scholarly journals Protracted statelessness and nationalitylessness among the Lahu, Akha and Tai-Yai in northern Thailand: Problem areas and the vital role of health insurance status

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Chantal Herberholz
Keyword(s):  
Health Insurance ◽  
Ethnic Groups ◽  
Insurance Coverage ◽  
Universal Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Primary Data ◽  
Health Coverage ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

Thailand has one of the largest stateless populations in the world. Stateless people are denied access to basic rights and services, driving inequality and discrimination and threatening peace and security. This article aims to explore the problems that stateless people are facing in their daily lives, with a focus on healthcare services, health insurance coverage, and mobility. Primary data were collected in 2020 from 108 stateless and nationalityless adults in Chiang Mai province, belonging to three ethnic minorities, and analyzed using a mixed methods approach. The respondents are exposed to daily environmental stressors, the most serious being exclusion from the Universal Coverage Scheme, mobility restrictions and the absence of land rights. While out-of-pocket health expenditures increase financial vulnerability, a lack of health insurance is also associated with perceived poor quality of care and unmet healthcare needs. However, observed differences among the three ethnic groups highlight that some problems are specific to individual ethnic groups and not necessarily a consequence of citizenship problems. Given the experience Thailand has gained in achieving universal health coverage for Thai citizens, there is an opportunity to address the healthcare plight of Thailand’s stateless and nationalityless population through prioritizing the expansion and improvement of the existing Health Insurance for People with Citizenship Problems policy.

The Current State of Employment-Based Health Coverage

2004 ◽  
Vol 32 (3) ◽  
pp. 404-409 ◽  
Author(s):  
Sherry A. Glied ◽  
Phyllis C. Borzi
Keyword(s):  
Health Insurance ◽  
Current System ◽  
Insurance Coverage ◽  
Universal Coverage ◽  
Health Insurance Coverage ◽  
State Agency ◽  
Health Coverage ◽  
Current State ◽  
Policy Analysts ◽  
Employer Mandate

American policymakers and health policy analysts have a love-hate relationship with job-based health insurance. The policy press routinely runs articles about the demise of the current system of voluntary employer-sponsored health insurance coverage. Conservatives argue that it ought to be replaced with individually-purchased insurance, such as tax-favored spending accounts (see Mark Pauly’s article this issue). Liberals assert that government insurance ought to supplant it.Meanwhile, as the debate rages on about the future of employer coverage, states and the federal government pass legislation buttressing and building on the existing employment-based system. Most recently, California has passed an employer mandate requiring employers to cover their workers (and many other states have contemplated similar legislation) and Maine has adopted a universal coverage initiative that includes a voluntary small employer insurance program offered through a state agency (Dirigo Health Care).

scholarly journals Does Universal Health Insurance Coverage Reduce Unmet Healthcare Needs in China? Evidence from the National Health Service Survey

2020 ◽  
Author(s):  
Shenping Zhou ◽  
Tianyu Huang ◽  
Anqi Li ◽  
Zhonghua Wang
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Early Discharge ◽  
Health Insurance Coverage ◽  
Universal Health Insurance ◽  
Outpatient Services ◽  
Healthcare Needs ◽  
Universal Health Insurance Coverage ◽  
Unmet Healthcare Needs ◽  
Universal Health

Abstract Background: China has nearly achieved universal health insurance coverage, but considerable unmet healthcare needs still exist. Although this topic has attracted great attention, there have been few studies examining the relationship between universal health insurance coverage and unmet healthcare needs. This study aimed to clarify the impact of universal health insurance coverage and other associated factors on Chinese residents’ unmet healthcare needs.Methods: Data was derived from the fourth, fifth, and sixth National Health Service Survey of Jiangsu Province, which were conducted in 2008, 2013, and 2018, respectively. Descriptive statistics were used to analyze the prevalence of unmet healthcare needs. Binary multivariate logistic regression was used to estimate the association between unmet healthcare needs and universal health insurance coverage, along with other socioeconomic factors.Results: 8.99%, 1.37%, 53.37%, and 13.16% of the respondents in Jiangsu Province reported non-use of outpatient services, inpatient services, physical examinations, and early discharge from hospital, respectively. The trend in the prevalence of unmet healthcare needs showed a decline from 2008 to 2018. Health insurance had a significant reducing effect on non-use of outpatient services, inpatient services, or early discharge from hospital. People having health insurance in 2013 and 2018 were significantly less likely to report unmet healthcare needs compared to those in 2008. The effect of health insurance and its universal coverage on reducing unmet healthcare needs was greater in rural than in urban areas. Other socioeconomic factors, such as age, marital status, educational level, income level, or health status, also significantly affected unmet healthcare needs.Conclusions: Universal health insurance coverage has significantly reduced Chinese residents’ unmet healthcare needs. Policy efforts should pay more attention to the benefits of health insurances in rural areas and optimize urban-rural health resources to promote effective utilization of healthcare.

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.

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 ◽  
Vol 19 (1) ◽  
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 33,168 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 33,168 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.

scholarly journals Does universal health insurance coverage reduce unmet healthcare needs in China? Evidence from the National Health Service Survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shenping Zhou ◽  
Tianyu Huang ◽  
Anqi Li ◽  
Zhonghua Wang
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Early Discharge ◽  
Health Insurance Coverage ◽  
Universal Health Insurance ◽  
Outpatient Services ◽  
Healthcare Needs ◽  
Universal Health Insurance Coverage ◽  
Unmet Healthcare Needs ◽  
Universal Health

Abstract Background China has nearly achieved universal health insurance coverage, but considerable unmet healthcare needs still exist. Although this topic has attracted great attention, there have been few studies examining the relationship between universal health insurance coverage and unmet healthcare needs. This study aimed to clarify the impact of universal health insurance coverage and other associated factors on Chinese residents’ unmet healthcare needs. Methods Data was derived from the fourth, fifth, and sixth National Health Service Survey of Jiangsu Province, which were conducted in 2008, 2013, and 2018, respectively. Descriptive statistics were used to analyze the prevalence of unmet healthcare needs. Binary multivariate logistic regression was used to estimate the association between unmet healthcare needs and universal health insurance coverage, along with other socioeconomic factors. Results 8.99%, 1.37%, 53.37%, and 13.16% of the respondents in Jiangsu Province reported non-use of outpatient services, inpatient services, physical examinations, and early discharge from hospital, respectively. The trend in the prevalence of unmet healthcare needs showed a decline from 2008 to 2018. Health insurance had a significant reducing effect on non-use of outpatient services, inpatient services, or early discharge from hospital. People having health insurance in 2013 and 2018 were significantly less likely to report unmet healthcare needs compared to those in 2008. The effect of health insurance and its universal coverage on reducing unmet healthcare needs was greater in rural than in urban areas. Other socioeconomic factors, such as age, marital status, educational level, income level, or health status, also significantly affected unmet healthcare needs. Conclusions Universal health insurance coverage has significantly reduced Chinese residents’ unmet healthcare needs. Policy efforts should pay more attention to the benefits of health insurances in rural areas and optimize urban-rural health resources to promote effective utilization of healthcare.

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.

scholarly journals Unmet Needs of Healthcare Services and Associated Factors among a Cohort of Ghanaian Adults: A Nationally Stratified Cross-Sectional Study Design

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Phaedra Yamson ◽  
John Tetteh ◽  
Daniel DeGraft-Amoah ◽  
Henry Quansah ◽  
George Mensah ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Associated Factors ◽  
Unmet Needs ◽  
Healthcare Services ◽  
Health System Strengthening ◽  
World Health ◽  
Health Coverage ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

We estimated the prevalence of unmet needs of healthcare services (UNHS) and its associated factors among a cohort of older Ghanaian adults. World Health Organization (WHO) Study on Global AGEing and Adult Health for Ghana was used with a total of 4735 participants. Logistics regression analysis was performed using Stata 16 to assess associated factors. The overall UNHS was 3.7% (95% CI = 2.7-4.8) and the prevalence was significantly high amongst older adults aged 60 to 69 years (5.9%). Could not afford the healthcare (56.4%) was the main contender for UNHS. UNHS was influenced by; those aged 60 to 69 years [OR (95% CI) = 1.86 (1.19-2.91)]; no formal educational [aOR (95% CI) = 4.71 (1.27-17.38)], and no NHIS [OR (95% CI) = 1.78 (1.03-3.09)]. Participants needed care for joint pain (25.4%), and communicable diseases (19.1%). The inability to access healthcare was relatively higher for older adults more advanced in age, with low education, and for those without health insurance. Health system strengthening including financial protection by expanding the National Health Insurance Scheme to all Ghanaians in line with Ghana’s Universal Health Coverage Roadmap would reduce the unmet healthcare needs of older adults.

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.

A COMPARATIVE STUDY ON AWARENESS AND HEALTH INSURANCE COVERAGE IN RURALAND URBAN MEERUT

2021 ◽  
pp. 65-67
Author(s):  
Harivansh Chopra ◽  
Tanveer Bano ◽  
Niharika Verma ◽  
Gargi Pandey
Keyword(s):  
Health Insurance ◽  
Urban Area ◽  
Rural Area ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Coverage ◽  
Rural And Urban ◽  
Economics Of Health ◽  
Poverty Status ◽  
Rural And Urban Area

Universal Health Coverage aims to provide essential health services to all while providing protection from catastrophic expenditure on health. To mitigate the economics of health expenditure, health insurance is one of the important tool. Hence, this study was conducted to nd out the awareness and practice of health insurance coverage in rural and urban Meerut.90 households were studied in both rural and urban area. Awareness was higher in urban area but coverage was higher in rural area. Awareness and coverage were found to be signicantly associated with poverty status in rural area of Meerut.

scholarly journals Union Effects on Health Insurance Provision and Coverage in the United States

ILR Review ◽  
2002 ◽  
Vol 55 (4) ◽  
pp. 610-627 ◽  
Author(s):  
Thomas C. Buchmueller ◽  
John Dinardo ◽  
Robert G. Valletta
Keyword(s):  
United States ◽  
Health Insurance ◽  
Survey Data ◽  
Insurance Coverage ◽  
Health Benefits ◽  
Union Density ◽  
Health Insurance Coverage ◽  
The United States ◽  
Health Coverage ◽  
Private Sector Union

During the past two decades, union density has declined in the United States and employer provision of health benefits has changed substantially in extent and form. Using individual survey data spanning the years 1983–97 combined with employer survey data for 1993, the authors update and extend previous analyses of private-sector union effects on employer-provided health benefits. They find that the union effect on health insurance coverage rates has fallen somewhat but remains large, due to an increase over time in the union effect on employee “take-up” of offered insurance, and that declining unionization explains 20–35% of the decline in employee health coverage. The increasing union take-up effect is linked to union effects on employees' direct costs for health insurance and the availability of retiree coverage.

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