Primary Non-adherence to Pharmacotherapy Among Patients With Chronic Diseases: A Case Study of Slovakia

BackgroundePrescription enables to investigate primary non-adherence (PNA) to pharmacotherapy by studying the percentage of prescriptions which have been issued (a prescription record present) but not dispensed in a pharmacy (a dispensation record missing) out of a total number of registered prescriptions. Identification of non-adherence enables to analyze its causes and target them efficiently.MethodsThis paper investigates PNA rate for prescriptions issued to patients with chronic diseases such as hypertension, diabetes mellitus and hypercholesterolemia (N=108 735), and its dependence on the following variables: geographic location, age, sex, social status, physicians specialty and the level of patient‘s co-payment for medications. The presented dataset comprises a private health insurance company’s prescription data collected over a period of 12 months (January 2018 – December 2018).ResultsThe PNA rate for ePrescriptions issued to patients with the above-mentioned chronic diseases reached up to 4.0%. In general, the PNA rate showed decrease with increasing comorbidity as well as with age. Primary non-adherence rates were lowest for the prescriptions written by general practitioners (3.6%). Among health insurance premium defaulters who pay the full price of prescribed medications, the PNA rate showed decrease with their cost. Significantly higher PNA rate was observed among premium payers (40.4%) compared with premium defaulters (3.5%).ConclusionsInterestingly, the very high rate of adherence among patients with chronic diseases exceeds the numbers previously reported in the literature, where adherence rate ≥80% is described as ‘good’ adherence. This could be partially explained by the fact that the present study included only chronic-disease patients undergoing a medical treatment – non-diagnosed patients or patients without a medical treatment were not considered.

Government Employees of Bangladesh and their Willingness to Pay for Social Health Insurance

Determining the health insurance premium is the most important aspect in providing social health insurance. In measuring the rate, it is needed to calculate the cost of providing the service. One possible methodological tool of calculating the cost is the contingent valuation method for the evaluation of the consumers’ capacity and their willingness to pay for the services. This study applied a Logit model, having binary depended variable with follow up dichotomous choice at different premium levels, to estimate the factors associated to joining the social health insurance scheme. The study found that 80.1 percent of the government employees of Bangladesh wants to pay on average 6.69 percent of their basic salary as social health insurance premium. The result shows that younger peoples are less willing to pay while older people are more willing to pay for social health insurance. The study also revealed that the area of residence and no of visit to doctor play a key role in determining the willingness to pay. This study should help the policymakers to formulate and implement the social health insurance scheme in Bangladesh.

Performance Evaluation of Health Insurance: Ways for Winning Confidence

Health is a fundamental force that decides the overall quality of human life. The health of the population is a vital and essential issue for any country. The new National Health Policy of India (2017) emphasizes the growing burden of non- communicable diseases and corresponding growing expenditure. Indian Government announced the world's most massive health scheme, the Ayushman Bharat Yojana, in 2018, which is a significant step towards attaining universal health coverage in India. This scheme provides a cover of Rs.5 lakh per family per year for various medical procedures. Although India's Government is taking many such initiatives to improve public health, a lot more needs to be done to attain universal coverage. Out of pocket expenditure paid by individuals towards health care in India ranges at a high percentage over the years. Although health insurance premium has shown an increase over the years, there is no drop in this expenditure. This study shows the phenomenal growth achieved by health insurance, specifically after privatization, premium growth, and improvement in claims ratios. It is suggested that the insurance companies should modify the coverage of health insurance policies so that the uncovered expenses are reimbursed during hospitalization. Insurance companies also should shift their focus towards wellness instead of covering sickness to keep their businesses sustainable in the long run.

Health insurance sector in India: an analysis of its performance

Purpose Health insurance is one of the major contributors of growth of general insurance industry in India. It alone accounts for around 29% of total general insurance premium income earned in India. The growth of this sector is important from the perspective of overall growth of general insurance Industry. At the same time, problems in this sector are also many which are affecting its performance. Design/methodology/approach The paper provides an understanding on performance of health insurance sector in India. This study attempts to find out how much claims and commission and management expenses it has to incur to earn certain amount of premium. Methodology used for the study is regression analysis to establish relationship between dependent variable (Profit/Loss) and independent variable (Health Insurance Premium earned). Findings Findings of the study indicate that there is significant relationship between earned premium and underwriting loss. There has been increase of premium earnings which instead of increasing profit for the sector in fact has increased underwriting loss over the years. The earnings of the sector is growing at compounded annual growth rate of 27% still it is unable to earn underwriting profit. Originality/value This study is self-driven based on secondary data obtained from insurance regulatory and development authority site.

An Empirical Analysis of Delayed Monthly Bill Payments as an Early Risk Factor of Increased Suicidal Behavior

This study examines the potential of delayed monthly bill payments as a predictor of suicidal behavior in South Korea with the highest suicide rate among developed countries. Using the Korea Welfare Panel Study, multivariable logistic regressions examined the association between suicide ideation/attempts and the frequency of late payments on utility bills or National Health Insurance premium during last three years. Confounding factors such as past depression and suicide ideation/attempts history were adjusted for. Among 10,988 individuals, 2.7% reported suicide ideation and 0.11% attempted suicide in the past year, while 7.1% reported they paid late once or more during the last three years. Adults with two or more delayed payment had 2.32 times increased odds of suicidal ideation and 10.99 times increased odds of suicide attempts, compared to having no late payments. Adjusting for other socio-economic characteristics rarely changed the relationship between late payments and suicide ideation/attempts (for suicidal ideation, OR = 2.11; for suicide attempts: OR = 7.44), suggesting the independent effect of late payments on suicide behavior. With these findings, it can be suggested that late payment is an important factor, preemptively signaling suicide behavior with serious consequences in health and life.

Sources of Financing Health Care in Poland – Findings

In the presented article scientific works published within the grant project were used. The objective of the article is to present results of the scientific research conducted by an international community of financial law researchers. The basic objective of the scientific project implemented was to establish whether Polish legal regulations determining types of public sources of financing secure the implementation of tasks within health care. From the conducted research it can be concluded that the health insurance premium constitutes the main source of financing health care in Poland. Significant sources of financing health care include budgets of local government units and state budget.