Search results for "Life care"
showing 10 items of 33 documents
Integrating Retirement and Long-Term Care (LTC) Annuities Using a Notional Defined Contribution (NDC) Framework
2014
This paper examines the possibility of embedding public long-term care (LTC) insurance within the retirement pension system, i.e. introducing life care annuities (LCAs) into a notional defined contribution (NDC) framework. To do this we develop a multistate overlapping generations model (MOLG) that includes the so-called survivor dividend and give special attention to the assumptions made about mortality rates for dependent persons and LTC incidence rates, which largely determine the contribution rate assigned to LTC. The proposed model could be of interest to policymakers because it could be implemented without too much difficulty, it would universalize LTC coverage with a "fixed" cost, an…
Converting Retirement Benefit into a Life Care Annuity with Graded Benefits: How Costly Would it Actually Be?
2016
This paper deals with life care annuities, i.e. bundled products comprising a life annuity and long-term care insurance. It aims to assess the cost of converting retirement benefit into a life care annuity with graded benefits using a pre-existing public pay-as-you-go pension scheme. With this objective in mind, we present an actuarial method based on array calculus for valuing this type of life care annuity. The health dynamics of the annuitant rely on a reversible illness-death multistate framework. The paper contains a numerical example in which mortality and disability assumptions are based on data from the USA and Australia, although this should be viewed simply as an illustration. In …
Patients with non-oncological chronic conditions: Improving end-of-life care through integrated care and early palliative care provision
2019
Background: The last WHO definition of palliative care (PC) recognizes the integration of early PC in the course of illness and in conjunction with other therapies that are intended to treat disease as the way to provide optimal care. There is wide literature highlighting the benefits of early implementation of PC in oncological patients and there is a growing recognition of PC as an integral aspect of cancer treatment with the establishment of a range of specific guidelines concerning palliative cancer care. Nevertheless, these advances are not developed to the same extent in the approach of non-oncological chronic conditions. In this regard, patients of non-cancer diseases are rarely offe…
Social Insurance Accounting for a Notional Defined Contribution Scheme Combining Retirement and Long-Term Care Benefits
2018
This paper develops a social insurance accounting model for a notional defined contribution (NDC) scheme combining retirement and long-term care (LTC) contingencies. The procedure relies on standard double-entry bookkeeping and enables us to compile a “Swedish” type actuarial balance sheet (ABS) following a framework equivalent to an open group approach. This methodology is suitable for reporting the system’s solvency status and can show periodical changes in the system’s financial position by means of an income statement. The information underpinning the actuarial valuation is based on events and transactions that are verifiable at the valuation date, without consid…
Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey
2018
Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied …
End-of-Life Care in High-Grade Glioma Patients. The Palliative and Supportive Perspective.
2018
High-grade gliomas (HGGs) are the most frequently diagnosed primary brain tumors. Even though it has been demonstrated that combined surgical therapy, chemotherapy, and radiotherapy improve survival, HGGs still harbor a very poor prognosis and limited overall survival. Differently from other types of primary neoplasm, HGG manifests also as a neurological disease. According to this, palliative care of HGG patients represents a peculiar challenge for healthcare providers and caregivers since it has to be directed to both general and neurological cancer symptoms. In this way, the end-of-life (EOL) phase of HGG patients appears to be like a journey through medical issues, progressive neurologic…
How Do Unisex Life Care Annuities Embedded in a Pay-As-You-Go Retirement System Affect Gender Redistribution?
2017
This paper deals with the idea of converting retirement benefit into a life care annuity with graded benefits using a pre-existing public pay-as-you-go pension scheme. Based on accurate biometric data from Australia and the US, the paper shows that using gender-neutral annuity factors to compute the initial benefit involves a large increase in ex-ante gender redistribution compared to a system without long-term coverage. In spite of the very different biometric data, the results are surprisingly similar for both countries. To disentangle the hidden redistribution, a methodology based on conversion (actuarial) factors is used. The value of the actuarial factor relies on a multistate framewor…
Palliative Care Principles and Anesthesiology Clinical Practice: Current Perspectives
2021
Background Palliative care is a person-centered approach aiming to relieve patient's health-related suffering and it is often needed when caring for critically ill patients to manage symptoms and identify goals of care. Aim To describe the integration of palliative care principles in anesthesiology clinical practice, within and outside the ICU and to analyze the additional challenges that COVID-19 pandemic is posing in this context. Methods For the purpose of this review, PubMed database was searched for studies concerning palliative care and end of life care, in contexts involving anesthesiologists and intensivists, published in the last 5 years. Results Anesthesiologists and intensivists …
Palliative Care Professionals' Inner Lives: Cross-Cultural Application of the Awareness Model of Self-Care
2021
Compassionate professional qualities traditionally have not received the most attention in either critical or end of life care. Constant exposure to death, time pressure and workload, inadequate coping with personal emotions, grieving, and depression urge the development of an inner curricula of competences to promote professional quality of life and compassionate care. The COVID-19 pandemic highlights the universality of these problems and the need to equip ourselves with rigorously validated measurement and monitoring approaches that allow for unbiased comparisons. The main objective of this study was to offer evidence on the generalizability of the awareness model of self-care across thr…
LIFE CARE ANNUITIES (LCA) EMBEDDED IN A NOTIONAL DEFINED CONTRIBUTION (NDC) FRAMEWORK
2016
AbstractThis paper examines the possibility of embedding public long-term care (LTC) insurance within the retirement pension system, i.e. introducing life care annuities into a notional defined contribution framework. To do this, we develop a multistate overlapping generations model that includes the so-called survivor dividend and give special attention to the assumptions made about mortality rates for dependent persons and LTC incidence rates, which largely determine the contribution rate assigned to LTC. The proposed model could be of interest to policymakers because it could be implemented without too much difficulty, it would universalize LTC coverage with a “fixed” cost, and it would …