scholarly journals Household preferences and willingness to pay for health insurance in Kampala City: a discrete choice experiment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Edward Kalyango ◽  
Rornald Muhumuza Kananura ◽  
Elizabeth Ekirapa Kiracho
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Public Health Care ◽  
Care Providers ◽  
Potential Health ◽  
Kampala City ◽  
Household Preferences

Abstract Introduction Uganda is in discussions to introduce a national health insurance scheme. However, there is a paucity of information on household preferences and willingness to pay for health insurance attributes that may guide the design of an acceptable health insurance scheme. Our study sought to assess household preferences and willingness to pay for health insurance in Kampala city using a discrete choice experiment. Methods This study was conducted from 16th February 2020 to 10th April 2020 on 240 households in the Kawempe division of Kampala city stratified into slum and non-slum communities in order to get a representative sample of the area. We purposively selected the communities that represented slum and non-slum communities and thereafter applied systematic sampling in the selection of the households that participated in the study from each of the communities. Four household and policy-relevant attributes were used in the experimental design of the study. Each respondent attended to 9 binary choice sets of health insurance plans that included one fixed choice set. Data were analyzed using mixed logit models. Results Households in both the non-slum and slum communities had a high preference for health insurance plans that included both private and public health care providers as compared to plans that included public health care providers only (non-slum coefficient β = 0.81, P < 0.05; slum β = 0.87, p < 0.05) and; health insurance plans that covered extended family members as compared to plans that had limitations on the number of family members allowed (non-slum β = 0.44, P < 0.05; slum β = 0.36, p < 0.05). Households in non-slum communities, in particular, had a high preference for health insurance plans that covered chronic illnesses and major surgeries to other plans (0.97 β, P < 0.05). Our findings suggest that location of the household influences willingness to pay with households from non-slum communities willing to pay more for the preferred attributes. Conclusion Potential health insurance schemes should consider including both private and public health care providers and allow more household members to be enrolled in both slum and non-slum communities. However, the inclusion of more HH members should be weighed against the possible depletion of resources and other attributes. Potential health insurance schemes should also prioritize coverage for chronic illnesses and major surgeries in non-slum communities, in particular, to make the scheme attractive and acceptable for these communities.

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.

New Challenges for Public Health Care: Biological and Chemical Weapons Awareness, Surveillance, and Response

2003 ◽  
Vol 4 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Joseph P. Dudley
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Clinical Symptoms ◽  
The United States ◽  
Public Health Care ◽  
Surveillance Systems ◽  
Care Providers ◽  
First Line ◽  
Nursing Professionals

Recent events in the United States have demonstrated a critical need for recognizing nurses and emergency health care providers as important elements of the nation’s first line of defense and response against terrorist attacks involving biological, chemical, or radiological weapons. The anthrax letter attacks of September/October 2001 demonstrate the importance of vigilance and attention to detail while interviewing and attending patients and when entering, reviewing, and cataloging patient records. Nursing professionals, emergency care responders, and physicians can perform a crucial role in our first-line defense against terrorism by detecting and reporting unusual or anomalous illness(es) consistent with possible exposure to biological or chemical agents. Nursing professionals should become more familiar with the etiology and clinical symptoms of biological agents of greatest current concern (smallpox, anthrax, tularemia, plague) and be alert for potentially anomalous or unfamiliar combinations of symptoms that could point to unwitting exposure to biological toxins, toxic chemicals, or cryptic radiological agents. Public health surveillance systems must be developed that encourage and facilitate the rapid reporting and follow-up investigation of suspect illnesses and potential disease outbreaks that will ensure early identification and response for covert attacks involving biological, chemical, or radiological weapons.

Study of the accreditation process at an institution of public health care providers in Rio de Janeiro state

2011 ◽  
Vol 5 (4) ◽  
pp. 1078
Author(s):  
Monica Simoes Duarte ◽  
Zenith Rosa Silvino
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Rio De Janeiro ◽  
Accreditation Process ◽  
Public Health Care ◽  
Care Providers ◽  
Process Data ◽  
Del Rio ◽  
Janeiro State

ABSTRACTObjective: to characterize an accredited institution of public health in Rio de Janeiro State, identify the paths taken by the health institution to be accredited and discuss the institutional benefits obtained from accreditation. Methodology: it’s an exploratory and descriptive research, qualitative method of case study one that will be developed in HEMORIO. It will use as a source of evidence documentation related to the management of the institution and semi-structured interviews with health and administrative professionals who work at the institution and followed the accreditation process. Data will be triangulated and treated with the thematic content analysis. Expected results: to contribute to a reflection on quality health services topic in public institutions, wake up and aware managers and health professionals from other institutions of public health in Rio de Janeiro State not accredited to join the implementation of this tool quality. Descriptors: accreditation; quality of health care; access and evaluation; nursing; health management.RESUMOObjetivo: caracterizar uma instituição de saúde acreditada, da rede pública do Estado do Rio de Janeiro, identificar os caminhos percorridos por esta instituição de saúde para ser acreditada e discutir os benefícios institucionais obtidos ao ser acreditada. Metodologia: estudo exploratório e descritivo, com abordagem qualitativa, método de estudo de caso único que será desenvolvido no HEMORIO. Utilizar-se-á como fonte de evidência, a documentação referente ao processo de gestão da instituição e entrevistas semi-estruturadas com os profissionais administrativos e de saúde que trabalham na instituição e acompanharam o processo de acreditação. Os dados obtidos serão triangulados e tratados através da análise de conteúdo temática. Resultados esperados: contribuir para uma reflexão acerca da temática ‘qualidade dos serviços de saúde em instituições públicas’, despertar e sensibilizar gestores e profissionais de saúde, das demais instituições de saúde da rede pública do Estado do Rio de Janeiro não acreditadas, a aderirem à implementação desta ferramenta da qualidade. Descritores: acreditação; qualidade da assistência à saúde; acesso e avaliação; enfermagem; gestão em saúde.RESUMENObjetivo: caracterizar una institución acreditada de salud pública en el Estado del Río de Janeiro, identificar los caminos tomados por la institución de salud para ser acreditada y discutir sobre los beneficios que son obtenidos de las instituciones acreditadas. Metodología: estudio exploratorio y descriptivo, con abordaje cualitativo de un estudio de caso que se desarrollará en HEMORIO. Se utilizará como fuente de documentación, pruebas relacionadas con la gestión de la institución y entrevistas semi-estructuradas con profesionales de la salud y administrativos que trabajan en la institución y seguían el proceso de acreditación. Los datos serán triangulados y tratados con el análisis de contenido temático. Resultados esperados: contribuir a una reflexión sobre el tema de los servicios de salud de calidad en las instituciones públicas, despertar y sensibilizar a los gerentes y profesionales de la salud de otras instituciones de salud pública en el Estado del Río de Janeiro no acreditas que se adhieren a la aplicación de esta herramienta de calidad. Descriptores: acreditación; calidad de la atención de salud; acceso y evaluación; enfermería; gestión en salud.

scholarly journals Understanding the Puzzle of Primary Health-care Use: Evidence from India

2021 ◽  
Author(s):  
Pramod Kumar Sur
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Care Use ◽  
Public Health Care ◽  
Private Health Care ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

In India, households' use of primary health-care services presents a puzzle. Even though most private health-care providers have no formal medical qualifications, a significant fraction of households use fee-charging private health-care services, which are not covered by insurance. Although the absence of public health-care providers could partially explain the high use of the private sector, this cannot be the only explanation. The private share of health-care use is even higher in markets where qualified doctors offer free care through public clinics; despite this free service, the majority of health-care visits are made to providers with no formal medical qualifications. This paper examines the reasons for the existence of this puzzle in India. Combining contemporary household-level data with archival records, I examine the aggressive family planning program implemented during the emergency rule in the 1970s and explore whether the coercion, disinformation, and carelessness involved in implementing the program could partly explain the puzzle. Exploiting the timing of the emergency rule, state-level variation in the number of sterilizations, and an instrumental variable approach, I show that the states heavily affected by the sterilization policy have a lower level of public health-care usage today. I demonstrate the mechanism for this practice by showing that the states heavily affected by forced sterilizations have a lower level of confidence in government hospitals and doctors and a higher level of confidence in private hospitals and doctors in providing good treatment.

scholarly journals Competition, Capitation, and Coding: Do Public Primary Care Providers Respond to Increased Competition?

2019 ◽  
Vol 65 (4) ◽  
pp. 402-423 ◽  
Author(s):  
Margareta Dackehag ◽  
Lina Maria Ellegård
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Public Health Care ◽  
Administrative Database ◽  
Care Providers ◽  
Economic Significance ◽  
Heterogeneous Effects ◽  
Entry Restrictions

Abstract The case for competition in health-care markets rests on economic models in which providers seek to maximize profits. However, little is known regarding how public health-care providers, who might not have a profit motive, react to increased competition from private providers. This study considers the heterogeneous effects of a primary health-care reform in a Swedish region that considerably loosened entry restrictions and increased patients’ freedom of choice, thus enabling increased competition. Our difference-in-differences analysis contrasts local markets that were affected by both entry and choice with local monopoly markets, which were unaffected by the reforms. Using detailed administrative data on all visits to public health centers in 2008–2011, we find that providers in markets with increasing competition registered more diagnoses in an administrative database, thus increasing their reimbursement per patient. Although the economic significance of the effect is small, the result suggests that public providers are indeed sensitive to competition.

scholarly journals THE INVOLUNTARY DETENTION AND ISOLATION OF PATIENTS INFECTED WITH EXTREME RESISTANT TUBERCULOSIS (XDR-TB): IMPLICATIONS FOR PUBLIC HEALTH, HUMAN RIGHTS AND INFORMED CONSENT Minister of Health, Western Cape v Goliath 2009 2 SA 248 (C)

Obiter ◽  
2021 ◽  
Vol 30 (2) ◽  
Author(s):  
Pieter Carstens
Keyword(s):  
Public Health ◽  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Care Providers ◽  
Bodily Integrity ◽  
Resistant Tuberculosis ◽  
Care Facilities

Public health-care providers (public hospitals) and related health-care services in South Africa have in recent times been under severe strain due to the seemingly uncontrollable increase in dangerous infectious airborne diseases like Extreme Resistant Tuberculosis (hereinafter “XDR-TB”). Ultimately these health-care providers/services have been challenged, not only in the diagnosis and treatment of XDR-TB patients, but specifically to control and curtail the spread thereof by effectively managing sufferers by way of forced isolation and monitoring to ensure that they abide by the rules and strict treatment regime related to XDR-TB. The said challenge hasbecome exacerbated specifically in public health-care facilities where patients suffering from XDR-TB fail to abide by the treatment regime and regularly abscond from follow-up appointments, posing a real threat of infection to the community at large. Consequently public health-care providers and communities have increasingly questioned whether it is possible to invoke some mechanism legally whereby the involuntary isolation of patients with XDR-TB in State-funded health-care facilities could be effected. It goes without saying that such a mechanism (by way of a court order/court authorisation) would have a definite and marked influence on a patient’s right to bodily integrity and freedom (as contemplated in s 12 of the Constitution of the Republic of South Africa, 1996) and will pose significant challenges to any constitutional limitation (as contemplated in s 36) and related legislation (such as the National Health Act 61 of 2003). Ultimately the question under consideration is whether the public’s right to be protected from potentially dangerous infectious diseases constitutionally trumps the right of an individual sufferer to bodily integrity. It is in this regard that the present case under discussion offers far-reaching perspectives. 

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