An increase in primary care prescriptions of stop-smoking medication as a result of health insurance coverage in the Netherlands: population based study

Using the Michigan Syndromic Surveillance System changes in emergency department (ED) volume are being monitored as health insurance coverage expands through the Healthy Michigan Plan (HMP), which provides healthcare coverage to low-income adults. Seasonally adjusted monthly ED visits prior to and after the HMP implementation on April 1, 2014 are being compared. Preliminary data show increasing trends in ED utilization among populations with previously low levels of health insurance coverage. Increased health insurance coverage may expand healthcare service options beyond EDs. Alternatively, the demand for primary care services may exceed the level of access leading to increased ED utilization for primary care.

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Impact of local health insurance schemes on primary care management and control of hypertension: a cross-sectional study in Shenzhen, China

BMJ Open ◽

10.1136/bmjopen-2019-031098 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031098 ◽

Cited By ~ 1

Author(s):

Haitao Li ◽

Zhu Wu ◽

Xia Hui ◽

Yanhong Hu

Keyword(s):

Primary Care ◽

Social Capital ◽

Health Insurance ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Hypertension Management ◽

Insurance Status ◽

Local Health ◽

Hypertensive Patients ◽

And Control

BackgroundIn China, the local health insurance coverage is usually related to timely reimbursement of hypertensive care in primary care settings, while health insurance that is not local could represent an obstacle for accessibility and affordability of primary care for hypertensive patients.ObjectiveTo investigate whether local health insurance schemes have a positive impact on hypertension management and control.DesignWe performed an on-site, face-to-face, patients survey in community health centres (CHCs) in Shenzhen, China.Setting and participantsHypertensive patients seeking healthcare from CHCs were selected as study participants using a systematic sampling design.Main measuresWe obtained information about insurance status, social capital, drug treatment and control of hypertension. Multivariable stepwise logistic regression models were constructed to test the associations between insurance status and hypertension management, as well as insurance status and social capital.ResultsA total of 867 participants were included in the final study analysis. We found that the participants covered by local insurance schemes were more likely to be managed in primary care facilities (61.1% vs 81.9%; OR=2.58, 95% CI: 1.56 to 4.28), taking antihypertensive drugs (77.2% vs 88.0%; OR=2.23, 95% CI: 1.37 to 3.62) and controlling blood pressure (43.0% vs 52.4%; OR=1.46, 95% CI: 1.03 to 2.07) when compared with those with insurance coverage that is not local. The participants covered by local insurance schemes reported a higher score of perceived generalised trust than those without (4.23 vs 3.97; OR=0.74, 95% CI: 0.53 to 0.86).ConclusionOur study demonstrates that local health insurance coverage could help improve management and control of hypertension in a primary care setting. Policymakers suggest initiating social interventions for better management and control of hypertension at the primary care level, although the causal pathways across insurance status, social capital and control of hypertension deserve further investigations.

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PHP27 Effect of Primary Care Availability and Health Insurance Coverage on Chronic and Acute Preventable Hospitalizations

Value in Health ◽

10.1016/j.jval.2012.03.104 ◽

2012 ◽

Vol 15 (4) ◽

pp. A18

Author(s):

S. Murty ◽

C.E. Begley ◽

L. Franzini ◽

J.M. Swint

Keyword(s):

Primary Care ◽

Health Insurance ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Preventable Hospitalizations ◽

Care Availability

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Prevalence of Self-Reported Chronic Diseases and Health Services Utilization by Ethnic Minorities in Manaus Metropolitan Region

Ethnicity & Disease ◽

10.18865/ed.28.1.49 ◽

2018 ◽

Vol 28 (1) ◽

pp. 49 ◽

Cited By ~ 4

Author(s):

Raquel Rodrigues Ferreira Rocha de Alencar ◽

Tais Freire Galvao ◽

Bruno Vianei Real Antonio ◽

Marcus Tolentino Silva

Keyword(s):

Health Insurance ◽

Chronic Diseases ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Population Based ◽

Metropolitan Region ◽

Care Utilization ◽

Cross Sectional ◽

Probabilistic Sampling ◽

Significant Difference

Objectives: To assess the prevalence of, and associated factors to, self-reported chronic diseases and health care utilization by ethnicity in the Manaus Metropolitan Region.Methods: We conducted a cross-sectional, population-based survey from May through August 2015. Using probabilistic sampling in three stages, we recruited adults aged ≥18 years. Ethnicity was self-identified as White, Black, Yellow, Brown (Brazilian mixed-race), and Indigenous. We calculated adjusted prevalence ratios (PR) and 95% CI of chronic diseases and health service utilization for each ethnic minority and compared the data using Poisson regression with data from White respondents.Results: In this study, we interviewed 4,001 people. Of these, 15.9% were White, 7.5% Black, 3.4% Yellow, 72.1% Brown, and 1.0% Indigenous. Indigenous respondents had the highest prevalence of self-reported hypertension (29.4%), diabetes (12.3%) and hypercholesterolemia (17.0%) among the ethnic respondent groups. Compared with the White population, Browns had less health insurance coverage (PR=.76; 95% CI: .62-.93) and reported hypertension (PR=.84; 95% CI: .72-0.98) and diabetes (PR=.69; 95% CI: .51-.94) less frequently. Yellows visited the doctor more frequently than Whites (PR=1.13; 95% CI: 1.04-1.22), with no significant difference in prevalence of diseases.Conclusions: Indigenous respondents had higher prevalence rates of the investigated diseases. Compared with Whites, Brown respondents had lower rates of self-reported arterial hypertension and diabetes, as well as lower rates of private health insurance coverage.Ethn Dis. 2018;28(1):49-54; doi:10.18865/ed.28.1.49

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