Search results for: out-of-pocket health payments
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8705

Search results for: out-of-pocket health payments

8705 Impact of Out-Of-Pocket Payments on Health Care Finance and Access to Health Care Services: The Case of Health Transformation Program in Turkey

Authors: Bengi Demirci

Abstract:

Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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8704 Adoptability of Digital Payment for Community Health Workers in Wakiso District, Uganda

Authors: Veronica Kembabazi, Arnold Tigaiza, Juliet Aweko, Charles Opio, Michael Ediau, Elizabeth Ekirapa, Andrew Tusubira, Peter Waiswa

Abstract:

Background: Digital payments have been branded as key in solving health payment challenges, evidence on their adoptability is still limited especially among Community Health Workers (CHWs), yet vital for ensuring sustainability. We therefore assessed the adoptability of digital payments for CHWs in Wakiso district, Uganda. Methods: In December 2022, we conducted a convergent parallel mixed-methods study among 150 randomly selected CHWs in Wakiso district. Supplementary qualitative data were collected from the Digital payment coordinators as Key Informants (KIs). We adopted the Technology Acceptance Model (TAM) framework to assess the adoptability of digital payments among CHWS. Factor analysis was performed to extract composite variables from the original constituting variables. Kaiser-Meyer-Olkin statistics were assessed for each construct to determine appropriateness for data reduction. Using logistic regression for multivariate analysis, we assessed the association between adoptability constructs and the CHW intention to use digital payments. Quantitative data was analyzed using STATA, while qualitative data was transcribed verbatim and analyzed using ATLAS.ti software. Results: Overall, 150 respondents were interviewed and nearly all participants (98.0%) had previously received payments through mobile money, a digital-payment method. The majority (52%) of CHWs said they intend to use digital payment modalities. Perceived risk had an 83% negative influence on the adoptability of digital payment modalities (OR= 0.167, p < 0.01), perceived trust had an almost three times positive influence on the adoptability of digital payment modalities (OR= 2.823, p < 0.01). Qualitative interviews showed that most CHWs reported good experiences in their use of digital health payment modalities except for delays associated with mobile money payments. Mobile money was reported to be easy to use, in addition to fostering financial responsibility compared to cash. Conclusion: CHWs in Wakiso district intend to use digital payment modalities, particularly mobile money/e-cash, and the perceived risk of the payment method and trust are key determinants of its adoptability. Synergized efforts by both payment providers and service operators to manage payment delays and identified risks among mobile money operators could attenuate perceived risk and build trust in digital payment modalities.

Keywords: digital health payments, community health workers, adoptability, technology acceptance model

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8703 Co-payment Strategies for Chronic Medications: A Qualitative and Comparative Analysis at European Level

Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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8702 How to Ensure Environmental Sustainability and Food Security through the Use of Payments for Environmental Services in Developing Countries

Authors: Carlos Alves

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This research paper demonstrates how payments for environmental services (PES) can be an effective mechanism to combat food insecurity and reduce environmental degradation in developing countries. The paper begins by discussing how environmental services affect each one of the pillars of food security: availability, access, and utilization of food. However, due to numerous global environmental challenges, a new pillar of food security based on environmental sustainability is proposed and discussed. An argument is then made that PES can usefully combat food insecurity. It can provide an extra income to those who take on environmental service and help them to have a better access to food. In order to be successful in addressing food insecurity, PES schemes should target on the poor and redress issues that can prevent their effectiveness. Finally, the research presents a case study that discusses how several developing countries addressed problems and successfully developed PES programs.

Keywords: environmental sustainability, food security, nutrition, payments for environmental services

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8701 E-Payments, COVID-19 Restrictions, and Currency in Circulation: Thailand and Turkey

Authors: Zeliha Sayar

Abstract:

Central banks all over the world appear to be focusing first and foremost on retail central bank digital currency CBDC), i.e., digital cash/money. This approach is predicated on the belief that the use of cash has decreased, owing primarily to technological advancements and pandemic restrictions, and that a suitable foundation for the transition to a cashless society has been revealed. This study aims to contribute to the debate over whether digital money/CBDC can be a substitute or supplement to physical cash by examining the potential effects on cash demand. For this reason, this paper compares two emerging countries, Turkey, and Thailand, to demystify the impact of e-payment and COVID-19 restrictions on cash demand by employing fully modified ordinary least squares (FMOLS), dynamic ordinary least squares (DOLS), and the canonical cointegrating regression (CCR). The currency in circulation in two emerging countries, Turkey and Thailand, was examined in order to estimate the elasticity of different types of retail payments. The results demonstrate that real internet and mobile, cart, contactless payment, and e-money are long-term determinants of real cash demand in these two developing countries. Furthermore, with the exception of contactless payments in Turkey, there is a positive relationship between the currency in circulation and the various types of retail payments. According to findings, COVID-19 restrictions encourage the demand for cash, resulting in cash hoarding.

Keywords: CCR, DOLS, e-money, FMOLS, real cash

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8700 Exchange Rate Variation and Balance of Payments: The Nigerian Experience (1970-2012)

Authors: Vitus Onyebuchim Onyemailu, Olive Obianuju Okalibe

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The study tried to examine relationship between exchange rate variations on the balance of payments in Nigeria from 1970 to 2012. Using time series on econometric measures such as Granger causality and ordinary least square (OLS), the study found that exchange rate movements especially the depreciation of naira has not contributed significantly on the balance of payments under the year of the study. The granger result conform the Marshall-Lerner short and long run prepositions that exchange rate devaluation enhances balance of payments. On disaggregation exchange rate granger causes current and capital account balances give the Nigeria data from 1970 to 2012. Overall in the long run OLS regression analysis, exchange rate on semi log functional form, exchange rate variation did not record significant effect on balance of payment equation. This height was also maintained in the current or trade balance which does not match the Marshall-Lerner. The capital account balance in reverse reported a significant impact of exchange rate variability on the capital account balance. Finally, on exchange rate determination equation, where many fundamentals were considered including lagged of exchange rate. Thus, the lagged of exchange rate recorded a positive and significant influence on the present exchange rate. This means that players in the financial markets usually out plays authority’s policy’s stances through their speculative tendencies. The work therefore, recommend that effort should be made by the authorities to providing enabling environment for production of goods and services to triumph in order to take advantages of steady devaluation of its currency. This is done by providing infrastructure, provision of science and technology. Thus, when this is done Nigeria would be able to have competitive power against the rest of the world.

Keywords: exchange rate variation, balance of payments, current account, capital account, Marshall-Lerner hypothesis

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8699 The Types of Annuities with Flexible Premium

Authors: Deniz Ünal Özpalamutcu, Burcu Altman

Abstract:

Actuaria uses mathematics, statistic and financial information when analyzing the financial impacts of uncertainties, risks, insurance and pension related issues. In other words, it deals with the likelihood of potential risks, their financial impacts and especially the financial measures. Handling these measures require some long-term payment and investments. So, it is obvious it is inevitable to plan the periodic payments with equal time intervals considering also the changing value of money over time. These series of payment made specific intervals of time is called annuity or rant. In literature, rants are classified based on start and end dates, start times, payments times, payments amount or frequency. Classification of rants based on payment amounts changes based on the constant, descending or ascending payment methods. The literature about handling the annuity is very limited. Yet in a daily life, especially in today’s world where the economic issues gained a prominence, it is very crucial to use the variable annuity method in line with the demands of the customers. In this study, the types of annuities with flexible payment are discussed. In other words, we focus on calculating payment amount of a period by adding a certain percentage of previous period payment was studied. While studying this problem, formulas were created considering both start and end period payments for cash value and accumulated. Also increase of each period payment by r interest rate each period payments calculated with previous periods increases. And the problem of annuities (rants) of which each period payment increased with previous periods’ increase by r interest rate has been analyzed. Cash value and accumulated value calculation of this problem were studied separately based on the period start/end and their relations were expressed by formulas.

Keywords: actuaria, annuity, flexible payment, rant

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8698 Resilience of the American Agriculture Sector

Authors: Dipak Subedi, Anil Giri, Christine Whitt, Tia McDonald

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This study aims to understand the impact of the pandemic on the overall economic well-being of the agricultural sector of the United States. The two key metrics used to examine the economic well-being are the bankruptcy rate of the U.S. farm operations and the operating profit margin. One of the primary reasons for farm operations (in the U.S.) to file for bankruptcy is continuous negative profit or a significant decrease in profit. The pandemic caused significant supply and demand shocks in the domestic market. Furthermore, the ongoing trade disruptions, especially with China, also impacted the prices of agricultural commodities. The significantly reduced demand for ethanol and closure of meat processing plants affected both livestock and crop producers. This study uses data from courts to examine the bankruptcy rate over time of U.S. farm operations. Preliminary results suggest there wasn’t an increase in farm operations filing for bankruptcy in 2020. This was most likely because of record high Government payments to producers in 2020. The Federal Government made direct payments of more than $45 billion in 2020. One commonly used economic metric to measure farm profitability is the operating profit margin (OPM). Operating profit margin measures profitability as a share of the total value of production and government payments. The Economic Research Service of the United States Department of Agriculture defines a farm operation to be in a) a high-risk zone if the OPM is less than 10 percent and b) a low-risk zone if the OPM is higher than 25 percent. For this study, OPM was calculated for small, medium, and large-scale farm operations using the data from the Agriculture Resource Management Survey (OPM). Results show that except for small family farms, the share of farms in high-risk zone decreased in 2020 compared to the most recent non-pandemic year, 2019. This was most likely due to higher commodity prices at the end of 2020 and record-high government payments. Further investigation suggests a lower share of smaller farm operations receiving lower average government payments resulting in a large share (over 70 percent) being in the critical zone. This study should be of interest to multiple stakeholders, including policymakers across the globe, as it shows the resilience of the U.S. agricultural system as well as (some) impact of government payments.

Keywords: U.S. farm sector, COVID-19, operating profit margin, farm bankruptcy, ag finance, government payments to the farm sector

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8697 Government Payments to Minority American Producers

Authors: Anil K. Giri, Dipak Subedi, Kathleen Kassel, Ashok Mishra

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The United States Department of Agriculture’s programs has been accused of being discriminatory in the past based on the race of the farmer, especially African-American producers. This study examines if there was racial discrimination in payments from the most recent new USDA programs, including those made in response to the pandemic. This study uses the Analysis of Variance (ANOVA) to examine the payments after normalizing them relative to cash receipts to test if discrimination in the number of payments received exists. Three programs investigated in this study are: i) the Coronavirus Food Assistance Program (CFAP), ii) the Market Facilitation Program (MFP), and (iii) the Paycheck Protection Program (PPP). The PPP program was administered by the Small Business Administration, whereas the other two were designed and implemented by the USDA. The PPP made forgivable loans to small businesses and, initially, was heavily criticized for not reaching minority businesses (in general). The Small Business Administration then initiated a second draw of PPP loans, prioritizing minority-owned businesses. This study compares attributes of PPP loans made to African-American farming businesses and other farming businesses in the two draws of the PPP. We find that the number of African-American farming businesses participating in the second draw of PPP loans decreased significantly from the first draw. However, the average amount of PPP loans to African-American farming businesses increased in the second draw. In the first draw, the average cost of jobs reported per loan was higher for African-American farming businesses than for other producers. In the second draw, the average cost of jobs reported per loan was significantly higher for other farming businesses than for African-American businesses. The share of PPP loans forgiven for African-American farming businesses is significantly below the national rate of 89 percent. The rate of forgiveness for PPP loans made to African-American producers is unlikely to increase significantly without policy changes. This can increase financial burdens in the future to farm operations operated by African- Americans. Finally, we conclude that the initial goal of increasing minority participation in PPP loans in the second draw, at least among African-Americans in the agricultural sector, did not meet. CFAP made almost $600 million in direct payments to minority producers, including Black producers. Black or African American producers received more than $52 million in CFAP payments. CFAP payments were proportional to the value of agricultural commodities sold for most minority producers. The 2017 Census of Agriculture showed that the majority of minority producers, including African American producers but excluding Asian producers, raised livestock. CFAP made the highest payments to livestock minority producers.

Keywords: United States department of agriculture (USDA), coronavirus food assistance program (CFAP), paycheck protection program (PPP), African-American producers, minority American producers

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8696 Health Payments and Household Wellbeing in India: Examining the Role of Health Policy Interventions

Authors: Shailender Kumar

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Current health policy pronouncements in India advocate for insurance-based financing mechanism to achieve universal health coverage (UHC), while undermine the role of comprehensive healthcare provision system. UHC is achieved when all people receive the health services they need without suffering financial hardship. This study, using 68th & 71st NSS rounds data, examines their relative and combined strength in achieving the above objective. Health-insurance has been unsuccessful in reducing prevalence and catastrophic effects of out-of-pocket payment and even dismantle the effectiveness of traditional way of health financing system. Healthcare provision is the best way forward to enhance health and well-being of households in condition if India removes existing inadequacies and inequalities in service provision across districts/states and ensure free/low cost medicines/diagnostics to the citizens.

Keywords: health policy, demand-side financing, supply-side financing, incidence of health payment

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8695 Enhancement of Transaction's Authentication for the Europay, MasterCard, and Visa Contactless Card Payments

Authors: Ossama Al-Maliki

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Europay, MasterCard, and Visa (EMV) is one of the most popular payment protocol in the world. The EMV protocol supports Chip and PIN Transactions, Chip and Signature transactions, and Contactless transactions. This protocol suffers from tens of £ millions of lost per year due to many fraudulent payments. This is due to several reported vulnerable points in the protocols used for such payments that allow skimming, replay, cloning, Mole Point of Sale (POS), relay, and other attacks to be conducted. In this paper, we are focusing on the EMV contactless specification and we have proposed two proposal solutions to the addition of a localization factor to enhance the payment authentication of such transactions designed to prevent relay, cloning, and Mole-POS attacks. Our proposed solution is a back-end localization scheme to help the Issuer-Bank compare the location of the genuine cardholder in relation to the used POS. Our scheme uses 'something you have' which is the Cardholder Smartphone (CSP) to provide the location of the cardholder at the time of the transaction and without impacting the contactless payment time/protocol. The Issuer-bank obtain the CSP Location using tried and tested localization techniques, and independently of the cardholder. Both of our proposal solutions do not require infrastructure changes, and it uses existing EMV/SP protocol messages to communicate our scheme information.

Keywords: NFC, RFID, contactless card, authentication, location, EMV

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8694 Effects of Subsidy Reform on Consumption and Income Inequalities in Iran

Authors: Pouneh Soleimaninejadian, Chengyu Yang

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In this paper, we use data on Household Income and Expenditure survey of Statistics Centre of Iran, conducted from 2005-2014, to calculate several inequality measures and to estimate the effects of Iran’s targeted subsidy reform act on consumption and income inequality. We first calculate Gini coefficients for income and consumption in order to study the relation between the two and also the effects of subsidy reform. Results show that consumption inequality has not been always mirroring changes in income inequality. However, both Gini coefficients indicate that subsidy reform caused improvement in inequality. Then we calculate Generalized Entropy Index based on consumption and income for years before and after the Subsidy Reform Act of 2010 in order to have a closer look into the changes in internal structure of inequality after subsidy reforms. We find that the improvement in income inequality is mostly caused by the decrease in inequality of lower income individuals. At the same time consumption inequality has been decreased as a result of more equal consumption in both lower and higher income groups. Moreover, the increase in Engle coefficient after the subsidy reform shows that a bigger portion of income is allocated to consumption on food which is a sign of lower living standard in general. This increase in Engle coefficient is due to rise in inflation rate and relative increase in price of food which partially is another consequence of subsidy reform. We have conducted some experiments on effect of subsidy payments and possible effects of change on distribution pattern and amount of cash subsidy payments on income inequality. Result of the effect of cash payments on income inequality shows that it leads to a definite decrease in income inequality and had a bigger share in improvement of rural areas compared to those of urban households. We also examine the possible effect of constant payments on the increasing income inequality for years after 2011. We conclude that reduction in value of payments as a result of inflation plays an important role regardless of the fact that there may be other reasons. We finally experiment with alternative allocations of transfers while keeping the total amount of cash transfers constant or make it smaller through eliminating three higher deciles from the cash payment program, the result shows that income equality would be improved significantly.

Keywords: consumption inequality, generalized entropy index, income inequality, Irans subsidy reform

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8693 Tourist Behavior Towards Blockchain-Based Payments

Authors: A. Šapkauskienė, A. Mačerinskienė, R. Andrulienė, R. Bruzgė, S. Masteika, K. Driaunys

Abstract:

The COVID-19 pandemic has affected not only world markets and economies but also the daily lives of customers and their payment habits. The pandemic has accelerated the digital transformation, so the role of technology will become even more important post-COVID. Although the popularity of cryptocurrencies has reached unprecedented heights, there are still obstacles, such as a lack of consumer experience and distrust of these technologies, so exploring the role of cryptocurrency and blockchain in the context of international travel becomes extremely important. Research on tourists’ intentions to use cryptocurrencies for payment purposes is limited due to the small number of research studies. To fill this research gap, an exploratory study based on the analysis of survey data was conducted. The purpose of the research is to explore how the behavior of tourists has changed making their financial transactions when paying for the tourism services in order to determine the intention to pay in cryptocurrencies. Behavioral intention can be examined as a dependent variable that is useful for the study of the acceptance of blockchain as cutting-edge technology. Therefore, this study examines the intention of travelers to use cryptocurrencies in electronic payments for tourism services. Several studies have shown that the intention to accept payments in a cryptocurrency is affected by the perceived usefulness of these payments and the perceived ease of use. The findings deepen our understanding of the readiness of service users to apply for blockchain-based payment in the tourism sector. The tourism industry has to focus not only on the technology but on consumers who can use cryptocurrencies, creating new possibilities and increasing business competitiveness. Based on research results, suggestions are made to guide future research on the use of cryptocurrencies by tourists in the tourism industry. Therefore, in line with the rapid expansion of virtual currency users, market capitalization, and payment in cryptographic currencies, it is necessary to explore the possibilities of implementing a blockchain-based system aiming to promote the use of services in the tourism sector as the most affected by the pandemic.

Keywords: behavioral intention, blockchain-based payment, cryptocurrency, tourism

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8692 End To End Process to Automate Batch Application

Authors: Nagmani Lnu

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Often, Quality Engineering refers to testing the applications that either have a User Interface (UI) or an Application Programming Interface (API). We often find mature test practices, standards, and automation regarding UI or API testing. However, another kind is present in almost all types of industries that deal with data in bulk and often get handled through something called a Batch Application. This is primarily an offline application companies develop to process large data sets that often deal with multiple business rules. The challenge gets more prominent when we try to automate batch testing. This paper describes the approaches taken to test a Batch application from a Financial Industry to test the payment settlement process (a critical use case in all kinds of FinTech companies), resulting in 100% test automation in Test Creation and Test execution. One can follow this approach for any other batch use cases to achieve a higher efficiency in their testing process.

Keywords: batch testing, batch test automation, batch test strategy, payments testing, payments settlement testing

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8691 A Deforestation Dilemma: An Integrated Approach to Conservation and Development in Madagascar

Authors: Tara Moore

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Madagascar is one of the regions of the world with the highest biodiversity, with more than 600 new species discovered in just the last decade. In parallel with its record-breaking biodiversity, Madagascar is also the tenth poorest country in the world. The resultant socio-economic pressures are leading to a highly threatened environment. In particular, deforestation is at the core of biodiversity and ecosystem loss, primarily from slash and burn agriculture and illegal rosewood tree harvesting. Effective policy response is imperative for improved conservation in Madagascar. However, these changes cannot come from the current, unstable government institutions. After a violent and politically turbulent coup in 2009, any effort to defend Madagascar's biodiversity has been eclipsed by the high corruption of government bodies. This paper presents three policy options designed for a private donor to invest in conservation in Madagascar. The first proposed policy consists of payments for ecosystem services model, which involves paying local Malagasy women to reforest nearby territories. The second option is a micro-irrigation system proposal involving relocating local Malagasy out of the threatened forest region. The final proposition is captive breeding funding for the Madagascar Fauna and Flora Group, which could then lead to new reintroductions in the threatened northeastern rainforests. In the end, all three options present feasible, impactful options for a conservation-minded major donor. Ideally, the policy change would involve a combination of all three options, as each provides necessary development and conservation re-structuring goals. Option one, payments for ecosystem services, would be the preferred choice if there were only enough funding for one project. The payments for ecosystem services project both support local populations and promotes sustainable development while reforesting the threatened Marojejy National Park. Regardless of the chosen policy solution, any support from a donor will make a huge impact if it supports both sustainable development and biodiversity conservation.

Keywords: captive breeding, cnservation policy, lemur conservation, Madagascar conservation, payments for ecosystem services

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8690 Implications of Measuring the Progress towards Financial Risk Protection Using Varied Survey Instruments: A Case Study of Ghana

Authors: Jemima C. A. Sumboh

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Given the urgency and consensus for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey methods such as the length of the recall period or the number of items included in the survey questionnaire or the farming of questions, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent, erroneous and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey conducted by the Navrongo Health Research Center in Ghana from May 2017 to December 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The household budget survey, structured around food and non-food expenditure, compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in household budget surveys), Version II (new questions developed through benchmarking the existing Classification of the Individual Consumption by Purpose (COICOP) OOPHP questions in household surveys) and Version III (existing questions used to measure OOPHP in health surveys integrated into household budget surveys- for this, the demographic and health surveillance (DHS) health survey was used). Version I, II and III contained 11, 44, and 56 health items, respectively. However, the choice of recall periods was held constant across versions. The sample size for Version I, II and III were 930, 1032 and 1068 households, respectively. Financial risk protection will be measured based on the catastrophic and impoverishment methodologies using STATA 15 and Adept Software for each version. It is expected that findings from this study will present valuable contributions to the repository of knowledge on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Keywords: Ghana, household budget surveys, measuring financial risk protection, out-of-pocket health payments, survey instruments, universal health coverage

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8689 The Outcome of the Discontinuation of Cheques on Bank Reconciliation

Authors: Estelle Abrahams, Tania Pretorius

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A joint media statement by the South African Reserve Bank, the Banking Association of South Africa, the Financial Sector Conduct Authority, and the Payments Association of South Africa was recently published, stating that the receipt or acceptance of cheques will terminate effectively on 31 December 2020. All stakeholders are urged to cease accepting or issuing cheques as a payment method. The purpose of the study is to examine the effect that the discontinuation of the usage of cheques has on bank reconciliations for the subject: economic and management sciences. A literature study was performed to gain insight into the bank reconciliation process to be able to draw conclusions on the outcome of the discontinuation of cheques on the bank reconciliation. The study found that the teaching of the bank reconciliation process will change to introduce new replacement source documents for digital payments, and this impacts the teaching of reconciling differences.

Keywords: bank reconciliation, internal control, accounting education, source documents

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8688 Payments for Forest Environmental Services: Advantages and Disadvantages in the Different Mechanisms in Vietnam North Central Area

Authors: Huong Nguyen Thi Thanh, Van Mai Thi Khanh

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For around the world, payments for environmental services have been implemented since the late 1970s in Europe and North America; then, it was spread to Latin America, Asia, Africa, and finally Oceania in 2008. In Vietnam, payments for environmental services are an interesting issue recently with the forest as the main focus and therefore known as the program on payment for forest environmental services (PFES). PFES was piloted in Lam Dong and Son La in 2008 and has been widely applied in many provinces after 2010. PFES is in the orientation for the socialization of national forest protection in Vietnam and has made great strides in the last decade. By using the primary data and secondary data simultaneously, the paper clarifies two cases of implementing PFES in the Vietnam North Central area with the different mechanisms of payment. In the first case at Phu Loc district (Thua Thien Hue province), PFES is an indirect method by a water supply company via the Forest Protection and Development Fund. In the second one at Phong Nha – Ke Bang National Park (Quang Binh Province), tourism companies are the direct payers to forest owners. The paper describes the PFES implementation process at each site, clarifies the payment mechanism, and models the relationship between stakeholders in PFES implementation. Based on the current status of PFES sites, the paper compares and analyzes the advantages and disadvantages of the two payment methods. Finally, the paper proposes recommendations to improve the existing shortcomings in each payment mechanism.

Keywords: advantages and disadvantages, forest environmental services, forest protection, payment mechanism

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8687 Electronic Payment Recording with Payment History Retrieval Module: A System Software

Authors: Adrian Forca, Simeon Cainday III

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The Electronic Payment Recording with Payment History Retrieval Module is developed intendedly for the College of Science and Technology. This system software innovates the manual process of recording the payments done in the department through the development of electronic payment recording system software shifting from the slow and time-consuming procedure to quick yet reliable and accurate way of recording payments because it immediately generates receipts for every transaction. As an added feature to its software process, generation of recorded payment report is integrated eliminating the manual reporting to a more easy and consolidated report. As an added feature to the system, all recorded payments of the students can be retrieved immediately making the system transparent and reliable payment recording software. Viewing the whole process, the system software will shift from the manual process to an organized software technology because the information will be stored in a logically correct and normalized database. Further, the software will be developed using the modern programming language and implement strict programming methods to validate all users accessing the system, evaluate all data passed into the system and information retrieved to ensure data accuracy and reliability. In addition, the system will identify the user and limit its access privilege to establish boundaries of the specific access to information allowed for the store, modify, and update making the information secure against unauthorized data manipulation. As a result, the System software will eliminate the manual procedure and replace with an innovative modern information technology resulting to the improvement of the whole process of payment recording fast, secure, accurate and reliable software innovations.

Keywords: collection, information system, manual procedure, payment

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8686 Lessons Learned from Ransomware-as-a-Service (RaaS) Organized Campaigns

Authors: Vitali Kremez

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The researcher monitored an organized ransomware campaign in order to gain significant visibility into the tactics, techniques, and procedures employed by a campaign boss operating a ransomware scheme out of Russia. As the Russian hacking community lowered the access requirements for unsophisticated Russian cybercriminals to engage in ransomware campaigns, corporations and individuals face a commensurately greater challenge of effectively protecting their data and operations from being held ransom. This report discusses two notorious ransomware campaigns. Though the loss of data can be devastating, the findings demonstrate that sending ransom payments does not always help obtain data. Key learnings: 1. From the ransomware affiliate perspective, such campaigns have significantly lowered the barriers for entry for low-tier cybercriminals. 2. Ransomware revenue amounts are not as glamorous and fruitful as they are often publicly reported. Average ransomware crime bosses make only $90K per year on average. 3. Data gathered indicates that sending ransom payments does not always help obtain data. 4. The talk provides the complete payout structure and Bitcoin laundering operation related to the ransomware-as-a-service campaign.

Keywords: bitcoin, cybercrime, ransomware, Russia

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8685 Decision Tree Model for the Recommendation of Digital and Alternate Payment Methods for SMEs

Authors: Arturo J. Anci Alméstar, Jose D. Fernandez Huapaya, David Mauricio

Abstract:

Companies make erroneous decisions by not evaluating the inherent difficulties of entering electronic commerce without a prior review of current digital and alternate means of payment. For this reason, it is very important for businesses to have reliable, complete and integrated information on the means of current digital and alternate payments that allow decisions to be made about which of these to use. However, there is no such consolidated information or criteria that companies use to make decisions about the means of payment according to their needs. In this paper, we propose a decision tree model based on a taxonomy that presents us with a categorization of digital and alternative means of payment, as well as the visualization of the flow of information at a high level from the company to obtain a recommendation. This will allow the company to make the most appropriate decision about the implementation of the digital means of payment or alternative ideal for their needs, which allows a reduction in costs and complexity of the payment process. Likewise, the efficiency of the proposed model was evaluated through a satisfaction survey presented to company personnel, confirming the satisfactory quality level of the recommendations obtained by the model.

Keywords: digital payment medium, decision tree, decision making, digital payments taxonomy

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8684 Student Loan Debt among Students with Disabilities

Authors: Kaycee Bills

Abstract:

This study will determine if students with disabilities have higher student loan debt payments than other student populations. The hypothesis was that students with disabilities would have significantly higher student loan debt payments than other students due to the length of time they spend in school. Using the Bachelorette and Beyond Study Wave 2015/017 dataset, quantitative methods were employed. These data analysis methods included linear regression and a correlation matrix. Due to the exploratory nature of the study, the significance levels for the overall model and each variable were set at .05. The correlation matrix demonstrated that students with certain types of disabilities are more likely to fall under higher student loan payment brackets than students without disabilities. These results also varied among the different types of disabilities. The result of the overall linear regression model was statistically significant (p = .04). Despite the overall model being statistically significant, the majority of the significance values for the different types of disabilities were null. However, several other variables had statistically significant results, such as veterans, people of minority races, and people who attended private schools. Implications for how this impacts the economy, capitalism, and financial wellbeing of various students are discussed.

Keywords: disability, student loan debt, higher education, social work

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8683 IT Investment Decision Making: Case Studies on the Implementation of Contactless Payments in Commercial Banks of Kazakhstan

Authors: Symbat Moldabekova

Abstract:

This research explores the practice of decision-making in commercial banks in Kazakhstan. It focuses on recent technologies, such as contactless payments and QR code, and uses interviews with bank executives and industry practitioners to gain an understanding of how decisions are made and the role of financial assessment methods. The aim of the research is (1) to study the importance of financial techniques to evaluate IT investments; (2) to understand the role of different expert groups; (3) to explore how market trends and industry features affect decisions on IT; (4) to build a model that defines the real practice of decision-making on IT in commercial banks in Kazakhstan. The theoretical framework suggests that decision-making on IT is a socially constructed process, where actor groups with different background interact and negotiate with each other to develop a shared understanding of IT and to make more effective decisions. Theory and observations suggest that the more parties involved in the process of decision-making, the higher the possibility of disagreements between them. As each actor group has their views on the rational decision on an IT project, it is worth exploring how the final decision is made in practice. Initial findings show that the financial assessment methods are used as a guideline and do not play a big role in the final decision. The commercial banks of Kazakhstan tend to study experience of neighboring countries before adopting innovation. Implementing contactless payments is widely regarded as pinnacle success factor due to increasing competition in the market. First-to-market innovations are considered as priorities therefore, such decisions can be made with exemption of some certain actor groups from the process. Customers play significant role and they participate in testing demo versions of the products before bringing innovation to the market. The study will identify the viewpoints of actors in the banking sector on a rational decision, and the ways decision-makers from a variety of disciplines interact with each other in order to make a decision on IT in retail banks.

Keywords: actor groups, decision making, technology investment, retail banks

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8682 The Role of Midwives in Promoting Childbearing in Respect to the Law of Population Youth in Iran

Authors: Parvin Abedi, Poorandokht Afshari

Abstract:

Introduction: In 2022, the Youth Law of the Population was notified to all organizations, including the Iranian Ministry of Health. Some of the articles of this law are about the role of midwives in health and treatment to promote childbearing. In this regard, articles number 45, 48, 49, and 50 are related to midwifery work that will be reviewed in this article. Methods: In this review, the law of population youth was reviewed. In this regard, the statistics of midwives working in the treatment and health sector were collected and analyzed according to the population youth law. Results: Nearly 47 000 midwives are working in the public and private sectors of the country and in the healthcare sector; according to Article 49, which states that there should be one midwife for every two parturient women, about 12,000 midwives are needed in the treatment department and about 8,000 midwives are needed in the health department. In Article 50 it is mentioned to modify tariffs and efficiency in order to increase natural childbirth, and in this field, insurance organizations should have sufficient cooperation with payments. The tariff for midwifery services has been increased, but it is not enough for the stressful job of midwifery. The labor incentive for delivery by midwives is also low. Conclusion: Midwives are one of the fundamental pillars of the law of the population, and without increasing the motivation of midwives, it is not possible to increase the rate of natural childbirth and make childbirth pleasant.

Keywords: law of the population, midwife, motivation, childbearing

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8681 Managerial Overconfidence, Payout Policy, and Corporate Governance: Evidence from UK Companies

Authors: Abdullah AlGhazali, Richard Fairchild, Yilmaz Guney

Abstract:

We examine the effect of managerial overconfidence on UK firms’ payout policy for the period 2000 to 2012. The analysis incorporates, in addition to common firm-specific factors, a wide range of corporate governance factors and managerial characteristics that have been documented to affect the relationship between overconfidence and payout policy. Our results are robust to several estimation considerations. The findings show that the influence of overconfident CEOs on the amount of, and the propensity to pay, dividends is significant within the UK context. Specifically, we detect that there is a reduction in dividend payments in firms managed by overconfident managers compared to their non-overconfident counterparts. Moreover, we affirm that cash flows, firm size and profitability are positively correlated, while leverage, firm growth and investment are negatively correlated with the amount of and propensity to pay dividends. Interestingly, we demonstrate that firms with the potential for undervaluation reduce dividend payments. Some of the corporate governance factors are shown to motivate firms to pay more dividends while these factors seem to have no influence on the propensity to pay dividends. The results also show that in general higher overconfidence leads to more share repurchases but the lower total payout. Overall, managerial overconfidence should be considered as an important factor influencing payout policy in addition to other known factors.

Keywords: dividends, repurchases, UK firms, overconfidence, corporate governance, undervaluation

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8680 Fraud Detection in Credit Cards with Machine Learning

Authors: Anjali Chouksey, Riya Nimje, Jahanvi Saraf

Abstract:

Online transactions have increased dramatically in this new ‘social-distancing’ era. With online transactions, Fraud in online payments has also increased significantly. Frauds are a significant problem in various industries like insurance companies, baking, etc. These frauds include leaking sensitive information related to the credit card, which can be easily misused. Due to the government also pushing online transactions, E-commerce is on a boom. But due to increasing frauds in online payments, these E-commerce industries are suffering a great loss of trust from their customers. These companies are finding credit card fraud to be a big problem. People have started using online payment options and thus are becoming easy targets of credit card fraud. In this research paper, we will be discussing machine learning algorithms. We have used a decision tree, XGBOOST, k-nearest neighbour, logistic-regression, random forest, and SVM on a dataset in which there are transactions done online mode using credit cards. We will test all these algorithms for detecting fraud cases using the confusion matrix, F1 score, and calculating the accuracy score for each model to identify which algorithm can be used in detecting frauds.

Keywords: machine learning, fraud detection, artificial intelligence, decision tree, k nearest neighbour, random forest, XGBOOST, logistic regression, support vector machine

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8679 Utilities as Creditors: The Effect of Enforcement of Water Bill Payment in Zambia

Authors: Elizabeth Spink

Abstract:

Providing safe and affordable drinking water to low-income households in developing countries remains a challenge. Policy goals of increasing household piped-water access and cost recovery for utility providers are often at odds. Nonpayment of utility bills is frequently cited as a constraint to improving the quality of utility service. However, nonpayment is widely tolerated, and households often accumulate significant debt to the utility provider. This study examines the effect of enforcement of water bill payment through supply disconnections in Livingstone, Zambia. This research uses a dynamic model of household monthly payments and accumulation of arrears, which determine the probability of disconnection, and simulates the effect of exogenous changes in enforcement levels. This model is empirically tested using an event-study framework of exogenous increases in enforcement capacity that occur during administrative rezoning events, which reduce the number of households that one enforcement agent is responsible for. The results show that households are five percentage points more likely to make a payment in the months following a rezoning event, but disconnections for low-income households increase as well, resulting in little change in revenue collected by the water utility. The results suggest that high enforcement of water bill payments toward credit-constrained households may be ineffective and lead to reduced piped-water access.

Keywords: enforcement, nonpayment, piped-water access, water utilities

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8678 Social Health and Adaptation of Armenian Physicians

Authors: A. G. Margaryan

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Ability of adaptation of the organism is considered as an important component of health in maintaining relative dynamic constancy of the hemostasis and functioning of all organs and systems. Among the various forms of adaptation (individual, species and mental), social adaptation of the organism has a particular role. The aim of this study was to evaluate the subjective perception of social factors, social welfare and the level of adaptability of Armenian physicians. The survey involved 2,167 physicians (592 men and 1,575 women). According to the survey, most physicians (75.1%) were married. It was found that 88.6% of respondents had harmonious family relationships, 7.6% of respondents – tense relationships, and 1.0% – marginal relationships. The results showed that the average monthly salary with all premium payments amounted to 88 263.6±5.0 drams, and 16.7% of physicians heavily relied on the material support of parents or other relatives. Low material welfare was also confirmed by the analysis of the living conditions. Analysis of the results showed that the degree of subjective perception of social factors of different specialties averaged 11.3±3.1 points, which corresponds to satisfactory results (a very good result – 4.0 points). The degree of social adaptation of physicians on average makes 4.13±1.9 points, which corresponds to poor results (allowable less than 3.0 points). The distribution of the results of social adaptation severity revealed that the majority of physicians (58.6%) showed low social adaptation, average social adaptation is observed in 22.4% of the physicians and high adaptation – in only 17.4% of physicians. In conclusions, the findings of this study suggest that the degree of social adaptation of currently practicing physicians is low.

Keywords: physician's health, social adaptation, social factor, social health

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8677 A Study of the Trap of Multi-Homing in Customers: A Comparative Case Study of Digital Payments

Authors: Shari S. C. Shang, Lynn S. L. Chiu

Abstract:

In the digital payment market, some consumers use only one payment wallet while many others play multi-homing with a variety of payment services. With the diffusion of new payment systems, we examined the determinants of the adoption of multi-homing behavior. This study aims to understand how a digital payment provider dynamically expands business touch points with cross-business strategies to enrich the digital ecosystem and avoid the trap of multi-homing in customers. By synthesizing platform ecosystem literature, we constructed a two-dimensional research framework with one determinant of user digital behavior from offline to online intentions and the other determinant of digital payment touch points from convenient accessibility to cross-business platforms. To explore on a broader scale, we selected 12 digital payments from 5 countries of UK, US, Japan, Korea, and Taiwan. With the interplays of user digital behaviors and payment touch points, we group the study cases into four types: (1) Channel Initiated: users originated from retailers with high access to in-store shopping with face-to-face guidance for payment adoption. Providers offer rewards for customer loyalty and secure the retailer’s efficient cash flow management. (2) Social Media Dependent: users usually are digital natives with high access to social media or the internet who shop and pay digitally. Providers might not own physical or online shops but are licensed to aggregate money flows through virtual ecosystems. (3) Early Life Engagement: digital banks race to capture the next generation from popularity to profitability. This type of payment aimed to give children a taste of financial freedom while letting parents track their spending. Providers are to capitalize on the digital payment and e-commerce boom and hold on to new customers into adulthood. (4) Traditional Banking: plastic credit cards are purposely designed as a control group to track the evolvement of business strategies in digital payments. Traditional credit card users may follow the bank’s digital strategy to land on different types of digital wallets or mostly keep using plastic credit cards. This research analyzed business growth models and inter-firms’ coopetition strategies of the selected cases. Results of the multiple case analysis reveal that channel initiated payments bundled rewards with retailer’s business discount for recurring purchases. They also extended other financial services, such as insurance, to fulfill customers’ new demands. Contrastively, social media dependent payments developed new usages and new value creation, such as P2P money transfer through network effects among the virtual social ties, while early life engagements offer virtual banking products to children who are digital natives but overlooked by incumbents. It has disrupted the banking business domains in preparation for the metaverse economy. Lastly, the control group of traditional plastic credit cards has gradually converted to a BaaS (banking as a service) model depending on customers’ preferences. The multi-homing behavior is not avoidable in digital payment competitions. Payment providers may encounter multiple waves of a multi-homing threat after a short period of success. A dynamic cross-business collaboration strategy should be explored to continuously evolve the digital ecosystems and allow users for a broader shopping experience and continual usage.

Keywords: digital payment, digital ecosystems, multihoming users, cross business strategy, user digital behavior intentions

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8676 Managing Human-Wildlife Conflicts Compensation Claims Data Collection and Payments Using a Scheme Administrator

Authors: Eric Mwenda, Shadrack Ngene

Abstract:

Human-wildlife conflicts (HWCs) are the main threat to conservation in Africa. This is because wildlife needs overlap with those of humans. In Kenya, about 70% of wildlife occurs outside protected areas. As a result, wildlife and human range overlap, causing HWCs. The HWCs in Kenya occur in the drylands adjacent to protected areas. The top five counties with the highest incidences of HWC are Taita Taveta, Narok, Lamu, Kajiado, and Laikipia. The common wildlife species responsible for HWCs are elephants, buffaloes, hyenas, hippos, leopards, baboons, monkeys, snakes, and crocodiles. To ensure individuals affected by the conflicts are compensated, Kenya has developed a model of HWC compensation claims data collection and payment. We collected data on HWC from all eight Kenya Wildlife Service (KWS) Conservation Areas from 2009 to 2019. Additional data was collected from stakeholders' consultative workshops held in the Conservation Areas and a literature review regarding payment of injuries and ongoing insurance schemes being practiced in areas. This was followed by the description of the claims administration process and calculation of the pricing of the compensation claims. We further developed a digital platform for data capture and processing of all reported conflict cases and payments. Our product recognized four categories of HWC (i.e., human death and injury, property damage, crop destruction, and livestock predation). Personal bodily injury and human death were provided based on the Continental Scale of Benefits. We proposed a maximum of Kenya Shillings (KES) 3,000,000 for death. Medical, pharmaceutical, and hospital expenses were capped at a maximum of KES 150,000, as well as funeral costs at KES 50,000. Pain and suffering were proposed to be paid for 12 months at the rate of KES 13,500 per month. Crop damage was to be based on farm input costs at a maximum of KES 150,000 per claim. Livestock predation leading to death was based on Tropical Livestock Unit (TLU), which is equivalent to KES 30,000, whick includes Cattle (1 TLU = KES 30,000), Camel (1.4 TLU = KES 42,000), Goat (0.15 TLU = 4,500), Sheep (0.15 TLU = 4,500), and Donkey (0.5 TLU = KES 15,000). Property destruction (buildings, outside structures and harvested crops) was capped at KES 150,000 per any one claim. We conclude that it is possible to use an administrator to collect data on HWC compensation claims and make payments using technology. The success of the new approach will depend on a piloting program. We recommended that a pilot scheme be initiated for eight months in Taita Taveta, Kajiado, Baringo, Laikipia, Narok, and Meru Counties. This will test the claims administration process as well as harmonize data collection methods. The results of this pilot will be crucial in adjusting the scheme before country-wide roll out.

Keywords: human-wildlife conflicts, compensation, human death and injury, crop destruction, predation, property destruction

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