Federal Health Coverage Mandates and Health Care Utilization: The Case of the Women's Health and Cancer Rights Act and Use of Breast Reconstruction Surgery

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.

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Association of SHI coverage and level of healthcare utilization and costs in the Philippines: a 10-year pooled analysis

Journal of Public Health ◽

10.1093/pubmed/fdz142 ◽

2019 ◽

Vol 42 (4) ◽

pp. e496-e505

Author(s):

Nel Jason L Haw ◽

Jhanna Uy ◽

Beverly Lorraine Ho

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care Utilization ◽

Health Care Costs ◽

Inpatient Care ◽

The Philippines ◽

Care Utilization ◽

Health Coverage ◽

Outpatient Services ◽

Care Costs

Abstract Background The Philippine Health Insurance Corporation (PhilHealth), which manages the Philippine national health insurance program, is a critical actor in the country’s strategy for universal health coverage. Over the past decade, PhilHealth has passed significant coverage, benefits and payment reforms to contain costs and improve the affordability care for high-cost diseases, inpatient care and select outpatient services. Methods We studied the association of PhilHealth with health care utilization and health care costs using three rounds of the Philippine Demographic and Health Survey with data on individual outpatient and inpatient visits from 2008 to 2017. Results PhilHealth membership was associated with 42% greater odds of outpatient utilization and 47–100% greater odds inpatient utilization depending on survey year. Depending on facility type, use of PhilHealth to pay for care was associated with higher average health care costs of 244–865% for outpatient care and 135–206% for inpatient care. Conclusions PhilHealth has likely decreased barriers to health care utilization but may have inadvertently driven up health care costs in the country. Results align with past studies that suggest that reforms in the prior decade have done little to contain health care costs for Filipinos.

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The Road Home: Predictors of Health Care Utilization Among Older Returning African American Men

The Review of Black Political Economy ◽

10.1177/0034644620967002 ◽

2020 ◽

pp. 003464462096700

Author(s):

Marquis A. Chandler ◽

Laurens Van Sluytman ◽

M. Taqi Tirmazi ◽

Minli Liao

Keyword(s):

Health Care ◽

African American ◽

Health Care Utilization ◽

African American Men ◽

College Education ◽

Care Utilization ◽

Health Coverage ◽

Or Education ◽

The Road ◽

Sentencing Policy

Black or African American men face disproportionate rates of incarceration and poor health outcomes. Recent changes in sentencing policy have allowed individuals to return to communities after substantial periods of incarceration. Returning citizens often reenter with numerous challenges: housing, employment, medical assistance, and transportation. Analyses were conducted using multivariable logistic regression to examine the relationship between health care utilization for returning men and need (chronic health conditions), predisposing (age, race, marital status, education, and housing situation), enabling (income, health coverage, employment status, and education) factors. Findings indicated that men 50 and above years (odds ratio [OR] = 1.83, 95% confidence interval [CI] = [1.04, 3.24]), Black or African American men (OR = 4.66, 95% CI = [2.35, 9.22]), those with college education (OR = 1.97, CI [1.07, 3.63]) and those having health coverage (OR = 3.34, CI [2.18, 5.11]) were more likely to utilize health care. These findings suggest the need for a greater need to establish linkages to community-based care during reentry planning. This is particularly relevant for reentering citizens who are not eligible for Medicare due to age or whose linkage to employer bases insurance is limited due to work history, employment discrimination, or education.

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