scholarly journals Effect of self-employment on the sub-health status and chronic disease of rural migrants in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian Zhou ◽  
Qiushi Wu ◽  
Zicheng Wang
Keyword(s):  
Health Insurance ◽  
Chronic Disease ◽  
Health Status ◽  
Causal Effect ◽  
Social Health Insurance ◽  
Social Health ◽  
Transmission Channel ◽  
Rural Migrants ◽  
Logit Regression ◽  
Self Employment

Abstract Background Rural migrants usually suffer from major disease risks, but little attention had been paid toward the relationship between self-employment behavior and health status of rural migrants in China. Present study aims to explore the causal effect of self-employment behavior on rural migrants’ sub-health status and chronic disease. Two research questions are addressed: does self-employment status affect the sub-health status and chronic disease of rural migrants? What is potential mechanism that links self-employment behavior and health status among rural migrants in China? Methods The dataset from the 2017 National Migrants Population Dynamic Monitoring Survey (NMPDMS-2017) was used to explore the causal effect. Logit regression was performed for the baseline estimation, and linear probability model with instrument variable estimation (IV-LPM) was applied to correct the endogeneity of self-employment. Additionally, logit regression was conducted to explore the transmission channel. Results Self-employed migrants were more susceptible to sub-health status and chronic disease, even when correcting for endogeneity. Moreover, self-employed migrants were less likely to enroll in social health insurance than their wage-employed counterparts in urban destinations. Conclusion Self-employed migrants were more likely to suffer from sub-health status and chronic disease; thus, their self-employment behavior exerted a harmful effect on rural migrants’ health. Social health insurance may serve as a transmission channel linking self-employment and rural migrants’ health status. That is, self-employed migrants were less prone to participate in an urban health insurance program, a situation which leaded to insufficient health service to maintain health.

scholarly journals Does the self-employment status affect the rural migrants’ health in China: the transmission channel of social health insurance?

2020 ◽  
Author(s):  
Zicheng Wang ◽  
Qiushi Wu ◽  
Juan Ming
Keyword(s):  
Health Insurance ◽  
Chronic Disease ◽  
Health Status ◽  
Causal Effect ◽  
Social Health Insurance ◽  
The Self ◽  
Social Health ◽  
Transmission Channel ◽  
Rural Migrants ◽  
Self Employment

Abstract Background There are growing attentions paid on rural migrants’ health. Previous studies found that rural migrants are more exposed to disease risks. The present study aims to explore the causal effect of self-employment behavior on the rural migrants’ health status, two issues are addressed to discuss: Does self-employment status affect the health of rural migrants? What is the potential mechanism linking the self-employment behavior and health status? Methods The dataset from the 2017 National Migrants Population Dynamic Monitoring Survey (NMPDMS-2017) is applied to explore the causal effect; the Logit regression is performed to make baseline estimation, while the IV-LPM estimation is applied to correct the endogeneity of self-employment. Additionally, the Logit regression is conducted to explore the transmission channel. Results The self-employed are more susceptible to sub-health status (OR= 1.042; 95% CI= 1.001, 1.084) and chronic disease (OR= 1.394; 95% CI= 1.317, 1.476), even when correcting the endogeneity, the causal effect estimation also demonstrates that the self-employed are more vulnerable to suffer sub-health status (Coefficient= 0.067; 95% CI= 0.050, 0.084) and chronic disease (Coefficient= 0.020; 95% CI= 0.008, 0.032). The self-employed are less likely to participate in social health insurance (OR= 0.057; 95% CI= 0.053, 0.061). Conclusion The self-employed are more likely to suffer sub-health status and chronic disease, the self-employment behavior take harmful effect on the rural migrants’ health. Social health insurance may serve as transmission channel linking self-employment and rural migrants’ health, that is, the self-employed are less prone to participate in the urban health insurance program, which induce to an insufficient health service to maintain health.

scholarly journals Dropout Analysis of a National Social Health Insurance Program at Pokhara Metropolitan City, Kaski, Nepal

2021 ◽  
Author(s):  
Prabin Sharma ◽  
Dipendra Kumar Yadav ◽  
Niranjan Shrestha ◽  
Prabesh Ghimire
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Social Health Insurance ◽  
Good Health ◽  
Social Health ◽  
Factors Associated ◽  
Insurance Program ◽  
Health Insurance Program ◽  
First Contact ◽  
Structured Questionnaire

Background: Nepal’s national social health insurance (SHI) program, which started in 2016, aims to achieve universal health coverage (UHC), but it faces severe challenges in achieving adequate population coverage. By 2018, enrolment and dropout rates for the scheme were 9 percent and 38 percent respectively. Despite government's efforts, retaining the members in SHI scheme remains a significant challenge. The current study therefore aimed to assess the factors associated with social health insurance program dropout in Pokhara, Nepal. Methods: A cross-sectional household survey of 355 households enrolled for at least one year in the national social health insurance program was conducted. A structured questionnaire was used to conduct face-to-face interviews with household heads were conducted using a structured questionnaire. Data was entered in Epi-Data and analysed using SPSS. The factors associated with social health insurance program dropout were identified using bivariate and multiple logistic regression analyses. Results: The findings of the study revealed a dropout prevalence of 28.2% (95% confidence interval: 23.6%-33.2%). Households having more than five members [adjusted odds ratio (aOR) 2.19, 95% CI: 1.22-3.94], belonging to underprivileged ethnic groups (Dalit/Janajati) (aOR 2.36, 95% CI: 1.08-5.17), living on rented homes (aOR: 4.53, 95%CI 1.87-10.95), absence of chronic illness in family (aOR 1.95, 95%CI: 1.07-3.59), perceived good health status of the family (aOR 4.21, 95%CI: 1.21-14.65), having private health facility as first contact point (aOR 3.75, 95%CI: 1.93-7.27), poor availability of drugs (aOR 4.75, 95%CI: 1.19-18.95) and perceived unfriendly behaviour of service providers (aOR 3.09, 95%CI: 1.01- 9.49) were statistically significant factors associated with SHI dropout. Conclusion: In Pokhara, more than one-fourth of households have dropped out of the Social Health Insurance Scheme, which is a significant number. Dropping out of SHI is most commonly associated with a lack of drugs, followed by rental housing, family members’ reported good health status and unfriendly service provider behaviour. Efforts to reduce SHI dropout must focus on addressing drugs availability issues and improving providers’ behaviour towards scheme holders. Increasing insurance awareness, including provisions to change first contact points, may help to reduce dropouts among rented households, which make up a sizable proportion of the Pokhara metropolitan area.

scholarly journals Factors Affecting the Purchase of Commercial Health Insurance: Based on Personal Health Status and the Substitution Effect of Social Insurance

2021 ◽  
Author(s):  
Wenguang Yu ◽  
Qi Wang ◽  
Guofeng Guan ◽  
Yujuan Huang
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Social Insurance ◽  
Regression Coefficient ◽  
Social Health Insurance ◽  
Poor Health ◽  
Social Health ◽  
Self Rated Health ◽  
Health Level ◽  
Commercial Health Insurance

Abstract Background: How health status affects residents’ purchase of commercial health insurance and whether social insurance will crowd out the demand of commercial health insurance are important issues related to the development of commercial health insurance. Further, this paper also attempts to answer why people with worse health buy less commercial health insurance through mechanism analysis. Methods: We used Logit model to analyze the impact of self-rated health level on the purchase of commercial health insurance and the crowding out effect of participating in social health insurance on the purchase of commercial health insurance. In addition, we also successively introduced the respondents with worse and worse health status for regression analysis and analyzed the reasons why the poor health groups reduce the purchase of commercial medical insurance. Results: When performing regression analysis on whether to purchase commercial health insurance, the regression coefficient of having social health insurance is -0.497 and the regression coefficient of self-rated health level is -0.182, but the health status has no significant impact on whether to have social health insurance. Conclusions: The expansion of social basic health insurance has a restraining effect on the promotion of commercial health insurance, and self-rated health level has a negative impact on the purchase of commercial health insurance. The reason why individuals with poor health buy less commercial health insurance is that commercial insurance companies often refuse to cover individuals in poor health.JEL: I11, G22

scholarly journals Acceptance of the proposed social health insurance among government-owned company employees in Northwest Ethiopia: implications for starting social health insurance implementation

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Abuneh Zemene ◽  
Adane Kebede ◽  
Asmamaw Atnafu ◽  
Tsegaye Gebremedhin
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Work Experience ◽  
Social Health Insurance ◽  
Quality Of Healthcare ◽  
Northwest Ethiopia ◽  
Social Health ◽  
Related Factors ◽  
The Government ◽  
Owned Company

Abstract Background Ethiopia is currently planning to introduce Social Health Insurance (SHI) that will lead to universal health coverage and assist a country to achieve its health system’s objectives and to prevent the catastrophic health expenditure. But there is no evidence until now about the level of acceptance of the proposed SHI among government-owned companies’ employees. Therefore, this study was intended to assess the acceptance of SHI and associated factors among government-owned companies’ employees in northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from February 1 to April 30, 2019. A randomly selected 541 government-owned companies’ employees were participated in the study. A pretested self-administered structured questionnaire was used that consisted sociodemographic and economic, health status-related factors, attitude (measured by 12 items), organizational related factors and knowledge about SHI (measured by 11 items). Finally, binary logistic regression analysis was performed and in the multivariable logistic regression analysis, a significant level at a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) were used to identify factors statistically associated with SHI acceptance. Results Overall, 32% (95% CI: 27.7–36.2) of the government-owned companies’ employees accepted the proposed Ethiopian SHI scheme. Self-perceived health status (AOR: 8.55, 95% CI: 2.69–27.13), heard about SHI (AOR: 1.69, 95% CI: 1.12–2.54), coverage of medical healthcare cost (AOR: 0.60, 95% CI: 0.39–0.92), work experience (AOR: 0.49, 95% CI: 0.26–0.89) and quality of healthcare service at the facilities (AOR: 0.17, 95% CI: 0.04–0.71) were significantly associated with acceptance of SHI among government-owned companies’ employees. Conclusions One-third of the study participants accepted the proposed Ethiopian SHI scheme. Self-perceived health status, quality of healthcare service at health facilities, coverage of the medical cost by their organization, heard about SHI and work experience were the factors that affect acceptance of the proposed SHI among the government-owned company employees. Therefore, policymakers should devise a plan to promote the benefit packages of SHI for the formal sector employees to start the implementation.

Which Therapeutic Progress Shall be Paid by Social Health Insurance?

2007 ◽  
Author(s):  
Jürgen Wasem ◽  
Hans-Dieter Nolting ◽  
Yvonne Grabbe ◽  
Stefan Loos
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

scholarly journals Effects of cancer treatment on household impoverishment: a multicentre cross-sectional study in China

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044322
Author(s):  
Wenqi Fu ◽  
Jufang Shi ◽  
Xin Zhang ◽  
Chengcheng Liu ◽  
Chengyao Sun ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Social Health Insurance ◽  
Poverty Line ◽  
Post Treatment ◽  
Social Health ◽  
Daily Consumption ◽  
Out Of Pocket Payments ◽  
Per Capita

ObjectivesTo determine the incidence and intensity of household impoverishment induced by cancer treatment in China.DesignAverage income and daily consumption per capita of the households and out-of-pocket payments for cancer care were estimated. Household impoverishment was determined by comparing per capita daily consumption against the Chinese poverty line (CPL, US$1.2) and the World Bank poverty line (WBPL, US$1.9) for 2015. Both pre-treatment and post-treatment consumptions were calculated assuming that the households would divert daily consumption money to pay for cancer treatment.ParticipantsCancer patients diagnosed initially from 1 January 2015 to 31 December 2016 who had received cancer treatment subsequently. Those with multiple cancer diagnoses were excluded.Data sourcesA household questionnaire survey was conducted on 2534 cancer patients selected from nine hospitals in seven provinces through two-stage cluster/convenience sampling.Findings5.89% (CPL) to 12.94% (WBPL) households were impoverished after paying for cancer treatment. The adjusted OR (AOR) of post-treatment impoverishment was higher for older patients (AOR=2.666–4.187 for ≥50 years vs <50 years, p<0.001), those resided in central region (AOR=2.619 vs eastern, p<0.01) and those with lower income (AOR=0.024–0.187 in higher income households vs the lowest 20%, p<0.001). The patients without coverage from social health insurance had higher OR (AOR=1.880, p=0.040) of experiencing post-treatment household impoverishment than those enrolled with the insurance for urban employees. Cancer treatment is associated with an increase of 5.79% (CPL) and 12.45% (WBPL) in incidence of household impoverishment. The median annual consumption gap per capita underneath the poverty line accumulated by the impoverished households reached US$128 (CPL) or US$212 (WBPL). US$31 170 395 (CPL) or US$115 238 459 (WBPL) were needed to avoid household impoverishment induced by cancer treatment in China.ConclusionsThe financial burden of cancer treatment imposes a significant risk of household impoverishment despite wide coverage of social health insurance in China.

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.

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