scholarly journals Examining gender differentials and determinants of private health insurance coverage in Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
James Mulenga ◽  
Mulenga C. Mulenga ◽  
Katongo M. C. Musonda ◽  
Chilizani Phiri
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Agricultural Sector ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Probit Regression ◽  
Gender Differentials ◽  
And Gender ◽  
Professional Occupation

Abstract Background Health insurance is an essential aspect of healthcare. This is because it enables the insured to acquire timely and essential healthcare services, besides offering financial protection from catastrophic treatment costs. This paper seeks to establish gender differentials and determinants of health insurance coverage in Zambia. Methods The data used in this study was obtained from the 2018 Zambia Demographic and Health Survey. Data were analyzed using STATA 13.0 software and focused on descriptive and Probit regression analyses. Results The study reveals that for women and men, age, wealth category, education, and professional occupation are positively associated with health insurance while being self-employed in the agricultural sector negatively influences health insurance coverage for both sexes. Other variables have gender-specific effects. For instance, being in marital union and having a clerical occupation increases the probability of having health insurance for women while being in the services, skilled, and unskilled manual occupations increases the probability of having health insurance for men. Further, residing in rural areas reduces the probability of having health insurance for men. Conclusion The study concludes that there are differences in factors that influence health insurance between women and men. Hence, this study highlights the need to enhance health insurance coverage by addressing the different factors that influence health insurance coverage among men and women. These factors include enhancing education, job creation, diversifying insurance schemes, and gender consideration in the design of National Health Insurance Scheme.

scholarly journals Examining Gender Differentials and Correlates of Private Health Insurance Subscription in Zambia

2021 ◽  
Author(s):  
James Mulenga ◽  
Mulenga C. Mulenga ◽  
Katongo M.C. Musonda ◽  
Chilizani Phiri
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Rural Areas ◽  
Health Care Services ◽  
Agricultural Sector ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Probit Regression ◽  
Gender Differentials ◽  
Professional Occupation

Abstract Background: Health insurance is an essential aspect of health care. This is because it enables the insured to acquire timely and essential health care services, besides offering financial protection from catastrophic treatment costs. This paper seeks to establish gender differentials and correlates of health insurance subscription in Zambia. Methods: The data used in this study was obtained from the 2018 Zambia Demographic and Health Survey. Data was analyzed using STATA 13.0 software and focused on descriptive and Probit regression analyses. Results: The study finds that for women and men, age, wealth category, education and professional occupation are positively associated with health insurance. While, being self-employed in the agricultural sector, negatively influences health insurance coverage for both sexes. Other variables have gender specific effects. For instance, being in marital union and in a clerical occupation increases the probability of having health insurance for women. While, being in the services, skilled and unskilled manual occupations increase the probability of health insurance for men. Further, residing in rural areas reduces the probability of having health insurance for men. Conclusion: The study concludes that there are differences in factors that influence health insurance between women and men. Hence, this study highlights the need to enhance health insurance coverage by addressing the different factors that influence health insurance coverage among men and women. These factors include, enhancing education, job creation, diversifying insurance schemes and gender consideration in the design of NHIS.

scholarly journals Health Insurance Deepening and Its Impact on Maternal Healthcare Demand in Private Hospitals in Kenya

2020 ◽  
Vol 16 ◽  
pp. 62-76
Author(s):  
George N. Mose ◽  
Joseph Abuga Orayo
Keyword(s):  
Health Insurance ◽  
Maternal Health ◽  
Insurance Coverage ◽  
Wealth Index ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Significant Rise ◽  
Probit Regression ◽  
Maternal Healthcare ◽  
Private Hospitals

Promotion of maternal healthcare services through the expansion of health insurance coverage has been a core strategy that has been adopted in the reduction of maternal and child mortalities in Kenya. In this study, we seek to establish how health insurance coverage and benefits influence the demand for maternal health utilization in private hospitals in Kenya. The study utilized the latest Kenya Demographic Household Survey 2014 data to estimate the relationship. The binary probit regression model was employed in estimation. From the findings, only 15 percent of mothers were enrolled in a health insurance plan, whereas 14 percent of the women reported to have attended antenatal clinics in private health facilities, and 13 percent benefited from skilled delivery in private healthcare facilities. Results further revealed that health insurance ownership led to a significant increase in the likelihood of utilizing maternal health care services in private hospitals in Kenya. Similarly, age of the mother, marital status, birth order, higher education level, all wealth index categories, and employment status were cofactors associated significantly with use of healthcare services. It was concluded that the advent and increase of health insurance coverage is associated with a significant rise in demand of maternal healthcare services in private hospitals. This study argues that the current health subsidies would be more effective if they were channeled through health insurance with wider coverage of private hospitals. The study recommends reforms in policies and guidelines governing insurance coverage, which we argue would significantly bring down the cost of insurance coverage, thus become more accessible to more Kenyans.

scholarly journals Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017–18 Jordan demographic and health survey

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Petula Fernandes ◽  
Emmanuel Kolawole Odusina ◽  
Bright Opoku Ahinkorah ◽  
Komlan Kota ◽  
Sanni Yaya
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Reproductive Age ◽  
Maternal Healthcare ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background Despite the relationship between health insurance coverage and maternal healthcare services utilization, previous studies in Jordan on the use of maternal healthcare services have mainly focused on patterns and determinants of maternal healthcare services utilization in Jordan. Therefore, this study investigated the relationship between health insurance coverage and maternal healthcare services utilization in Jordan. Methods This study used secondary data published in 2017-18 Jordan Demographic and Health Survey on 4656 women of reproductive age (15–49 years). The independent variable was health insurance coverage and the outcome variable was maternal healthcare services utilization, measured through timing of first antenatal visit, four or more antenatal care visits, and skilled birth attendance. The data were analyzed using descriptive statistics and binary logistic regression. Results Out of the total number of women who participated in the study, 38.2% were not covered by health insurance. With maternal healthcare utilization, 12.5%, 23.2%, and 10.1% respectively, failed to make early first antenatal care visit, complete four or more antenatal care visits and have their delivery attended by a skilled worker. After controlling for the socio-demographic factors, health insurance coverage was associated with increased odds of early timing of first antenatal care visits and completion of four or more antenatal care visits (aOR = 1.33, p < 0.05, aOR = 1.25, p < 0.01, respectively). However, women who were covered by health insurance were less likely to use skilled birth attendance during delivery (aOR = 0.72 p < 0.001). Conclusions Jordanian women with health insurance coverage were more likely to have early first antenatal care visits and complete four or more antenatal care visits. However, they were less likely to have their delivery attended by a skilled professional. This study provides evidence that health insurance coverage has contributed to increased maternal healthcare services utilization, only in terms of number and timing of antenatal care visits in Jordan. It is recommended that policy makers in Jordan should strengthen the coverage of health insurance in the country, especially among women of reproductive age in order to enhance the use of maternal healthcare services in the country.

scholarly journals Challenges with Pain Treatment for Rural Older Adults: Family Caregivers' Views

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 893-894
Author(s):  
Hyunjin Noh ◽  
Cho Rong Won ◽  
Zainab Suntai
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Family Caregivers ◽  
Rural Areas ◽  
Pain Treatment ◽  
Financial Burden ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Thinking Skills ◽  
Rural Older Adults

Abstract Family caregivers face various challenges in assisting older adults experiencing pain and difficult symptoms. Living in rural areas poses additional obstacles to their caregiving. The purpose of this study was to explore family caregivers’ lived experiences in caring for older adults with pain and discomfort in rural communities. A qualitative research design was adopted to capture the common essence of participants’ experiences through a phenomenological method. Purposeful sampling was used, and the participant criteria was: age 18+, have good thinking skills, resident of Alabama, provide unpaid assistance to a family/relative who has chronic/serious health conditions and experienced pain/discomfort in the last 3 months. Ten participants were recruited from rural counties of Alabama. Individual semi-structured interviews were conducted via phone and were recorded and transcribed verbatim. Inductive, thematic analysis of the data revealed themes in five categories: 1) impact of pain (physical and psychological/emotional toll), 2) coping strategies (faith/contentment with life/logistical adaptation), 3) impact of Covid-19 (physical health/social interaction/mental health/added caregiving), 4) challenges in pain treatment (transportation (time/distance/driver/cost) and non-transportation related problems (healthcare provider issues/health insurance/financial burden)), and 5) suggestions (transportation-related (more transportation options/tailored services) and non-transportation-related support (home-based services/better health insurance coverage)). Findings of this study highlight rural family caregivers’ unique experiences in assisting older adults’ access to pain treatment, particularly during the Covid-19 pandemic. Policy- and program-level intervention is called for to increase individualized transportation options, improve health insurance coverage, and expand financial support for rural older adults experiencing pain and their caregivers.

scholarly journals Inequality in healthcare use among older people in Colombia

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jorge Garcia-Ramirez ◽  
Zlatko Nikoloski ◽  
Elias Mossialos
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Healthcare Utilization ◽  
Insurance Coverage ◽  
Wealth Quintile ◽  
The Elderly ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Healthcare Use

Abstract Background Since the early 1990s, Colombia has made great strides in extending healthcare coverage to its population. In order to measure the impact of these efforts, it is important to assess whether the introduction of universal health coverage has translated into equitable access to healthcare in the country, particularly for the elderly. Thus, in this study we assessed the inequality in utilization of health services among elderly patients in Colombia. In addition, we identified the determinants of healthcare utilization. Methods We analyzed the 2015 Colombian health, well-being and aging study (SABE). To classify determinants of healthcare use into predisposing, enabling and need factors, we employed the Anderson framework of healthcare utilization. Use of outpatient, inpatient and preventive health services constituted the dependent variables. We performed multivariate logistic regressions, estimated concentration indexes (CI) and performed decomposition analyses of the CIs to determine the contribution of various determinants to inequality of healthcare utilization. Results The study sample included 23,694 adults over 60-years-old. Wealth quintile, urban dwelling, health insurance type and multimorbidity predicted the utilization of all types of healthcare services except for hospitalization. Aside from inpatient care, pro-rich inequality in utilization of healthcare services was present. Wealth quintile and type of health insurance were the largest contributors to pro-rich inequality in use of preventive services. Conclusions While there has been progress in health insurance coverage for the elderly in Colombia, there are still equality challenges in the delivery of healthcare, especially for preventive and outpatient care. These inequalities are driven by individual characteristics such as wealth, urban residence, type of health insurance carried, and presence of multimorbidity. To address this issue, the Colombian health system should extend health insurance coverage to uninsured populations, as well as reduce barriers of access to healthcare services among poorest and the rural population receiving subsidized insurance.

Financing and Insurance

2018 ◽  
Author(s):  
Samuel H Zuvekas ◽  
Earle Buddy Lingle ◽  
Ardis Hanson ◽  
Bruce Lubotsky Levin
Keyword(s):  
Public Health ◽  
United States ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Safety Net ◽  
The United States ◽  
Public And Private

The complexity of US healthcare systems is staggering. In 2015, Americans spent approximately $3.7 trillion on healthcare, averaging almost $10,000 per person. Further, Americans rely on a mixture of public and private health insurance coverage to pay for the bulk of the healthcare services they receive. To provide a better understanding of the financing of healthcare in the United States, this chapter examines major government healthcare programs and funding. It begins with a look at the US public health insurance system and the healthcare “safety net,” comprised of a patchwork of public, private, and philanthropic providers and programs. The next sections look at how US insurers and families pay doctors, hospitals, nursing homes, and other healthcare providers to deliver services in the United States and how pharmacy services are financed in public health.

scholarly journals Effects of health insurance on patient demand for physician services

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jerome Dugan
Keyword(s):  
Logistic Regression ◽  
Health Insurance ◽  
Multinomial Logistic Regression ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Routine Care ◽  
Physician Services ◽  
Publicly Insured ◽  
Privately Insured

Abstract Background In recent years, policymakers have sought to reduce health disparities between the insured and uninsured through a federal health insurance expansion policy; however, disparities continue to persist among the insured population. One potential explanation is that the use of healthcare services varies by the type of health insurance coverage due to differences in the design of coverage. The aim of this study is to examine whether health insurance coverage type is associated with the structure and use of healthcare services. Methods The nationally representative Medical Expenditure Panel Survey and multinomial logistic regression are used to estimate the effects of different types of health coverage on the combinations of routine and emergency care sought and received. Results The multinomial logistic regression analysis for the overall sample revealed privately insured respondents reported higher use of routine care only p < 0.01 and lower use of emergency room care only (− 2.13%; p < 0.01) than the uninsured. The publicly insured reported similar trends for use of routine care only (17.93%; p < 0.01) as the privately insured, as compared to the uninsured. Both the privately and publicly insured reported higher use of a mixture of care; however, publicly insured were more likely to use a mixture of care (8.57%, p < 0.01). Conclusion The results show that health insurance is associated with higher use of the physician services, but does not promote the use of cost-effective schedules of care among the publicly insured.

scholarly journals Acceptability, feasibility and implementation of a web-based U.S. Health Insurance Navigation Tool (HINT)

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Caiwei Zheng ◽  
Alberto J. Caban-Martinez
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Population Based ◽  
Web Tool ◽  
Web Based ◽  
Survey Tool ◽  
Navigation Tool ◽  
The Web

Abstract Objective In the U.S., health insurance is a crucial determinant of the affordability of healthcare services and access to care. Population-based studies indicate Americans do not have an adequate understanding of their insurance plans and face difficulties navigating their health insurance coverage. The purpose of this pilot study is to collect qualitative data using a key informant interview format to learn about the acceptability, feasibility and implementation of a newly devised online health insurance navigation tool (HINT). Results A total of 57 Florida residents completed the 18-item HINT web-based survey tool and provided feedback on their experience, of which 63.2% were women, 40.7% Black race, and had average sample age of 46.9 years. Participants reported the web tool to be of good length, easy readability, relevant, and overall helpful for insurance selection. All respondents reported that they would use the tool themselves should they find themselves in the process of selecting an insurance plan and 98.2% of respondents reported that they would suggest the web tool to a family or friend. The average time it took to complete the questionnaire was 4 min and 20 s.The HINT tool met study criteria on feasibility, implementation, and acceptability among study participants.

scholarly journals Identifying the determinants of health insurance coverage among Peruvian women of reproductive age: an assessment based on the national Peruvian demographic survey of 2017

2020 ◽  
Author(s):  
Eduardo Ramos Rosas ◽  
Volker Winkler ◽  
Stephan Brenner ◽  
Manuela De Allegri
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Multinomial Logistic Regression ◽  
Insurance Coverage ◽  
Universal Coverage ◽  
Health Insurance Coverage ◽  
Reproductive Age ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Coverage Rates

Abstract Background: Like many other Latin America- and Caribbean countries, Peru has introduced a tax-financed health insurance scheme called “Sistema Integral de Salud (SIS)” to foster progress towards Universal Health Coverage. The scheme explicitly targets the poorest sections of the population. Our study explores levels of health insurance coverage and their determinants among Peruvian women following the introduction of SIS. We wish to determine the extent to which the introduction of SIS has effectively closed gaps in insurance coverage and for whom. Methods: Relying on the 2017 round of ENDES (Encuesta Nacional Demográfica y de Salud Familiar) survey, we analyzed data for 33168 women aged 15-49. We used multinomial logistic regression to explore the association between health insurance coverage (defined as No Insurance, SIS, Standard Insurance) and women’s socio-demographic and economic characteristics. Results: Out of the 33168 women, 25.3% did not have any insurance coverage, 45.5% were covered by SIS and 29.2% were covered by a Standard Insurance scheme. Women in the SIS group were found to have lower educational levels, live in rural areas and more likely to be poorer. Women in the Standard insurance group were found to be more educated, more likely to be “Spanish”, and to be wealthier. Most uninsured women appeared to belong to a middle class, not poor enough to be eligible for SIS, but also not eligible for standard insurance. Conclusions: Our study confirms that SIS has been effective in increasing coverage among vulnerable women, with coverage rates comparable with those observed among men. Nevertheless, on its own, it has proven to be insufficient to ensure universal coverage among women. Further reforms are needed to ensure that coverage is extended to all population groups.

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