scholarly journals Does inpatient health services utilization vary by remoteness in the medical financial assistance population? Evidence from Shaanxi province, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yangling Ren ◽  
Zhongliang Zhou ◽  
Guanping Liu ◽  
Chi Shen ◽  
Dan Cao ◽  
...  
Keyword(s):  
Low Income ◽  
Inpatient Care ◽  
Financial Assistance ◽  
Shaanxi Province ◽  
Inpatient Stay ◽  
Geographic Access ◽  
Services Utilization ◽  
Annual Total ◽  
Drive Time ◽  
Medical Financial Assistance

Abstract Background Medical Financial Assistance (MFA) provides health insurance and financial support for millions of low income and disabled Chinese people, yet there has been little systematic analysis focused on this vulnerable population. This study aims to advance our understanding of MFA recipients’ access to health care and whether their inpatient care use varies by remoteness. Methods Data were collected from the Surveillance System of Civil Affairs of Shaanxi province in 2016. To better proxy remoteness (geographic access), drive time from the respondent’s village to the nearest county-level or city-level hospital was obtained by a web crawler. Multilevel models were used to explore the impacts of remoteness on inpatient services utilization by MFA recipients. Furthermore, the potential moderating role of hospital grade (i.e. the grade of medical institution where recipient’s latest inpatient care services were taken in the previous year) on the relationship between geographic access and inpatient care use was explored. Results The analytical sample consisted of 9516 inpatient claims within 73 counties of Shaanxi province in 2016. We find that drive time to the nearest hospital and hospital grade are salient predictors of inpatient care use and there is a significant moderation effect of hospital grade. Compared to those with shortest drive time to the nearest hospital, longer drive time is associated with a longer inpatient stay but fewer admissions and lower annual total and out-of-pocket (OOP) inpatient costs. In addition, these associations are lower when recipients are admitted to a tertiary hospital, for annual total and OOP inpatient expenditures, but higher for length of the most recent inpatient stay no matter what medical treatments are taken in secondary or tertiary hospitals for the most remote recipients. Conclusion Our results suggest that remoteness has a significant and negative association with the frequency of inpatient care use. These findings advance our understanding of inpatient care use of the extremely poor and provide meaningful insights for further MFA program development as well as pro-poor health strategies.

scholarly journals The effects of poverty reduction policy on health services utilization among the rural poor: a quasi-experimental study in central and western rural China

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Qi Zou ◽  
Xiaoqun He ◽  
Zhong Li ◽  
Wanchun Xu ◽  
Liang Zhang
Keyword(s):  
Health Services ◽  
Poverty Reduction ◽  
Health Services Utilization ◽  
Financial Assistance ◽  
Western China ◽  
Rural Poor ◽  
Outpatient Services ◽  
Services Utilization ◽  
Inequality In Health ◽  
Medical Financial Assistance

Abstract Background China poverty reduction policy (PRP) addresses two important elements: the targeted poverty reduction (TPA) project since 2015 in line with social assistance policy as national policy; and reducing inequality in health services utilization by making provision of medical financial assistance (MFA). Therefore, this study aims to assess the effects of the PRP in health services utilization (both inpatient and outpatient services) among the central and western rural poor of China. Methods The study conducted household survey and applied propensity score matching (PSM) method to assess the effects of the PRP on health services utilization among the rural poor of Central and Western China. A sensitivity test was also performed on the PSM results to test their robustness. Results Key findings showed 17.6% of respondents were the beneficial of PRP. The average treatment effects on the treated (ATT) of the PRP on the inpatient visits within one year was found significantly positive (P = 0.026). Conclusion There has been relationship between PRP with medical financial assistance and reduction of inequality in health services utilization by the poorer, in particular to accessing the inpatient services from the county or township hospitals of China. Policy makers should pay attention for making provision of improving responsiveness of supply, when subsidizing on the demand side.

Immigration Relief and Insurance Coverage: Evidence from Deferred Action for Childhood Arrivals

2020 ◽  
Vol 20 (3) ◽  
Author(s):  
Jung Bae
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Financial Assistance ◽  
Eligibility Criteria ◽  
Deferred Action ◽  
Percentage Points ◽  
Health Institutions ◽  
Medical Financial Assistance ◽  
The U.S

AbstractI find that the 2012 Deferred Action for Childhood Arrivals (DACA) program, which conferred protection from deportation and work authorization to undocumented immigrants who had been brought to the U.S. as children, increased eligible immigrants’ likelihood of having health insurance coverage. Exploiting a cutoff rule in the eligibility criteria of DACA, I implement a difference-in-regression-discontinuities design. The insured rate increased by up to 4.3 percentage points more for DACA-eligible immigrants than for ineligible immigrants following DACA. Two-thirds of this increase is accounted for by upticks in employer-sponsored and privately purchased insurance. The findings are also consistent with immigrants becoming less averse to approach health institutions, and taking up medical financial assistance at a higher rate.

IMF activities as a provider of financial assistance to the countries affected by the COVID-19 pandemic

2021 ◽  
pp. 137-146
Author(s):  
М.Б. Медведева ◽  
Л.И. Хомякова ◽  
А.Д. Зверева
Keyword(s):  
Low Income ◽  
Debt Relief ◽  
Financial Assistance ◽  
Low Income Countries ◽  
Extensive Program ◽  
The Imf

В целях поддержки стран по преодолению экономических последствий пандемии COVID-19 МВФ выделил им финансовые ресурсы и предоставил инструменты облегчения обслуживания долга в рамках различных механизмов кредитования и финансирования. Программа действует с конца марта 2020 года. В статье отмечено, что МВФ быстро отреагировал на чрезвычайную ситуацию, вызванную пандемией, и развернул широкую программу помощи странам с низким уровнем дохода в целях преодоления ее последствий. The IMF provides financial assistance and debt relief under various lending and financing mechanisms to member countries facing the economic fallout from the COVID-19 pandemics. The article provides an overview of the assistance approved by the IMF since the end of March 2020. It was noted that the IMF quickly responded to the emergency caused by the pandemic and launched an extensive program of assistance to low-income countries in order to overcome its consequences.

Foreign Aid, FDI and Economic Growth in South-East Asia and South Asia

2020 ◽  
pp. 097215091989095
Author(s):  
D. Tripati Rao ◽  
Narayan Sethi ◽  
Devi Prasad Dash ◽  
Padmaja Bhujabal
Keyword(s):  
Economic Growth ◽  
Private Sector ◽  
East Asia ◽  
Foreign Aid ◽  
South Asia ◽  
Low Income ◽  
Trade Openness ◽  
Financial Assistance ◽  
South East Asia ◽  
Domestic Investment

We examine the interrelationship among foreign aid, foreign direct investment (FDI) and economic growth in South-East Asia (SEA) and South Asia (SA) during 1980–2016. The findings from alternative empirical estimations suggest that while foreign aid is negatively associated with FDI as well as growth, FDI positively influences growth. Further, governmental financial assistance to private sector for domestic investment turns out to be important in all empirical estimations insofar as positively associated with FDI flows as well as growth. We, therefore, infer that low-income SEA and SA economies should focus on channelizing governmental financial assistance to private sector for domestic investment, macroeconomic stabilization, trade openness, and efficient utilization of aid flows, in order to attract, absorb and reap the benefits of complementing FDI flows and sustaining higher economic growth.

Inequalities in dental services utilization among Brazilian low-income children: the role of individual determinants

2011 ◽  
Vol 71 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Marcia Helena Baldani ◽  
Yasmine Bittencourt Emílio Mendes ◽  
Juliana Aparecida de Campos Lawder ◽  
Ana Paula Ingles de Lara ◽  
Michelli Marta Azevedo da Silva Rodrigues ◽  
...  
Keyword(s):  
Low Income ◽  
Dental Services ◽  
Services Utilization ◽  
Low Income Children ◽  
Individual Determinants ◽  
Dental Services Utilization

scholarly journals Perceived Value Influencing the Household Waste Sorting Behaviors in Rural China

2020 ◽  
Vol 17 (17) ◽  
pp. 6093
Author(s):  
Ying Ma ◽  
Mansoor Ahmed Koondhar ◽  
Shengke Liu ◽  
Huiling Wang ◽  
Rong Kong
Keyword(s):  
Low Income ◽  
Perceived Value ◽  
Income Group ◽  
Policy Implications ◽  
Shaanxi Province ◽  
Household Waste ◽  
Time Cost ◽  
Material Cost ◽  
Perceived Benefit ◽  
Waste Classification

Waste sorting is the cardinal measurement to solve the problem of low efficiency of rural environmental governance and to alleviate environmental pollution by reduction, recycling, and harmlessness in rural areas. However, non-excludable and non-rival features of public goods easily cause a wide free-rider problem, which results in a low frequency of participation in the waste sorting of rural people. Based on the theory of the utility maximization of the rational economic man, this paper investigates survey data of 688 farm households in three cities and three counties of Shaanxi Province to explore the effect of the perceived value on the household waste classification behavior based on cost-benefit analysis. The results show that perceived benefit and perceived cost are important perceived value factors affecting farmers’ participation in waste sorting. Specifically, the spiritual benefit of the perceived benefit has a significantly positive impact on classification behavior, while the time cost, physical cost, and material cost of the perceived cost have a negative impact on waste classification behavior. Further study of the heterogeneity of income impact shows that time cost only has a significant impact on the high-income group of farmers’ classification behavior, while spiritual benefit and learning cost only affect the low-income group of farmers’ waste classification behavior. Material cost has different influence directions on high- and low-income groups. In view of the aforementioned findings, this study highlights corresponding policy implications from the perspective of perceived benefit and perceived cost.

Abstract 1: The Impact of State Medicaid Expansions on Care Quality and Outcomes for Low-Income Patients Hospitalized With Heart Failure

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Rishi K Wadhera ◽  
Karen E Joynt Maddox ◽  
Gregg C Fonarow ◽  
Xin Zhao ◽  
Paul A Heidenreich ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Outcome Measures ◽  
Low Income ◽  
Inpatient Care ◽  
The United States ◽  
Care Quality ◽  
National Quality ◽  
Quality And Outcomes ◽  
The Impact

Background: Heart failure (HF) is the leading cause of morbidity and mortality in the United States. Despite considerable advancement in the management of HF, outcomes remain suboptimal, particularly among the uninsured. In 2014, the ACA expanded Medicaid eligibility, and millions of low-income, non-elderly adults gained insurance coverage in 32 states. Little is known about Medicaid expansion’s effect on quality and outcomes of inpatient care for HF. Methods: We used the American Heart Association’s Get With The Guidelines-HF registry to assess changes in inpatient care quality and outcomes among low income, non-elderly patients hospitalized for HF prior to and following Medicaid expansion, in expansion and non-expansion states. Patients were classified as low income if covered by Medicaid, uninsured, or missing insurance. We considered expansion states to be those that implemented expansions in 2014. We constructed piecewise logistic multivariable regression models to track quarterly trends over time of quality and outcome measures in the pre-expansion (1/1/2010-12/31/2013) and post-expansion (1/1/14 - 6/30/17) periods, by state expansion status. Results: The cohort included 58,804 patients hospitalized across 391 sites - 53% were covered by Medicaid, 21.3% uninsured, and 25.6% missing insurance. Among expansion states, defect-free HF care increased significantly during the pre-expansion period (aOR 1.06, 95% CI 1.03-1.08) but did not change after expansion (aOR 0.99, 95% CI 0.97-1.02). Similarly, other quality measures, such as use of aldosterone antagonists, evidence-based beta blockers, and ICD implantation significantly increased prior to expansion, but did not change following expansion (Table). In-hospital mortality rates remained similar during the pre-expansion (aOR 0.99, 95% CI 0.96-1.02) and post-expansion periods (aOR 1.00, 95% CI 0.97-1.03). Trends in quality and outcome measures for non-expansion states are also shown in the table. Conclusion: The ACA Medicaid state expansions were not associated with improvements in quality of care or in-hospital mortality in expansion states among sites participating in a national quality improvement initiative. Future investigation should evaluate the long-term impact of expansion on HF care during the post-discharge period.

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