107 research outputs found
Capitation payments to competing Dutch sickness funds based on diagnostic information from prior hospitalizations
In many countries market-oriented health care reforms are high on the
political agenda. The purpose of these reforms is to make resource
allocation in health care more efficient, more innovative and more
responsive to the consumers' preferences. The Netherlands is no exception
in this respect. The Dutch health care reform shows close similarities with
the reforms in, for instance, Belgium (Kesenne, 1996), Germany (Graf von
der Schulenburg, 1994; Files and Murray, 1995), Switzerland (Beck and
Zweifel, 1996), Israel (Chinitz, 1994) and the U.S. (Newhouse, 1994). A
common element of these reforms is that the consumers may choose
among competing health insurers or health plans, which are largely
financed through premium-replacing capitation payments
Mandatory pooling as a supplement to risk-adjusted capitation payments in a competitive health insurance market
Risk-adjusted capitation: recent experiences in The Netherlands
The market-oriented health care reforms taking place in the Netherlands
show a clear resemblance to the proposals for managed competition in U.S.
health care. In both countries good risk adjustment mechanisms that
prevent cream skimming--that is, that prevent plans from selecting the
best health risks--are critical to the success of the reforms. In this
paper we present an overview of the Dutch reforms and of our research
concerning risk-adjusted capitation payments. Although we are optimistic
about the technical possibilities for solving the problem of cream
skimming, the implementation of good risk-adjusted capitation is a
long-term challenge
Risk adjustment and risk selection on the sickness fund insurance market in five European countries
From the mid-1990s citizens in Belgium, Germany, Israel, the Netherlands and Switzerland have a guaranteed periodic choice among risk-bearing sickness funds, who are responsible for purchasing their care or providing them with medical care. The rationale of this arrangement is to stimulate the sickness funds to improve efficiency in health care production and to respond to consumers' preferences. To achieve solidarity, all five countries have implemented a system of risk-adjusted premium subsidies (or risk equalization across risk groups), along with strict regulation of the consumers' direct premium contribution to their sickness fund. In this article we present a conceptual framework for understanding risk adjustment and comparing the systems in the five countries. We conclude that in the case of imperfect risk adjustment-as is the case in all five countries in the year 2001-the sickness funds have financial incentives for risk selection, which may threaten solidarity, efficiency, quality of care and consumer satisfaction. We expect that without substantial improvements in the risk adjustment formulae, risk selection will increase in all five countries. The issue is particularly serious in Germany and Switzerland. We strongly recommend therefore that policy makers in the five countries give top priority to the improvement of the system of risk adjustment. That would enhance solidarity, cost-control, efficiency and client satisfaction in a system of competing, risk-bearing sickness funds. [Authors]]]>
Health Care Reform ; Insurance Selection Bias ; Managed Competition ; National Health Programs ; Risk Adjustment
eng
oai:serval.unil.ch:BIB_C1056E4EB1E1
2022-05-07T01:26:22Z
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https://serval.unil.ch/notice/serval:BIB_C1056E4EB1E1
Accurate Estimation of Running Temporal Parameters Using Foot-Worn Inertial Sensors
info:doi:10.3389/fphys.2018.00610
info:eu-repo/semantics/altIdentifier/doi/10.3389/fphys.2018.00610
info:eu-repo/semantics/altIdentifier/pmid/29946263
Falbriard, M.
Meyer, F.
Mariani, B.
Millet, G.P.
Aminian, K.
info:eu-repo/semantics/article
article
2018
Frontiers in physiology, vol. 9, pp. NA
info:eu-repo/semantics/altIdentifier/pissn/1664-042X
urn:issn:1664-042X
<![CDATA[The aim of this study was to assess the performance of different kinematic features measured by foot-worn inertial sensors for detecting running gait temporal events (e.g., initial contact, terminal contact) in order to estimate inner-stride phases duration (e.g., contact time, flight time, swing time, step time). Forty-one healthy adults ran multiple trials on an instrumented treadmill while wearing one inertial measurement unit on the dorsum of each foot. Different algorithms for the detection of initial contact and terminal contact were proposed, evaluated and compared with a reference-threshold on the vertical ground reaction force. The minimum of the pitch angular velocity within the first and second half of a mid-swing to mid-swing cycle were identified as the most precise features for initial and terminal contact detection with an inter-trial median ± IQR precision of 2 ± 1 ms and 4 ± 2 ms respectively. Using these initial and terminal contact features, this study showed that the ground contact time, flight time, step and swing time can be estimated with an inter-trial median ± IQR bias less than 12 ± 10 ms and the a precision less than 4 ± 3 ms. Finally, this study showed that the running speed can significantly affect the biases of the estimations, suggesting that a speed-dependent correction should be applied to improve the system's accuracy
Health-based risk adjustments: is inpatient and outpatient diagnostic information sufficient?
De voorspelkracht van het diagnose kosten groepen-model: een evaluatie gebruikmakend van een gezondheidsenquête
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