scholarly journals Comparison of Health Care Utilization and Costs for Patietns with Asthma by Severity and Health Insurance in Thailand: Using Generalized Linear Regression Model

2014 ◽  
Vol 17 (7) ◽  
pp. A778
Author(s):  
P. Dilokthornsakul ◽  
T.A. Lee ◽  
T. Dhippayom ◽  
N. Jeanpeerapong ◽  
N. Chaiyakunapruk
2020 ◽  
Vol 33 (4) ◽  
pp. 207-218 ◽  
Author(s):  
Rinshu Dwivedi ◽  
Jalandhar Pradhan

Background Absence of better financing mechanism results in higher out of pocket expenditure and catastrophe, which leads to impoverishment and poverty especially among low- and middle-income countries like India. This paper examines the major characteristics associated with the higher out of pocket expenditure and provides an insight from Andersen’s behavioural model that how predisposing, enabling and need factors influence the level and pattern of out of pocket expenditure in India. Methods Data has been extracted from three rounds of nationally representative consumer expenditure surveys, i.e. 1993–1994, 2004–2005 and 2011–2012 conducted by the Government of India. States were categorized based on regional classification, and adult equivalent scale was used to adjust the household size. Multiple Generalized-Linear-Regression-Model was employed to explore the relative effect of various socio-economic covariates on the level of out of pocket expenditure. Results The gap has widened between advantaged and disadvantaged segment of the population along with noticeable regional disparities among Indian states. Generalized-Linear-Regression-Model indicates that the most influential predisposing and enabling factor determining the level of out of pocket expenditure were age composition, religion, social-group, household type, residence, economic status, sources of cooking and lighting arrangements among the households. Conclusions Present study suggests the need for strengthening the affordability mechanism of the households to cope with the excessive burden of health care payments. Furthermore, special consideration is required to accommodate the needs of the elderly, rural, backward states and impoverishment segment of population to reduce the unjust burden of out of pocket expenditure in India.


2018 ◽  
Vol 3 (1) ◽  
pp. 238146831878109 ◽  
Author(s):  
Mary C. Politi ◽  
Enbal Shacham ◽  
Abigail R. Barker ◽  
Nerissa George ◽  
Nageen Mir ◽  
...  

Objective. Numerous electronic tools help consumers select health insurance plans based on their estimated health care utilization. However, the best way to personalize these tools is unknown. The purpose of this study was to compare two common methods of personalizing health insurance plan displays: 1) quantitative healthcare utilization predictions using nationally representative Medical Expenditure Panel Survey (MEPS) data and 2) subjective-health status predictions. We also explored their relations to self-reported health care utilization. Methods. Secondary data analysis was conducted with responses from 327 adults under age 65 considering health insurance enrollment in the Affordable Care Act (ACA) marketplace. Participants were asked to report their subjective health, health conditions, and demographic information. MEPS data were used to estimate predicted annual expenditures based on age, gender, and reported health conditions. Self-reported health care utilization was obtained for 120 participants at a 1-year follow-up. Results. MEPS-based predictions and subjective-health status were related ( P < 0.0001). However, MEPS-predicted ranges within subjective-health categories were large. Subjective health was a less reliable predictor of expenses among older adults (age × subjective health, P = 0.04). Neither significantly related to subsequent self-reported health care utilization ( P = 0.18, P = 0.92, respectively). Conclusions. Because MEPS data are nationally representative, they may approximate utilization better than subjective health, particularly among older adults. However, approximating health care utilization is difficult, especially among newly insured. Findings have implications for health insurance decision support tools that personalize plan displays based on cost estimates.


2003 ◽  
Vol 93 (10) ◽  
pp. 1740-1747 ◽  
Author(s):  
Jacqueline W. Lucas ◽  
Daheia J. Barr-Anderson ◽  
Raynard S. Kington

2009 ◽  
Vol 27 (25) ◽  
pp. 4142-4149 ◽  
Author(s):  
Daniela Matei ◽  
Anna M. Miller ◽  
Patrick Monahan ◽  
David Gershenson ◽  
Qianqian Zhao ◽  
...  

Purpose This study compares late effects of treatment on physical well-being and utilization of health care resources between ovarian germ cell tumor (OGCT) survivors and age/race/education-matched controls. Patients and Methods Eligible patients had OGCT treated with surgery and chemotherapy and were disease-free for at least 2 years at time of enrollment. The matched control group was selected from acquaintances recommended by survivors. Symptoms and function were measured using previously validated scales. Health care utilization was assessed by questions regarding health insurance coverage and health services utilization. Results One hundred thirty-two survivors and 137 controls completed the study. Survivors were significantly more likely to report a diagnosis of hypertension (17% v 8%, P = .02), and marginally hypercholesterolemia (9.8% v 4.4%, P = .09), and hearing loss (5.3% v 1.5%, P = .09) compared with controls. There were no significant differences in the rates of self-reported arthritis, heart, pulmonary or kidney disease, diabetes, non-OGCT malignancies, anxiety, hearing loss, or eating disorders between groups. Among chronic functional problems, numbness, tinnitus, nausea elicited by reminders of chemotherapy (v general nausea triggers for controls), and Raynaud's symptoms were reported more frequently by survivors. Patients who received vincristine, dactinomycin, and cyclophosphamide in addition to cisplatin therapy had increased functional complaints, particularly numbness and nausea. Health care utilization was similar, but 15.9% of survivors reported being denied health insurance versus 4.4% of controls (P < .001). Conclusion Although a few sequelae of treatment persist, in general, OGCT survivors enjoy a healthy life comparable to that of controls.


Author(s):  
Roger Muremyi ◽  
Dominique Haughton ◽  
François Niragire ◽  
Ignace Kabano

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.


Author(s):  
Chhabi Ranabhat ◽  
Chun-Bae Kim ◽  
Myung-Bae Park

Background: Health insurance (HI) run by government is providing health care service to large population. Due to poor accountability, participation and sustainability, cooperative health insurance is becoming more popular and effective in low and middle income and some high-income countries too. In Nepal, there are public and cooperative HI is in practice. The aim of this study is to compare the effectiveness of public (government) and cooperative HI in relation to benefit packages, population coverage, inclusiveness, health care utilization, and promptness for treatment in these two health insurance models in Nepal. Method: This is an institution based concurrent mixed study consists of qualitative and quantitative variables from public and cooperative groups. We included all public HI operated by government hospitals and cooperatives groups those purchased hospital service in contract. Two separate study tools were applied to access the effectiveness of insurance models. The key questions were asked for the representatives of government and private health insurance. The numeric information consisted of in quantitative data and subjective response was included in qualitative approach. Descriptive statistics and Mean Whitney U test was applied in numeric data and qualitative information were analyzed by inductive approach Results: The study revealed that new enrolment was not increased, health care utilization rate was increased and the benefit package was almost same in both groups. The overall inclusiveness was higher for the government HI, but enrolment from the religious minority, proportion of negotiated amount during treatment were significantly higher (p&lt;0.05). During illness, the response time to reach hospital was significantly faster in cooperative health insurance than government health insurance. Qualitative findings showed that level of participation, accountability, transparency and recording system was better in cooperative health insurance than public. Conclusion: Cooperative HI could be more sustainable and accountable to the community for all; low, middle and high-income countries.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Nicolas Pröllochs ◽  
Dominik Bär ◽  
Stefan Feuerriegel

AbstractEmotions are regarded as a dominant driver of human behavior, and yet their role in online rumor diffusion is largely unexplored. In this study, we empirically study the extent to which emotions explain the diffusion of online rumors. We analyze a large-scale sample of 107,014 online rumors from Twitter, as well as their cascades. For each rumor, the embedded emotions were measured based on eight so-called basic emotions from Plutchik’s wheel of emotions (i.e., anticipation–surprise, anger–fear, trust–disgust, joy–sadness). We then estimated using a generalized linear regression model how emotions are associated with the spread of online rumors in terms of (1) cascade size, (2) cascade lifetime, and (3) structural virality. Our results suggest that rumors conveying anticipation, anger, and trust generate more reshares, spread over longer time horizons, and become more viral. In contrast, a smaller size, lifetime, and virality is found for surprise, fear, and disgust. We further study how the presence of 24 dyadic emotional interactions (i.e., feelings composed of two emotions) is associated with diffusion dynamics. Here, we find that rumors cascades with high degrees of aggressiveness are larger in size, longer-lived, and more viral. Altogether, emotions embedded in online rumors are important determinants of the spreading dynamics.


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