Socioeconomic inequality in catastrophic healthcare expenditures in Western Iran

2019 ◽  
Vol 46 (9) ◽  
pp. 1049-1060 ◽  
Author(s):  
Satar Rezaei ◽  
Mohammad Hajizadeh ◽  
Sina Ahmadi ◽  
Sadaf Sedghi ◽  
Bakhtiar Piroozi ◽  
...  
Keyword(s):  
Health Insurance ◽  
Healthcare Expenditure ◽  
Socioeconomic Inequality ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Content Type ◽  
The Poor ◽  
Poor Households

Purpose Financial protection of households against catastrophic healthcare expenditure (CHE) is defined as one of the main goals in health systems. The purpose of this paper is to measure and decompose socioeconomic inequality in CHE among households in Kermanshah province, Western of Iran. Design/methodology/approach This cross-sectional study was carried out among 1,188 households in 2017. Data were extracted from the Household Income and Expenditure Survey which is conducted by the Statistical Center of Iran. The CHE is defined as household healthcare expenditure greater than or equal to the 40 percent of household’s “capacity to pay.” The concentration curve and the Wagstaff (W) and Erreygers (E) indexes were used to illustrate and measure the extent of socioeconomic inequality in CHE. In addition, the authors decomposed the W and E indexes to identify the main determinants of socioeconomic inequality in CHE. Findings The results indicated that the prevalence of CHE among households was 4.12 percent (95% confidence interval (CI): 3.13 to 5.42 percent). The estimated value of the W and E indexes were −0.2849 (95% CI: −0.4493 to −0.1205) and −0.0451 (95% CI: −0.0712 to −0.0190), respectively; suggesting the concentration of CHE prevalence among the poor households. Decomposition analyses indicated socioeconomic status as the most important factor contributing to the concentration of CHE among the poor. In contrast, health insurance coverage was found to increase the concentration of CHE among the rich in Iran. Originality/value The current study demonstrated a higher concentration of CHE among the poor households in Kermanshah province. These results call for the government’s efforts to reduce healthcare expenditure among socioeconomically disadvantaged populations. Further studies are required to understand the mechanisms through which health insurance coverage increased the probability of CHE among rich in Kermanshah province.

scholarly journals Societal preferences for standard health insurance coverage in the Netherlands: a cross-sectional study

BMJ Open ◽  
2012 ◽  
Vol 2 (2) ◽  
pp. e001021 ◽  
Author(s):  
Ineke van der Wulp ◽  
Wilbert B van den Hout ◽  
Marieke de Vries ◽  
Anne M Stiggelbout ◽  
Elske M van den Akker-van Marle
Keyword(s):  
Health Insurance ◽  
The Netherlands ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Societal Preferences

scholarly journals The association of obesity with health insurance coverage and demographic characteristics: a statewide cross-sectional study

Medicine ◽  
2020 ◽  
Vol 99 (27) ◽  
pp. e21016 ◽  
Author(s):  
Evangelia K. Mylona ◽  
Gregorio Benitez ◽  
Fadi Shehadeh ◽  
Elvira Fleury ◽  
Sophia C. Mylonakis ◽  
...  
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Health insurance coverage and its awareness among population in the rural field practice area of Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka

2019 ◽  
Vol 6 (3) ◽  
pp. 1065
Author(s):  
L. M. Manuja ◽  
P. G. Viswanatha ◽  
Kanchana Nagendra
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Chi Square ◽  
Cross Sectional ◽  
Statistical Measures ◽  
Field Practice ◽  
Chi Square Test

Background: In India, there is marked lack of awareness of health insurance in the rural and low socioeconomic sector due to reasons like the existing burden on the poor making them reluctant to think of the credit policies that are actually issued in their interest, illiteracy, lack of exposure and the growth of the private sectors has an upper hand over public sectors. Hence this study was done with the objective to determine the health insurance coverage and its awareness including perception among the rural population around Adichunchanagiri Institute of Medical Sciences, BG Nagara, Mandya.Methods: This cross sectional study was carried out among 295 households in the rural field practice area of Adichunchanagiri Institute of Medical Sciences, B G Nagara for a period of 3 months. Personal interview of the households was done using pretested semi structured questionnaire after obtaining the consent. Data was entered in MS excel and descriptive statistical measures like percentage, mean, and standard deviations were calculated. An inferential statistical measure like Chi square test was applied.Results: Among 295 households, Male constituted 49.5% and Hindus were 94.9%. 44.7% of the families were enrolled to health insurance schemes and 75.0% of them use to renew their health insurance scheme regularly. The factors which were significantly associated with health insurance enrollment and awareness were gender, education, occupation, hospitalization during last year and socioeconomic status. Only 173 (58.6%) of the respondents were aware of health insurance.Conclusions:More than half of the study population was covered by health insurance policies and majority of them were unaware of the available insurance schemes, risks and benefits of the same.  

scholarly journals Health insurance coverage and its awareness among population in the rural field practice area of Adichunchanagiri Institute of Medical Sciences, B G Nagara, Karnataka

2019 ◽  
Author(s):  
L. M. Manuja ◽  
P. G. Viswanatha ◽  
Kanchana Nagendra
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Chi Square ◽  
Cross Sectional ◽  
Statistical Measures ◽  
Field Practice ◽  
Chi Square Test

Background: In India, there is marked lack of awareness of health insurance in the rural and low socioeconomic sector due to reasons like the existing burden on the poor making them reluctant to think of the credit policies that are actually issued in their interest, illiteracy, lack of exposure and the growth of the private sectors has an upper hand over public sectors. Hence this study was done with the objective to determine the health insurance coverage and its awareness including perception among the rural population around Adichunchanagiri Institute of Medical Sciences,BG Nagara, Mandya.Methods: This cross sectional study was carried out among 295 households in the rural field practice area of Adichunchanagiri Institute of Medical Sciences, B G Nagara for a period of 3 months. Personal interview of the households was done using pretested semi structured questionnaire after obtaining the consent. Data was entered in MS EXCEL and Descriptive statistical measures like percentage, mean, and standard deviations were calculated. An inferential statistical measure like Chi square test was applied.Results: Among 295 households, Male constituted 49.5% and Hindus were 94.9%. 44.7% of the families were enrolled to health insurance schemes and 75.0% of them use to renew their health insurance scheme regularly. The factors which were significantly associated with health insurance enrollment and awareness were gender, education, occupation, hospitalization during last year and socioeconomic status. Only 173 (58.6%) of the respondents were aware of health insurance.Conclusions: More than half of the study population was covered by health insurance policies and majority of them were unaware of the available insurance schemes, risks and benefits of the same.

PARTICIPATING IN HEALTH INSURANCE AND FACTORS AFFECTING AMONG PERSONS WHOSE ENROLMENT IS VOLUNTARY IN THUA THIEN HUE PROVINCE

2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Factors Affecting ◽  
The People ◽  
Universal Health Insurance Coverage ◽  
The Social

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue

scholarly journals Prevalence and factors associated with health insurance coverage in resource-poor urban settings in Nairobi, Kenya: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031543 ◽  
Author(s):  
Peter O Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri F Mohamed ◽  
Hermann Pythagore Pierre Donfouet ◽  
Martin K Mutua
Keyword(s):  
Health Insurance ◽  
Primary Outcome ◽  
Insurance Coverage ◽  
Scale Up ◽  
Household Head ◽  
Health Insurance Coverage ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Insurance Cover

ObjectiveTo determine the prevalence of health insurance and associated factors among households in urban slum settings in Nairobi, Kenya.DesignThe data for this study are from a cross-sectional survey of adults aged 18 years or older from randomly selected households in Viwandani slums (Nairobi, Kenya). Respondents participated in the Lown scholars’ study conducted between June and July 2018.SettingThe Lown scholars’ survey was nested in the Nairobi Urban Health and Demographic Surveillance System in Viwandani slums in Nairobi, Kenya.ParticipantsA total of 300 randomly sampled households participated in the survey. The study respondents comprised of either the household head, their spouses or credible adult household members.Primary outcome measureThe primary outcome of this study was enrolment in a health insurance programme. The households were classified into two groups: those having at least one member covered by health insurance and those without any health insurance cover.ResultsThe prevalence of health insurance in the sample was 43%. Being unemployed (adjusted OR (aOR) 0.17; p<0.05; 95% CI 0.06 to 0.47) and seeking care from a public health facility (aOR 0.50; p<0.05; 95% CI 0.28 to 0.89) was significantly associated with lower odds of having a health insurance cover. The odds of having a health insurance cover were significantly lower among respondents who perceived their health status as good (aOR 0.62; p<0.05; 95% CI 1.17 to 5.66) and those who were unsatisfied with the cost of seeking primary care (aOR 0.34; p<0.05; 95% CI 0.17 to 0.69).ConclusionsHealth insurance coverage in Viwandani slums in Nairobi, Kenya, is low. As universal health coverage becomes the growing focus of Kenya’s ‘Big Four Agenda’ for socioeconomic transformation, integrating enabling and need factors in the design of the national health insurance package may scale-up social health protection.

scholarly journals Private health insurance coverage-related lawsuits

2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Ana Beatriz Perez Afonso ◽  
Mayra Gonçalves Menegueti ◽  
Thamiris Ricci de Araújo ◽  
Lucieli Dias Pedreschi Chaves ◽  
Ana Maria Laus
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Medical Procedures ◽  
Cross Sectional ◽  
Positron Emission ◽  
Percutaneous Rhizotomy ◽  
Using Data ◽  
National Regulatory Agency

ABSTRACT Objectives: to analyze lawsuits brought by beneficiaries of health insurance operators. Methods: this was a cross-sectional descriptive study carried out in a large-capacity private health insurance operator using data collected by the company from 2012 to 2015. Results: ninety-six lawsuits were brought by 86 beneficiaries regarding medical procedures (38.5%), treatments (26.1%), examinations (14.6%), medications (9.4%), home care (6.2%), and other types of hospitalization (5.2%). The procedures with the highest number of lawsuits were percutaneous rhizotomy; chemotherapy; treatment-related positron-emission tomography scans; and for medications relative to antineoplastic and Hepatitis C treatment. Conclusions: the lawsuits were filed because of the operators’ refusal to comply with items not established in contracts or not regulated and authorized by the Brazilian National Regulatory Agency for Private Health Insurance and Plans, refusals considered unfounded.

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