Estimation of the Financial Burden to the National Health Insurance for Patients with Major Cancers in Taiwan

Abstract BackgroundFinancial protection is a key dimension of universal health coverage. In 2016, Lao PDR implemented a National Health Insurance system covering the entire population of certain provinces. This cross-sectional study investigated the health-seeking behavior and financial burden of households, including those with chronic patients, post coverage. MethodThe study was conducted in Bolikhamxay province from January 15 to February 13, 2019. In total, 487 households, selected via stratified random sampling, were surveyed, and questionnaire-based interviews were conducted. Health care service utilization and financial burden were examined.ResultsA total of 370 households had at least one member with some type of self-reported health problem within the last 3 months prior to the interview, while 170 had at least one member with a chronic condition. More than 75% of the households accessed a health facility when a member experienced health problems. The prevalence of catastrophic health expenditure (health expenditure/income between 20% and 40%) was 25.1% (threshold of 20%) and 16.2% (threshold of 40%). Through logistic regression, we found that the major factors determining financial catastrophes owing to health problems were household members with chronic illness, hospitalization, household poverty status, family size (both 20% and 40% thresholds), visiting a private facility (20% threshold), and distance from the province to the referral hospital (40% threshold).ConclusionsThe National Health Insurance system has positively impacted households’ access to health facilities. However, catastrophic health expenditure remains high, especially among chronic patients. Facilities under the National Health Insurance should be strengthened to provide more services, including care for chronic conditions.

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Financial Burden and Health-seeking Behaviors Related to Chronic Diseases Under the National Health Insurance Scheme in Bolikhamxay Province, Lao PDR: a Cross-sectional Study

10.21203/rs.3.rs-885719/v1 ◽

2021 ◽

Author(s):

Tomoo Ito ◽

Chiaki Miyoshi ◽

Sengchanh Kounnavong

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Health Expenditure ◽

Financial Burden ◽

Lao Pdr ◽

Health Seeking ◽

Chronic Patients ◽

National Health Insurance System ◽

Cross Sectional

Abstract Background: Financial protection is a key dimension of universal health coverage. In 2016, Lao PDR implemented the National Health Insurance system covering the entire population of certain provinces. This cross-sectional study investigated households’ health-seeking behavior and their financial burden with chronic patients, post coverage. Method: The study was conducted in Bolikhamxay province from January 15 to February 13, 2019. In total, 487 households, selected via stratified random sampling, were surveyed, and questionnaire-based interviews conducted. Health care service utilization and financial burden were examined.Results: Totally, 370 households had at least one member with some type of self-reported health problem within the last 3 months prior to the interview, while 170 had at least one member with a chronic condition. More than 75% of the households accessed a health facility when a member experienced health problems. We observed that the prevalence of catastrophic health expenditure (health expenditure/income between 20% and 40%) was 25.1% (threshold of 20%) and 16.2% (threshold of 40%). Through logistic regression, we found that the major factors determining financial catastrophes owing to health problems were household members with chronic illness, hospitalization, household poverty status, family size (both 20% and 40% thresholds), visiting a private facility (20% threshold), and distance from provincial top referral hospital (40% threshold).Conclusions: The National Health Insurance system has positively impacted households’ access to health facilities. However, catastrophic health expenditure remains high, especially among chronic patients. Facilities under National Health Insurance should be strengthened to provide more services, including care for chronic conditions.

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[WITHDRAWN] The importance of increasing cigarette prices on National Health Insurance financing in Indonesia

Journal of Socioeconomics and Development ◽

10.31328/jsed.v4i1.1739 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Renny Nurhasana ◽

Risky Kusuma Hartono ◽

Faizal Rahmanto Moeis ◽

Suci Puspita Ratih

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Financial Burden ◽

Public Support ◽

Cross Sectional Study ◽

Cross Sectional ◽

Phone Survey ◽

High Prevalence ◽

Cigarette Prices

Indonesia faces the combined challenges of a high prevalence of active smokers and an increased financial burden of smoking-related Non-Communicable Diseases (NCDs) on National Health Insurance (NHI). This study aims to assess the importance of increasing cigarette prices for NHI funding. It was a cross-sectional study conducted through a phone survey. The survey was administered to 1,000 respondents aged 18 and over from various telecommunications operators in Indonesia. We performed the multivariate analysis and the framework of the importance of increasing cigarette prices for funding NHI. The result shows that the majority of the public supports the increase of cigarette price for funding NHI except for active smokers at Odds Ratio=0.529. The importance of increasing cigarette prices for funding NHI is supported by society, able to reduce the prevalence of active smokers, and it raises the government’s tax income. With the current strong public support, cigarette prices should be increased which will then be tagged to fund the NHI consistently. This is also seen as a means to compensate the high NCD-related claims of the NHI which are caused by smoking behavior.JEL Classification H51; I13; I18

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Pelatihan Deteksi Karier Thalassemia kepada Bidan di Banyumas

Dinamisia Jurnal Pengabdian Kepada Masyarakat ◽

10.31849/dinamisia.v5i5.4659 ◽

2021 ◽

Vol 5 (5) ◽

Author(s):

Lantip Rujito ◽

Qodri Santosa ◽

Diyah Woro Dwi Lestari ◽

Eman Sutrisna ◽

Ariadne Tri Hapsari

Keyword(s):

Genetic Counseling ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Health Workers ◽

Financial Burden ◽

Insurance Coverage ◽

National Health System ◽

Health Insurance Coverage ◽

Knowledge And Skills

Thalassemia ranks top on the list of diseases caused by the monogenic mechanism, especially in hematology disorders. Currentlly, Thalassemia ranks 5th in the national health insurance coverage. Prevention is the only effective way to control the clinical, psychological and financial burden of the country. One aspect of prevention is the discovery and genetic counseling process of persons who carry the mutan gene or carier of thalassemia. Midwives as the most peripheral health workers in the national health system are very important in their role in the discovery and counseling of these people. Provision of sufficient knowledge and skills of midwives can be a reliable tool in efforts to prevent thalassemia in the community.

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The Financial Burden Associated with Medical Costs among Childhood Cancer Patients and Their Families Related to Their Socioeconomic Status: The Perspective of National Health Insurance Service

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176020 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6020

Author(s):

Wonjeong Chae ◽

Juyeong Kim ◽

Sohee Park ◽

Eun-Cheol Park ◽

Sung-In Jang

Keyword(s):

Socioeconomic Status ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Medical Cost ◽

Financial Burden ◽

Treatment Phase ◽

Medical Costs ◽

Initial Diagnosis ◽

Total Medical Cost

The number of cancer survivors is increasing as a consequence of improved therapeutic options. Many families are suffering from the resultant financial burden. Our study aims to determine the total medical cost for 5 years after the initial diagnosis of childhood cancers. A customized dataset from the Korean National Health Insurance Claims Database was requested for this study. A total of 7317 patients were selected to determine the total medical cost. The costs are presented as the 2% trimmed mean value to exclude extreme costs. The medical costs were further classified according to cancer type, treatment phase, and socioeconomic status. Multiple linear regression analyses were performed. The average total medical cost per patient is 36.8 million Korean Wons or 32,157 United States Dollars. Analysis of socioeconomic status revealed that the higher income group demonstrated higher medical expenditure when compared to other groups. Analysis of the treatment phase showed that costs associated with the early phase of treatment are the highest, especially in the first 3 months after initial diagnosis. To alleviate the financial burden and reduce the socioeconomic disparities associated with medical care and costs, a better understanding of the current experience of patients and their families is required.

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PP011 Covering New Medical Devices With Low Cost-Effectiveness Evidence

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317002045 ◽

2017 ◽

Vol 33 (S1) ◽

pp. 71-72

Author(s):

Su-Jin Cho ◽

Jung Ae Ko ◽

Lee Yo Seb ◽

Eun Ji Yun ◽

Rang Kyoung Ha

Keyword(s):

Health Insurance ◽

Cost Effectiveness ◽

Medical Device ◽

National Health Insurance ◽

National Health ◽

Medical Devices ◽

Low Cost ◽

Financial Burden ◽

New Technology ◽

Clinical Effectiveness

INTRODUCTION:The Korea National Health Insurance (K-NHI) has covered medical devices with low cost-effectiveness evidence by what is known as the Selective Benefit (SB) since December of 2013 as a type of conditional coverage. Most medical devices in the SB category are new technology and have higher levels of clinical effectiveness and/or functions than those in the benefit category, but they are characterized as being expensive. We compare the K-NHI medical device coverage system to those in Japan and Taiwan so as to be more informed about how to cover and set prices for new medical devices.METHODS:We searched for materials related to medical device coverage or the reimbursement systems of three countries (Korea, Japan, and Taiwan). National health insurance laws, policy reports, and the websites of the Ministries of Health of the respective countries, for instance, were also reviewed.RESULTS:The NHI systems of Korea, Japan, and Taiwan have several similarities with regard to their medical device benefit lists. They reimburse listed medical devices separately although they cover them basically by including procedures or a diagnosis-related group (DRG) fee. The K-NHI reimburses for medical devices with low cost-effectiveness using the actual market medical price, similar to other medical devices in the benefit category. However, there are no detailed rules regarding how to set prices for these devices. Every listed medical device is covered at the notified price in Japan, but the prices of new medical devices with improved functions can add 1 -100 percent of the price to the notified price. The prices of devices related to new medical procedures are determined by cost-accounting methods. The NHI service in Taiwan compensates for medical devices which are alternates but clinically improved types through a balance billing method.CONCLUSIONS:The NHI systems in Japan and Taiwan set prices with regard to reimbursements for new medical devices separately, specifically for devices which are advanced clinically or functionally but expensive. The K-NHI must consider establishing a pricing or reimbursement system for new medical devices through the discussion with stakeholders for reasonable reimbursements and decreasing the financial burden on the K-NHI.

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Estimating the effectiveness of national health insurance in covering catastrophic health expenditure: Evidence from South Korea

PLoS ONE ◽

10.1371/journal.pone.0255677 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255677

Author(s):

Hyunwoo Jung ◽

Junhyup Lee

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Health Expenditure ◽

Low Cost ◽

Financial Burden ◽

Insurance Coverage ◽

Catastrophic Health Expenditure ◽

Cost Burden ◽

Out Of Pocket Payments

The catastrophic health expenditure (CHE) indicator has been used to measure the medical cost burden of households. Many countries have institutionalized their health insurance systems to reduce out-of-pocket payments, the main contributor to the financial burden. However, there is no method to estimate how the insurance coverage reduces the CHE. This study proposes an approach to evaluate the effectiveness of insurance in reducing the CHE impacts in terms of incidence and gap, which are based on a modified calculation method of CHE. Additionally, we apply these methods to data from the Korea Health Panel Survey (2011–2016). The results are as follows. First, under the setting of a threshold of 10%, the CHE incidence rate was 19.26% when the Korean national health insurance benefits reduced the CHE’s incidence for 15.17% of the population in 2017. Second, the results of the concentration index of CHE showed that the intensity approach of CHE is better than the incidence approach. Third, the new approach we applied revealed that health insurance reduces the burden of CHE to some degree, although it was not an efficient way to reduce CHE. In conclusion, this study provides new policy approaches to save the finances of national health insurance and reduce the intensity of CHE at the same time by raising the low-cost burden of medical services and lowering that of high cost. Moreover, we suggest that policymakers should focus on income level of the households rather than specific diseases.

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