scholarly journals Improving the performance of social health insurance system through increasing outpatient expenditure reimbursement ratio: a quasi-experimental evaluation study from rural China

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Yudong Miao ◽  
Jianqin Gu ◽  
Liang Zhang ◽  
Ruibo He ◽  
Sandeep Sandeep ◽  
...  
Keyword(s):  
Health Insurance ◽  
Experimental Evaluation ◽  
Rural China ◽  
Social Health Insurance ◽  
Evaluation Study ◽  
Social Health ◽  
Health Insurance System ◽  
Insurance System ◽  
Social Health Insurance System ◽  
Quasi Experimental

scholarly journals Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 238
Author(s):  
Roger V. Araujo-Castillo ◽  
Carlos Culquichicón ◽  
Risof Solis Condor
Keyword(s):  
Health Insurance ◽  
Burden Of Disease ◽  
Hip Osteoarthritis ◽  
Social Health Insurance ◽  
Social Health ◽  
World Health ◽  
Health Insurance System ◽  
Insurance System ◽  
Life Years ◽  
Social Health Insurance System

Introduction: Since its introduction by the World Health Organization (WHO), the concept of burden of disease has been evolving. The current method uses life expectancy projected to 2050 and does not consider age-weighting and time-discounting. Our aim is to estimate the burden of disease due to hip, knee, and unspecified osteoarthritis using this new method in the Peruvian Social Health Insurance System (EsSalud) during 2016. Methods: We followed the original 1994 WHO study and the current 2015 Global Burden of Disease (GBD) methods to estimate disability adjusted life years (DALY) due to osteoarthritis, categorized by sex, age, osteoarthritis type, and geographical area. We used disability weights employed by the Peruvian Ministry of Health, and the last update issued by WHO. Results: Overall, EsSalud reported 17.9 new cases of osteoarthritis per 1000 patients per year. Annual incidence was 23.7/1000 among women, and 72.6/1000 in people above 60 years old. Incidence was 5.6/1000 for knee osteoarthritis and 1.1/1000 for hip. According to the 1994 WHO method, there were 399,884 DALYs or 36.6 DALYs/1000 patients per year due to osteoarthritis. 12.4 and 2.2 DALYs/1000 patients per-year were estimated for knee and hip osteoarthritis, respectively. Using the 2015 GBD method, there were 1,037,865 DALYs or 94.9 DALYs/1000 patients per year. 31.4 and 5.3 DALYs/1000 patients per year were calculated for knee and hip osteoarthritis, respectively. Conclusions: In the Peruvian social health insurance subsystem, hip, knee, and unspecified osteoarthritis produced a high burden of disease, especially among women and patients over 60. The 2015 GBD methodology yields values almost three times higher than the original recommendations.

scholarly journals Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 238
Author(s):  
Roger V. Araujo-Castillo ◽  
Carlos Culquichicón ◽  
Risof Solis Condor
Keyword(s):  
Health Insurance ◽  
Burden Of Disease ◽  
Hip Osteoarthritis ◽  
Social Health Insurance ◽  
Social Health ◽  
World Health ◽  
Health Insurance System ◽  
Insurance System ◽  
Life Years ◽  
Social Health Insurance System

Introduction: Since its introduction by the World Health Organization (WHO), the concept of burden of disease has been evolving. The current method uses life expectancy projected to 2050 and does not consider age-weighting and time-discounting. Our aim is to estimate the burden of disease due to hip, knee, and unspecified osteoarthritis using this new method in the Peruvian Social Health Insurance System (EsSalud) during 2016. Methods: We followed the original 1994 WHO study and the current 2015 Global Burden of Disease (GBD) methods to estimate disability adjusted life years (DALY) due to osteoarthritis, categorized by sex, age, osteoarthritis type, and geographical area. We used disability weights employed by the Peruvian Ministry of Health, and the last update issued by WHO. Results: Overall, EsSalud reported 17.9 new cases of osteoarthritis per 1000 patients per year. Annual incidence was 23.7/1000 among women, and 72.6/1000 in people above 60 years old. Incidence was 5.6/1000 for knee osteoarthritis and 1.1/1000 for hip. According to the 1994 WHO method, there were 399,884 DALYs or 36.6 DALYs/1000 patients per year due to osteoarthritis. 12.4 and 2.2 DALYs/1000 patients per-year were estimated for knee and hip osteoarthritis, respectively. Using the 2015 GBD method, there were 1,037,865 DALYs or 94.9 DALYs/1000 patients per year. 31.4 and 5.3 DALYs/1000 patients per year were calculated for knee and hip osteoarthritis, respectively. Conclusions: In the Peruvian social health insurance subsystem, hip, knee, and unspecified osteoarthritis produced a high burden of disease, especially among women and patients over 60. The 2015 GBD methodology yields values almost three times higher than the original recommendations.

scholarly journals Multi-Level Social Health Insurance System in the Age of Frequent Employment Change: The Urban Unemployment-Induced Insurance Transition and Healthcare Utilization in China

Healthcare ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 77 ◽  
Author(s):  
Bocong Yuan ◽  
Jiannan Li ◽  
Lily Wu ◽  
Zhaoguo Wang
Keyword(s):  
Health Insurance ◽  
Healthcare Utilization ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Insurance System ◽  
Employment Change ◽  
Insurance System ◽  
Social Health Insurance System ◽  
Multi Level ◽  
Basic Medical

Job tenure has been significantly shortened with the prevalence of the gig economy around the world. Workers are faced with a new age of frequent employment change. This emerging situation is out of expectation of social health insurance policymakers. As the multi-level social health insurance system in China is closely associated with employment status; urban workers cannot enjoy the urban employee basic medical insurance (UEBMI) during the unemployment period. At this time, unemployed rural-to-urban migrant workers can only rely on the new cooperative medical scheme (NCMS) and unemployed urban residents can only rely on the urban resident basic medical insurance (URBMI). This study provides a preliminary analysis on healthcare utilization change triggered by the unemployment-induced social health insurance transition that has never been investigated. Using the data of a nationwide survey, empirical results show that the unemployment-induced social health insurance transition can significantly deteriorate the healthcare utilization of insurance beneficiaries experiencing the transitions from the UEBMI to the NCMS (or from the UEBMI to the URBMI). Specifically, the outpatient service quality and the conventional physical examination become worse, and the out-of-pocket expenditure increases. Therefore, the multi-level social health insurance system currently in effect can expose workers to a high risk of insufficient health security in the age of frequent employment change.

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