我國加入WTO之後，為因應先進國家自由化、國際化的潮流和趨勢，以及追求我國保險制度的健全發展，保險主管機關乃決定將過去長期採用的規章費率改為自由費率。而為了避免對保險業的衝擊過大，乃將整個費率自由化的時程分成三個階段實施，以達到逐步開放產險市場的目標。費率自由化的目的主要是希望能藉此廢除不合理干預市場機制的法規，並建立合理的競爭環境，以及保護消費者的權益等。事實上，費率自由化並不是盲目的開放市場，而是藉由有制度的監理，確保保險業有足夠的清償能力，並且維護市場秩序和紀律。 從歐、美及日本等國在費率自由化的發展趨勢及經驗來看，費率自由化的實施已成為一種不可抵擋的趨勢，而保險業者為了能在競爭的市場中生存，都會積極的推出新產品、新通路，並提出各項經營策略以為因應，因為也唯有如此才能立足於保險市場，也不會在這股洪流中被淹沒。 就我國的現況來看，民國91年開放的第一階段費率自由化，主要是以放寬「附加費用率」為主，就「危險保費」部分得讓業者做有限度的偏離，則在第二階段始予以開放，惟保險公司必須依規定檢具各項資料先行向主管機關申請。至於最後一個階段除了強制保險外，其餘之商品均得由業者自行釐定費率，簡單的說，從第三階段開始費率就全面自由化了。 本篇論文主要目的係探討費率自由化之相關議題。首先介紹費率自由化之意義與實施源由，接著將闡述各歐美先進國家之發展狀況與衝擊，最後，則根據各國實施費率自由化的經驗，以及我國汽車保險市場的實際情況，提出實施費率自由化後的趨勢分析，而面對未來車險市場的變革，也提出個人幾點因應之道，期望所有的保險業者都能藉由努力提昇獲利力，在競爭的車險市場中各占有一席之地，並且也期盼本文對於日後在費率自由化的研究上，能提供業者作為參考。 / After Taiwan’s entrance into WTO, insurance authorities decide to follow the trend of internationalization and liberalization and adopt rate deregulation, for soundness development of insurance market. To avoid heavy impact on insurance companies, authorities divide the plan of rate deregulation into three phases, in order to open the property/casualty market gradually. The objective of deregulation is to eliminate the improper control, and to establish a rational competition environment for protecting consumers’ rights. In fact, the main purpose of rate deregulation is to ensure insurers’ solvency and to maintain the discipline of the insurance market. The implementation of rate deregulation is an inevitable trend in the world, many insurers make a great deal of efforts to develop the various products and channels to increase market share. From the prospective of Taiwan’s condition, the first stage of rate deregulation focuses on releasing the restrictions of “loading expenses” and making “risk premium” relax limited. The main purpose of the second stage is to deregulate “risk premium” completely, but insurers should report the relevant information and files to authorities concerned in advanced. In the last stage, insurers can rate all products individually other than compulsory insurance. That is, it will be a fully liberalization stage. The purpose of the study aims to clarify several issues. First, the study introduces the reasons of the implementation of the rate deregulation. Second, the study elaborates the background and influence of the experience of rate deregulation in every developed country as well. Meanwhile, the study makes descriptions of the current situation of Taiwan. Finally, according to the experience of rate deregulation of every country and the condition of Taiwan, the study analyzes the trend of implementation of rate deregulation and suggests several strategies to deal with the potential influence which may be helpful to insurers in Taiwan.

The diploma thesis analyzes the topic of preparedness of individual regional and training centers of medical rescue service providers and employees of such organizations for cases of emergencies with mass casualties. In order to collect the data required for the empirical part of the diploma thesis, I prepared two questionnaires: one was a qualitative research aimed only at managers of educational and training centres of individual regional medical rescue services. The other questionnaire was used for a quantitative research, in the form of an anonymous non-standardized questionnaire, which was prepared for employees of medical rescue service. The evaluation of the results of the questionnaire surveys has shown that in spite of the usually appropriate conditions secured by the medical rescue service providers and in spite of the relatively frequent trainings, the knowledge of individual employees in this field is not sufficient. Based on the results acquired it is obvious that individual educational and training centres of medical rescue service providers should pay more attention to the professional training of their employees on this issue. These results will be, upon request, presented to the representatives of individual educational and training centres, and should be used to make the preparation of their employees for cases of emergencies with mass casualties more effective.

This is the first monograph to be published on the work of the Queen Alexandra's Imperial Military Nursing Service (QAIMNS) in the Great War. The historiography of British military nursing during this period is scant, and research based monograph are negligible. What exists, does not focus specifically on the work of the Queen Alexandra's Imperial Military Nursing Service, (QAIMNS) the Reserve, (QAIMNSR) or the Territorial Force Nursing Service (TFNS) but tends to concentrate on the work of the volunteer, untrained, Voluntary Aid Detachment (VAD) nurses. Unfortunately, this has resulted in factually inaccurate representations of British WW1 nursing. The mass mobilisation of nurses by professional and voluntary nursing services led to rivalry between the different groups and my research addresses the relationship that develop between the trained and volunteer nurses. Also, my research examines the climatic and environmental conditions that impacted upon the effective delivery of nursing and casualty care and the mismanagement of services and supplies by the War Office and the Army Medical Services. Additionally, the political controversies and scandals over inadequate planning for the care, treatment and transportation of mass casualties is addressed. Furthermore, diseases and traumatic injuries sustained by nurses on active service are examined and, shell-shock, hitherto considered a combatants' condition is cited in relation to mental health issues of nurses on active service. Moreover, my research examines the deaths and disability rates within the ranks of nursing services. My research features individual awards for acts of bravery and mentioned in Dispatches. On the Home Front the politics of nursing are addressed. Nurses campaigned for professional recognition and many were supportive of universal suffrage and they argued for both professional and personal liberation. The struggle for professional recognition led to divisions within the civilian nursing leadership because they failed to arrive at a consensus on the content of the Nurse Registration Bill. Also, the supply of nurses for the war effort was consistently problematic and this led the Government to establish the Supply of Nurses Committee. Before it had its first sitting it had already become contentious and controversial. The issues are discussed. Using extensive primary sources, the monograph moves away from the myths, and uncritical and overly romanticised views of WW1 military nursing. It is hoped that by examining the personal, professional and political issues that impacted upon nurses the monograph will make a significant contribution to the historiography of WW1 military nursing and to the history of the Great War more generally.

<p>För att kunna erbjuda god och lättillgänglig hälso- och sjukvård vid stora olyckor och katastrofer krävs en katastrofberedskap grundad på planläggning, utbildning och övning. Sjukvårdens särskilda beredskap måste kunna hantera såväl den "lilla vardagsolyckan" som den stora olyckan eller katastrofen. Syftet med denna studie var att undersöka hur enhetschefer och distriktssköterskor vid primärvården i två kommuner i Jämtlands län upplevde sig förberedda inför en katastrof eller en stor olycka där utryckning krävdes utanför vårdinrättningar till olycksplats. Syftet var även att undersöka hur katastrofberedskap prioriteras av enhetschefer. En intervjustudie har genomförts med tre enhetschefer och fem distriktssköterskor. Intervjuerna har analyserats med kvalitativ innehållsanalys. Utifrån analysen skapades två<strong> </strong>kategorier: ”känsla av säkerhet”<strong> </strong>och ”organisation” samt fyra underkategorier ”beredskap”, ”prioritet”, ”förmåga” och<strong> </strong>”kunskap”. Huvudfyndet var att samtliga intervjudeltagare önskade ha övningar för att känna sig mer förberedd vid en stor olycka. I dagsläget övades det inte alls på katastrofberedskap.</p> / <p>In order to provide good and accessible healthcare in case of emergencies and disasters, an emergency plan based on planning, training and practice is required. Special care must be prepared to deal with both the ”small everyday accident” but also the major accident and disaster. The purpose of this study was to examine how unit managers and districtnurses in primary care in two municipalities in Jämtland county experience themselves prepared in case of a disaster or a major accident which requires emergency care facilities outside the unit. The aim was also to examine how emergency preparedness is a priority for the unit managers. An interview study has been carried out with three unitmanagers and five districtnurses. The interviews were analyzed with qualitative content analysis. Based on the analysis two categories were created: 'feeling of security "and" organization "and four sub-categories of" security "," priority "," ability "and" knowledge ". Major findings was that all the interview participants wished to have exercises to feel more prepared for a major accident. For the time being, no practice in disaster preparedness is carried out.</p>

För att kunna erbjuda god och lättillgänglig hälso- och sjukvård vid stora olyckor och katastrofer krävs en katastrofberedskap grundad på planläggning, utbildning och övning. Sjukvårdens särskilda beredskap måste kunna hantera såväl den "lilla vardagsolyckan" som den stora olyckan eller katastrofen. Syftet med denna studie var att undersöka hur enhetschefer och distriktssköterskor vid primärvården i två kommuner i Jämtlands län upplevde sig förberedda inför en katastrof eller en stor olycka där utryckning krävdes utanför vårdinrättningar till olycksplats. Syftet var även att undersöka hur katastrofberedskap prioriteras av enhetschefer. En intervjustudie har genomförts med tre enhetschefer och fem distriktssköterskor. Intervjuerna har analyserats med kvalitativ innehållsanalys. Utifrån analysen skapades två kategorier: ”känsla av säkerhet” och ”organisation” samt fyra underkategorier ”beredskap”, ”prioritet”, ”förmåga” och ”kunskap”. Huvudfyndet var att samtliga intervjudeltagare önskade ha övningar för att känna sig mer förberedd vid en stor olycka. I dagsläget övades det inte alls på katastrofberedskap. / In order to provide good and accessible healthcare in case of emergencies and disasters, an emergency plan based on planning, training and practice is required. Special care must be prepared to deal with both the ”small everyday accident” but also the major accident and disaster. The purpose of this study was to examine how unit managers and districtnurses in primary care in two municipalities in Jämtland county experience themselves prepared in case of a disaster or a major accident which requires emergency care facilities outside the unit. The aim was also to examine how emergency preparedness is a priority for the unit managers. An interview study has been carried out with three unitmanagers and five districtnurses. The interviews were analyzed with qualitative content analysis. Based on the analysis two categories were created: 'feeling of security "and" organization "and four sub-categories of" security "," priority "," ability "and" knowledge ". Major findings was that all the interview participants wished to have exercises to feel more prepared for a major accident. For the time being, no practice in disaster preparedness is carried out.

再保險交易為國內產物保險業者經營業務及風險管理上不可或缺之工具，近年衍生融通資金及改善財務結構之財務面功能，並傳出國際知名保險業者不當運用之情事，而引起各國保險監理機關之重視，開始建立再保險完整之監理制度及詳細規範。就我國產險業而言，現行再保險交易分出業務之會計處理，可透過再保費支出、再保佣金收入、再保攤回賠款及提存未滿期保費準備減少數等會計科目，產生盈餘釋放數，進而操控公司財務報表。本研究擬探討我國產險公司是否會利用承作再保險交易從事盈餘管理。 本研究分別採用縱橫資料迴歸及分量迴歸兩種模型，以1994-2008年之國內12家產險公司為樣本，探討再保險交易量及再保險交易盈餘釋放數與盈餘管理動機之關聯。實證結果顯示我國產險公司，就資本市場動機而言，當期盈餘數愈低者，會避免虧損而從事愈多再保險交易或有愈高之盈餘釋放數，若當期盈餘低於前期愈多者，則有愈高之盈餘釋放數；就稅負動機而言，若為高稅負成本者，將從事較少再保險交易或有較低之盈餘釋放數；惟就監理動機而言，發現產險公司保單持有人盈餘與實收資本之45%的差距愈小者，反而從事愈少之再保險交易。 / Reinsurance is an indispensable tool for property-casualty insurers’ business operating and risk management. In recent years, reinsurance derived some financial functions such capital finance and financial structure improvement. Some of the world famous insurers had been found improper use of financial reinsurance, which caused regulators of various countries try to establish more supervisory systems and detailed standards to monitor such behavior. The present accounting procedures of reinsurance ceded-out business might release surplus through reinsurance premiums ceded, reinsurance commission earned, claims recovered from reinsures, and the decrease of unearned premium reserves, which release might give insurers to manipulate the financial reporting. Therefore, this research attempts to examine association between reinsurance arrangements and earnings management on Taiwan’s property-casualty insurers. This research applies panel data model and quantile regression model to test the reinsurance transactions and the surplus release associated with earnings management motivation. The data draw from12 property-casualty Taiwan’s insurers from 1994 to 2008. For capital market motivations, the evidence indicates that property-casualty insurers manage more reinsurance transactions or the higher surplus release to avoid losses, and manage the higher surplus release to avoid earnings decreases. For tax burden motivations, the result shows that the higher tax burden insurers have, the fewer insurers manage reinsurance transactions and the lower surplus release. However, for regulatory motivations, the empirical results indicate that the less difference between policyholders’ surplus and 45% of total capital has, the fewer reinsurance transactions are being managed.

In 2011 and 2012, dramatic changes were made to the health care reform in the Czech Republic. As a consequence, almost the complete legislation related to traumatological planning was changed. This reform primarily introduced two new types of operating divisions; a department of emergency preparedness, as for the emergency medical service providers, and a contact point, from the aspect of emergency inpatient care providers. Emergency preparedness primarily processes a concept of the traumatological plan for the emergency medical service and introduces potential changes. The contact point, as a department of the emergency inpatient care with continuous operation, receives calls from the emergency medical service, especially in the event of emergencies and crisis situations. The given Master's Diploma Thesis entitled "Cooperation of the Trauma Centre of the Hospital České Budějovice and Medical Operation Center of the Emergency Medical Service of the South Bohemian Region in the Event of Mass-Casualty Incident" develops a key issue of the interconnection of traumatological plans established by health service providers within the South Bohemian Region and the level of their cooperation. Then the work analyses three mass-casualty incidents which happened in the past within the area and the level of involvement and cooperation of the aforementioned departments, i.e. the Hospital's trauma centre and Medical Operation Centre upon the Medical Emergency Centre of the Region of South Bohemia. The Diploma Thesis proceeds from the qualitative research which is divided into two parts. The first one defines the V1 research question specifying the role of the Traumatological Plan of the South Bohemian health care during the cooperation with the trauma centre under the Hospital České Budějovice and medical operation centre of the Medical Emergency Service of the South Bohemian Region in the event of a mass-casualty incident. By using a comparative method, which assessed the three traumatological plans, the level of cooperation did not exceed more than 20 % owing to the fact that the Traumatological Plan of the South Bohemian health care is out-dated. As a consequence, the answer to the V1 research question was following: The role of the Traumatological Plan of the South Bohemian health care with the cooperation of the trauma centre under the Hospital České Budějovice and Medical operation centre of the Medical Emergency Service of the South Bohemian Region in the event of a mass-casualty incident is insignificant. The second part develops the V2 research question: whether the failure in communication between the aforementioned trauma centre and medical operation centre could have any impact on the injured in the event of a mass-casualty incident. The qualitative research with the use of a method of analysis implemented during the previous mass-casualty incidents and interviews with four operators working for the medical operation centre and four doctors working at the accident, emergency and plastic surgery department provided the second answer to the V2 research question: Failure in communication between the two aforementioned departments could have a significant impact on the injured in the event of a mass-casualty incident. In the end, the thesis refers to the dramatic difference between the ideal traumatological planning and the current situation pointing out the Traumatological Plan of the South Bohemian healthcare which has not been updated for three and a half years since the reform. The given work also describes the issue of the ideal solution to the establishment of contact points in hospitals and compares it with the current situation at the Hospital České Budějovice where the contact point was established only in order to comply with the legislation, i.e. the contact point is based in the operating centre of medical transport.

Medical rescue workers are routinely employed in emergency medicine. In emergencies where a large number of people are affected, knowledge of medical disaster practices is necessary. Within a second, the intervening crews should switch to another mode with a different approach to the patients than they use daily. The diploma thesis has set the following goals: to map the level of knowledge of medical rescuers in the field of emergency response with mass health impairment, their personal experience and, last but not least, education and training. Three research questions were asked to reach these objectives. What are the skills of medical rescuers in dealing with emergency health issues with mass health impairment? How do medical rescuers assess incidents with mass health impairment at which they were present and what is their attitude towards training and education in the field of dealing with emergencies with mass health impairment? The research part consists of interviews with two groups of participants: eight medical rescuers of the Medical Rescue Service of the Pardubice Region and the same number of medical rescuers of the Medical Rescue Service of the South Bohemian Region. These interviews supplemented the information provided by the crisis preparedness managers of both medical rescue services. The survey used a qualitative research strategy, conversations were recorded on a dictaphone, then processed into categories, subcategories, tables and evaluated. From the results of the work, a great difference in the knowledge of health rescuers in the field of emergency health problems can be seen. Participants of the South Bohemian Medical Emergency Rescue Service showed shortcomings in both the basic terminology and the solving of extraordinary events in particular, from reporting the situation with a report form to the classification of the disabled. On the contrary, the majority of participants in the Paramedical Rescue Service of the Pardubice Region would be able to file an initial emergency report and categorize and transport patients correctly. On the basis of the evaluated results, this difference in knowledge can be attributed mainly to the frequency and content of the training provided. In the case of South Bohemian participants, we can find the cause in the absence of practical training. The alarming results were noted in the participants' ability to use the START sorting method, from all of the sixteen respondents only one was able to answer there. The elaborated case report of an extraordinary event points to the fact that theoretical shortcomings can subsequently be transferred into practice.

The goal of this thesis was to analyze processes of the Emergency Medical Dispatch Center of the Emergency Medical Service of the Pilsen Region (ZOS ZZS Pk) when dealing with a mass casualty incident. The theoretical part of the thesis provides basic information relevant to the Pilsen Region, the Emergency Medical Service of the Pilsen Region, basic information on operations and general work processes of an emergency medical dispatch center during a normal work regime, and specific activities performed when dealing with a mass casualty incident. The research part of this thesis analyses activities and processes of an emergency medical dispatch center as described in the Mutual Mission Types Manual for Integrated Rescue System forces while at a mutual incident - Activities of Integrated Rescue System Forces at a Mass Casualty Incident (STČ 09/IZS). Further on the thesis evaluates activities of the ZOS ZZS Pk taken while dealing with two mass casualty incidents. These were a bus accident nearby Rokycany town in 2013 and a two trains collision nearby Horažďovice town in 2015. In order to make the analysis of readiness of the ZOS ZZS Pk to deal with mass casualty incidents more complex, SWOT analysis was added to the results. Based on the results of the STČ 09/IZS-manual analysis and of the SWOT analysis, suggestions for new manuals were made, that should make all the actions taken by employees of the ZOS ZZS Pk while dealing with a mass casualty incident more efficient and more effective. The goal of this thesis: to analyze activities of the ZOS ZZS Pk while dealing with a mass casualty incident, and to create suggestions of which inadequacies to remove and how to make operations of the ZOS ZZS Pk more efficient and more effective when dealing with mass casualty incidents; has therefore been fulfilled. The main outcome of the thesis are the final recommendations for making operations of the ZOS ZZS Pk more efficient and more effective when dealing with a mass casualty incident.

Syfte: Att kartlägga triagekunskap hos kliniskt verksam ambulanspersonal i en masskadesituation med patientfall från MACSIM. Metod: Studien är en kvantitativtvärsnittsstudie som baseras på en webenkät med 84 respondenter som arbetar inom ambulansverksamheten. Enkäten innehöll slutna bakgrundsfrågor och ett kunskapstest med 30 patientfall som bygger på simuleringsverktyget MACSIM. All data bearbetades med analytiskoch deskriptiv statistik. Resultat: Studien resulterade i totalt 2520 triageringar, inklusive 924 triageringar av barn. Resultatet visar total korrekt triage (66,8 %), undertriage (17,9 %) och övertriage (15,2 %) samt triage av barn som visar korrekt triage (72,7 %), undertriage (8,4 %) och övertriage (18,8 %). Studien visar signifikanta och icke signifikanta skillnader i ovanstående triageresultat beroende på bakgrundsfaktorer. Konklusion: Det framkommertydligt i denna studie att ambulanspersonal är i behov av mer utbildning i hur man triagerar enligt sållningstriage vid en masskadesituation. Sållningstriage är tänkt att vara ett enkelt tillvägagångssätt under det första triaget vid en masskadesituation. Trots detta var det bara ett fåtal av deltagarna som hade en acceptabel nivå av såväl korrekt triage som undertriage.Däremot visar det totala resultatet en acceptabel nivå av övertriage. / Aim: The aim of this study is to identify triage knowledge of clinically active ambulance personnel in a mass casualty incident (MCI) with patient cases from MACSIM. Method: The study is a quantitative, cross-sectional study based on a digital survey with 84 respondents working in the prehospital organization. The survey included closed background questions and a knowledge test with 30 patient cases based on the simulation tool, MACSIM. All data were processed with analytical and descriptive statistics. Results: The study resulted in total of 2520 triages, including 924 triages of children. Results showed a total correct triage (66,8 %), undertriage (17,9 %) and overtriage (15,2 %) and triage of children showing correct triage (72.7%), undertriage (8.4%) and overtriage (18.8%). The study shows significant and nonsignificant differences in the above triage results depending on the background factors.Conclusion: It stands clear in this study that ambulance personnel need more education in how to triage according to MCI triage. MCI triage is supposed to be an easy approach during the first triage in an MCI. Even so, only a small number of the participants had an acceptable level of correct triage as well as undertriage. However, the overall result showed an acceptable level of overtriage.