Impact evaluation of subsidized health insurance programs on utilization of healthcare facilities: evidence from Indonesia

2022 ◽  
Author(s):  
Riska Dwi Astuti ◽  
Rindang Nuri Isnaini Nugrohowati
Keyword(s):  
Health Insurance ◽  
Impact Evaluation ◽  
Healthcare Facilities ◽  
Utilization Of Healthcare

scholarly journals An Analysis of The National Health Insurance Policy Implementation in 2014 (Presidential Regulation No. 12 And 111/2013 on Health Insurance) from The Regulator’s Position

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Muhammad Arief Hasan ◽  
Puput Oktamianti ◽  
Dumilah Ayuningtyas
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Health Coverage ◽  
Healthcare Services ◽  
Regional Government ◽  
Health Coverage ◽  
Healthcare Facilities ◽  
Road Map ◽  
Universal Health

Abstract. JKN (National Health Insurance) is a government program that aims to provide health assurance for all Indonesian citizens for a healthy, productive, and prosperous life. In the two years after JKN was implemented, various problems occurred. This research used the qualitative approach with the Edward II implementation theory. Results of the research indicated that there were problems in communication, stemming from the lack of socialization and inharmonic regulations, there was also the problem of the lack of healthcare resources. From the disposition side, the policy makers often obstructs the implementation preparation, this is evident from the information on determining the premium size. From the organization structure, all the stakeholders have been well coordinated. We conclude that we are not ready to implement the JKN. We recommend that mass and effective socialization program to be performed using various methods of communication and involve the community. To reduce the disparity of healthcare services, we recommend that the regional government to establish various healthcare facilities to accelerate health development. There should also be regulations that allocates healthcare staff in every corner of the country to achieve Universal Health Coverage in 2019, as stated in the National Health Insurance Road Map. Keywords: policy analysis, national health insurance, universal health coverage

Impact Evaluation of National Health Insurance toward Access Hospital Inpatient Care in Indonesia

2018 ◽  
Vol 9 (2) ◽  
pp. 196
Author(s):  
Wahyu P Nugraheni ◽  
Budi Hidayat ◽  
Mardiati Nadjib ◽  
Eko Setyo Pambudi ◽  
Soewarta Kosen ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Impact Evaluation ◽  
Inpatient Care ◽  
Hospital Inpatient ◽  
Hospital Inpatient Care

scholarly journals Location Efficiency of Healthcare Facilities in Ikot Ekpene Local Government of Akwa-Ibom State: The Role of Geographical Information System (GIS)

2013 ◽  
Vol 15 ◽  
pp. 22-30
Author(s):  
Elijah Akwarandu Njoku ◽  
Patrick Etim Akpan
Keyword(s):  
Health Care ◽  
Information System ◽  
Geographical Information System ◽  
Healthcare Facility ◽  
Facility Management ◽  
Geographical Information ◽  
Distributional Pattern ◽  
Healthcare Facilities ◽  
Utilization Of Healthcare ◽  
Health Care Centers

Given the effect of locational decisions on access and utilization of healthcare facilities in any society, the current study attempted an evaluation of the locational efficiency of available health facilities in Ikot Ekpene LGA with a view to ascertain the distributional pattern of the health care centers in the study area. It was discovered that health care centers in the area are randomly distributed but moderately concentrated in a few wards leaving more than half the area under-served. Using a WHO population/distance criterion of 1/4km, it is shown that only a small portion of the study area has effective access to healthcare facilities. Potential sites for location of additional health centers were suggested and the capability of Geographical Information System (GIS) in spatial planning and healthcare facility management is demonstrated.

scholarly journals Impact evaluation of a social protection programme paired with fee waivers on enrolment in Ghana’s National Health Insurance Scheme

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028726
Author(s):  
Tia M Palermo ◽  
Elsa Valli ◽  
Gustavo Ángeles-Tagliaferro ◽  
Marlous de Milliano ◽  
Clement Adamba ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Impact Evaluation ◽  
Social Protection ◽  
National Health Insurance Scheme ◽  
Health Insurance Scheme ◽  
Secondary Outcome ◽  
Insurance Scheme ◽  
Poor Households

ObjectivesThe study aimed to understand the impact of integrating a fee waiver for the National Health Insurance Scheme (NHIS) with Ghana’s Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer programme on health insurance enrolment.SettingThe study was conducted in five districts implementing Ghana’s LEAP 1000 programme in Northern and Upper East Regions.ParticipantsWomen, from LEAP households, who were pregnant or had a child under 1 year and who participated in baseline and 24-month surveys (2497) participated in the study.InterventionLEAP provides bimonthly cash payments combined with a premium waiver for enrolment in NHIS to extremely poor households with orphans and vulnerable children, elderly with no productive capacity and persons with severe disability. LEAP 1000, the focus of the current evaluation, expanded eligibility in 2015 to those households with a pregnant woman or child under the age of 12 months. Over the course of the study, households received 13 payments.Primary and secondary outcome measuresPrimary outcomes included current and ever enrolment in NHIS. Secondary outcomes include reasons for not enrolling in NHIS. We conducted a mixed-methods impact evaluation using a quasi-experimental design and estimated intent-to-treat impacts on health insurance enrolment among children and adults. Longitudinal qualitative interviews were conducted with an embedded cohort of 20 women and analysed using systematic thematic coding.ResultsCurrent enrolment increased among the treatment group from 37.4% to 46.6% (n=5523) and decreased among the comparison group from 37.3% to 33.3% (n=4804), resulting in programme impacts of 14 (95% CI 7.8 to 20.5) to 15 (95% CI 10.6 to 18.5) percentage points for current NHIS enrolment. Common reasons for not enrolling were fees and travel.ConclusionWhile impacts on NHIS enrolment were significant, gaps remain to maximise the potential of integrated programming. NHIS and LEAP could be better streamlined to ensure poor households fully benefit from both services, in a further step towards integrated social protection.Trial registration numberRIDIE-STUDY-ID-55942496d53af.

scholarly journals Patterns of Nonemergent Visits to Different Healthcare Facilities on the Same Day: A Nationwide Analysis in Taiwan

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Meng-Hsuan Wu ◽  
Meng-Ju Wu ◽  
Li-Fang Chou ◽  
Tzeng-Ji Chen
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Respiratory System ◽  
Digestive System ◽  
Family Physicians ◽  
Research Database ◽  
Common Phenomenon ◽  
Healthcare Facilities ◽  
Taiwanese People

Doctor shopping is a common phenomenon in many countries. However, patterns of switching healthcare facilities on the same day were little known. The data were obtained from the longitudinal cohort datasets (LHID2010) of Taiwan’s National Health Insurance Research Database in 2010. Of 1,000,000 persons of the cohort with 13,276,928 nonemergent visits, 185,347 patients had visited different healthcare facilities within one day, with a total of 672,478 visits and 337,260 switches between facilities in 329,073 patient-days. While 63.0% (n=212,590) of all switches occurred between facilities of the same accreditation level, 14.1% (n=47,664) moved from lower to higher level, and 22.8% (n=77,006) moved in the opposite direction. In 33,689 switches, patients moved to the same specialty of another facility. In 48,324 switches, patients moved to another facility with the same diagnosis, and the most frequent diagnoses were diseases of the digestive system (11,148) and diseases of the respiratory system (10,393). In a densely populated country without strict referral regulation, a high percentage of Taiwanese people had the experience of visiting different healthcare facilities on the same day. The system of family physicians as personal doctors and gatekeepers to healthcare might ameliorate the harmful impact.

scholarly journals Utilization of healthcare services and renewal of health insurance membership: evidence of adverse selection in Ghana

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Stephen Kwasi Opoku Duku ◽  
Francis Asenso-Boadi ◽  
Edward Nketiah-Amponsah ◽  
Daniel Kojo Arhinful
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Healthcare Services ◽  
Utilization Of Healthcare

scholarly journals Health Insurance Ownership and Quality of Computed Tomography Requests: Experience from a Peripheral Referral Hospital in Cameroon

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Joshua Tambe ◽  
Yannick Onana ◽  
Sylviane Dongmo ◽  
Georges Nguefack-Tsague ◽  
Pierre Ongolo-Zogo
Keyword(s):  
Computed Tomography ◽  
Health Insurance ◽  
Univariate Analysis ◽  
Healthcare Services ◽  
Referral Hospital ◽  
Health Coverage ◽  
Appropriateness Criteria ◽  
Acr Appropriateness Criteria ◽  
Baseline Information ◽  
Utilization Of Healthcare

Background. Health insurance ownership facilitates access and minimizes financial hardship after utilization of healthcare services such as computed tomography (CT). Understanding the rational utilization of CT by people with health insurance can help optimize the scheme and provide baseline information for a national universal health coverage program. Objective. To assess the relationship between health insurance ownership and the appropriateness of requests for CT in a peripheral referral hospital in Cameroon. Methods. A survey of CT users was conducted during which information on health insurance ownership was collected and the request forms for CT assessed for appropriateness using the American College of Radiologists (ACR) Appropriateness Criteria®. Results. We consecutively enrolled 372 participants of which 167 (45%) were females. The median age (range) was 52 (18–92) years. Thirty-eight out of 370 participants reported having health insurance (10.3%; 95% confidence interval (CI): 7.2%–13.4%). Twenty-nine out of 352 CT scan requests (8.2%; 95% CI: 5.3–11.0) were judged to be “inappropriate.” The proportion of inappropriate scan requests was higher amongst people with health insurance compared to those without health insurance (18.4% vs. 7.0%; χ2 = 5.8; p = 0.02 ). In the logistic regression analysis, health insurance ownership was associated to the appropriateness of CT requests in the univariate analysis only (OR = 0.33; 95% CI: 0.13–0.84; p = 0.020 ). Conclusions. Inappropriate requests for CT were low but nevertheless associated to health insurance ownership. The continuous sensitization and training of physicians would help minimize potential wasteful utilization of resources.

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