Economic analysis of medical malpractice claims and costs in Taiwan

Thesis (Ph.D.)--Boston UniversityThe number of medical malpractice claims has been increasing in recent years. However, because of the sensitiveness of information and no malpractice insurance coverage, no objective claims-based data has been released in Taiwan to estimate malpractice risk and its economic burden. In a university hospital of Taiwan, after forming a working group for solving malpractice claims in the past 6 years (2005-2010), we have collected 445 cases and examined the clinical, administrative, economic and legal information for these cases. First, after applying the Theory of Planned Behavior as our conceptual framework, we have performed several risk-adjustment models of associated factors on the odds of having legal action. Our main results are that the number of meetings between doctor and patient (OR= 2.478, p less than O.OOO1), along with other factors are significantly associated with the incidence of a malpractice claim developing into a legal action (c-statistics= 0.838). Second, using the amount of compensation as the outcome variable in all settled claims, we have constructed two-part models to describe the relationship between risk factors and outcome. The two-part models contain a logistic regression model as the first part to predict the frequency of paid claims (4.2 times more odds of having paid claims with every meeting between doctor and patient, OR= 4.235, p<0.001; c-statistics= 0.918) and an ordinary linear regression model as the second part to predict the amounts of these payments (every meeting between doctors and patient increasing the payment at 0.18 million NTD [R-square= 0.5521]). Our third study estimates nationwide malpractice costs for Taiwan based on our database, given limitations of extrapolating from a single hospital. We find that the estimated annual cost of medical malpractice for all of Taiwan's doctors is NTD 239.6 million (7.99 million USD) with a range from NTD 168.6 million to 404.3 million (5.62 million to 13.4 million USD). Such a low estimate may be caused by low lawsuit costs (42.7 million NTD, 1.42 million USD) and lower paid claims ratio for settled claims (21%). The results of the legal-economic analysis will contribute to forming a rational basis for policy debate for current malpractice reform in Taiwan

Building Intercultural Competence in the Lower Division Chinese Language Classroom: A Lesson Plan Analysis

This portfolio is a compilation of what the author has learned in the field of Chinese as a second language in the Master of Second Language Teaching program at Utah State University. There are three main sections in the portfolio. The first section contains the author’s teaching philosophy statement, with a focus on intercultural competence development and teacher-student rapport. The second section consists of a reflection on a classroom observation. The main paper presents how the author designed a lesson plan and implemented it, as well as her analysis and introspection on a video recording of the lesson. The portfolio ends with a statement of the author’s future goals and plans

Case Study of Altruistic Behavior and Relational Network with Business Value on Local Travel Agency

The present study based on a local travel agency in Tainan, investigation how does the altruistic behavior affected the relational network and created the business value. The case company’s CEO had voluntary participated in charity societies more than 20 years. The present study first showed how the case company’s CEO to build an emotional relational network through altruistic behavior. Second, how does the emotional relational network form mixed relational network based on the key features demonstrated by altruistic behavior. Finally, also showed how the mixed relational network is transfer into an instrumental relational network. The results showed that the altruistic behavior can help local travel agency develop and increase their business value via relational network. The key factors to maximize the business value are the professional knowledge and altruistic behavior

KINETIC PROPERTIES AND EMG ACTIVITY OF NORMAL AND OVER-SPEED PEDALING IN TRACK SPRINT CYCLISTS: A CASE STUDY

Track sprint cycling requires unique skills. We investigate the pedaling kinetics and muscle coordination of a male track sprinter (170cm, 65kg, peak power 1513W) to see if they differ from that of a non-sprinter, and if the subject’s own technique vary from normal riding to an under-load maximal cadence sprint. Two trials were collected using 3D motion capture technology. EMG signals of 8 leg muscles were recorded. Joint torque and power of each trial were calculated using a subject specific musculoskeletal model, with realistic pedal forces as input to our dynamic simulation. Flexion torque appears at the knee during its extension, different from the non-sprinters. Joint torque and power appears similar for both trials, but 6 of the 8 muscles showed differences in EMG patterns. These findings could potentially benefit the evolvement of training methods

The Effects of Green Energy Production on Farmland: A Case Study in Yunlin County, Taiwan

Taiwan enacted the Act of Renewable Energy in the year 2009 which promotes energy safety, green economy, and a sustainable environment, and with that the government envisages a contribution of photovoltaic energy of up to 20% by the year 2025. In this study we look into the motivation and background of this energy policy, plans for implementation and associated challenges, and its actual consequences for farmland use and farmers. In addition, we take a look into the implementation of mixed-use farmland in which agricultural activity and photovoltaic installations are planned to coexist in order to increase land value and productivity. We furthermore report on some of our findings related to a field survey conducted in Taiwan’s corn chamber of Yunlin County which has been facing a number of socioeconomic challenges

An Effective Mixture-Of-Experts Approach For Code-Switching Speech Recognition Leveraging Encoder Disentanglement

With the massive developments of end-to-end (E2E) neural networks, recent years have witnessed unprecedented breakthroughs in automatic speech recognition (ASR). However, the codeswitching phenomenon remains a major obstacle that hinders ASR from perfection, as the lack of labeled data and the variations between languages often lead to degradation of ASR performance. In this paper, we focus exclusively on improving the acoustic encoder of E2E ASR to tackle the challenge caused by the codeswitching phenomenon. Our main contributions are threefold: First, we introduce a novel disentanglement loss to enable the lower-layer of the encoder to capture inter-lingual acoustic information while mitigating linguistic confusion at the higher-layer of the encoder. Second, through comprehensive experiments, we verify that our proposed method outperforms the prior-art methods using pretrained dual-encoders, meanwhile having access only to the codeswitching corpus and consuming half of the parameterization. Third, the apparent differentiation of the encoders' output features also corroborates the complementarity between the disentanglement loss and the mixture-of-experts (MoE) architecture.Comment: ICASSP 202

Relationship of cash conversion cycle and PRGap with firm performance: an empirical study of Taiwanese companies

The study investigates how working capital management (WCM) impacts the profitability and operating performance of publicly traded companies in Republic of China, Taiwan. The authors use the quarterly data of 539 stocks listed on the Stock Exchange of Taiwan from 2008 to 2015, containing 17,248 observations. The study examines whether two WCM variables, namely, the cash conversion cycle (CCC), as well as the gap between days of payables outstanding and days of sales outstanding (PRGap) have any significant effects on firm profitability and operating performance. The findings demonstrate that there are significantly negative relationships between the CCC and performance indicators, whereas there are consistent positive relationships between PRGap and performance indicators. Keywords: working capital management, performance, cash conversion cycle, PRGap, Tobin’s Q. JEL Classification: G30, G31, G32, M1

The Physical Effects of Aromatherapy in Alleviating Work-Related Stress on Elementary School Teachers in Taiwan

People use aromatherapy to relieve the symptoms of physical and psychological stress. However, previous studies have not precisely clarified a scientific basis for the beneficial effects of aromatherapy. Therefore, the overall purpose of this study was to elucidate the beneficial effect of aromatherapy in relieving work-related stress. Twenty-nine elementary school teachers from Taiwan participated in this study. The experimental procedures comprised 2 phases. First, we verified the effect of aromatherapy by conducting 2 blind tests. We used natural bergamot essential oil extracted from plants and synthesized a chemical essential oil as the placebo to do the aromatherapy. Second, we analyzed the performance of the aromatherapy treatment on the teachers who had various workloads. We measured the teachers’ heart rate variability to evaluate their autonomic nervous system activity. The results show that only the natural bergamot essential oil had an effect and that the aromatherapy treatment relieved work-related stress of teachers with various workloads. However, the aromatherapy treatment had a weak effect on young teachers who had a heavy workload. Moreover, the aromatherapy treatment exhibited no effect on teachers who belong to the abnormal body mass index subgroup having a heavy workload

Pre-Emptive Treatment of Lidocaine Attenuates Neuropathic Pain and Reduces Pain-Related Biochemical Markers in the Rat Cuneate Nucleus in Median Nerve Chronic Constriction Injury Model

This study investigates the effects of lidocaine pre-emptive treatment on neuropathic pain behavior, injury discharges of nerves, neuropeptide Y (NPY) and c-Fos expression in the cuneate nucleus (CN) after median nerve chronic constriction injury (CCI). Behavior tests demonstrated that the pre-emptive lidocaine treatment dose dependently delayed and attenuated the development of mechanical allodynia within a 28-day period. Electrophysiological recording was used to examine the changes in injury discharges of the nerves. An increase in frequency of injury discharges was observed and peaked at postelectrical stimulation stage in the presaline group, which was suppressed by lidocaine pre-emptive treatment in a dose-dependent manner. Lidocaine pretreatment also reduced the number of injury-induced NPY-like immunoreactive (NPY-LI) fibers and c-Fos-LI neurons within the CN in a dose-dependent manner. Furthermore, the mean number of c-Fos-LI neurons in the CN was significantly correlated to the NPY reduction level and the sign of mechanical allodynia following CCI