长期护理需求评估体系建设研究——基于地方试点与德国实践

长期护理需求评估是长期护理保险筹资与给付的联结点,直接决定了保险给付,并对长期护理保险筹资有重要影响.当前我国试点地方在长期护理需求评估制度的设计上分歧较大,虽积累了差异化的经验与案例,但地区分割不利于社会公平与社会流动.应立足于长期护理保险的社会保险属性,结合社会实际与试点效果,适当借鉴德国经验,统筹设计长期护理需求评估体系,通过"法律+行政法规+部门规章"的规范形式,精准定位评估对象,明确独立的评估主体、科学设计评估指标与评估工具、严格规范评估程序等确保评估结果的科学、客观与公正,并根据评估结果进行分级分类给付,实现长期护理保险资源流向精准.     

参加医疗保险对农村居民健康的影响——基于CHARLS 2015数据的实证分析

基于CHARLS 2015数据,采用倾向得分匹配法实证分析参加医疗保险对农村居民健康的影响。研究发现:参加医疗保险对农村居民的日常活动能力和自评健康影响不显著,参加医疗保险对农村居民认知能力具有显著的正向影响。据此提出,应进一步提升社会医疗保险保障水平、扩大社会医疗保险保障范围、促进商业医疗保险有序发展、推进"三医"高效协同联动等,以充分发挥医疗保险的健康保障功能,从而进一步提升参加医疗保险对农村居民健康的正向影响。     

Factors associated with a positive childbirth experience in Brazilian women: A cross-sectional study

BackgroundHaving a positive childbirth experience is an increasingly valued outcome. Few studies evaluated the women’s satisfaction with childbirth through face-to-face interviews out of the health service environment. The objective of this study was to identify factors associated with a higher level of satisfaction with the childbirth experience among Brazilian women.MethodsThis cross-sectional study involved 287 women giving birth in two hospitals in southern Brazil. Women who gave birth to healthy newborns at term were randomly selected. Face-to-face interviews were conducted 31–37 days after delivery, at the mothers’ homes, using a structured questionnaire. Satisfaction with the childbirth experience was measured using a Likert-type scale ranging from very satisfied to very dissatisfied. Prevalence ratios (PR) were estimated using Poisson regression with robust variance.ResultsFollowing hierarchical multivariate analysis, the following factors remained associated with a higher level of satisfaction with the childbirth experience: being satisfied with antenatal care (PR = 1.30; 95% confidence interval [95%CI] = 1.06−1.59), understanding the information provided by health professionals during labor and delivery (PR = 1.40; 95%CI = 1.01−1.95), not having reported disrespect and abuse (PR = 1.53; 95%CI = 1.01−2.31), and having had the baby put to the breast within the first hour of life (PR = 1.63; 95%CI = 1.26−2.11). No association was observed with type of delivery or hospital status (public or private).ConclusionsA higher level of satisfaction with the childbirth experience is related to satisfactory antenatal care, a non-abusive, respectful, and informative environment during childbirth, and to the opportunity to breastfeed the baby within the first hour of life. In clinical practice, greater attention to these basic principles of care during pregnancy and delivery could provide more positive experiences during birth.     

科技保险的困境—一个制度供求非均衡分析

现阶段，我国步入了创新驱动引领升级的关键时期，科技创新受到了整个社会的空前重视。科技保险作为分散和转移科技风险的重要手段，可以为科技创新提供有力的风险保障。目前，我国科技保险工作已经进入全面推广阶段，虽然取得了一定的成效，但整体运行并不理想，科技企业参保率低，科技保险缺失严重。究其原因，主要在于制度供给不能适应科技企业对科技保险的需求，科技保险制度供求非均衡，在现行的科技保险制度下积聚着大量的潜在利润，而这些潜在利润既是科技保险制度非均衡的原因，又是科技保险制度创新的动力。     

城镇职工基本养老保险税预测研究——以浙江省为例

在当前经济形势下，逐步开征基本养老保险税是实现缓解各省养老保险基金缺口、减轻企业负担以及推进养老保险全国统筹三者协调发展的重要决策。本文以浙江省为例，基于2005-2016年的历史数据，对有关参数进行线性拟合分析并加以合理设定，对税率和养老金替代率分别按高中低和高低进行假设，形成六种方案进行测算。研究发现当养老金替代率为35%，税率为14%（方案五）时，基础养老金收支平衡比较稳定；进一步研究发现浙江省未来30年内养老保险社会统筹基金的平均税率为1256%，同时基本养老保险税率降低可为正在试点中的长期护理保险制度留出发展空间。进而本文对我国养老保险税制提出相应的配套政策建议。     

Flood Risk Perceptions and Insurance Choice: Do Decisions in the Floodplain Reflect Overoptimism?

In the presence of rare disasters, risk perceptions may not always align with actual risks. These perceptions can nevertheless influence an individual's willingness to mitigate risks through activities such as purchasing flood insurance. In a survey of Maryland floodplain residents, we find that stated risk perceptions predict voluntary flood insurance take‐up, while perceptions themselves varied widely among surveyed residents, owing in large part to differences in past flood experience. We use a formal test for overoptimism in risk perceptions and find that, on aggregate, floodplain residents are overly optimistic about flood risks.     

The Use of Telematics Devices to Improve Automobile Insurance Rates

Most automobile insurance databases contain a large number of policyholders with zero claims. This high frequency of zeros may reflect the fact that some insureds make little use of their vehicle, or that they do not wish to make a claim for small accidents in order to avoid an increase in their premium, but it might also be because of good driving. We analyze information on exposure to risk and driving habits using telematics data from a pay‐as‐you‐drive sample of insureds. We include distance traveled per year as part of an offset in a zero‐inflated Poisson model to predict the excess of zeros. We show the existence of a learning effect for large values of distance traveled, so that longer driving should result in higher premiums, but there should be a discount for drivers who accumulate longer distances over time due to the increased proportion of zero claims. We confirm that speed limit violations and driving in urban areas increase the expected number of accident claims. We discuss how telematics information can be used to design better insurance and to improve traffic safety.     

相互保险的风险识别及创新解决方案——基于TRIZ和TIF理论

相互保险是保险组织形态中非常重要的一种,但是由于信息不对称,相对于其他保险模式而言,同样存在着逆向选择和道德风险问题。传统的监管模式下,监管渗透不够,反制力不强,导致了相互保险无法彻底解决逆向选择和道德风险的治理困境。本文基于塔福域理论和TRIZ理论系统地分析了相互保险模式中存在的风险,并且提出了创新性的解决方案,即构建“保险域”。     

Childhood exposure to the Second World War and financial risk taking in adult life

Adverse childhood experiences might have long-lasting effects on decisions under uncertainty in adult life. Merging the European Survey on Health, Ageing and Retirement with data on conflict events during the Second World War, and relying on region-by-cohort variation in war exposure, we show that warfare exposure during childhood is associated with lower financial risk taking in later life. Individuals who experienced war episodes as children hold less – and are less likely to hold – stocks, but are more likely to hold life insurance, compared to non-exposed individuals. Effects are robust to the inclusion of potential mediating factors, and are tested for nonlinearity and heterogeneity. Moreover, we provide evidence of hedonic adaptation to war, as high and low intensity of war exposure have comparable long-term effects. We also document that war exposure in childhood increases sensitivity to financial uncertainty since exposed-to-war individuals are less likely to hold stocks after periods of high volatility. Finally, we shed light on the most likely mechanism in the relationship between war exposure and financial risk taking – i.e., enhanced sensitivity to uncertainty – and we show that preferences, and not beliefs, channel this relationship.     

社会保险制度中社会风险的产生、内涵及应对*

社会风险是社会保险制度存在的前提，没有社会风险，就不会有社会保险。从风险、风险社会及社会风险这些相关概念出发，全面阐述社会保险制度中社会风险的产生及其发展路径，发现社会保险制度上所应对的社会风险是一种中度危险的风险事故，有着自身特定的制度内涵。在此基础上，从作为技术途径的保险原则与社会保险权之权利规则的两个视角分析了社会保险制度对社会风险的应对原理、机制与优势。