Does COVID-2019 have an Impact on the Purchase Intention of Commercial Long-Term Care Insurance among the Elderly in China?

A scoping review of the impact of ageing on individual consumers' insurance purchase intentions

Recently, the phenomenon of population ageing and its impact on the insurance industry has garnered increasing global attention. However, a notable gap in scholarly research persists in understanding the nuanced effects of ageing on consumer behaviour and insurance purchase intentions. This study maps the current academic evidence on how ageing influences individual consumers' insurance decisions. Using a scoping review methodology aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews and Joanna Briggs Institute guidelines, 44 articles out of 1082 from four databases-Web of Science, Scopus, ScienceDirect, and Emerald Insight-are reviewed. The results reveal a rising interest in this research area, with China emerging as a significant contributor. The focus is predominantly on Theory of Planned Behavior, quantitative methods, questionnaire survey, regression analysis, older population, and general health insurance. Variables capturing the impact of ageing, beyond demographic information, include family-related, risk-related, and expectation-related factors. This study highlights the current state of research on ageing's effect on insurance purchase intentions and offers valuable insights and directions for future research.

Can major public health emergencies increase the participation of commercial insurance? Evidence from China

Background

Public health emergencies have a lasting impact on a country's economic and social development. However, commercial insurance can disperse these negative consequences and reduce risk losses.

Method

Based on the Chinese Household Tracking Survey and Peking University Digital Inclusive Finance Index, this study employed a difference-in-differences model to test the impact of the COVID-19 outbreak on commercial insurance participation and the impact mechanism.

Results

The analysis showed that the outbreak of COVID-19 improved residents' risk perception, risk preference and digital finance and promoted their participation in commercial insurance, commercial endowment insurance, and commercial medical insurance.

Conclusion

Major public health emergencies can increase commercial insurance participation, but the promotional effect of commercial insurance on rural and low-income individuals is relatively limited. To tap into potential customers, financial institutions should focus on vulnerable societal groups. This study supplements the relevant literature on the impact of major public health emergencies on commercial insurance participation.

Psychological Distress of International Students during the COVID-19 Pandemic in China: Multidimensional Effects of External Environment, Individuals' Behavior, and Their Values

The COVID-19 epidemic has had a significant impact on society. In particular, it has had a strong impact on college students, including international students. Through an online questionnaire survey, it is found that the psychological distress experienced by international students is the result of a combination of the external environment (including the lockdown measures, social distancing, and social support) and internal factors such as values and behavior. The analysis shows that the new teaching mode and the corresponding changes in learning behavior are significantly associated with the psychological distress brought about by the COVID-19 epidemic. In addition, the influence of international students' values also plays a significant role in their psychological distress. Collective values are conducive to the alleviation of psychological distress, while individual values have the opposite effect. At the same time, the study also reveals that if there is sufficient social support, isolation (due to lockdown or social distancing early or later on) is not necessarily directly related to psychological distress. However, only formal social support can effectively alleviate psychological distress, while informal social support does not play a similar role. These conclusions have certain policy significance for the prevention of and response to epidemics in other countries.

Differences in mortality of cancer patients with COVID-19 in a Brazilian cancer center

INTRODUCTION

To analyze COVID-19 mortality in cancer patients and associated factors such as age, sex, type of insurance, situation at COVID-19 diagnosis, and cancer histology during the pandemic at a cancer center in Brazil.

METHODS

Cross-sectional study carried out from April 02, 2020 to August 31, 2020 at A.C. Camargo Cancer Center (ACCCC), in São Paulo, Brazil. Cases were extracted from the Hospital Cancer Registry. COVID-19 lethality rates by histology were calculated; multiple logistic regression was used to identify factors associated with COVID-19 mortality. The log-rank test was applied to compare the survival curves for each variable.

RESULTS

Of the 411 patients analyzed, 51 (12.4%) died due to COVID-19. Death occurred at an average age of 63 years. The fatality rate was higher for lung (0.333) and hematological (0.213) cancers and was associated with age over 60 years. The greatest chances of death from COVID-19 were in cases of lung (odds ratio, OR, 4.05, 95% confidence interval, CI 1.33-12.34) and hematological (OR 2.17, 95% CI 0.96-4.90) cancers, and in patients currently undergoing cancer treatment (OR 2.77, 95% CI 1.25-6.13). There were no statistical differences in survival by sex, age group, type of insurance, situation at the diagnosis of COVID-19, and histology of cancer for COVID-19.

CONCLUSIONS

Mortality due to COVID-19 in cancer patients is heterogeneous. These findings reinforce the need for individualized strategies for the management of different types of cancer that reduce the risk of death from COVID-19.

The effect of trade openness on the relationship between agricultural technology inputs and carbon emissions: evidence from a panel threshold model

The development of low-carbon agriculture systems has been a global consensus to reduce carbon emissions in the agricultural sector for addressing climate change challenges. This fact brings the need to study the agricultural carbon emissions (ACEs). Studies focusing on calculating the spatiotemporal changes of ACEs and analyzing the main factors for ACE changes have been conducted. The agricultural technology inputs (ATIs) as an important factor to influence ACEs have been identified. The traditional linear model was the commonly used method to study the relationship between ATIs and ACEs, whereas the impact of ATIs on ACEs in different areas might be complex and nonlinear due to the differences in trade openness causing different development levels of agricultural technologies. Therefore, this study aims to investigate the effect of trade openness on the relationship between ATIs and ACEs using a panel threshold model and put forward policy implications for the low-carbon agriculture development. The analysis was based on data from a panel of 31 provinces of China during 2003-2018. The results show that ATIs and ACEs increased from 2003 to 2018 and the spatial distribution of ATIs was similar to that of ACEs. The ATIs had a positive effect on ACEs with a significant single-threshold effect from trade openness. When the trade openness was below the threshold (0.1425), the positive effect of ATIs on ACEs was significant (coefficient, 0.117), whereas, when the trade openness was above the threshold (0.1425), the positive effect of ATIs on ACEs significantly decreased (coefficient, 0.062). Furthermore, industrial structure and agricultural economic development were the positive drivers of ACEs, while trade openness, education level of rural workers, R&D funding, and natural disasters had negative relationships with ACEs. The results provide valuable references for understanding ACE drivers and developing low-carbon agriculture with the consideration of ATIs and trade openness.

Direct and indirect neurological, cognitive, and behavioral effects of COVID-19 on the healthy elderly, mild-cognitive-impairment, and Alzheimer's disease populations

Introduction

Healthy elderly, mild cognitive impairment and Alzheimer’s disease populations have been among the most affected in the early stages of the COVID-19 pandemic due to the direct effects of the virus, and numerous indirect effects now emerge and will have to be carefully assessed over time.

Methods

This article reviews the main articles that have been published so far about the direct and indirect effects of the COVID-19 pandemic on these particularly fragile populations.

Results

The pandemic associated to COVID-19 has shifted most of the health resources to the emergency area and has consequently left the three main medical areas dealing with the elderly population (oncology, time-dependent diseases and degenerative disease) temporarily “uncovered”. In the phase following the emergency, it will be crucial to guarantee to each area the economic and organizational resources to quickly return to the level of support of the prepandemic state.

Conclusions

The emergency phase represented a significant occasion of discussion on the possibilities of telemedicine which will inevitably become increasingly important, but all the limits of its use in the elderly population have to be considered. In the post-lockdown recovery phase, alongside the classic medical evaluation, the psychological evaluation must become even more important for doctors caring about people with cognitive decline as well as with their caregivers.

Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge

Background

The growing demand for LTC (Long-term care) services for disabled elderly has become a daunting task for countries worldwide, especially China, where population aging is particularly severe. According to CSY (China Statistical Yearbook,2019), the elderly aged 65 or above has reached 167 million in 2018, and the number of disabled elderly is as high as 54%. Germany and other countries have alleviated the crisis by promoting the public LTCI (Long-Term Care Insurance) system since the 1990s, while China’s public LTCI system formal pilot only started in 2016. Therefore, the development of the public LTCI system has gradually become a hot topic for scholars in various countries, including China.

Methods

This review has been systematically sorted the existing related literature to discuss the development of public LTCI (Long-Term Care Insurance)system form four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, challenge of public LTCI, and the relationship between public LTCI and private LTCI. We searched some databases including Web of Science Core Collection, Medline, SCOPUS, EBSCO, EMBASE, ProQuest and PubMed from January 2008 to September 2020. The quality of 38 quantitative and 21 qualitative articles was evaluated using the CASP(Critical Appraisal Skills Programme) critical evaluation checklist.

Results

The review systematically examines the development of public LTCI system from four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, the challenge of public LTCI, and the relationship between public LTCI and private LTCI. For example, LTCI has a positive effect on the health and life quality of the disabled elderly. However, the role of LTCI in alleviating the financial burden on families with the disabled elderly may be limited.

Conclusion

Some policy implications on the future development of China’s LTCI system can be obtained. For example, the government should fully consider the constraints such as price rise, the elderly disability rate, and the substantial economic burden. It also can strengthen the effective combination of public LTCI and private LTCI. It does not only help to expand the space for its theoretical research but also to learn the experiences in the practice of the LTCI system in various countries around the world. It will significantly help the smooth development and further promote the in-depth reform of the LTCI system in China.

Cost-Effectiveness Analysis of Spending on Research and Development to Address the Needs for Innovative Therapeutic Products in Indonesia

Background

The annual gross domestic expenditure on research and development (GERD) per capita of Indonesia ($24) remains relatively lower than the annual GERD per capita of neighboring countries, such as Vietnam ($36), Singapore ($1804), Malaysia ($361), and Thailand ($111).

Objective

The aim of this study was to conduct a cost-effectiveness analysis of spending on healthcare R&D to address the needs of developing innovative therapeutic products in Indonesia.

Methods

A decision tree model was developed by taking into account four stages of R&D: stage 1 from raw concept to feasibility, stage 2 from feasibility to development, stage 3 from development to early commercialization, and stage 4 from early to full commercialization. Considering a 3-year time horizon, a stage-dependent success rate was applied and analyses were conducted from a business perspective. Two scenarios were compared by assuming the government of Indonesia would increase GERD in health and medical sciences up to 2- and 3-times higher than the baseline (current situation) for the first and second scenario, respectively. Cost per number of innovative products in health and medical sciences was considered as the incremental cost-effectiveness ratio (ICER). Univariate sensitivity analysis was conducted to investigate the effects of different input parameters on the ICER.

Results

There was a statistically significant association (P-value<0.05) between countries’ GERD in medical and health sciences with the number of innovative products. We estimated the ICER would be $8.50 million and $2.04 million per innovative product for the first and second scenario, respectively. The sensitivity analysis showed that the success rates in all stages and total GERD were the most influential parameters impacting the ICER.

Conclusion

The result showed that there was an association between GERD in medical and health sciences with the number of innovative products. In addition, the second scenario would be more cost-effective than the first scenario.

Cancer inpatients with COVID-19: A report from the Brazilian National Cancer Institute

Objective

This study aimed to describe the demographic and clinical characteristics of cancer inpatients with COVID-19 exploring clinical outcomes.

Methods

A retrospective search in the electronic medical records of cancer inpatients admitted to the Brazilian National Cancer Institute from April 30, 2020 to May 26, 2020 granted identification of 181 patients with COVID-19 confirmed by RT-PCR.

Results

The mean age was 55.3 years (SD ± 21.1). Comorbidities were present in 110 (60.8%) cases. The most prevalent solid tumors were breast (40 [22.1%]), gastrointestinal (24 [13.3%]), and gynecological (22 [12.2%]). Among hematological malignancies, lymphoma (20 [11%]) and leukemia (10 [5.5%]) predominated. Metastatic disease accounted for 90 (49.7%) cases. In total, 63 (34.8%) had recently received cytotoxic chemotherapy. The most common complications were respiratory failure (70 [38.7%]), septic shock (40 [22.1%]) and acute kidney injury (33 [18.2%]). A total of 60 (33.1%) patients died due to COVID-19 complications. For solid tumors, the COVID-19-specific mortality rate was 37.7% (52 out of 138 patients) and for hematological malignancies, 23.5% (8 out of 34). According to the univariate analysis COVID-19-specific mortality was significantly associated with age over 75 years (P = .002), metastatic cancer (p <0.001), two or more sites of metastases (P < .001), the presence of lung (P < .001) or bone metastases (P = .001), non-curative treatment or best supportive care intent (P < .001), higher C-reactive protein levels (P = .002), admission due to COVID-19 (P = .009), and antibiotics use (P = .02). After multivariate analysis, cases with admission due to symptoms of COVID-19 (P = .027) and with two or more metastatic sites (P < .001) showed a higher risk of COVID-19-specific death.

Conclusion

This is the first Brazilian cohort of cancer patients with COVID-19. The rates of complications and COVID-19-specific death were significantly high.

Applying the WHO ICF Framework to the Outcome Measures Used in the Evaluation of Long-Term Clinical Outcomes in Coronavirus Outbreaks

(1) Objective: The World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) classification is a unified framework for the description of health and health-related states. This study aimed to use the ICF framework to classify outcome measures used in follow-up studies of coronavirus outbreaks and make recommendations for future studies. (2) Methods: EMBASE, MEDLINE, CINAHL and PsycINFO were systematically searched for original studies assessing clinical outcomes in adult survivors of severe acute respiratory distress syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease-19 (COVID-19) after hospital discharge. Individual items of the identified outcome measures were linked to ICF second-level and third-level categories using ICF linking rules and categorized according to an ICF component. (3) Results: In total, 33 outcome measures were identified from 36 studies. Commonly used (a) ICF body function measures were Pulmonary Function Tests (PFT), Impact of event scale (IES-R) and Hospital Anxiety and Depression Scale (HADS); (b) ICF activity was 6-Minute Walking Distance (6MWD); (c) ICF participation measures included Short Form-36 (SF-36) and St George’s Respiratory Questionnaire (SGRQ). ICF environmental factors and personal factors were rarely measured. (4) Conclusions: We recommend future COVID-19 follow-up studies to use the ICF framework to select a combination of outcome measures that capture all the components for a better understanding of the impact on survivors and planning interventions to maximize functional return.

Effect Evaluation of the Long-Term Care Insurance (LTCI) System on the Health Care of the Elderly: A Review

Background

How to cope with the rapid growth of LTC (long-term care) needs for the old people without activities of daily living (ADL), which is also a serious hazard caused by public health emergencies such as COVID-2019 and SARS (2003), has become an urgent task in China, Germany, Japan, and other aging countries. As a response, the LTCI (long-term care insurance) system has been executed among European countries and piloted in 15 cities of China in 2016. Subsequently, the influence and dilemma of LTCI system have become a hot academic topic in the past 20 years.

Methods

The review was carried out to reveal the effects of the LTCI system on different economic entities by reviewing relevant literature published from January 2008 to September 2019. The quality of 25 quantitative and 24 qualitative articles was evaluated using the JBI and CASP critical evaluation checklist, respectively.

Results

The review systematically examines the effects of the LTCI system on different microeconomic entities such as caretakers or their families and macroeconomic entities such as government spending. The results show that the LTCI system has a great impact on social welfare. For example, LTCI has a positive effect on the health and life quality of the disabled elderly. However, the role of LTCI in alleviating the financial burden on families with the disabled elderly may be limited.

Conclusion

Implementation of LTCI system not only in reducing the physical and mental health problems of health care recipients and providers, and the economic burden of their families, but also promote the development of health care service industry and further improvement of the health care system. However, the dilemma and sustainable development of the LTCI system is the government needs to focus on in the future due to the sustainability of its funding sources.

Conceptualizing COVID-19 and Public Panic with the Moderating Role of Media Use and Uncertainty in China: An Empirical Framework

Uncertainty puts people in a binary state of mind, where every piece of external information can positively or negatively affect their state of health. Given the uncertain situation created by the new coronavirus pandemic, this study claims to be the first empirical analysis of the real-time status of public panic in China. It frames peoples’ intrinsic and extrinsic stimuli, creating a psychosocial analysis of public panic. We conducted an online survey of WeChat and QQ users in February 2020 and collected 1613 samples through a QR code questionnaire. We used the ordinary least squares (OLS) regression equation model to conceptualize public panic pathways in different gender and age groups. This underlines the psychological origins of fear and anxiety and points out how the media uses socially constructed public panic. The results show that the outbreak of COVID-19 created uncertainty among the public, and the official media intensified it because of the late dissemination of news about the outbreak’s real-time status. Hence, unofficial media remained faster in news reporting, but the news reporting remained contradictory with official reports. This created doubts about the authenticity of the given information and caused public mental health abnormalities. The study provides a conceptual framework based on lessons learned from physiology, psychology, and social psychology and real-time public analysis to inform policymakers and public administrators about the contextual dynamics of public panic in China. It provides useful insights into the wise handling of this uncertain time and controlling the fatal conditions of public panic created by COVID-19. It has implications for other countries as well.