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Many developed countries rely, to varying degrees, on competition among private health plans to obtain affordable and high-quality health insurance for their residents. Incorporating beneficiary-level competitive bidding into these healthcare systems can better align the incentives of these health plans, increase their willingness to enroll, and serve the sickest and most vulnerable patients while keeping costs manageable. We identify two digitally enabled program designs that allow private insurance plans to competitively bid to enroll individual beneficiaries. Compared with those used in existing entitlement programs, these designs always make a larger share of the beneficiary population profitable to enroll, thereby increasing willingness of the plans to enroll the most costly beneficiaries and improving access to care. On simulating the conditions of existing real-word healthcare entitlement programs, we found that these new designs actually tend to lower the tax burden in up to 83% of simulations. The research findings suggest that these new designs hold great promise in achieving the dual aim of improved access and lower costs. We believe that findings from this research can guide policymakers implement policies that will enroll more beneficiaries and cost the taxpayers less.

This paper discusses how the first person pronouns ‘I’ and ‘We’ and the two proper nouns ‘the Education Bureau [EDB]’ and ‘the Government’ were used strategically by government officials in an attempt to delineate the level of involvement and commitment of the officials themselves, the EDB and the Hong Kong Government in the course of implementing and fine-tuning the medium-of-instruction policy in Hong Kong’s secondary schools. The data comprises the speeches delivered at various formal educational occasions and the documents issued and distributed to various stakeholders of the secondary education in Hong Kong. The clauses having these pronouns and proper nouns as either the Agent or Beneficiary were identified and examined in order to find out: (1) the level of commitment of the officials/administrative entities with reference to the process types used; (2) the level of commitment of these officials/administrative entities with reference to the modality level chosen; (3) the power status of the officials/administrative entities; and (4) the specific role, if any, played by the officials/administrative entities. Systemic functional grammar was the framework being drawn upon in undertaking the analysis.

Purpose This study compared opioid prescription patterns among oral and maxillofacial surgeons (OMSs) treating Medicare beneficiaries in urban and rural settings, in an effort to identify avenues to further promote responsible opioid prescribing in a patient demographic vulnerable to opioid diversion. Methods This study used Medicare Provider Utilization and Payment Data from 2014 to 2018, focusing on providers labeled as an OMS. Rural-Urban Commuting Area Codes were used to categorize each OMS as urban or rural. Demographic variables included total number of OMSs, provider gender, beneficiaries per provider, beneficiaries age, and beneficiary hierarchal condition category (proxy for clinical complexity). Outcome variables included opioid prescribing rate, opioid claims per provider, opioid claims per beneficiary, and number of days’ supply of opioids per claim. Descriptive statistics, chi-squared tests, 2-tailed t-tests, and Wilcoxon rank-sum tests were used as appropriate. Results Across all years, the data consisted of mostly urban and male OMSs. The mean number of Medicare beneficiaries prescribed opioids per OMS varied widely, and the mean age of beneficiaries was 70.4 ± 4.4 and 69.9 ± 4.1 years for urban and rural OMSs, respectively. Mean opioid claims per provider were higher among rural OMSs, with large standard deviations among both rural and urban OMSs. However, there were no significant differences in the opioid prescribing rate or in the mean opioid claims per beneficiary in all 5 years included in the study. There were also no clinically significant differences between urban and rural OMSs in the number of days’ supply per claim (between 3 to 4 days in all periods). However, in each year, there was a significantly higher proportion of urban OMSs who prescribed more than 7 days’ supply per claim. Conclusions Opioid prescription practices were generally similar between rural and urban OMSs treating Medicare beneficiaires. The small subset of longer-term opioid prescribers, which were more prevalent in urban areas, warrants further investigation.

Purpose of study Accountable Care Organizations (ACOs) aiming to reduce healthcare expenditure adopt strategies targeting costly postacute service utilization, asking "why not home?" as a part of the hospital discharge planning paradigm. This study examined the impact of an interventional approach to implement evidence-based interventions to improve transitions of care to the least restrictive next site of care on the rate of skilled nursing facility (SNF) admissions per 1,000, SNF length of stay (LOS), and total SNF cost. Primary practice setting The impact of the interventional approach for an ACO-attributed Medicare population, analyzing Medicare Shared Savings Plan Part A and Part B beneficiary claims data, was examined. Methodology and sample A pre-/postintervention analysis was conducted, for dates of service 12 months pre- and postintervention for patients admitted to any hospital within the integrated health care system. The outcome variables were defined as SNF admission rate, SNF LOS, cost of care (total SNF cost, SNF cost per admission), and hospital LOS prior to SNF discharge. Results There was early evidence of the effectiveness of the multifaceted interventions that involved the delivery of interprofessional team member education focused on the tenets of value-based care and discharging patients to the least restrictive setting, as appropriate. In the normalized data review, it was noted that the rate of SNF discharges per 1,000 patients changed from 73 per 1,000 patients in the preintervention period to 70 per 1,000 patients in the postintervention period. The total SNF cost in the postintervention period only increased by 3%, with a difference of $616,014, despite the 10% increase in the total ACO-attributed patient population during the same period. Implications for case management practice The results of this study imply that a multifaceted intervention with aims to shift the transitional care planning paradigm toward discharging to the least restrictive next site of care is an effective strategy for ACOs with aspirations to improve the utilization and expenditure in the postacute setting. The analyses suggest that providing education to interprofessional team members that reinforces the tenets of value-based care and the importance of asking, "why not home?" for every hospitalized patient, and leveraging technology-based insights positively impact discharge rates to SNF and other ACO outcomes.

Aim The study aims to explore the current knowledge and skills of healthcare providers already trained by SIMESON (simulation for essential skills for obstetrical and neonatal care), in reviewing perinatal health situations including current status of healthcare facilities and cost estimation. Design It was an observational study. Methods Cost estimation following both quantitative and qualitative approaches was also attempted. Result Knowledge and skills of 88 healthcare providers about the provision of normal delivery and immediate postpartum care, management of postpartum haemorrhage (PPH), retained placenta and use of bag and mask ventilation to help a baby breathe were found to be considerably strengthened following SIMESON training. During the 6 months after training, there were 477 PPH cases managed successfully with only one death; neonatal deaths observed were 6.6/1,000 live births; twice the number of facility deliveries; and 80% use rate of Ambu bag for helping baby breathe. The estimated cost per trainee was 395.68 USD, and 5.85 USD per beneficiary.

Ministry of Industry assesses that the processing industry is still consistently contributing the most tothe achievement of export value national. There are manufacturing industry sectors that have achieved lowscores on the contribution of export value. Namely the apparel industry, wood industry, and industrialfurniture. There are obstacles and problems for the three industries to increase export value. The problem isthe low competitiveness of the three industries in exporting. This study aims to analyze and see thecondition of the competitiveness of the Small and Medium Creative Industry in the KI Jakarta basedon exports from the supply-side analysis. This research is qualitative research using interview and surveymethods. The samples of this research were Furniture / Furniture IKM, Batik IKM, and Handicraft IKMwhich succeeded in contributing the export contribution value to IKM. The results of this study indicate thatthe conditions of the three creative SMIs in Jakarta have different capabilities and strategies in contributing toexport value. Based on the results of the SWOT and SPACE matrix analysis, a special strategy is needed toincrease competitiveness. Among them, the right strategies are Furniture IKM and Handicraft IKM located inthe quadrant size “aggressive” which indicates that the Furniture IKM in DKI Jakarta is in a very goodposition in using its internal strength. Therefore, the strategies suitable for use by IKM Furniture in DKI Jakartainclude market penetration strategy, market development, product development, backward integration, forwardintegration, horizontal integration, or diversification. Meanwhile, IKM Batik is in the quadrant position“Conservative” which indicates that IKM Batik is in a low or weak competitive position and must improve thecompany's strategic position to have strong competitiveness.

BACKGROUND: The U.S. Preventive Services Task Force (USPSTF) modified breast cancer screening guidelines in November 2009. The impact has been studied among privately and Medicare insured populations, but not among universally insured women. MATERIALS AND METHODS: This study compared the proportion of TRICARE beneficiaries aged 40–64 receiving mammograms from fiscal years 2006 to 2015 using an interrupted time series analysis to determine the impact of the 2009 USPSTF guideline changes. Stratified analyses evaluated differences by age (ages 40–49, 50–64), race, care setting, beneficiary type, and military status. RESULTS: The proportion of women receiving mammograms increased from October 2005 through September 2009. A small, but significant decrease of 65–66 fewer women screened per 10,000 occurred in the first quarter of 2010 (October 1 to December 31) following the screening guideline update publication. The proportion screened then remained unchanged through 2015. Comparative analysis revealed no differences in impact between age groups, blacks and whites, or military dependents and active-duty/retirees. CONCLUSIONS: This study determined that the USPSTF guideline updates had a small, but immediate and lasting impact that was not different across age groups, beneficiary type, or race. No racial disparities in the proportion screened or in the impact of the guideline change were noted in our universally insured population.

Agricultural industries are facing a dual challenge of increasing production to meet the growing population with a disruptive changing climate and, at the same time, reducing its environmental impacts. Digital agriculture supported by big data technology has been regarded as a solution to address such challenges. However, realising the potential value promised by big data technology depends upon farm-level data generated by digital agriculture being aggregated at scale. Yet, there is limited understanding of farmers' willingness to contribute agricultural data for analysis and how that willingness could be affected by their perceived beneficiary of the aggregated data. The present study aimed to investigate farmers' perspective on who would benefit the most from the aggregated agricultural data, and their willingness to share their input and output farm data with a range of agricultural sector stakeholders (i.e. other farmers, industry and government statistical organisations, technology businesses, and research institutions). To do this, we conducted a computer-assisted telephone interview with 880 Australian farmers from broadacre agricultural sectors. The results show that only 34 % of participants regarded farmers as the primary beneficiary of aggregated agricultural data, followed by agribusiness (35 %) and government (21 %) as the main beneficiary. The participants’ willingness to share data was mostly positive. However, the level of willingness fluctuated depending on who was perceived as the primary beneficiary and with which stakeholder the data would be shared. While participants reported concerns over aggregated farm data being misused and privacy of own farm data, perception of farmers being the primary beneficiary led to the lowest levels of concerns. The findings highlight that, to seize the opportunities of sustainable agriculture through applying big data technologies, significant value propositions for farmers need to be created to provide a reason for farmers to share data, and a higher level of trust between farmers and stakeholders, especially technology and service providers, needs to be established.

OBJECTIVE: To estimate the impact of the Medicare Part D coverage gap reform under the Affordable Care Act (ACA) on the utilization of and expenditures for prescription drugs within the first five years of the policy's implementation. DATA SOURCES: 2008‐2015 Medicare Current Beneficiary Survey (MCBS). STUDY DESIGN: We used a difference‐in‐differences approach to estimate the year‐by‐year changes in prescription drug use and expenditures before (2006‐2010) and after (2011‐2015) the ACA’s Part D coverage gap reform between Part D beneficiaries not receiving the Low‐Income Subsidy (LIS) and those receiving the LIS. DATA COLLECTION: The study sample included Part D beneficiaries (a) aged 65 years or older; (b) not disabled or having end‐stage renal disease; (c) continuously enrolled in a Part D plan (d) having at least one prescription fill in a given year. Survey‐reported and administrative Part D events data in the MCBS were used for the analyses. PRINCIPAL FINDINGS: After the ACA reform, annual out‐of‐pocket drug spending significantly decreased by $88 (P

There is a huge parallel economy going on in the country, and that economy is financed and managed by alternative system of money exchange and remittance. This sector is largely undocumented and very little has been written on it. By some standard, this sector caters to more than 50% of overall foreign exchange business in the country, the proceeds of which largely goes out of the economy undocumented. Government of Pakistan recently taken measures to regularize this sector and state bank devised some bylaws and policy to document this sector. Establishment of exchange companies and abolition of money changers are the few steps that state bank have taken in this regards. Exchange companies are required to follow proper standards and auditing requirements and by virtue of this state bank is now be able to have more insight of how much money is coming and flown from this country and on accounts of which beneficiary. At the same time there is a need that people making our policies should better be aware of how this system works and who are involved, its by trades and what measure to adopt to canalized the proceeds into the documented economy and also identify various changes that could be made in our financial sector to better caters the needs of expatriates like this system does. This study is done to answer these and similar questions.

Background Patch testing is the best diagnostic test for allergic contact dermatitis. However, there is presently a lack of data on the test's geographic availability and the characteristics of the providers offering this test across the United States. Objective To evaluate the geographic variation in the availability of patch testing for the Medicare population and to characterize the temporal trends of patch testing cost, use, and provider specialty from 2012 to 2017. Methods Retrospective cohort study of the Medicare Provider Utilization and Payment Data from 2012 to 2017. Results As of 2017, patch testing was available in 20.3% of metropolitan counties and in 1.1% of nonmetropolitan counties. From 2012 to 2017 in metropolitan regions, the number of beneficiaries tested by dermatologists grew by an average annual growth rate of 1.84%, whereas those tested by allergists grew by an average annual growth rate of 20.31%. Most providers that averaged use of 80 or more patches per beneficiary were dermatologists (76.3%). Limitations Analysis was restricted to Medicare Part B claims; data were unavailable on individuals with commercial insurance. Conclusions Most of the increase in patch testing utilization from 2012 to 2017 has been in metropolitan regions. Although growth was especially prominent among allergists in metropolitan counties, the majority of providers performing comprehensive patch testing were dermatologists.

The Government of India created a historic act, by enacting the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), the largest employment generating programme in the world, ensuring the right to work in a country with a population of over one billion. This Act gives legal guarantee of at least one hundred days of wage employment in a financial year to a rural household, whose adult members volunteer to do unskilled and manual work. The present study was conducted in Dinara block of Rohtas district of Bihar. Ex post facto research design was followed for the analysis because the research is conducted after the occurrence of a particular incident. There are 61 villages in Dinara block, including the village of Dinara itself. Total number of 6 villages were selected through random sampling based on existence of MGNREGA Program. A total number of 60 beneficiaries and 60 non-beneficiaries of MGNREGA scheme were selected through random sampling for the present study. From the above analysis, it was concluded that 51.67 percent of the beneficiaries’ respondents is having high level of Attitude, whereas in non-beneficiaries 56.67 percent of the respondents is having medium level of Attitude. View Article DOI: 10.47856/ijaast.2021.v08i10.006

Supervision of the conservation of bat animals in ensuring the preservation of bat animals and economic stability for the beneficiary groups. The purpose of the service is to implement independent supervision of bat conservation. Conservation monitoring activities are carried out in the Bat Conservation area in Olibu Village, Paguyaman Pantai District, Boalemo Regency. The target group is the Bat Utilization Group and the community. Service activities are focused on increasing group and community understanding of supervisory understanding (1). Designing an independent conservation monitoring model focused on monitoring the fishing process and monitoring conservation areas (2). Monitoring line (3). The initial assessment illustrates that the group's understanding of the importance of supervision is still low at 9.95% before receiving material delivery. The final assessment illustrates that there is an increased understanding of knowledge about the self-monitoring model that will be applied in conservation areas by 82.93%. Supervision activities on the management of bat animal capture are comprehensive supervision, starting from the time the catching is carried out until the bats are marketed. Supervision during capture is needed in order to stabilize the protection and survival of captured bats, especially for animals that are not fit to be caught and traded. Supervision of Conservation Areas is the right step to take in preserving bat animals and economic stability for groups using bats, in addition to existing conservation areas, they can develop into tourist areas. There are 2 bat control lines and a conservation area, namely land and sea routes. The monitoring model for bat conservation independently can be realized by involving groups of users, the village community as the object of supervision over the activities of monitoring the capture management process and supervision of conservation areas, while the Olibu village government as a supervisory control through implementation.

CONTEXT: During the COVID-19 pandemic, demand for telehealth services increased to reduce disease exposure for patients and providers and to meet preexisting demand for physician services in health resource shortage areas. OBJECTIVE: To estimate self-reported telehealth availability, equipment for accessing telehealth, and telehealth usage among Medicare beneficiaries during the COVID-19 pandemic. DESIGN: We used data from the 2020 Medicare Current Beneficiary Survey (MCBS) COVID-19 Fall Supplement Public Use File to estimate the weighted percentages of beneficiaries who had (a) access to telehealth before or during COVID-19;(b) equipment for accessing telehealth;and (c) telehealth visits during COVID-19. We used logistic regression to examine sociodemographic factors associated with telehealth usage. PARTICIPANTS: Beneficiaries who participated in the MCBS COVID-19 Fall Supplements. RESULTS: During October and November 2020, telehealth appointments offered by providers were available to 63.8% (95% confidence interval [CI], 61.8-65.9) of Medicare beneficiaries who had accessed medical care by telephone or video. Among those, only 18.0% (95% CI, 16.1-19.9) had been offered telehealth before the pandemic. The majority of beneficiaries (92.2%;95% CI, 91.2-93.1) had 1 or more types of equipment available for accessing telehealth, but only 44.9% (95% CI, 43.0-46.9) had had a telehealth visit since July 1, 2020. Older adults, minorities, those with a lower income, and non-English speakers had less availability of telehealth equipment. Patient characteristics were significantly (P < .05) associated with telehealth use, including age, sex, race/ethnicity, and equipment availability. CONCLUSION: Telehealth availability for Medicare beneficiaries increased substantially during the COVID-19 pandemic. Even with the improvement in telehealth offerings and use hastened by the pandemic, gaps in access and use still exist. Effectiveness and implementation research can find ways to close gaps in telehealth services between vulnerable and underrepresented populations and counterparts.

Government-funded assistance program enrollment may play an important role in the overall increase of HIV testing among low-income U.S. adults. We pooled data from the 2016–2018 National Health Interview Survey and limited analyses to respondents aged 18 to 64 years with incomes less than 100% of the U.S. poverty threshold ( N = 9,497). The outcome of interest was ever testing for HIV. Prevalence ratios were used to assess the likelihood of ever testing for HIV and were adjusted for sociodemographic covariates including whether the respondent was a beneficiary of any government-funded assistance programs (e.g., Medicaid; job-placement/training/human services; or Temporary Assistance for Needy Families). After adjusting for significant sociodemographic covariates, government-funded assistance beneficiaries were significantly more likely to ever test for HIV (adjusted prevalence ratio = 1.3; 95% CI = [1.2, 1.4], p < .0001) than adults with incomes less than 100% of the U.S. poverty threshold who did not receive government assistance. Beneficiaries of government-funded assistance programs are more likely to test for HIV.

More than half of Indian population were engaged in agricultural sector but the available technology doesn’t ensure food security of the country. Hence, to diffuse new agricultural invention and innovation in the farming community, there arises a need for effective medium for transfer of technology. Thus, KVK bridges the gap between the technology generation and dissemination. The present study was proposed to understand the impact of KVK in doubling farmers income to formulate suitable programmes. For the study, descriptive research design was adopted. 120 respondents from Biswan taluk of Sitapur district of Uttar Pradesh were selected as respondents. Primary data collected from respondents and secondary data from available literatures. The findings revealed that majority of the respondents were middle aged, illiterate, upto 5 members in their family, medium level of annual income, possesses their own land, agriculture as their main occupation, medium level of mass media exposure, office bearer in one organization, high level of extension contact. Meanwhile, more than half of the respondents had reported medium level of impact towards the activities carried out by KVK, beneficiary selection is not unbiased is a major constraint suggested that maximum emphasis should be given on learning by doing. View Article DOI: 10.47856/ijaast.2021.v08i9.011

The Covid19 pandemic has made a huge impact on the ecommerce industry. The industry has experienced some benefits and problems during the pandemic. People tend to buy more items online as it can be more secure when it comes to the spread of disease. The repocommerce industry is having an increased sales growth. Many methods and techniques are being used by the e rts are saying that overall ecommerce industry to make Covid19 pandemic. This sup the negative impacts that happened to online business during the study is done to deeply analyse the problems and factors that are affecting the Online businesses and to know about the situations of ecommerce business in different parts of the world.The COVID-19 pandemic has had a significant impact on the Indian economy, which saw one of the largest lockdowns globally. The Indian internet economy, which was one of the most attractive markets worldwide, saw a 90% decline in April 2020, crippled by the shutdowns.1The decline was a result of steep falls in business for e-commerce and travel, the largest sectors in the internet ecosystem. However, the pandemic helped accelerate growth for segments such as hyperlocal delivery, edtech, healthtechand online payments as Indian consumers moved online to fulfil their daily needs. Despite a steep GMV fall in the initial months of the lockdown, India’s internet economy is likely to be a net beneficiary in longer run, driven by multi-fold increase in digital interactions and adoption of digital platforms. The number of first time online users has witnessed an increase across segments, along with an increase in online activity from tier 2 and tier 3 cities, which indicates a strong opportunity for enterprises and start-ups to cater to these cohorts digitally as the new normal. What is also expected to drive growth for digitally native start-ups is rising adoption by small and medium businesses in the country. Small merchants across cities are now adopting mobile channels, implementing online payments and exploring collaborations with technologydriven start-ups. Keywords: Ecommerce, Eshops, Covid19, Lockdowns, etc.

Objectives The objective of this study was to examine racial/ethnic differences in enrollment trends for supplemental insurance coverage among traditional Medicare (TM) and Medicare Advantage (MA) beneficiaries. Study design We employed a retrospective cohort study design using the 2010-2016 Medicare Current Beneficiary Survey. Methods We included two types of outcomes: 1) seven exclusive types of insurance coverage in a given year and 2) changes in insurance coverage in the next year for those with each of the seven exclusive types of insurance coverage. Our primary independent variable was race/ethnicity. We conducted regression while controlling for demographic, socioeconomic, and health characteristics. We calculated the adjusted value of the outcome by race/ethnicity after adjusting for demographic, socioeconomic, and health status characteristics. Results We found substantial racial/ethnic differences in supplemental insurance coverage among TM and MA beneficiaries. Compared to White beneficiaries, racial/ethnic minority beneficiaries had lower adjusted rates of enrollment in Medigap among TM beneficiaries and higher enrollment in Medicaid among both TM and MA beneficiaries. Trends in enrollment differed by supplemental insurance coverage, but an increasing trend in enrollment among MA beneficiaries without supplemental insurance coverage and MA beneficiaries with Medicaid was notable. Overall trends were consistent across all racial/ethnic groups. Finally, most beneficiaries were less likely to change insurance coverage in the next year, but a distinct phenomenon was observed among Black beneficiaries with the lowest rates of remaining in Medigap or MA only. Conclusions Our findings indicate the minority Medicare beneficiaries may not have equitable access to supplemental insurance coverage.

BackgroundKnowledge of one’s HIV status is the gateway to treatment and prevention, but remains low among young people. We investigated the early impact (2016–2017) of Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS), a multisectoral HIV prevention package, on knowledge of HIV status among adolescent girls and young women (AGYW).MethodsIn 2017, randomly selected AGYW were enrolled into surveys, N=1081 aged 15–22 years in Nairobi slum settlements, and N=2174 aged 13–22 years in rural KwaZulu-Natal. We estimated the causal effect of being a DREAMS beneficiary on knowledge of HIV status (those who self-reported as HIV-positive or tested HIV-negative in the past year), accounting for an AGYW’s propensity to be a DREAMS beneficiary.ResultsIn Nairobi, knowledge of HIV status was higher among DREAMS beneficiaries compared with non-beneficiaries (92% vs 69%, adjusted OR=8.7; 95% CI 5.8 to 12.9), with DREAMS predicted to increase the outcome by 28%, from 65% if none were a DREAMS beneficiary to 93% if all were beneficiaries. The increase attributable to DREAMS was larger among younger participants: 32% and 23% among those aged 15–17 and 18–22 years, respectively. In KwaZulu-Natal, knowledge of status was higher among DREAMS beneficiaries aged 13–17 years (37% vs 26% among non-beneficiaries), with a 9% difference due to DREAMS (95% CI 4.8% to 14.4%), and no evidence of effect among 18–22 years (−2.8%; 95% CI −11.1% to 5.7%).ConclusionDREAMS substantially increased knowledge of HIV status among AGYW in Nairobi, and among younger but not older AGYW in KwaZulu-Natal. Adolescent girls can be reached early (before age 18) with community-based HIV testing programmes in diverse high-prevalence settings, with a large impact on the proportion who know their HIV status.

BackgroundHealthcare fraud entails great financial and human losses; however, there is no consensus regarding its definition, nor is there an inventory of its manifestations and factors. The objective is to identify the definition, manifestations and factors that influence health insurance fraud (HIF).MethodsA scoping review on health insurance fraud published between 2006 and 2020 was conducted in ACM, EconPapers, PubMed, ScienceDirect, Scopus, Springer and WoS.ResultsSixty-seven studies were included, from which we identified 6 definitions, 22 manifestations (13 by the medical provider, 7 by the beneficiary and, 2 by the insurance company) and 47 factors (6 macroenvironmental, 15 mesoenvironmental, 20 microenvironmental, and 6 combined) associated with health insurance fraud. We recognized the elements of fraud and its dependence on the legal framework and health coverage. From this analysis, we propose the following definition: “Health insurance fraud is an act of deception or intentional misrepresentation to obtain illegal benefits concerning the coverage provided by a health insurance company”. Among the most relevant manifestations perpetuated by the provider are phantom billing, falsification of documents, and overutilization of services; the subscribers are identity fraud, misrepresentation of coverage and alteration of documents; and those perpetrated by the insurance company are false declarations of benefits and falsification of reimbursements. Of the 47 factors, 25 showed an experimental influence, including three in the macroenvironment: culture, regulations, and geography; five in the mesoenvironment: characteristics of provider, management policy, reputation, professional role and auditing; 12 in the microenvironment: sex, race, condition of insurance, language, treatments, chronic disease, future risk of disease, medications, morale, inequity, coinsurance, and the decisions of the claims-adjusters; and five combined factors: the relationships between beneficiary-provider, provider-insurance company, beneficiary-insurance company, managers and guānxi.ConclusionsThe multifactorial nature of HIF and the characteristics of its manifestations depend on its definition; Identifying the influence of the factors will support subsequent attempts to combat HIF.

Background The COVID-19 pandemic has changed health care systems and clinical workflows in many countries, including the United States. This public health crisis has accelerated the transformation of health care delivery through the use of telehealth. Due to the coronavirus' severity and pathogenicity, telehealth services are considered the best platforms to meet suddenly increased patient care demands, reduce the transformation of the virus, and protect patients and health care workers. However, many hospitals, clinicians, and patients are not ready to switch to virtual care completely. Objectives We designed six experiments to examine how people (as an actual beneficiary of telehealth) evaluate five telehealth encounters versus face-to-face visits. Methods We used an online survey to collect data from 751 individuals (patients) in the United States. Results Findings demonstrate that significant factors for evaluating five types of telehealth encounters are perceived convenience expected from telehealth encounters, perceived psychological risks associated with telehealth programs, and perceived attentive care services delivered by telehealth platforms. However, significant elements for comparing telehealth services with traditional face-to-face clinic visits are perceived cost-saving, perceived time-saving, perceived hygienic services, perceived technical errors, perceived information completeness, perceived communication barriers, perceived trust in medical care platforms' competency, and perceived privacy concerns. Conclusion Although the in-person visit was reported as the most preferred care practice, there was no significant difference between people's willingness to use face-to-face visits versus virtual care. Nevertheless, before the widespread rollout of telehealth platforms, health care systems need to determine and address the challenges of implementing virtual care to improve patient engagement in telehealth services. This study also provides practical implications for health care providers to deploy telehealth effectively during the pandemic and postpandemic phases.

La formación en emprendimiento requiere de usar la metodología correcta con las personas indicadas. En esa línea, el trabajo formativo con mujeres indígenas demanda respeto, comunicación y cercanía, los cuales se pueden transmitir de mejor forma implementando un proceso de mentoría para compartir experiencias y generar los resultados esperados. El objetivo del presente trabajo es revisar los resultados de un trabajo de mentoring con beneficiarias indígenas realizado en un año calendario en el marco del Programa Originarias de ONU Mujeres, para luego destacar los puntos fuertes, los aprendizajes y sistematizar un modelo base para replicar en próximas generaciones de participantes. Para lograr lo anterior, se revisará la bibliografía y lo que se propone para este tipo de trabajos, y se contrastará con los resultados obtenidos, en cuanto a métricas y experiencias generadas. Durante el 2020 se beneficiaron 36 mujeres con esta iniciativa, de las cuales el 33% logró levantar financiamiento no reembolsable para ejecutar sus planes y negocios. A destacar que los elementos fundamentales radican en la calidad del acompañamiento (de mentoras, mentores y servicios de apoyo), así como en la cercanía generada entre las partes. Finalmente, la propuesta plantea como elemento principal el trabajar con la beneficiaria en el centro del modelo para levantar constantemente necesidades o requerimientos, y complementar en un mismo nivel de importancia la cobertura de formación técnica con la pertinencia cultural, siendo el elemento que genera la propuesta de valor ante las usuarias.

Importance The Merit-based Incentive Payment System (MIPS), established as part of the Quality Payment Program, is a Medicare value-based payment program that evaluates clinicians' performance across 4 categories: quality, cost, promoting interoperability, and improvement activities. The cost category includes novel episode-based measures designed for targeted evaluation of the resource use of specific conditions. This report describes the development of episode-based cost measures and their role in the shift from volume-based to value-based purchasing. Objectives Episode-based cost measures focus on resource use related to the treatment of a specific condition or procedure. The measures exclude health care costs unrelated to the condition or procedure of focus. The episode-based cost measures provide a nuanced examination of resource use that can be used alongside quality metrics to identify opportunities to improve the value by capturing costs that are clinically related to the care being delivered within a given patient-clinician relationship of care delivered to patients. These measures were developed with the input of clinical committees composed of over 320 clinicians from 127 specialty societies and stakeholder organizations. The MIPS program currently evaluates clinician cost category performance based on 2 population-based cost measures (Medicare spending per beneficiary and total per capita costs) in addition to 18 episode-based cost measures. Additional episode-based cost measures are currently under development. Conclusions and Relevance The transition to value-based payment requires an accurate assessment of clinician effect on health care quality and cost. The use of episode-based cost measures to assess clinician influence on health care costs for high-priority conditions and procedures is an important step. The Centers for Medicare & Medicaid Services is introducing MIPS Value Pathways that will align episode-based cost measures with related quality measures to further incentivize the transition from fee-for-service to value-based care.

Enabled by the underpinnings of critical theory, this article discusses research methodology developed with the aim of empowering beneficiaries within Third Sector Organisations, through their participation in organisational evaluation processes. The discussion on methodology in this article occurs at three levels: conceptual, processual, and reflexive. The conceptual level explores ontological and epistemological assumptions that shape the critical approach. At the processual level, research methods are explored, drawing on case studies involving interviews with beneficiaries. In interviewing beneficiaries, Third Sector research becomes a means of representing this group. Finally, the reflexive level explores how findings from the processual level enable praxis through the development of approaches supporting beneficiaries’ participation in organisational evaluation processes. As such, Third Sector research can engage beneficiary participation, in order to promote more effective beneficiary participation organisationally.

Identifying the key determinants of vaccine uptake in the context of coronavirus disease 2019 (COVID-19) is critical to increasing vaccination rates, especially for Medicare beneficiaries. We examined how the source of COVID-19 information shapes perceptions of COVID-19 severity and the likelihood of COVID-19 vaccine uptake among Medicare beneficiaries. We included 6478 Medicare beneficiaries from the Fall 2020 Medicare Current Beneficiary Survey COVID-19 Supplement. Our dependent variables were perception of COVID-19 severity and the likelihood of getting a COVID-19 vaccine. Our key independent variable was the beneficiaries’ primary source of information about COVID-19 and included six mutually exclusive categories: traditional news sources, guidance from government officials, social media, other webpages/Internet, friends or family members, or health care providers. Compared to those relying on traditional news sources or guidance from governmental officials, those relying on other sources had lower perceptions of COVID-19 severity and lower likelihood of getting a COVID-19 vaccine. Those relying on social media had the lowest levels in all measures (65.5% for those who agreed that COVID-19 is more contagious than the flu, 62.1% for those who agreed that COVID-19 is more deadly than the flu, 87.8% for those who agreed that all should take COVID-19 precautions, and 43.3% for those who answered that they would get a COVID-19 vaccine). The likelihood of COVID-19 vaccine uptake was also low among those relying on health care providers (55.5%). These findings remained similar even after adjusting for perceptions of COVID-19 severity in the relationship between the source of COVID-19 information and the likelihood of COVID-19 vaccine uptake. The primary source of information that Medicare beneficiaries used to learn about COVID-19 may play a critical role in shaping perceptions of COVID-19 severity and attitudes toward getting a COVID-19 vaccine.

Despite high enthusiasm surrounding the rollout of the COVID-19 vaccine, some older adults continue to remain hesitant about its receipt. There is limited evidence on vaccine hesitancy among community-dwelling older adults. In this study, we examine the prevalence and predictors (particularly the role played by information sources) of vaccine hesitancy in this group. We use the Medicare Current Beneficiary Survey and employ multivariable logistic regression models to explore this. Relative to those relying on regular news, those depending on health care providers (HCPs), social media, other internet/webpages, and family/friends as the main information source on COVID-19 expressed higher negative vaccine intent. The high negative intent with HCPs as the main information source should be interpreted with caution. This could be reflective of the timing of the survey and changing attitude toward the vaccine among HCPs themselves.

Background China started to cover novel medicines for the treatment of major cancers, such as trastuzumab for breast cancer by the government health insurance programs since 2016. Limited data have been published on the use of cancer medications and little is known about how government health insurance coverage of novel anti-cancer medicines benefited patients in the real world. This study aimed to generate evidence to inform the health security authorities to optimize the government health insurance coverage of novel anti-cancer medicines as a more inclusive and equal policy, through which each of the needed patient can get access to the novel anti-cancer medicines regardless of the ability to pay. Methods The study targeted one of the government health insurance newly covered novel medicines for breast cancer and the breast cancer patients. The analyses were based on the data collected from one tertiary public hospital in Fujian province of China. We conducted interrupted time series analysis with a segmented regression model and multivariate analyses with a binary logistic regression model to analyze the impact of the government health insurance coverage on medicines utilization and the determinants of patient’s medication choice. Results The average proportion of patients who initiated medication with novel medicines increased from 37.4% before the government health insurance coverage to 69.2% afterwards. Such an increase was observed in all patient sub-groups. The monthly proportion of patients who initiated medication with novel medicines increased sharply by 18.3 % (95 %CI,10.4-34.0 %, p = 0.01) in September 2017, the afterwards trend continuously increased (95 %CI,1.03–3.60, p = 0.02). The critical determinants of patient's medication choice were mostly connected with the patient's health insurance benefits packages. Conclusions The government health insurance coverage of novel anti-breast-cancer medicines benefited the patients generally. The utilization of novel medicines such as trastuzumab continuously increased. The insurance coverage benefited well the patients in the high-risk age groups. However, rural patients, patients enrolled in the “resident program”, and patients from low-income residential areas and non-local patients benefited less from this policy. Improving the benefits package of the low-income patients and the “resident program” beneficiary would be of considerable significance for a more inclusive and equal health insurance coverage of novel anti-cancer medicines.

In this issue of The Journal of Rheumatology , Concha, et al 1 describe the effects of the implementation, in 2010, of a national, legally mandated universal access program (Explicit Health Guarantees [GES]) for guaranteed juvenile idiopathic arthritis (JIA) diagnosis and treatment in Chile. The GES program guarantees that evaluation by a specialist takes place less than 30 days after referral from primary care, and that treatment must start no later than 7 days after confirmation of diagnosis. The authors report that this program led to earlier access to a pediatric rheumatologist and earlier JIA diagnosis. Diagnostic delay and time to evaluation by a pediatric rheumatologist were significantly reduced. Prior to GES, patients were evaluated and diagnosed 15 months after onset of symptoms vs 9 months post-GES. They found increased rates of treatment with biologic medications as well as increased magnetic resonance imaging (MRI) scans performed (9 vs 71). JIA remission rates, defined by Wallace criteria,2 were found to be higher (29% vs 43%) and uveitis complications rates lower (45% vs 13%).1 The GES was implemented in Chile in 2005. A 2015 World Health Organization (WHO) report on the system demonstrated improved efficiency in the Chilean healthcare system.3 The plan prioritizes and guarantees a number of issues or health conditions considered to be priorities (e.g., cancer, congenital heart diseases, high blood pressure, premature labor) based on people’s needs. The target group with each health condition has the right of access, with a defined maximum time for the delivery of the service; the right to financial protection, which regulates the co-payment according to the type of health insurance that the beneficiary may have; and the right to quality, which means receiving health care that is guaranteed by a registered provider who is accredited according to the law. The … Address correspondence to Dr. M. Batthish, Division of Rheumatology, Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. Email: batthim{at}mcmaster.ca.

Background Pilot-testing is important in standards development because it facilitates agile navigation of the gap between needs for and use of standards in real-world settings and can reveal the practicalities of implementation. As the implementation and use of health data standards are usually more complicated than anticipated, the Office of the National Coordinator for Health Information Technology (ONC) routinely oversees and organizes relevant pilot projects. Objectives This article provides an in-depth look into a sample of ONC's standards-focused pilot projects to (1) inform readers of the complexities of developing, implementing, and advancing standards and (2) guide those seeking to evaluate new standards through pilot projects. Methods The ONC's approach to conducting pilot projects begins with identifying a clinical care need, research requirement, or policy outcome that is not well supported by existing standards through a landscape review. ONC then selects a testing approach based on the identified need and maturity of relevant standards. Next, ONC identifies use cases and sites to pilot-test the relevant standard. Once complete, ONC publishes a report that informs subsequent projects and standards development. Results Pilot projects presented here are organized into three categories related to their demonstrated focus and related approach: (1) improving standards for presenting and sharing clinical genetic data, (2) accelerating the development and implementation of new standards, and (3) facilitating clinical data reuse. Each project illustrates the pilot approach from inception to next steps, capturing the role of collaboration among standards development organizations, stakeholders, and end-users to ensure standards are practical and fit for purpose. Conclusion The ONC approach identifies implementation difficulties prior to broader adoption and use of standards, and provides insight into the steps needed to scale use of standards. The ONC's organization of pilot projects serves as a natural accelerator for building communities of practice, often providing a well-connected beneficiary of lessons learned.

Audit of budget programs in EU countries requires a detailed study of the audit procedure in order to minimize possible deviations and errors in the implementation of programs. The principal result of the audit of budget programs' indicators financed from EU funds is to verify the cost-effectiveness, efficiency and effectiveness of the use of budget resources. The purpose of the academic paper is to study the results of the audit of budget programs in EU countries in order to identify the causes and factors that influenced the violations and errors in the use of budget funds. The research methods are as follows: system and logical analysis; information synthesis method; systematization and generalization; comparison method; statistical analysis. Study contributes relevant information and processed data regarding to internal and external audit standards and mechanisms to improving their efficiency. Limitations of the study are possible unknown violations of the budget programs that result in inaccurate data analysis. Results. Conducting audit of the budget programs in the EU in accordance with international auditing standards complies with the generally accepted procedure for audit of using budget funds by beneficiaries. In 2019, as a result of the audit of budget programs by European Commission, it was found that 51 out of 130 transactions (39%) contained violations and errors. A significant number of errors have been found in programs that direct budget funds to research and innovation. It has been revealed that most of the errors were found in the budget program Horizon 2020, in connection with which the European Court of Auditors calls in question the eligibility of all costs declared by the beneficiary for the audit period. The main errors in reporting in other budget programs were reimbursements of travel expenses not related to the implemented EU budget program; the erroneous exchange rate used in the programs was not that provided by the rules of the program. The level of error in conducting audit of budget programs in 2019 has been 4.0%, which is a significant reserve for improving the efficiency and effectiveness of the audit.

The subject of our research is to investigate a study on the attitude of the students of higher education about the ‘Student Credit Card Scheme’ in West Bengal. The seven purposes for which we have studied are – 1. To know the attitude of the students of higher education about the ‘Student Credit Card Scheme’. 2. To know the attitude of the male students of higher education about the ‘Student Credit Card Scheme’. 3.To know the attitude of the female students of higher education about the ‘Student Credit Card Scheme’. 4. To know the attitude of the rural students of higher education about the ‘Student Credit Card Scheme’. 5. To know the attitude of the urban students of higher education about the ‘Student Credit Card Scheme’.6.To know the attitude of the poor family students of higher education about the ‘Student Credit Card Scheme’. 7. To know the attitude of the students belonged to rich family of higher education about the ‘Student Credit Card Scheme’. The quantitative research method has been used for the study. The results we obtained through the self- constructed attitude scale are–There is no significant difference in attitude towards ‘Student Credit Card Scheme’ between male and female students of higher education, there is no significant difference in attitude towards ‘Student Credit Card Scheme’ between rural and urban students of higher education and there is no significant difference in attitude towards ‘Student Credit Card Scheme’ between the students of poor and rich family in higher education. Most of the students think that the ‘Student Credit Card Scheme’ will be convenient for all students. Most of the students think that the parents are very happy with the launch of ‘Student Credit Card Scheme’. Most of the students think that the ‘Student Credit Card Scheme’ will increase students’ interest in higher education. Most of the students think that the ‘Student Credit Card Scheme’ will increase the rate of higher education for rural students. Most of the students think that the ‘Student Credit Card Scheme’ will remove the financial barriers for higher education of the students belonged to the poor families. Most of the students think that the ‘Student Credit Card Scheme' will increase the rate of students’ going to abroad for higher study. Most of the students think that after receiving higher education with the beneficiary of ‘Students Credit Card Scheme’, students may suffer in mental depression if they do not get any suitable job as per their qualifications.

The paper examined the incidence, depth and severity of food insecurity among farming household in Sokoto, Nigeria. Data was collected with aid of questionnaire from a total of 440 farming households comprising of (220 beneficiaries and 220 non-beneficiaries of BOA) were randomly selected using four multistage sampling techniques. The data generated was analysed using FGT index. The result for the incidences of food insecurity as indicated by head count ratio shows that 39.55% and 48.18% of food insecure farming households beneficiary and nonbeneficiary respectively were not able to meet their recommended daily allowance (RDAs) which is 2,250 kcal valued at N278.40/person equivalent to 0.87 USD. The coefficient of food insecurity depth (gap) shows that 19% of beneficiary and 44% of non-beneficiary food insecure farming households are below the recommended daily calorie requirement. The severity of food insecurity shows that 3.6% of beneficiaries’ food insecure farming households are most food insecure in the study area as compared with 19% non-beneficiaries’ food insecure farming households. High incidence, depth and severity of food insecurity among non-beneficiary food insecure farming households, indicated that BOA has impacted on beneficiary farming households by increasing their food security status. Therefore, this study recommends financial policies that ensure financial support to farming households most especially non-beneficiary in the study area.

Background: Kayakalp is an innovative initiatory started by the Health and Family Welfare Ministry through Swachh Bharat Abhiyan campaign on 15th May 2015. These instructions concentrate on advancement of desirable schemes for housekeeping facilities, pest control procedure, water sanitation, appointment & tutoring of manpower, advancement and accomplishment of appropriate cleansing procedure in terms of protocols / Standard Operating Procedures (SOPs), powerful management and inspection by the employees and inherent Machinery in the treaties linked with an organizational framework which places a bonus on excellent cleaning services and sanitary facilities. This study aims to describe the experiences and knowledge based on assessment of Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha District using this tool. Objectives: To assess and document hospital upkeep, Sanitation, Hygiene Practices, Hygiene Promotion and to study Handling of Biomedical Waste, Infection Control and Hospital Support Services. Methodology: This cross sectional hospital based study that will be conducted at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha District. Apart from observation of various practices and Processes, the participants to be interviewed will be Nursing staff in-charge in different wards along with Biomedical engineers, Administrative officers and beneficiary patients. For Quantitative data collection, a kayakalp checklist will be used. Data will be collected through observation, staff interview, record keeping, and patient interview forms as per Kayakalp Initiative Tool. Results: This study would help to understand current hospital sanitation procedures, hospital hygiene, infection prevention, general maintenance, waste management, and support services, etc. and will help to improve services based on findings of the study so as to improve satisfaction of population catered by hospital and provide an ideal working environment for all stakeholders. Conclusion: This work will assist in improving hospital/facility management and will aid in improvement of sanitation and hygiene practices, it will also improve overall satisfaction of all stakeholders after due implementation of changes suggested at the end of study.

To better understand engagement behaviors in online hospitality brand communities, the purpose of this research was to understand hotel customers’ online engagement behaviors, associated cocreated nontransactional values, and the underlying drivers. Netnography analysis and qualitative surveys along with multiorder categorization analysis were used. The netnography results indicate that hotel customer engagement behaviors cocreate five types of value. Importantly, these values accrue in different levels to not only the customer, but also to other customers and to the firm. Analyses of a subsequent qualitative survey data validated the four factors driving these engagement behaviors and, importantly, found that the motivational drivers vary by type of engagement. A conceptual framework of value cocreation via customer engagement is proposed.

Introduction Economic evidence on how much it may cost for vaccinators to reach populations is important to plan vaccination programs. Moreover, knowing the incremental costs to reach populations that have traditionally been undervaccinated, especially those hard-to-reach who are facing supply-side barriers to vaccination, is essential to expanding immunization coverage to these populations. Methods We conducted a systematic review to identify estimates of costs associated with getting vaccinators to all vaccination sites. We searched PubMed and the Immunization Delivery Cost Catalogue (IDCC) in 2019 for the following costs to vaccinators: (1) training costs; (2) labor costs, per diems, and incentives; (3) identification of vaccine beneficiary location; and (4) travel costs. We assessed if any of these costs were specific to populations that are hard-to-reach for vaccination, based on a framework for examining supply-side barriers to vaccination. Results We found 19 studies describing average vaccinator training costs at $0.67/person vaccinated or targeted (SD $0.94) and $0.10/dose delivered (SD $0.07). The average cost for vaccinator labor and incentive costs across 29 studies was $2.15/dose (SD $2.08). We identified 13 studies describing intervention costs for a vaccinator to know the location of a beneficiary, with an average cost of $19.69/person (SD $26.65), and six studies describing vaccinator travel costs, with an average cost of $0.07/dose (SD $0.03). Only eight of these studies described hard-to-reach populations for vaccination; two studies examined incremental costs per dose to reach hard-to-reach populations, which were 1.3–2 times higher than the regular costs. The incremental cost to train vaccinators was $0.02/dose, and incremental labor costs for targeting hard-to-reach populations were $0.16–$1.17/dose. Conclusion Additional comparative costing studies are needed to understand the potential differential costs for vaccinators reaching the vaccination sites that serve hard-to-reach populations. This will help immunization program planners and decision-makers better allocate resources to extend vaccination programs.

This study aimed to introduce the importance of implementing the e-government project in general and in Syria in particular, in addition to clarifying the economic impact on the implementation of this strategic project, and thus clarifying the necessity of the financing and directing this project. Accordingly, the study used the most important recent periodic government reports issued by the government regarding the implementation of this project. This paper relied on an analytical approach whereby the economic impact of e-government was analyzed in general, and then the same effect was studied on the Syrian side, and the study took into account the analysis of the return on the basis of value. The study showed that e-government initiatives improve labor productivity in the public sector, provide meaningful services, save costs, and achieve growth in GDP. Where the study confirmed that the application of e-government has a positive impact on the Syrian economy by studying the return, whether on the government as an implementing agency or on the citizen as a beneficiary. Syria is currently going through a transitional phase and economic progress and is striving for success. This requires re-engineering the infrastructure and managing all official bodies that deal with beneficiaries through the application of e-government in most of its institutions, and based on the results of this study, future analytical studies must be conducted. About statistical analysis to know the impact of implementing the e-government project inside the institutions on the beneficiary citizens and on the performance of employees. Accordingly, this study provides a methodology for analyzing the financial and economic benefits of projects within the e-government strategy, it can be said: This paper helps shed light on the goals of e-government and spread public awareness as a result of implementing this project and show its economic impact. Also, this study may serve the researchers as input for future research.

PurposeThe purpose of this study is to examine how employee competences can be developed through corporate volunteering (CV). Specifically, this study focuses on diversity of volunteering studies categorized according to the type of beneficiaries and intensity of volunteer contact with them. The study examines how the beneficiary-employee relation influences the development of employee competences in CV projects.Design/methodology/approachIn this qualitative empirical study, interview data collected in Poland about the perceived effects of CV projects on employee competences was used.FindingsThe findings suggest that to understand the competences generated in CV, attention needs to be paid to the nature of the volunteering study itself. The study proposes four different logics of competence development in CV, based on the type of the beneficiary and contact with them.Research limitations/implicationsThe study builds on managers’ perceptions of competence development. For a holistic understanding, future research should include employees’ perceptions of the process. Also, more research is needed regarding national and organizational settings as factors in competence development through CV.Practical implicationsThe study suggests how companies could best engage in volunteering programs and improve existing ones to make them more beneficial for all parties involved.Social implicationsThe findings build the better business case for CV and other corporate social responsibility (CSR) initiatives, i.e. they deliver rationales for business engagement in this regard.Originality/valueThe study contributes to the conceptual understanding of CSR activities by presenting four logics of competence development in CV.

The active usage of investment and financing mechanisms in sphere of construction of housing determines the necessity of involving the financial means of individuals and legal entities to such process and comes with risks for investors. At the same time the negative experience associated with frauds in sphere of construction of housing that caused a damage to the persons who had invested in housing within the territory of Ukraine and the intentions of lawmaker to establish the juridical mechanisms of financing of the construction that would neutralize or minimalize appropriate dangers determines the necessity to researched such juridical schemes in context of ensuring and protection of rights and interests of the participants of appropriate relationships. The author determines the advantages and disadvantages of the model of financing of construction of housing through building financing funds. It is defined that the obvious advantages of such model are: the professionalism of trustee; the usage of such ensuring and protective means for beneficiary’s (investor’s) rights and interests as hypothec, insurance of the developer’s risk of break the terms of obligations execution. The ensuring character also has the process of fixation of an investment object for beneficiary. At the same time the author states that it is difficult to justify the “encumbrance” of basic investment model by abovementioned ensuring and protective components. Even within basic investment model the beneficiary’s (investor’s) rights and interests could be ensured by hypothec of proprietary interests rights. Moreover the beneficiary (investor) can use insurance. The main advantage of the mechanism of financing of the construction through the building financing fund is the beneficiaries (investors) possibility to acquire with less organizational costs of a right of property on unfinished building in case when developer breaks his obligations. But at the same time the mechanism of financing of the construction through the fund rises the price of investment objects because of additional expenses. It is defined that despite of the provision of part three of the article 4 of the Law of Ukraine On investment Activity such provision does not neutralize a possibility to use alternative juridical schemes of the investment and financing of housing.

This research aims at how the Village Fund Direct Cash Unity program in the 2019 Corona Dessease Virus pandemic (Covid-19) In Tondegesan Village, Kawangkoan District, this research uses a qualitative approach method, and uses data techniques: observation, interviews and documentation, with data sources are : The Tondegesan Village Government and the Tondegesan Village Community, with the results of the research showing 1). The standards and targets that defined the criteria set did not qualify as BLT-DD recipients. 2) Characteristics of Implementers related to the nature and tendency of implementers in the distribution of BLT-DD to go through various stages carried out through village meetings 3) The communication between the village government and the community is due to the absence of socialization from the village government regarding the BLT-DD program. For request 1) Need to be implemented as much as possible with existing standards and the right target. 2) The village government must be more objective in determining the beneficiary families of BLT-DD according to the established criteria. 3) Communication is needed in creating a harmonious relationship.

The study aimed to investigate the drivers of demand for healthcare in South Africa 26 years after democracy. The pattern healthcare demand by households in South Africa is that most households use public healthcare services particularly public clinics compared to private and traditional healthcare facilities. Using conditional probability models, the logit model to be more specific, the results revealed that households head who is unemployed, households who do not have a business, households who were not receiving pension money, had a greater probability of demand for public healthcare institutions. On the other hand, being male, being White, Indian and Coloured, being a property owner and being not a grant beneficiary, reduces the probability of demand for public healthcare facilities in South Africa. As a result, the study recommends more investment in public healthcare but more in public clinics in South Africa due to the high percentage of households using these services. Also, the government must consider investing more in the maintenance and improvement of the welfare of nurses in the country considering the huge role they play in the delivery of healthcare to the citizens.

The paper reviews the procedure of waqf formation of Tahira-hanuma Tuzlić, widow of Gradaščević from Tuzla. Based on the presented contents, this endowment (waqf) did not pass without certain difficulties. Namely, Tahira-hanuma Tuzlić comes from a well-known bey Tuzla family, and on that basis she inherited significant land holdings and numerous other real estates. She was married to Bećir-bey Gradaščević and they had no children. At the age of over 60, she decided to endow a significant part of her property in an “evladijet waqf”. Since Esad ef. Kulović, the mayor of Sarajevo, was married to Tahira-hanuma Tuzlić's sister, Rashid hanuma, he was appointed as mutevelija (guardian) of the said waqf. It was planned to include in the endowment significant land holdings located in the cadastral municipalities: Pasci, Husino, Bistarac and Donja Tuzla, as well as several houses and shops in Donja Tuzla. Bakir-beg Tuzlić, the only male descendant of the prominent bey family Tuzlić at the time, opposed this endowment. When he found out about the endowment, Bakir-bey Tuzlić tried in every possible way to prevent the same. For these reasons, he addressed the Sharia Court in Tuzla, the Village District Office of Donja Tuzla, and later the Provincial Government for Bosnia and Herzegovina and the Joint Ministry in Vienna. In the above-mentioned petitions, Bakir-bey Tuzlić pointed out that he had learned from the Bazaar conversations that his aunt Tahira-hanuma Tuzlić had planned to endow most of the property she owned. In his explanations, he pointed out that she was doing it outside the law and domestic customs, all with the aim of preventing him, as the closest descendant of the respectable Tuzlić family, from reaching his inheritance. In addition, he stated that in the past few years, his aunt Tahira-hanuma Tuzlić has been behaving wastefully, giving away parts of her property without a valid reason. He especially pointed out the unjustified donation of a large property in the village of Dubravice in the Brčko district, as well as other property of Esad ef. Kulović, which Bakir-beg Tuzlić objected to, because he believed that Esad ef. Kulović has an obligation to Tahiri-hanuma, and not she to him, because thanks to Tahiri-hanuma Tuzlić, he married her sister Rashid hanuma and thus inherited significant property. In his petitions, Bakir-beg Tuzlić pointed out that Tahira-hanuma Tuzlić was a mother-in-law and that she was not capable of making valid decisions, which could put her in an unenviable position. In addition, he said that she was doing it in spite of him, so that he would not have the said property, as the only male heir. After the Sharia Court and the Village District Office in Donja Tuzla rejected Bakir-beg Tuzlić's requests, he addressed the Provincial Government for Bosnia and Herzegovina and the Joint Ministry of Finance in Vienna. But neither did they have an understanding for his pleas. Simultaneously with the requests of Bakir-beg Tuzlić, Tahira-hanuma Tuzlić addressed these same institutions, asking them for consent to endow the property in the “Evledijet waqf of Tahira-hanuma Tuzlić”. After the above-mentioned institutions determined that there were no obstacles to the endowment, the Provincial Government finally, on November 2, 1907, gave approval for the endowment of the said property. The process of endowment was confirmed at the Sharia Court in Tuzla by a waqfnama, which appointed the mutevelija “Evladijet vakuf Tahire-hanume Tuzlić”, and established the rules of its use for humanitarian, religious-educational and economic-social purposes. In this way, this waqf was given to the community for use, and it served its intended purpose for several decades, until the establishment of communist rule after World War II, when this waqf, like many others in Bosnia and Herzegovina, came under fire from numerous processes. This waqf is interesting for several reasons. It was one of the larger waqfs created in Austro-Hungarian times, and behind the said waqf stood a woman as a waqif. Therefore, we considered it important to give some important facts related to the procedure of endowment of the endowment, and to point out some important characteristics of the same.

Online users discuss and converse about all sorts of topics on social networks. Facebook, Twitter, Reddit are among many other networks where users can have this freedom of information sharing. The abundance of information shared over these networks makes them an attractive area for investigating all aspects of human behavior on information dissemination. Among the many interesting behaviors, controversiality within social cascades is of high interest to us. It is known that controversiality is bound to happen within online discussions. The online social network platform Reddit has the feature to tag comments as controversial if the users have mixed opinions about that comment. The difference between this study and previous attempts at understanding controversiality on social networks is that we do not investigate topics that are known to be controversial. On the contrary, we examine typical cascades with comments that the readers deemed to be controversial concerning the matter discussed. This work asks whether controversially initiated information cascades have distinctive characteristics than those not controversial in Reddit. We used data collected from Reddit consisting of around 17 million posts and their corresponding comments related to cybersecurity issues to answer these emerging questions. From the comparative analyses conducted, controversial content travels faster and further from its origin. Understanding this phenomenon would shed light on how users or organization might use it to their help in controlling and spreading a specific beneficiary message.

PurposeWe discuss the beneficiary accountability implications that arose due to the COVID-19 pandemic (and resultant social distancing restrictions) for a branch of a religious non-governmental organisation (NGO) based in mainland Spain, whose main beneficiaries are homeless individuals.Design/methodology/approachWe utilise a singular case method to observe accountability implications in the case organisation. We also utilise two sources of primary data: eight semi-structured interviews with volunteers of the NGO branch, supported by auto-ethnographic data recorded in forty-six diary entries throughout the period of research.FindingsAs the main mechanism for the discharge of beneficiary accountability for the case organisation is through action, this was affected greatly by the COVID-19 pandemic and social distancing measures. Beneficiary accountability (discharged through action) changed rapidly, resulting in neglect of previous beneficiaries, carrying profound implications for charitable actors, beneficiaries and the organisation.Research limitations/implicationsOur case focuses on that of a small organisation, and therefore the generalisability of findings will be somewhat limited and context specific. The number of interviews (eight) is also relatively small.Practical implicationsInsights can be drawn for the management of volunteers, alignment of personally held accountabilities of internal actors with those of organisations and emotional aspects of accountability for NGO managers and organisers.Originality/valueNGO accountability theorisation is enhanced via the use of Levinas' Judaic writings concerning the importance of the ritual practice of ethics for the individual involved in charitable action. The intertwined nature of personal accountability of volunteers and beneficiary accountability for the organisation is emphasised.

Breast cancer treatment includes increasingly complex and expensive treatments. Accordingly, the current estimates of the cost of breast cancer treatment are out of date. The SEER-Medicare Data Link provided 142,837,978 paid Medicare claims from 398,148 female beneficiaries between the ages of 22 and 110 diagnosed with breast cancer between 2007 and 2016. These claims were compared with 153,071,044 claims from 443,952 Medicare beneficiaries without a cancer diagnosis. The total, fully adjudicated, amounts for each claim were summed to determine total treatment cost for each beneficiary. These costs were then aggregated by year after diagnosis and stage at diagnosis. The actuarial survival of beneficiaries with cancer was calculated using the Kaplan–Meier method. Mean costs for the control group were $8,019 per year. The 10-year cost of cancer treatment in Medicare beneficiaries was directly related to stage at diagnosis and ranged from $103,573 for stage 0 cancers to $376,573 for stage 4 cancers. The highest cost occurred during the first 2 years after diagnosis, the time of the beneficiary’s initial treatment. Following the first 2 years, healthcare costs remained elevated for at least 10 years after diagnosis. The 10-year treatment cost of female Medicare beneficiaries with breast cancer increases with increasing stage at diagnosis. Any effective screening technology that reduces stage at diagnosis will result in significant treatment cost savings to the Medicare program.

Hearing loss is associated with higher health care spending and use, but little is known about the unmet health care needs of people with hearing loss or difficulty. Analysis of 2016 Medicare Current Beneficiary Survey data for beneficiaries ages sixty-five and older reveals that those who reported a lot of trouble hearing in the past year were 49 percent more likely than those who reported no trouble hearing to indicate not having a usual source of care. Compared with those who reported no trouble hearing, those who reported some trouble hearing were more likely to indicate not having obtained medical care in the past year when they thought it was needed, as well as not filling a prescription, with the risk for both behaviors being greater among those reporting a lot of trouble hearing versus a little. Interventions that improve access to hearing services and aid communication may help older Medicare beneficiaries meet their health care needs.

The development of ICT technologies in recent years has shown remarkable changes with the internet of things and smart gadgets. This presented an opportunity for indoor navigation to develop a system for indoor positioning systems, such as GPS, that can assist any beneficiary in navigating inside the building and locating themselves. This paper focuses on the educational sector, specifically in King Saud University's Common First Year. To fit the educational setting, a detailed study using various techniques was reviewed. Overall, a meta-analysis was completed that will aid in the implementation of the sensors nodes technique in the future as a prototype on Common First Year campuses.

The analysis of innovation contests and/or awards represents a promotion to the production of this topic in public administration. This research aimed at mapping the main antecedent innovation dimensions which are present in the initiatives awarded by the Innovation Contest in Public Administration. This is a qualitative and descriptive work based on documental research whose data characterization/classification was done according to the model by De Vries, Beckkers and Tummers (2016). A theme analysis was used with the support of the QSR NVivo® software. The results pointed that, from 2008 to 2016, innovation in the initiatives awarded happened predominantly in the federal domain and it is the process-type. The main dimensions that contributed to innovation in the public administration were: Social Participation (Environmental antecedent); Client/beneficiary and market knowledge, Strategic information management/Standardization of data and processes, Strategic planning and Transforming leadership/Managers’ pro-innovation attitudes (Organizational antecedents); Strategic intention to innovate and Project management (Innovation Characteristics antecedents); and Commitment (Individual antecedents). The managerial contribution of this research lies on the identification of the main antecedent dimensions, such as the good practices that contribute to innovation in the public administration, since they can control plans, programs and innovation policies, especially on subnational levels. The dimensions that were mapped could also favor the development of an innovation culture that has society satisfaction with public services as a result.

Innovation in the context of humanitarian supply chain (HSC) is essential to meet the varying needs of beneficiaries around the world. Humanitarian organizations themselves do not possess all the necessary resources for new product innovation. Hence, suppliers working with them play a vital role in helping them deliver innovative products and services to the beneficiaries. This study examines the phenomenon of supplier innovativeness in long-term humanitarian aid delivered by a non-governmental organization (NGO). It employs a single case study approach to investigate the antecedents and drivers of supplier innovativeness in an NGO-led HSC and proposes a novel framework for supplier innovativeness in the HSC context. The findings also underpin beneficiary satisfaction due to supplier innovativeness. Further, the implications of the results show that the new product developed through supplier innovativeness improved social, environmental, and economic dimensions of the beneficiaries. This study also highlights the social and managerial implications of supplier innovativeness and beneficiary satisfaction.

OBJECTIVES: Proponents of a single-payer or public option health care system often cite the lower administrative expenses in public Medicare compared with those in private Medicare, claiming that this difference represents efficiency. We check the validity of this comparison in terms of accuracy and definitions and suggest expanding its scope to include expanded financial data of the 2 Medicare systems. STUDY DESIGN: Using annual Medicare Boards of Trustees and National Health Expenditure Accounts data from CMS and health insurers' financial statement data, we compare the level and percentage of the administrative expenses of the Medicare systems and show incompatible and not reconcilable definitions of administrative expenses. We expand our analysis to income, benefits, gains and losses, and loss ratios of the programs. METHODS: Our methodology is a careful comparison of categories of expenses between public and private insurers using official data sources. The comparison is both qualitative and quantitative. RESULTS: We validate the low administrative expenses of Medicare parts A, B, and D (1.35% of benefits in 2018) compared with Medicare Part C (10.86% of benefits without loss adjustment expenses [LAE] and 14.84% with LAE for 2018). Expanding the focus, the income and benefits per beneficiary grew faster and larger in Medicare parts A, B, and D than in Medicare Part C-a reversal of earlier trends. The public Medicare program suffered losses in 11 years during 2002-2018, whereas private insurers' Medicare remained solvent with about an 85% loss ratio. CONCLUSIONS: Comparisons of the systems in the United States would benefit from expanding the focus beyond incomparable administrative expenses. For the current period of coronavirus disease 2019, if the trends continue, public Medicare may suffer greater deficits relative to the private Medicare Part C.