MODELLING HEALTH MAINTENANCE ORGANIZATIONS PAYMENTS UNDER THE NATIONAL HEALTH INSURANCE SCHEME IN NIGERIA

The Nigerian National Health Insurance Scheme (NHIS) is set up to ensure equitable payment of health care bills combining and prudently reducing cost-burden distribution for residents, versus high health care costs. Health maintenance organizations (HMO) are limited liability companies which could be established by private, public or individual entities with the main aim of being players in the scheme. This paper explored logistic regression (LR), linear discriminant analysis (LDA) and random forest (RF) in determining the factors that could determine if an HMO will cover full or part of an individual's healthcare bill. The results do not show a significant difference in the classification accuracies of the three methods. Inferring that the highest number of the Nigerian residents that make use of the NHIS lie between the 31-40yrs age bracket and that largely, ailment classification and the insured’s age are key determining factors of whether an HMO would cover all or part of the bill

Assessment of ground water pollution in the residential areas of Ewekoro and Shagamu due to cement production

Chemical and physico–chemical parameters of ground water samples from wells were analyzed by multivariate statistical tools to provide the characterisation of the ground water distribution of the settlements around cement factories in Ewekoro and Shagamu, Ogun State in Nigeria. The 17 parameters determined include: pH, conductivity, dissolved oxygen (DO), total dissolved solids (TDS), biochemical oxygen demand (BOD), total hardness, acidity, and alkalinity; anions such as chlorides, sulphates, phosphates and nitrates as well as potentially toxic metals such as copper, lead, zinc, iron and cadmium. The analytical data were obtained from 6 wells in Ewekoro and 11 wells in Shagamu sampled during three different periods along a year covering both the wet, break and dry seasons of 2009. The concentrations of lead and cadmium are above the World Health Organisation (WHO) standard in all three seasons investigated with lead having as high as 1.05 mg/L and maximum of 0.068 mg/L for cadmium. It was also observed that the levels of sulphate was higher that the WHO standard during the dry season with a maximum concentration of 623 mg/L. All other physicochemical parameters fell within the permissible range as stipulated by the WHO. There was no seasonal difference in the concentrations of the potentially toxic metals analysed in the ground water from the two sites, while for the physicochemical properties, there was a seasonal variation in the results of the ground water quality in the two sites studied with DO having a p-value of 0.009, BOD with p-value of 0.04 and Alkalinity of 0.044 p-value. An approach for the characterisation of the groundwater system of the neighbourhood of the cement factories is proposed on the basis of its physico-chemical composition, in order to detect multivariate patterns for unpolluted waters as well as for eventual polluted zones.Key words: Toxic metals, physico-chemical composition, multivariate, cement, ground water

Endodontic flare-ups: comparison of incidence between single and multiple visit procedures in patients attending a Nigerian teaching hospital

BACKGROUND: Until recently the most accepted technique of doing root canal treatment stresses multiple visit procedure. Most schools also concentrated upon teaching the multi-visit concept. However, it has now been reported that the procedure of single visit treatment is advocated by at least 70% of schools in all geographical areas. It was therefore the aims of the present study to find the incidence of post-obturation flare-ups following single and multiple visit endodontic treatment procedures, and to establish the relationship between pre-operative and post-obturation pain in patients referred for endodontic therapy in a Nigerian teaching Hospital. METHODS: Data collected included pulp vitality status, the presence or absence of pre-operative, inter-appointment and post-obturation pain. Pain was recorded as none, slight, or moderate/severe. Flare-ups were defined as either patient's report of pain not controlled with over the counter medication or as increasing swelling. The patients were recalled at three specific post-obturation periods, 1(st), 7(th )and 30(th )day. The presence or absence of pain, or the appropriate degree of pain was recorded for each recall visits and the interval between visits. The compiled data were analysed using chi-square where applicable. P level ≤ 0.05 was taken as significant. RESULTS: Ten endodontic flare-ups (8.1%) were recorded in the multiple visit group compared to 19 (18.3%) flare-ups for the single visit group, P = 0.02. For both single and multiple visit procedures, there were statistically significant correlations between pre-operative and post-obturation pain (P = 0.002 and P = 0.0004 respectively). Teeth with vital pulps reported the lowest frequency of post-obturation pain (48.8%), while those with nonvital pulps were found to have the highest frequency of post-obturation pain (50.3%), P = 0.9. CONCLUSION: The present study reported higher incidences of post-obturation pain and flare-ups following the single visit procedures. However, single visit endodontic therapy has been shown to be a safe and effective alternative to multiple visit treatment, especially in communities where patients default after the first appointment at which pain is relieved

Review of Classical Methods in Supersaturated Designs (SSD) for factor Screening

Supersaturated designs are fractional factorial designs that have too few runs to allow the estimation of the main effects of all the factors in the experiment. There has been a great deal of interest in the development of these designs for factor screening in recent years. A review of supersaturated design is presented, including criteria for design selection, with reference to the popular E(s2) criterion and classical methods for constructing supersaturated designs. Classical methods have been suggested for the analysis of data from supersaturated designs and these are critically reviewed and illustrated. Keywords: Supersaturated, Classical method, Screening, fractional factorial and E(S2

A BINOMIAL MODEL APPROXIMATION FOR MULTIPLE TESTING

Multiple testing is associated with simultaneous testing of many hypotheses, and frequently calls for adjusting level of significance in some way that the probability of observing at least one significant result due to chance remains below the desired significance levels. This study developed a Binomial Model Approximations (BMA) method as an alternative to addressing the multiplicity problem associated with testing more than one hypothesis at a time. The proposed method has demonstrated capacity for controlling Type I Error Rate as sample size increases when compared with the existing Bonferroni and False Discovery Rate (FDR).     &nbsp

Modelling tool for solving manufactoring system dysfunction in rubber seed oil based alkyd resin preparation

Variability in production output, low quality, wastes, and downtimes are serious production problems which manufacturers of alkyd resin product are facing and it invariably affect manufacturers’ economic performance and the nation economic growth which are often caused by differences in process temperatures and length of the resin. There is a strong incentive in controlling the end of the batch product property values so as to minimize the variability in product quality. This study seeks to investigate the relationship among variables capable of affecting the production process output of rubber seed oil based alkyd resin. A random survey of relevant literature was conducted to gather relevant information required that are capable of causing a dysfunction in the manufacturing process of rubber seed oil based alkyd resin for use in anti-corrosion paint application. The sensitivity and versatile applicability of opinion discrimination analysis as an off-line tool for dealing with these types of problems was apt. Our result showed that there is a strong relationship between temperature, catalyst, absence of catalyst, length of resin, acidic content, water resistance which can be manipulated to appreciably reduce product degradation and control process variability. Moreover, we showed that opinion discrimination analysis modelling tool can be used to determine the need to understand production process approach for alkyd resin. The study has ably demonstrated that opinion discrimination analytical modelling tool is very effective in fault diagnosis.Keywords: Opinion discrimination analysis, discriminative power, manufacturing system dysfunction, rubber seed oil, alkyd resi

A RISK ADJUSTED CAPITATION REGIME FOR COMMUNITY BASED SOCIAL HEALTH INSURANCE PROGRAMME

The general poor state of Nigeria’s healthcare services informed the need for the establishment of the National Health Insurance Scheme (NHIS). Health care providers reimbursing systems under the scheme include among others reimbursement method, capitation and fee-for-service with capitation specifically being used under Community Based Social Health Insurance Programme (CBSHIP). This study applies a risk adjustment model on managed care organizations with the goal of attaining a fair and adequate reimbursement. The risk-based reimbursements reflect cost differences attributable to the enrolees. Using enrolees data of 23,375 individuals, results show that a sum of N528, 546.52 ($1,679.26) will be saved by the scheme and cream-skimming of members by health status and plans due to morbidity risk will be neutralized

The Gamma-Rayleigh Distribution and Applications to Survival Data

Studies on probability distribution functions and their properties are needful as they are very important in modeling random phenomena. However, research has shown that some real life data can be modeled more adequately by distributions obtained as combination of two random variables with known probability distributions. This paper introduces the Gamma-Rayleigh distribution (GRD) as a new member of the Gamma-X family of generalized distributions. The Transformed-Transformer method is used to combine the Gamma and Rayleigh distributions. Various properties of the resulting twoparameter Gamma-Rayleigh distribution, including moments, moment generating function, survival function and hazard function are derived. Results of simulation study reveals that the distribution is unimodal, skewed and normal-type for some values of the shape parameter. The distribution is also found to relate with the Gamma, Rayleigh and Generalized-Gamma distributions. The method of maximum likelihood has been used to estimate the shape and scale parameters of the distribution. To illustrate its adequacy in modelling real life data the distribution is fitted to two survival data sets. The results show that the distribution produced fits that are competitive and compared better, in some cases, to the Gamma, Rayleigh, Weibull and Lognormal distributions.Keywords: Gamma-X family, Gamma-Rayleigh distribution, Maximum Likelihood estimators, Survival data

Conjugate Gradient Method Approach to Multi-Channel Queuing Theory

In this paper we examine the application of the classical conjugate gradient method to queue theory. The parameters of the symmetric definite positive linear operator of a quadratic cost functional were obtained from the various characteristic features of a multi-channel queue system. The outcome was tested with numerical values and a comparison was made for systems with two, three and four service points. The numerical computations were carried out in a Maple 14 environment. The results obtained validate previous work done with a single-channel syste