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Journal of insurance medicine (New York, N.Y.)最新文献

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Patients' Rights to Mental Health Care: Legal Regulation of Access to Health Services and Insurance Programs. 病人获得精神卫生保健的权利：获得卫生服务和保险方案的法律规定。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-03 DOI: 10.17849/insm-52-2-1-13.2
Anatolii Berlach, Nataliia Zdanevych, Alla Melnyk, Serhii Soldatkin, Oleksandr Lavryk
{"title":"Patients' Rights to Mental Health Care: Legal Regulation of Access to Health Services and Insurance Programs.","authors":"Anatolii Berlach, Nataliia Zdanevych, Alla Melnyk, Serhii Soldatkin, Oleksandr Lavryk","doi":"10.17849/insm-52-2-1-13.2","DOIUrl":"https://doi.org/10.17849/insm-52-2-1-13.2","url":null,"abstract":"<p><p>The study examines the importance of legal regulation of access to health services and insurance programs for persons with mental disorders in Ukraine, taking into account modern challenges, in particular the impact of war on the mental health of the population. In conditions of extraordinary psycho-emotional burden and imperfect regulatory framework, analysis can help to improve legislation using the experience of highly developed countries. This study uses methods of analysis, synthesis, induction, deduction, dialectical, analytical, analogy and generalization. The goal is to develop recommendations for integrating international standards that will provide comprehensive protection of patients' rights and access to effective medical care even in crisis conditions. The conflict in Ukraine has further exacerbated mental health problems, with a growing demand for psychological and psychiatric care due to trauma related to war, displacement, and constant stress. Current legislation does not meet modern psycho-emotional needs. Legislative inconsistencies, funding gaps, and terminological uncertainty impede access to basic medical services and insurance programs. Establishing a unified legal framework aligned with international standards is crucial to ensuring comprehensive health care and protecting patients' rights.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep Duration and All-Cause Mortality. 睡眠时间与全因死亡率。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-01 DOI: 10.17849/insm-52-1-6-13.1
Mahrrouz Caputo
{"title":"Sleep Duration and All-Cause Mortality.","authors":"Mahrrouz Caputo","doi":"10.17849/insm-52-1-6-13.1","DOIUrl":"10.17849/insm-52-1-6-13.1","url":null,"abstract":"<p><p>Sleep, as a behavioural lifestyle factor, has so far received limited attention in medical risk assessment. Nonetheless, behavioural lifestyle factors can offer valuable insights into the health status of applicants. Health trackers enable the continuous recording of lifestyle factors such as physical activity and sleep patterns. Currently, there is a dearth of experience in incorporating such data when calculating premiums, as well as in understanding the correlation between continuously recorded lifestyle factors and mortality/morbidity. Hence, the literature was reviewed to examine the association between sleep duration and all-cause mortality to derive dose-response rates. Relative risks were calculated by pooling data from 10 selected studies comprising over 3 million study participants. The findings suggest that both short (<6 hours) and long sleep duration (>9 hours) are associated with an increased risk of all-cause mortality.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"52 1","pages":"6-13"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Narcotic-Seeking Behavior and Self-Injury: A Report of Three Cases. 寻求毒品行为与自残：附三例报告。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-01 DOI: 10.17849/insm-52-1-23-30.1
Vera F Dolan
{"title":"Narcotic-Seeking Behavior and Self-Injury: A Report of Three Cases.","authors":"Vera F Dolan","doi":"10.17849/insm-52-1-23-30.1","DOIUrl":"10.17849/insm-52-1-23-30.1","url":null,"abstract":"<p><p>Patients addicted to prescription opiates have found innovative ways to reliably obtain their desired prescription opiates at a time when such prescriptions are restricted due to the opioid crisis. Instead of turning to the black market, some patients deceive their health care providers and malinger to create or enhance severe chronic pain conditions that require medically necessary treatment with prescription opiates. Such sophisticated narcotic-seeking patients set up situations by which they become severely and chronically injured through natural or iatrogenic means. This article reports 3 cases of narcotic seeking manifested through deceptive self-injury behavior that were underwritten for life expectancies in legal matters. Underwriting mortality risk requires different authority, resources, and anti-fraud skills than what is typically available to health care providers. Using such authority, resources, and anti-fraud skills, life underwriters can identify deception, malingering, and sophisticated narcotic-seeking behavior that health care providers typically do not or cannot explicitly acknowledge.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"52 1","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sweet Solutions: Unlocking the Diabetes-Dementia Connection for Better Outcomes. 甜蜜的解决方案：解开糖尿病和痴呆之间的联系，获得更好的结果。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-01 DOI: 10.17849/insm-52-1-14-20.1
Emoke Posan
{"title":"Sweet Solutions: Unlocking the Diabetes-Dementia Connection for Better Outcomes.","authors":"Emoke Posan","doi":"10.17849/insm-52-1-14-20.1","DOIUrl":"10.17849/insm-52-1-14-20.1","url":null,"abstract":"<p><p>Type 2 diabetes and Alzheimer's dementia represent important health challenges in our society today. Understanding the relationship between these conditions is crucial. This article explores the research on whether they share common risk factors or if they may influence each other's development, which could lead to more effective prevention and treatment strategies.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"52 1","pages":"14-20"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psoriatic Arthritis - A Mortality Abstract. 银屑病关节炎-死亡率摘要。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-01 DOI: 10.17849/insm-52-1-3-5.1
De-Ann R Williams
{"title":"Psoriatic Arthritis - A Mortality Abstract.","authors":"De-Ann R Williams","doi":"10.17849/insm-52-1-3-5.1","DOIUrl":"10.17849/insm-52-1-3-5.1","url":null,"abstract":"<p><strong>Objective.—: </strong>To analyze a published study on all-cause mortality between psoriatic arthritis and matched population comparator-subjects to derive comparative mortality statistics applicable to life insurance underwriting.</p><p><strong>Method.—: </strong>The pixel method was employed for extracting cumulative survivals. It was chosen for its capability to extract data from published graphs despite potential precision and reliability limitations.</p><p><strong>Results.—: </strong>The mortality analysis indicated an increase in mortality starting in year 4, aligning with the Table rating for Psoriatic arthritis. Pharmacological treatment data from the study revealed only 28% were on advanced therapies such as targeted synthetic or biologic DMARDs. This low percentage suggests most of the cohort had milder PsA, as advanced treatments are generally reserved for moderate to severe psoriatic arthritis. The distribution of treatment regimens provides essential insights into disease severity and its implications for mortality assessment.</p><p><strong>Conclusion.—: </strong>The comparative mortality findings correspond to Table rating for psoriatic arthritis. This finding underscores the importance of understanding treatment profiles and disease severity in life insurance underwriting to accurately assess risk.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"52 1","pages":"3-5"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Mortality of Behcet's Disease. 白塞氏病的死亡率。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-01 DOI: 10.17849/insm-52-1-1-2.1
John R Iacovino
{"title":"The Mortality of Behcet's Disease.","authors":"John R Iacovino","doi":"10.17849/insm-52-1-1-2.1","DOIUrl":"10.17849/insm-52-1-1-2.1","url":null,"abstract":"<p><p>As medical directors, we often receive referrals for an underwriting opinion on rare and unusual diseases. This necessitates time-consuming medical literature searches and analyzing studies for appropriate mortality data. Behcet's disease (BD) belongs in this category. Although this review article does not have all the elements of a typical mortality abstract, with a rare disease such as BD, we must rely on the available literature.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"52 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical Illness Insurance: In Search of Its Identity. 重大疾病保险：寻找其身份。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-01 DOI: 10.17849/insm-52-1-31-33.1
Timothy Meagher
{"title":"Critical Illness Insurance: In Search of Its Identity.","authors":"Timothy Meagher","doi":"10.17849/insm-52-1-31-33.1","DOIUrl":"10.17849/insm-52-1-31-33.1","url":null,"abstract":"<p><p>Critical illness insurance is a complex type of coverage that does not enjoy wide appeal. Insurers around the world are introducing different strategies to attract consumers. This article explains why these changes are problematic and why insurers may be losing sight of the core value of critical illness insurance.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"52 1","pages":"31-33"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Chest X- Ray: The Ship has Sailed, But Has It? 胸部X光：船已经启航了，是吗？
Journal of insurance medicine (New York, N.Y.) Pub Date : 2025-07-01 DOI: 10.17849/insm-52-1-21-22.1
John R Iacovino
{"title":"The Chest X- Ray: The Ship has Sailed, But Has It?","authors":"John R Iacovino","doi":"10.17849/insm-52-1-21-22.1","DOIUrl":"10.17849/insm-52-1-21-22.1","url":null,"abstract":"<p><p>In the past, the chest X-ray (CXR) was a traditional age and amount requirement used to assess potential mortality risk in life insurance applicants. It fell out of favor due to inconvenience to the applicant, cost, and lack of protective value. With the advent of deep learning techniques, can the results of the CXR, as a requirement, now add additional value to underwriting risk analysis?</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"52 1","pages":"21-22"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Future of the Journal of Insurance Medicine and AAIM. 保险医学杂志》和 AAIM 的未来。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2024-11-01 DOI: 10.1029/AAIMEDICINE-D-24-00036.1
John R Iacovino
{"title":"The Future of the Journal of Insurance Medicine and AAIM.","authors":"John R Iacovino","doi":"10.1029/AAIMEDICINE-D-24-00036.1","DOIUrl":"https://doi.org/10.1029/AAIMEDICINE-D-24-00036.1","url":null,"abstract":"","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"51 3","pages":"199-200"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Outline of a Simple, Interpretable Epigenetic Composite Score for Mortality Prediction for Accelerated Underwriting. 用于加速核保的死亡率预测的简单、可解释的表观遗传综合评分概要。
Journal of insurance medicine (New York, N.Y.) Pub Date : 2024-11-01 DOI: 10.1029/AAIMEDICINE-D-24-00027.1
James A Mills, Jeffrey D Long, Robert A Philibert
{"title":"An Outline of a Simple, Interpretable Epigenetic Composite Score for Mortality Prediction for Accelerated Underwriting.","authors":"James A Mills, Jeffrey D Long, Robert A Philibert","doi":"10.1029/AAIMEDICINE-D-24-00027.1","DOIUrl":"10.1029/AAIMEDICINE-D-24-00027.1","url":null,"abstract":"<p><strong>Background.—: </strong>In principle, it is generally accepted that DNA methylation measures can be used to predict mortality. However, as of yet, no epigenetic metric has been successfully incorporated into underwriting procedures. In part, this failure results from the relative incompatibility of many DNA methylation measures with conventional underwriting practices.</p><p><strong>Objective.—: </strong>To test the ability of previously established epigenetic markers of smoking, drinking and diabetes to standard lipid-based approaches for predicting mortality.</p><p><strong>Method.—: </strong>We constructed a series of Cox proportional hazards models for mortality using clinical data and DNA methylation data from 4 previously described loci from the Framingham Heart Study.</p><p><strong>Results.—: </strong>The incorporation of vital signs, standard lipid and diabetes laboratory assessments to a base model consisting of age and sex only modestly increased prediction of mortality from 0.732 to 0.741 area under the curve (AUC). However, the addition of epigenetic marker information for smoking and drinking to the base model markedly increased prediction (AUC=0.787) while the addition of epigenetic marker for diabetes increased prediction even further (AUC=0.792).</p><p><strong>Conclusion.—: </strong>These results demonstrate the potential of simple interpretable, epigenetic models to predict mortality in a manner compatible with standard underwriting procedures. Potentially, this epigenetic approach using rapid methylation sensitive digital PCR procedures that can utilize saliva or whole blood DNA would increase prediction power even further while facilitating more accurate accelerated underwriting assessments of mortality.</p>","PeriodicalId":39345,"journal":{"name":"Journal of insurance medicine (New York, N.Y.)","volume":"51 3","pages":"175-183"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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