shortage of training programs dealing with violence, lack of violence management protocols, and delays in response times. Therefore, afterthought and resolve are more crucial than ever. Workplace violence reduction strategies and suggestions for future studies are also discussed

A Developed Methodology in Design of Highly Loaded Tandem Axial Flow Compressor Stage

This study, primarily reports the development of a 3D design procedure for axial flow tandem compressor stages and then the method is used to design a highly loaded tandem stage. In order to investigate the effects of such arrangement, another stage with conventional loading with single blade for both rotor and stator rows is designed with similar specification. In order to ease the comparison of results, chord lengths and hub/shroud geometries are selected with the same dimensions. At the next stage a three dimensional numerical model is developed to predict the characteristic performance of both tandem and conventional stages. The model is validated with the experimental results of NASA-67 stage and the level of the accuracy of the model is presented. Employing the model to simulate the performance of both stages at design and offdesign operating points show that, tandem stage can provide higher pressure ratio with acceptable efficiency. In another word, tandem stage is capable having the same pressure ratio at lower rotational speed. The safe operation domain and loss mechanism in tandem stage are also discussed in this report

Macroscopic and microscopic description of phase transition in cerium isotopes

The spherical-to-deformed phase transition in cerium isotopes recently suggested to occur between Ce146 and Ce148 has been examined in the framework of the macroscopic algebraic collective model and two microscopic approaches, namely Skyrme-Hartree-Fock + Bardeen-Cooper-Schrieffer (BCS) calculations and the symmetry conserving configuration mixing method with Gogny energy density functionals applied also to the neighboring nuclei along the cerium isotopic chain. Possible spectral signatures of the phase transition are discussed in more details. The microscopic calculations predict octupole softness manifested by rather flat potential energy curves as a function of the octupole deformation parameter β3 for Ce146 and Ce148 and shape coexistence characterized by axially symmetric 0+ states, triaxial 2+ bands, and octupole deformation for the lowest 1- state

Core competencies for health headquarters: a systematic review and meta-synthesis

BACKGROUND: The availability of human resources for the health sector is not enough requirement for addressing health needs. Instead, it is necessary to take effective steps to meet the requirements of the health care system in case the system has the necessary competencies. This study was performed to identify the competencies of health headquarters in meeting the needs of the health system. METHODS: This thematic synthesis was performed to develop a set of central themes that summarize all the topics raised in the articles reviewed in this study. The quality of the articles was assessed by the Standards for Reporting Qualitative Research. RESULTS: We included 12 articles from seven countries. Seven central themes were inductively developed from the analysis: (1) Leadership and management, (2) Analyzing, interpreting, and reporting, (3) Public health knowledge, (4) Interpersonal relationship, (5) Personality competencies, (6) Cultural and community competencies, and (7) International/Global health competencies. CONCLUSION: The findings of this review may help to address how to recruit and retain health headquarters, optimize the headquarters ability and expertise, and develop some approaches to promote their scientific, practical, and professional levels. These issues can drive the organization toward their visions, strategies, and great objectives

Generation of polarization-entangled photon pairs in a Bragg reflection waveguide

We demonstrate experimentally that spontaneous parametric down-conversion in an AlGaAs semiconductor Bragg reflection waveguide can make for paired photons highly entangled in the polarization degree of freedom at the telecommunication wavelength of 1550 nm. The pairs of photons show visibility higher than 90% in several polarization bases and violate a Clauser-Horne-Shimony-Holt Bell-like inequality by more than 3 standard deviations. This represents a significant step toward the realization of efficient and versatile self pumped sources of entangled photon pairs on-chip.Comment: 9 pages, 4 figures, published versio

A highly sensitive quadruple D-shaped open channel photonic crystal fiber plasmonic sensor : A comparative study on materials effect

Funding Information: This work was supported by the National Research Foundation of Korea-Grant funded by the Korean Government (Ministry of Science and ICT-NRF-2020R1A2B5B02002478). Publisher Copyright: © 2021 The Author(s)Peer reviewedPublisher PD

Qualitative Analysis of Causal Anisotropic Viscous Fluid Cosmological Models

The truncated Israel-Stewart theory of irreversible thermodynamics is used to describe the bulk viscous pressure and the anisotropic stress in a class of spatially homogeneous viscous fluid cosmological models. The governing system of differential equations is written in terms of dimensionless variables and a set of dimensionless equations of state is utilized to complete the system. The resulting dynamical system is then analyzed using standard geometric techniques. It is found that the presence of anisotropic stress plays a dominant role in the evolution of the anisotropic models. In particular, in the case of the Bianchi type I models it is found that anisotropic stress leads to models that violate the weak energy condition and to the creation of a periodic orbit in some instances. The stability of the isotropic singular points is analyzed in the case with zero heat conduction; it is found that there are ranges of parameter values such that there exists an attracting isotropic Friedmann-Robertson-Walker model. In the case of zero anisotropic stress but with non-zero heat conduction the stability of the singular points is found to be the same as in the corresponding case with zero heat conduction; hence the presence of heat conduction does not apparently affect the global dynamics of the model.Comment: 35 pages, REVTeX, 3 Encapsulated PostScript Figure