Life Transitions![]() For a copy of Dr. Robinson's work, see A Long-Term-Care Status Transition Model. Dr. Robinson's methodology and its derivatives are used in the American insurance industry, particularly in long-term care insurance, to develop premiums, reserves, and do other essential computations. The methodology employed by Dr. Robinson involved empirical work and statistics to determine the best function of initial age and gender that would compute transition rates among the eight states into which the data had divided health. Matrix exponentiation is then used to convert this transition rate matrix into a Markov matrix. The health states differ according to three variables: (a) the number of "instrumental activities of daily living" that are impaired; (b) the number of "activities of daily living" that are impaired; and (c) whether a "cognitive impairment" exists. An activity of daily living, ubiquitously abbreviated as ADL, means an activity such as bathing, dressing, "transferring" (getting out of bed), toileting, continence, and eating. An instrumental activity of daily living, IADL, refers to something such as an inability to drive, prepare meals, or do housework. A cognitive impairment generally refers to a loss or deterioration in intellectual capacity such as that caused by Alzheimer's disease that requires substantial supervision to protect the person. In State 1, the person has no IADL, no ADLs, and no cognitive impairment. In State 2, the person has an IADL, no ADLS and no cognitive impairment. In State 3, the person has 1 ADL and no cognitive impairment. In State 4, the person has 2 ADLs and no cognitive impairments. In State 5, the person has 3 or more ADLs and no cognitive impairment. In State 6, the person has fewer than 2 ADLs but has cognitive impairment. In State 7, the person has 2 or more ADLS and has cognitive impairment. In State 8, the person is dead. Many long-term care insurance policies use definitions similar to these states to determine whether benefits are owing and whether premiums otherwise due are excused. ![]() "Life Transitions" from The Wolfram Demonstrations Project http://demonstrations.wolfram.com/LifeTransitions/ Contributed by: Seth J. Chandler |
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