THE EFFECTS OF SOCIAL HEALTH INSURANCE ON WOMEN’S HEALTHCARE USE: EVIDENCE FROM INDONESIA

2020 ◽  
pp. 1-24
Author(s):  
SHANIKA SAMARAKOON ◽  
RASYAD A. PARINDURI
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Healthcare Services ◽  
Social Health ◽  
Public Healthcare ◽  
Delivery Care ◽  
Healthcare Use ◽  
Healthcare Facilities ◽  
The Poor ◽  
The Government

To increase the use of healthcare services in Indonesia, the government of Indonesia introduced Askeskin, a subsidized social health insurance for the poor, in 2005. We examine the effects of this social health insurance on women’s healthcare use. Using propensity score matching, we find Askeskin induces women to use public healthcare facilities for birth delivery and antenatal checkup, discourages them from getting help from midwives for birth delivery, and makes them more likely to use contraceptives. The insurance seems to increase delivery care expenditure, however. We do not find evidence that it increases women’s preventive and curative healthcare use.

scholarly journals Social health insurance for the poor: lessons from a health insurance programme in Karnataka, India

2018 ◽  
Vol 3 (1) ◽  
pp. e000582 ◽  
Author(s):  
Neeraj Sood ◽  
Zachary Wagner
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Tertiary Care ◽  
Substantial Reduction ◽  
Unmet Need ◽  
Social Health Insurance ◽  
Well Being ◽  
Poverty Line ◽  
Social Health ◽  
The Poor

Life-saving technology used to treat catastrophic illnesses such as heart disease and cancer is often out of reach for the poor. As life expectancy increases in poor countries and the burden from chronic illnesses continues to rise, so will the unmet need for expensive tertiary care. Understanding how best to increase access to and reduce the financial burden of expensive tertiary care is a crucial task for the global health community in the coming decades. In 2010, Karnataka, a state in India, rolled out the Vajpayee Arogyashree scheme (VAS), a social health insurance scheme focused on increasing access to tertiary care for households below the poverty line. VAS was rolled out in a way that allowed for robust evaluation of its causal effects and several studies have examined various impacts of the scheme on poor households. In this analysis article, we summarise the key findings and assess how these findings can be used to inform other social health insurance schemes. First, the evidence suggests that VAS led to a substantial reduction in mortality driven by increased tertiary care utilisation as well as use of better quality facilities and earlier diagnosis. Second, VAS significantly reduced the financial burden of receiving tertiary care. Third, these benefits of social health insurance were achieved at a reasonable cost to society and taxpayers. Several unique features of VAS led to its success at improving health and financial well-being including effective outreach via health camps, targeting expensive conditions with high disease burden, easy enrolment process, cashless treatment, bundled payment for hospital services, participation of both public and private hospitals and prior authorisation to improve appropriateness of care.

Application of digital technologies in health insurance for social good of bottom of pyramid customers in India

2019 ◽  
Vol 39 (9/10) ◽  
pp. 752-772
Author(s):  
Bishwajit Nayak ◽  
Som Sekhar Bhattacharyya ◽  
Bala Krishnamoorthy
Keyword(s):  
Risk Management ◽  
Health Insurance ◽  
Digital Technology ◽  
Social Health Insurance ◽  
Social Health ◽  
Strategic Choices ◽  
Content Type ◽  
Study Results ◽  
The Government ◽  
Health Insurers

Purpose Social health insurance framework of any country is the national identifier of the country’s policy for taking care of its population which cannot access or afford quality healthcare. The purpose of this paper is to highlight the strategic imperatives of digital technology for the inclusive social health models for the BoP customers. Design/methodology/approach A qualitative exploratory study using in-depth personal interviews with 53 Indian health insurance CXOs was conducted with a semi-structured questionnaire. Using MaxQDA software, the interview transcripts were analyzed by means of thematic content analysis technique and patterns identified based on the expert opinions. Findings A framework for the strategic imperatives of digital technology in social health insurance emerged from the study highlighting three key themes for technology implementation in the social health insurance sector – analytics for risk management, cost optimization for operations and enhancement of customer experience. The study results provide key insights about how insurers can enhance the coverage of BoP population by leveraging technology. Social implications The framework would help health insurers and policymakers to select strategic choices related to technology that would enable creation of inclusive health insurance models for BoP customers. Originality/value The absence of specific studies highlighting the strategic digital imperatives in social health insurance creates a unique value proposition for this framework which can help health insurers in developing a convergence in their risk management and customer delight objectives and assist the government in the formulation of a sustainable social health insurance framework.

scholarly journals Willingness to Join and Pay for Social Health Insurance Scheme Among employees in Debere Berhan Town, Ethiopia

2019 ◽  
Author(s):  
Wassie Negash Mekonnen ◽  
Mesfin Wondaferew ◽  
Adugnaw Birhane Mekonen
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Contingent Valuation Method ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Insurance Scheme ◽  
The Government

Abstract Back ground: Social Health Insurance improves access to health services among civil servants by removing catastrophic health expenditure. In Ethiopia, only 7.3% of the population covered by health insurance. Due to this fact the government of Ethiopia initiated Social Health Insurance scheme to be applied in the formal employers and employees with compulsory membership of the scheme. This study therefore aimed to assess willingness to join and pay for social health insurance scheme among government and private employees in Debere Berhan Town, Ethiopia .Methods: Cross-sectional study was conducted .At mean time Stratified sampling technique was used to select 619 employees. A modified dichotomous contingent valuation method (CVM) was applied to elicit employees’ willingness to pay. Bi-variant and multivariable logistic regression analysis was done . Then the result at 95% CI and P value <0.05 was declared as variables have statistically significant association. Results: A total of 619 employees with response rate of 97.8% were participated in the study. About 406 (65%) of the respondents were willing to join to Social Health Insurance scheme. Of which 113 (27.8%) of employees were willing to pay the government proposed 3% premium. The employee’s average willingness to pay for social health insurance scheme was 1.88% of their monthly salary. In this study the odds of respondents who had degree and above (AOR=3.608, 95%CI 1.177-11.061), employees good perception on quality health service (AOR=3.150, 95% CI 1.140-8.699) and employees who perceive benefit packages of social health insurance as enough (AOR=5.229, 95%CI: 2.230-12 .594) were higher than the counter parts. Conclusion: Employees willingness to join of the Social Health Insurance scheme(SHIS) is low and very low number of employees agree to pay the government proposed premium for SHIS. So decision-makers should emphasize to revise the benefit packages and the premiums to be contributed. likewise insurance agency and all responsible bodies should aware the society about the importance of social health insurance for the employees.

scholarly journals SOCIAL HEALTH INSURANCE LITERACY: LESSON LEARNED FROM SOCIAL INSURANCE FOR MATERNITY CARE BY NATIONAL HEALTH INSURANCE PROGRAMME

2019 ◽  
Vol 7 (1) ◽  
pp. 25
Author(s):  
Choirun Nisa' ◽  
Intan Nina Sari
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Maternity Care ◽  
Social Insurance ◽  
Post Partum ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Insurance Literacy ◽  
The Government

Background: Health insurance is a right for all Indonesian citizens. To provide this, the Indonesian government must provide health services that are equitable, fair, and affordable for all levels of society. Before National Health Insurance (JKN) was established, the government launched Social Insurance for Maternity Care or Jaminan Persalinan (Jampersal) as a special health facility for pre-pregnant to post-partum mothers. The JKN program will run well if it is accompanied with good health service literacy of the community.Aims: This study aims to analyze the relationship of social health insurance literacy with the utilization of Jampersal and predict the response towards JKN utilization based on Jampersal mothers. These responses can be used as an input for JKN improvement.Methods: This research is a descriptive study that focuses on the experience of the subjects. The study does so by analyzing Jampersal users’ response and utilizing it for the improvement of JKN. The respondents of this study are Jampersal and non-Jampersal mothers consisting of 75 pregnant and post-partum mothers.Results: The results show that the number of Jampersal users (47%) were less than non Jampersal (53%) with a ratio of 2:3. In addition, literacy about Jampersal of Jampersal mothers' was higher (28 out of 30 people - 93.33%) compared to non Jampersal mothers (29 out of 45 people - 64.44%).Conclusions: This study concludes that there is a lack of promotion of government programs, especially social health insurance. What needs to be done to improve participation and use of social health insurance is to encourage primary healthcare centers to promote the programs. Intervention policy, especially by educating the communities, is necessary for the improvement of JKN literacy.                                                                                                                                                          Keywords: Literacy, Participation, Social health insurance.

scholarly journals Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abel Mekonne ◽  
Benyam Seifu ◽  
Chernet Hailu ◽  
Alemayehu Atomsa
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Health Professionals ◽  
Addis Ababa ◽  
Social Health Insurance ◽  
Social Health ◽  
Care Providers ◽  
The Government

Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

scholarly journals Moving to Social Health Insurance Financing and Payment for HIV/AIDS Treatment in Vietnam

2021 ◽  
Vol 14 ◽  
pp. 117863292098884
Author(s):  
Lan Thi Hoang Vu ◽  
Benjamin Johns ◽  
Quyen Thi Tu Bui ◽  
Anh Duong Thuy ◽  
Diu Nguyen Thi ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Inpatient Admission ◽  
Social Health ◽  
Cross Sectional ◽  
Related Services ◽  
Donor Funding ◽  
Outpatient Visits ◽  
The Government ◽  
Hiv Aids

This study estimates the amount antiretroviral therapy (ART) clients paid out of pocket for preventive and treatment services and the percentage of ART clients incurring catastrophic payments during the period when ART services were transitioning from donor funding to domestic social health insurance (SHI) in Vietnam. Using a cross-sectional facility-based survey in 9 provinces, a sample of 582 clients across 18 ART facilities representatives of all facilities where SHI-financed ART was being implemented were interviewed in 2019. Results indicated 13.4% (95% CI: 5.7%, 28.2%) of clients incurred a payment for outpatient ART care. The average out of pocket expenditures for outpatient visits and HIV related outpatient visits was USD $71.2 and $8 per year, respectively. The average out of pocket expenditure for inpatient admission and HIV related inpatient admission was $7.1 and $1.6, respectively. Only 0.1% clients currently experienced HIV-related catastrophic payment at the 25% of total expenditures threshold. The study confirms the transition from donor-financed ART to SHI-financed ART is not causing financial hardship for ART clients. However, more commitment from the Government of Vietnam to strengthen HIV-related services under SHI may be needed in the future, and there is still need to ensure universal SHI coverage among people with HIV/AIDs in Vietnam.

scholarly journals Social health insurance schemes in Africa leave out the poor

2018 ◽  
Vol 10 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Ama Pokuaa Fenny ◽  
Robert Yates ◽  
Rachel Thompson
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
The Poor

scholarly journals A Dynamic Analysis of the Demand for Health Care in Post-Apartheid South Africa

2021 ◽  
Vol 11 (2) ◽  
pp. 484-494
Author(s):  
David Mhlanga
Keyword(s):  
South Africa ◽  
Logit Model ◽  
Healthcare Services ◽  
Public Healthcare ◽  
Probability Models ◽  
Delivery Of Healthcare ◽  
Healthcare Facilities ◽  
The Government ◽  
Public Clinics ◽  
Demand For Health

The study aimed to investigate the drivers of demand for healthcare in South Africa 26 years after democracy. The pattern healthcare demand by households in South Africa is that most households use public healthcare services particularly public clinics compared to private and traditional healthcare facilities. Using conditional probability models, the logit model to be more specific, the results revealed that households head who is unemployed, households who do not have a business, households who were not receiving pension money, had a greater probability of demand for public healthcare institutions. On the other hand, being male, being White, Indian and Coloured, being a property owner and being not a grant beneficiary, reduces the probability of demand for public healthcare facilities in South Africa. As a result, the study recommends more investment in public healthcare but more in public clinics in South Africa due to the high percentage of households using these services. Also, the government must consider investing more in the maintenance and improvement of the welfare of nurses in the country considering the huge role they play in the delivery of healthcare to the citizens.

Kosovo

2021 ◽  
pp. 958-966
Author(s):  
Arta Uka
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Social Insurance ◽  
Social Health Insurance ◽  
Healthcare Services ◽  
Social Health ◽  
The Public ◽  
Insurance System ◽  
Building Process ◽  
Kosovo War

This chapter offers an in-depth look at health politics and the tax-financed health system in Kosovo, a system which is in a process of transition towards social health insurance. It traces the development of Kosovo’s healthcare system, characterized by the establishment of a decentralized free-for-all-at-point-of-delivery health system during communism. After the end of the Kosovo War in 1999, Kosovo started actively seeking independence. Until the declaration of independence in 2008, politics in the country was mainly focused on the state-building process, while health policy was not a priority. Although facilitated by international organizations, legislation for establishing a social health insurance has been passed, the social health insurance system has not been implemented yet. Thus, healthcare services still remain financed by state and municipal budgets, medical professionals are public employees, and the private sector is not integrated into the public insurance system. Key healthcare issues have been high out-of-pocket payments, mainly for pharmaceuticals and private services, inequalities in health access, and high unemployment rates, which are likely to undermine the collection of social insurance contributions in the future.

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