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.

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.

Understanding Subnational Variation in Chinese Social Health Insurance

2020 ◽  
pp. 134-159
Author(s):  
Xian Huang
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Health Insurance Coverage ◽  
Social Health ◽  
Cross Sectional ◽  
Insurance Benefits ◽  
Social Risks ◽  
Political Economies ◽  
Regional Comparisons

Chapter 6 investigates the coverage and generosity of Chinese social health insurance in the first decade of the 2000s, with a focus on the regional (i.e., cross-provincial) variation using a cross-sectional time-series research design. First, a cluster analysis provides supportive evidence for the existence of four models of social health insurance expansion in China. The clustering of Chinese provinces in social health insurance expansion also corresponds to the differences among local political economies. Second, the chapter makes detailed inter-regional comparisons and intra-regional studies to reconstruct the mechanism linking a local political economy to the local distributive patterns of health insurance benefits—that is, local socioeconomic conditions shape local leaders’ policy preferences and choices for allocating social health insurance benefits in their jurisdictions. Finally, a regression analysis demonstrates significant correlations between local social risks and social health insurance coverage, and between local fiscal resources and social health insurance generosity.

Current sistuation on using health insurance card among people with HIV/AIDS in Sa Dec city, Dong Thap province in 2019

2020 ◽  
pp. 50-57
Author(s):  
Thu Ha Nguyen ◽  
◽  
Thi Ngoc Diep Huynh ◽  
Khanh Phuong Nguyen
Keyword(s):  
Health Insurance ◽  
Transition Period ◽  
Health Sector ◽  
Social Health Insurance ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Factors Associated ◽  
Keywords Hiv ◽  
Living With Hiv ◽  
Hiv Aids

To describe the situation and factors associated with the use of health insurance cards among people living with HIV/AIDS in Sa Dec city, Dong Thap province in 2019.A qualitative cross-sectional study combnied with a quantitative section were employed to describe the situation and factors associated with the use of health insurance cards among 210 people living with HIV/AIDS in Ward 1, 2 and 3 of Sa Dec city, Dong Thap province from March 2019 to December 2019.There were 125 people living with HIV/AIDS (59.5%) used health insurance cards during medical examination and treatment within the last 12 months. In which, only 5 people living with HIV/AIDS (4%) use health insurance cards for ARV treatment. The main reason for not using health insurance cards is self-discrimination (accounting for 83.5%). The study also found that many factors that belong to individuals, peer/family members and communication/education about health insurance are related to the proportion of people using health insurance cards in the past 12 months.The health sector and Provincial Social Security in Dong Thap need to be well-prepared for the upcoming transition period when the Global Fund no longer funding for ARV treatment. Besides, it is necessary to strengthen communication and education strategies to improve knowledge and reduce the issue of self-discrimination among people living with HIV/AIDS when using health insurance cards. Keywords: HIV/AIDS, social health insurance, treatment, ARV.

scholarly journals Policy options to integrate HIV services into Social Health Insurance (JKN) in Indonesia

2019 ◽  
Vol 10 (1) ◽  
pp. 67-76
Author(s):  
Mardiati Nadjib ◽  
Purwa Kurnia Sucahya ◽  
Mondastri Korib ◽  
Ratih Oktarina ◽  
Pujiyanto Pujiyanto ◽  
...  
Keyword(s):  
Health Insurance ◽  
Research Question ◽  
Social Health Insurance ◽  
Hiv Treatment ◽  
Hiv And Aids ◽  
Social Health ◽  
Health Coverage ◽  
Benefit Package ◽  
Hiv Services ◽  
Hiv Aids

Latar belakang: Setelah sekian tahun bergantung pada sumber pendaaan luar negeri, pembiayaan Program HIV AIDS di Indonesia diharapkan menggunakan sumber pendanaan dalam negeri. Skema Jaminan Kesehatan Semesta atau Jaminan Kesehatan Nasional (JKN) yang dimulai tahun 2014 menanggung pengobatan termasuk infeksi oportunistik. Pertanyaan penelitian apakah paket manfaatnya dapat mencakup intervensi kesehatan masyarakat seperti HIV tanpa menghambat penyediaan pelayanan? Implementasi untuk Program HIV yang selama ini disubsidi Pemerintah memerlukan kehati-hatian. Studi ini bertujuan untuk menganalisis skenario terkait biaya dan utilisasi pada pelayanan HIV guna mendukung kebijakan yang potensial untuk mengintegrasikan intervensi HIV ke dalam paket manfaat JKN. Metode: Penelitian ini menganalisis paket manfaat dan mekanisme pembiayaan terkait pelayanan HIV, keanggotaan JKN, target populasi kunci, serta estimasi premi untuk pelayanan HIV hingga tahun 2019. Studi observasional ini menghasilkan data biaya dan utilisasi dari tingkat nasional dan daerah sebagai data dasar. Peneliti membangun model dan menganalisis skenario proyeksi biaya dan utilisasi dari beragam program aktivitas HIV serta konsekuensinya. Hasil: Skenario dikembangkan berdasarkan kelengkapan paket manfaat dan komponen mana yang bisa dijamin dalam JKN.Pelayanan yang terkait HIV saat ini sebagian besar dijamin oleh pemerintah mulai dari Konseling dan Tes HIV Sukarela (KTS) hingga pengobatan Infeksi Oportunistik. Pengobatan dan perawatan kemungkinan dapat dijamin oleh JKN, dengan bantuan pemerintah untuk pencegahan dan pelayanan ART. Kesimpulan: Skenario dengan paket manfaat dasar akan membutuhkan biaya medis yang rasional per pasien per bulan, tergantung pada kelengkapan paket manfaat. Sebuah peta jalan yang jelas perlu disusun untuk memastikan seluruh pelayanan terjangkau dan berkualitas baik.  Kata kunci: Jaminan kesehatan semesta, pelayanan HIV, dan Opsi Kebijakan   Abstract   Background: HIV and AIDS program in Indonesia is planned to be financed by domestic sources after depending on external sources for many years. Indonesia has started its Social Health Insurance scheme so called Jaminan Kesehatan Nasional (JKN) program in 2014, that covers HIV treatment including opportunistic infection. Research question is whether JKN could expand its benefit package to public health interventions without hampering service provision. Converting HIV program that has been subsidizied by the Government needs careful considerations. The study aimed to assess scenarios on cost and utilization to support decision on integration of HIV interventions into the JKN benefit package. Methods: The study assessed the current coverage and funding mechanisms for HIV-related services, JKN membership, key target populations, and estimated premium for HIV services up to 2019. We captured cost and utilization from national and subnational levels as the baseline through an observational study. Researchers developed model and scenarios on the projection of cost and utilization of various HIV program activities and its consequences. Results: We developed scnearios based on benefit covered by JKN. current services mostly covered by government. The Care and treatment could be possibly covered by the JKN, with support from government for prevention and ART. Conclusion: The scenarios show that provision of HIV services within the basic benefits package of JKN would require a reasonable cost per member per month, depending on the comprehensiveness of the benefit. A clear roadmap should be developed to ensure all services provided are affordable and in good quality.  Keywords: Universal Health Coverage, HIV AIDS, Policy Option

Social Health Insurance Difference in Inpatient Expenditure and Service Category in China

2018 ◽  
Vol 30 (1) ◽  
pp. 56-66 ◽  
Author(s):  
Qing Wang ◽  
Jay Shen ◽  
Jennifer Rice ◽  
Kaitlyn Frakes
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Public Hospitals ◽  
Social Health ◽  
Institutional Characteristics ◽  
Inpatient Service ◽  
Care Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Service Category

China successfully achieved universal health insurance coverage in 2011. Previous work on the effects of social health insurance in China has overlooked the association between health insurance and inpatient service category as well as the mechanisms of institutional characteristics. This study seeks to estimate the social health insurance difference in inpatient expenditure and service category. The role of institutional characteristics was also studied. The logistic model was applied to estimate the association of social health insurance and service category. In addition, Heckman Selected Model and generalized linear model were used to examine the association of health insurance and inpatient expenditure. Estimations were done for 4076 individuals older than 45 years using pooled cross-sectional survey data from the China Health and Retirement Longitudinal Study conducted in 2011 and 2013. Patients with health insurance were more likely to spend more and receive more types of inpatient service. This relationship was partially explained by the institutional characteristics. Therefore, this study highlights the importance of enforcing the regulation of referral mechanisms, the tiered copayment requirement to guide people’s care-seeking behavior, and reforming the allocation of limited health resources between different levels of facilities and also between private and public hospitals.

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