scholarly journals Acceptance for Social Health Insurance among Health Professionals in Government Hospitals, Mekelle City, North Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Alemtsehay Tewele ◽  
Mezgebu Yitayal ◽  
Adane Kebede
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Professionals ◽  
Health Care Services ◽  
Social Health Insurance ◽  
Social Health ◽  
Care Services ◽  
Government Hospitals ◽  
Mekelle City ◽  
Monthly Salary

Background. Ethiopia is one of the countries with high out-of-pocket payments leading to catastrophic health expenditure. The government of Ethiopia introduced social health insurance (SHI) scheme with the overall objective of achieving universal health care access. Studying health professionals’ acceptance to pay for social health insurance is crucial for the successful implementation of the scheme. Therefore, this study aimed to assess the acceptance of social health insurance and its associated factors among health professionals in government hospitals, Mekelle city, North Ethiopia. Methods. An institution-based cross-sectional study design was used. The study participants were selected using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 20. Bivariable and multivariable logistic regression models at a 5% level of significance, and odds ratios with 95% CI level were used to determine the association between the health professionals’ acceptance of health insurance and explanatory variables. Results. The study revealed that 62.5% of the respondents were willing to participate in the SHI scheme in which 74.9% were willing to pay 3% or more of their monthly salary. Health professionals’ acceptance for SHI significantly associated with monthly salary (AOR = 9.49; 95% CI: 2.51, 35.86), awareness about SHI (AOR = 3.89; 95% CI: 1.05, 14.28), history of difficulty in covering medical bills (AOR = 6.2; 95% CI: 2.42, 15.87), attitudes towards social health insurance (AOR = 7.57; 95% CI: 3.14, 18.21), and perceived quality of health care services if SHI implemented (AOR = 2.89; 95% CI: 1.18, 7.07). Conclusion. The study indicated that there were still a high proportion of health professionals who were not willing to pay for SHI. Therefore, strengthening awareness creation, creating awareness about SHI, promoting the scheme using the different channels of communication to bring about favorable attitude, and providing health care services with required standard quality could help to increase the acceptance of SHI by health professionals.

HEALTH INSURANCE IN ACEH

2021 ◽  
Author(s):  
Irwan Saputra
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Social Health Insurance ◽  
Social Health ◽  
Fee For Service ◽  
Payment Method ◽  
Care Services ◽  
Provider Payment ◽  
Aceh Province

The implementation of social health insurance programme in Aceh Province of Indonesia as a mechanism to achieve universal health care coverage, equitable access and good quality in health care services requires a sustainable financial resource for a longterm period. Government of Aceh Province has established the Social Health Insurance (SHI) programme to cover the whole population of Aceh (4.6 Million) since 1 st June 2006. The SHI programme is called “Jaminan Kesehatan Aceh (JKA)”. Fee-forservice has been used in this programme as the provider payment method from year 2006 to year 2013. Based on the official reports from Aceh government and other sources, the health care expenditure increases every year even though the provisions of health care services were not still not optimum. Many countries faced similar problems with the use of fee-for-service. Hence, WHO recommended the use of prospective payment method in SHI. To ensure sustainability of JKA, reform in the health financing system need to be carried out by introducing more efficient provider payment method such as prospective payment. This book will evaluate the implementation of JKA programme and to compare the hospital tariff based on fee- for- service with prospective method using Indonesia Case Base Group (INA-CBG). This study employs both qualitative and quantitative methods. In-depth interviews were carried out among selected stakeholders involved in the designing and implementing JKA. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using 602 INACBG groups from 17,547 cases.

scholarly journals Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abel Mekonne ◽  
Benyam Seifu ◽  
Chernet Hailu ◽  
Alemayehu Atomsa
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Health Professionals ◽  
Addis Ababa ◽  
Social Health Insurance ◽  
Social Health ◽  
Care Providers ◽  
The Government

Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

scholarly journals Social health insurance in the Philippines: do the poor really benefit?

2020 ◽  
Vol 45 (1) ◽  
pp. 171-187
Author(s):  
Salaheddine El Omari ◽  
Mahmoud Karasneh
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
Access To Health Care ◽  
Social Health Insurance ◽  
The Philippines ◽  
Social Health ◽  
Free Access ◽  
Care Services ◽  
Access To Health

AbstractDeveloping countries have spent a tremendous amount of time and money on social health insurance programs to give the low-income population free access to health care services. Standard economic theory predicts that people use care services more frequently and regularly when they are free. In this paper, we show that providing free access to health services might not be enough to enhance the utilization of health care by indigents.

Race and gender as factors in access to health insurance and utilization of health care services

2014 ◽  
Author(s):  
Susana J. Ferradas ◽  
G. Nicole Rider ◽  
Johanna D. Williams ◽  
Brittany J. Dancy ◽  
Lauren R. Mcghee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Race And Gender ◽  
Care Services ◽  
Access To Health ◽  
And Gender

scholarly journals Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

2021 ◽  
Vol 18 (5) ◽  
pp. 2767
Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Disease ◽  
National Health Insurance ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Resource Usage ◽  
Care Services ◽  
Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

Umowy o udzielanie świadczeń opieki zdrowotnej zawierane przez Narodowy Fundusz Zdrowia (leczenie w ramach ubezpieczenia zdrowotnego) a leczenie na zasadach komercyjnych. Implikacje prawne i praktyczne

2021 ◽  
pp. 141-151
Author(s):  
Paweł Lipowski
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Providers ◽  
Health Care Services ◽  
Legal Status ◽  
Healthcare Services ◽  
Care Providers ◽  
Care Services ◽  
Public Payer ◽  
Universal Health

The aim of this study is to identify the legal characteristics of contracts for the health care services provided by a public payer, i.e. the National Health Fund (NFZ) as part of treatment covered by universal health insurance, as compared to those provided by the health care providers with public or private legal status. This issue is discussed in relation to the legal conditions for the treatment of patients on a commercial basis in those institutions (private or public) which have contracts for the provision of healthcare services under the general health insurance (so-called contracts). The discussion is presented based on author’s own observations, resulting both from his scientific studies in the field of medical law and his work in various entities operating in the health care system.

scholarly journals COMMUNITY-BASED HEALTH INSURANCE SCHEME IN A RURAL COMMUNITY OF NORTH WEST NIGERIA: A ROADMAP TO ACHIEVING UNIVERSAL HEALTH COVERAGE.

2020 ◽  
Vol 14 (2) ◽  
pp. 125-130
Author(s):  
Lawal A ◽  
◽  
Gobir AA ◽  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Health Insurance Scheme ◽  
Willingness To Participate ◽  
Insurance Scheme ◽  
Community Based ◽  
Quality Health Care ◽  
Community Based Health Insurance ◽  
Care Services

Background: Community Based Health Insurance (CBHI) scheme is aimed at reducing out of pocket spending on health care services, ensuring final risk protection to all, especially the poor and the most vulnerable, improvement of quality of health care services, access and utilization as well as the promotion of equity. Objective: This research was aimed at determining willingness to participate in a community-based health insurance scheme among rural households in Katsina State. Method: A cross-sectional descriptive study was conducted in December 2016 among households of Batagarawa LGA, Katsina State. We used a pre-tested, electronic, semi-structured interviewer-administered questionnaire to obtain data from households that were selected using a multistage sampling technique and we analyzed the data using STATA version 13. Results: Most, (28.5%) of the respondents were in the age range of 30-39 years with a mean age of 35.5 years. Males were the dominant household heads (93%). Most were married (90%). Most, (90.5%) of households were willing to pay for a community-based health insurance scheme with a median premium of 100 Naira per household member per month. Conclusions: The high proportion of households willing to pay for the scheme should inform the decision of policy makers to design and maintain Community Based Health Insurance Scheme to improve access to and utilization of quality health care services.

scholarly journals The shared experiences of insured members and the uninsured in health care access and utilization under Ghana’s national health insurance scheme: Evidence from the Hohoe Municipality

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244155
Author(s):  
Suraiya Umar ◽  
Adam Fusheini ◽  
Martin Amogre Ayanore
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Health Care Services ◽  
National Health Insurance Scheme ◽  
Insurance Scheme ◽  
Financial Barriers ◽  
Care Access ◽  
Care Services ◽  
Barriers To Health

Background The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003 to remove financial barriers and to promote equitable access to health care services. Post implementation has been characterized by increases in access and utilization of services among the insured. The uninsured have been less likely to utilize services due to unaffordability of health care costs. In this study, we explored the experiences of the insured members of the NHIS, the uninsured and health professionals in accessing and utilizing health care services under the NHIS in the Hohoe Municipality of Ghana. Methods Qualitative in-depth interviews were held with twenty-five NHIS insured, twenty-five uninsured, and five health care professionals, who were randomly sampled from the Hohoe Municipality to collect data for this study. Data was analyzed using thematic analysis. Results Participants identified both enablers or motivating factors and barriers to health care services of the insured and uninsured. The major factors motivating members to access and use health care services were illness severity and symptom persistence. On the other hand, barriers identified included perceived poor service quality and lack of health insurance among the insured and uninsured respectively. Other barriers participants identified included financial constraints, poor attitudes of service providers, and prolonged waiting time. However, the level of care received were reportedly about the same among the insured and uninsured with access to quality health care much dependent on ability to pay, which favors the rich and thereby creating inequity in accessing the needed quality care services. Conclusion The implication of the financial barriers to health care access identified is that the poor and uninsured still suffer from health care access challenges, which questions the efficiency and core goal of the NHIS in removing financial barrier to health care access. This has the potential of undermining Ghana’s ability to meet the Sustainable Development Goal 3.8 of universal health coverage by the year 2030.

scholarly journals Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
N. Mlenzana ◽  
R. Mwansa
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Waiting Times ◽  
Care Providers ◽  
Persons With Disabilities ◽  
Care Services ◽  
Primary Health

To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54%) were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction. Other clients were satisfied with thoroughness ofhealth care providers regarding symptoms, feelings, reception and treatment received at the primary health care centre.Understanding the views of the clients is essential in improving health delivery services and could impact on thecompliance of people attending primary health care services.

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