scholarly journals Effect of Community-Based Health Insurance on Utilization of Outpatient Health Care Services in Southern Ethiopia: A Comparative Cross-Sectional Study

2020 ◽  
Vol Volume 13 ◽  
pp. 141-153 ◽  
Author(s):  
Bekele Demissie ◽  
Keneni Gutema Negeri
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Care Services

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: Does health insurance make a difference? A cross-sectional study

2020 ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract BackgroundResponsiveness has become an important health system performance indicator in evaluating the ability of health care systems to meet patients’ expectations. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania and to explore the association of health insurance (HI) with responsiveness in this population. MethodsA community-based cross-sectional study was conducted in 2017 where a pre-tested household survey, administered to the elderly (60 + years) living in Igunga and Nzega districts, was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and 12 months were selected. Responsiveness was measured based on the short version of the World Health Organization (WHO) multi-country responsiveness survey study, which included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance adjusted for sociodemographic factors.ResultsA total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used outpatient and inpatient health services, respectively. All domains were rated relatively highly but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (−1; 95% CI: −1.45, −0.45) and inpatient (−2; 95% CI: −2.69, −1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked poorly. Further research is necessary to reveal the reasons for the lower responsiveness noted among insured elderly. A continuous monitoring of health care system responsiveness is recommended.

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: Does health insurance make a difference? A cross-sectional study

2020 ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract Introduction Responsiveness has become an important health systems performance indicator in evaluating the ability of the health care systems to meet the expectations of the patients. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania, in order to contribute with relevant knowledge to improve the performance of the health care system among the elderly in the country. Methods A community-based cross-sectional study was conducted in 2017 where a pre-tested household survey administered to elderly (60 +) living in Igunga and Nzega districts was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and twelve months were selected. Responsiveness was measured based on the WHO-SAGE questionnaire that included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance and socio-demographic factors.Results A total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used the outpatient and inpatient health services respectively. All the different domains were rated relatively high but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (-1; 95% CI: -1.45, -0.45) and inpatient (-2; 95% CI: -2.69, -1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked low. Further research is necessary to reveal the reasons for the lower responsiveness among insured elderly. A continuous monitoring of the health care system responsiveness is recommended.

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: does health insurance make a difference? A cross-sectional study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract Background Responsiveness has become an important health system performance indicator in evaluating the ability of health care systems to meet patients’ expectations. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania and to explore the association of health insurance (HI) with responsiveness in this population. Methods A community-based cross-sectional study was conducted in 2017 where a pre-tested household survey, administered to the elderly (60 + years) living in Igunga and Nzega districts, was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and 12 months were selected. Responsiveness was measured based on the short version of the World Health Organization (WHO) multi-country responsiveness survey study, which included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance adjusted for sociodemographic factors. Results A total of 1453 and 744 elderly, of whom 50.1 and 63% had health insurance, used outpatient and inpatient health services, respectively. All domains were rated relatively highly but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (− 1; 95% CI: − 1.45, − 0.45) and inpatient (− 2; 95% CI: − 2.69, − 1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked poorly. Further research is necessary to reveal the reasons for the lower responsiveness noted among insured elderly. A continuous monitoring of health care system responsiveness is recommended.

The Impact of Community Based Health Insurance in Enhancing Better Accessibility and Lowering the Chance of Having Financial Catastrophe Due to Health Service Utilization

2015 ◽  
Vol 47 (3) ◽  
pp. 504-518 ◽  
Author(s):  
Somdeth Bodhisane ◽  
Sathirakorn Pongpanich
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Household Income ◽  
Health Care Services ◽  
Lower Probability ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Care Services ◽  
The Impact

The Lao population mostly relies on out-of-pocket expenditures for health care services. This study aims to determine the role of community-based health insurance in making health care services accessible and in preventing financial catastrophe resulting from personal payment for inpatient services. A cross-sectional study design was applied. Data collection involved 126 insured and 126 uninsured households in identical study sites. Two logistic regression models were used to predict and compare the probability of hospitalization and financial catastrophe that occurred in both insured and uninsured households within the previous year. The findings show that insurance status does not significantly improve accessibility and financial protection against catastrophic expenditure. The reason is relatively simple, as catastrophic health expenditure refers to a total out-of-pocket payment equal to or more than 40% of household income minus subsistence. When household income declines as a result of inability to work due to illness, the 40% threshold is quickly reached. Despite this, results suggest that insured households are not significantly better off under community-based health insurance. However, compared to uninsured households, insured households do have better accessibility and a lower probability of reaching the financial catastrophe threshold.

scholarly journals Does health insurance contribute to improved utilization of health care services for the elderly in rural Tanzania? A cross-sectional study

2020 ◽  
Vol 13 (1) ◽  
pp. 1841962
Author(s):  
Malale Tungu ◽  
Paul Joseph Amani ◽  
Anna-Karin Hurtig ◽  
Angwara Dennis Kiwara ◽  
Mughwira Mwangu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Rural Tanzania

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.

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