scholarly journals Out of pocket expenditure among Rashtriya Swasthya Bima Yojana beneficiary and non-beneficiary patients admitted to a tertiary care centre, Berhampur, India: a comparative study

2019 ◽  
Vol 6 (2) ◽  
pp. 376
Author(s):  
Sushree Priyadarsini Satapathy ◽  
Nivedita Karmee ◽  
Durga Madhab Satapathy ◽  
Radha Madhab Tripathy
Keyword(s):  
Health Insurance ◽  
Life Support ◽  
Insurance Coverage ◽  
Tertiary Care ◽  
Total Sample ◽  
Health Insurance Coverage ◽  
P Value ◽  
Indian Government ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: RSBY, a health insurance scheme, was launched by the Indian government to protect BPL families from incurring financial liabilities which are likely to occur due to hospitalization. Objectives was to compare over all OOPE among RSBY beneficiaries and non-beneficiaries and to estimate its extent during hospitalization in different domains among RSBY beneficiaries and non-beneficiaries.Methods: It was a cross-sectional study conducted for 2 months (January-February 2018) among BPL families residing in Ganjam district, Odisha. Multistage random sampling was done. Total sample size was 256, the number of beneficiaries and non beneficiaries taken was 128 each.Results: Non beneficiaries incurred higher overall OOPE higher i.e. 95.3% than the Beneficiaries and it was found to be statistically significant with x²=74.8 and P-value <0.001. Among beneficiaries out of pocket expenditure was found in 46.1% of the study population. 45.3% of beneficiaries had to borrow partially from friends and relatives to fulfil their hospital related expenses followed by 32% borrowing fully for their treatment. Among beneficiaries, most out of pocket expenditure was for life support services as they sought treatment mostly for surgical conditions.Conclusions: Health insurance coverage should be improved by increasing enrolment. People should be made aware about the services covered under the schemes.

scholarly journals Household catastrophic health expenditure and its effective factors: a case of Iran

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ramin Ravangard ◽  
Faride Sadat Jalali ◽  
Mohsen Bayati ◽  
Andrew J. Palmer ◽  
Abdosaleh Jafari ◽  
...  
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Health Insurance Coverage ◽  
World Health ◽  
P Value ◽  
Cross Sectional ◽  
Supplementary Health Insurance ◽  
Multiple Logistic Regression Modeling

Abstract Background The World Health Organization (WHO) has placed special emphasis on protecting households from health care expenditures. Many households face catastrophic health expenditures (CHEs) from a combination of economic poverty and financing the treatment of medical conditions. The present study aimed to measure the percentage of households facing catastrophic CHEs and the factors associated with the occurrence of CHEs in Shiraz, Iran in 2018. Methods The present cross-sectional study was performed on 740 randomly selected households from different districts of Shiraz, Iran in 2018 using a multi-stage sampling method. Data were collected using the Persian version of the “WHO Global Health Survey” questionnaire. CHEs were defined as health expenditures exceeding 40% of households’ capacity to pay. Households living below the poverty line before paying for health services were excluded from the study. The associations between the households’ characteristics and facing CHEs were determined using the Chi-Square test as well as multiple logistic regression modeling in SPSS 23.0 at the significance level of 5%. Results The results showed that 16.48% of studied households had faced CHEs. The higher odds of facing CHEs were observed in the households living in rented houses (OR = 3.14, P-value < 0.001), households with disabled members (OR = 27.98, P-value < 0.001), households with children under 5 years old (OR = 2.718, P-value = 0.02), and those without supplementary health insurance coverage (OR = 1.87, P-value = 0.01). Conclusion CHEs may be reduced by increasing the use of supplementary health insurance coverage by individuals and households, increasing the support of the Social Security and the State Welfare Organizations for households with disabled members, developing programs such as the Integrated Child Care Programs, and setting home rental policies and housing policies for tenants.

scholarly journals Household Catastrophic Health Expenditure and Its Effective Factors: A Case of Iran

2020 ◽  
Author(s):  
Abdosaleh Jafari ◽  
Farideh Sadat Jalali ◽  
Mohsen Bayati ◽  
Andrew J. Palmer ◽  
Peivand Bastani ◽  
...  
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Health Insurance Coverage ◽  
World Health ◽  
P Value ◽  
Cross Sectional ◽  
Significance Level ◽  
Supplementary Health Insurance

Abstract Background:The World Health Organization (WHO) has placed special emphasis on protecting households from health care expenditures. Many households face catastrophic health expenditures (CHEs) from a combination of economic poverty and financing the treatment of medical conditions. The present study aimed to measure the percentage of households facing catastrophic CHEs and the factors associated with the occurrence of CHEs in Shiraz, Iran in 2018.Methods:The present cross-sectional study was performed on 740 randomly selected households from different districts of Shiraz, Iran in 2018 using a multi-stage sampling method. Data were collected using the Persian version of the "WHO Global Health Survey” questionnaire. CHEs were defined as health expenditures exceeding 40% of households’ capacity to pay. The associations between the households’ characteristics and facing CHEs were determined using the Chi-Square test as well as multiple logistic regression modelling in SPSS 23.0 at the significance level of 5%. Results:The results showed that 16.48% of studied households had faced CHEs. The higher odds of facing CHEs were observed in the households living in rented houses (OR=3.14, P-value<0.001), households with disabled members (OR=27.98, P-value<0.001), households with children under 5 years old (OR=2.718, P-value=0.02), and those without supplementary health insurance coverage (OR=1.87, P-value=0.01).Conclusion:CHEs may be reduced by increasing the use of supplementary health insurance coverage by individuals and households, increasing the support of the Social Security and the State Welfare Organizations for households with disabled members, developing programs such as the Integrated Child Care Programs, and setting home rental policies and housing policies for tenants.

PARTICIPATING IN HEALTH INSURANCE AND FACTORS AFFECTING AMONG PERSONS WHOSE ENROLMENT IS VOLUNTARY IN THUA THIEN HUE PROVINCE

2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Factors Affecting ◽  
The People ◽  
Universal Health Insurance Coverage ◽  
The Social

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue

scholarly journals Prevalence and factors associated with health insurance coverage in resource-poor urban settings in Nairobi, Kenya: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031543 ◽  
Author(s):  
Peter O Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri F Mohamed ◽  
Hermann Pythagore Pierre Donfouet ◽  
Martin K Mutua
Keyword(s):  
Health Insurance ◽  
Primary Outcome ◽  
Insurance Coverage ◽  
Scale Up ◽  
Household Head ◽  
Health Insurance Coverage ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Insurance Cover

ObjectiveTo determine the prevalence of health insurance and associated factors among households in urban slum settings in Nairobi, Kenya.DesignThe data for this study are from a cross-sectional survey of adults aged 18 years or older from randomly selected households in Viwandani slums (Nairobi, Kenya). Respondents participated in the Lown scholars’ study conducted between June and July 2018.SettingThe Lown scholars’ survey was nested in the Nairobi Urban Health and Demographic Surveillance System in Viwandani slums in Nairobi, Kenya.ParticipantsA total of 300 randomly sampled households participated in the survey. The study respondents comprised of either the household head, their spouses or credible adult household members.Primary outcome measureThe primary outcome of this study was enrolment in a health insurance programme. The households were classified into two groups: those having at least one member covered by health insurance and those without any health insurance cover.ResultsThe prevalence of health insurance in the sample was 43%. Being unemployed (adjusted OR (aOR) 0.17; p<0.05; 95% CI 0.06 to 0.47) and seeking care from a public health facility (aOR 0.50; p<0.05; 95% CI 0.28 to 0.89) was significantly associated with lower odds of having a health insurance cover. The odds of having a health insurance cover were significantly lower among respondents who perceived their health status as good (aOR 0.62; p<0.05; 95% CI 1.17 to 5.66) and those who were unsatisfied with the cost of seeking primary care (aOR 0.34; p<0.05; 95% CI 0.17 to 0.69).ConclusionsHealth insurance coverage in Viwandani slums in Nairobi, Kenya, is low. As universal health coverage becomes the growing focus of Kenya’s ‘Big Four Agenda’ for socioeconomic transformation, integrating enabling and need factors in the design of the national health insurance package may scale-up social health protection.

scholarly journals Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

2019 ◽  
Vol 7 (11) ◽  
pp. 4227
Author(s):  
Atul V. Rajkondawar ◽  
Amit Yele
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Tertiary Care ◽  
P Value ◽  
Age Group ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Significant Difference

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.

scholarly journals Private health insurance coverage-related lawsuits

2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Ana Beatriz Perez Afonso ◽  
Mayra Gonçalves Menegueti ◽  
Thamiris Ricci de Araújo ◽  
Lucieli Dias Pedreschi Chaves ◽  
Ana Maria Laus
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Medical Procedures ◽  
Cross Sectional ◽  
Positron Emission ◽  
Percutaneous Rhizotomy ◽  
Using Data ◽  
National Regulatory Agency

ABSTRACT Objectives: to analyze lawsuits brought by beneficiaries of health insurance operators. Methods: this was a cross-sectional descriptive study carried out in a large-capacity private health insurance operator using data collected by the company from 2012 to 2015. Results: ninety-six lawsuits were brought by 86 beneficiaries regarding medical procedures (38.5%), treatments (26.1%), examinations (14.6%), medications (9.4%), home care (6.2%), and other types of hospitalization (5.2%). The procedures with the highest number of lawsuits were percutaneous rhizotomy; chemotherapy; treatment-related positron-emission tomography scans; and for medications relative to antineoplastic and Hepatitis C treatment. Conclusions: the lawsuits were filed because of the operators’ refusal to comply with items not established in contracts or not regulated and authorized by the Brazilian National Regulatory Agency for Private Health Insurance and Plans, refusals considered unfounded.

Understanding Subnational Variation in Chinese Social Health Insurance

2020 ◽  
pp. 134-159
Author(s):  
Xian Huang
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Health Insurance Coverage ◽  
Social Health ◽  
Cross Sectional ◽  
Insurance Benefits ◽  
Social Risks ◽  
Political Economies ◽  
Regional Comparisons

Chapter 6 investigates the coverage and generosity of Chinese social health insurance in the first decade of the 2000s, with a focus on the regional (i.e., cross-provincial) variation using a cross-sectional time-series research design. First, a cluster analysis provides supportive evidence for the existence of four models of social health insurance expansion in China. The clustering of Chinese provinces in social health insurance expansion also corresponds to the differences among local political economies. Second, the chapter makes detailed inter-regional comparisons and intra-regional studies to reconstruct the mechanism linking a local political economy to the local distributive patterns of health insurance benefits—that is, local socioeconomic conditions shape local leaders’ policy preferences and choices for allocating social health insurance benefits in their jurisdictions. Finally, a regression analysis demonstrates significant correlations between local social risks and social health insurance coverage, and between local fiscal resources and social health insurance generosity.

scholarly journals Prevalence of Self-Reported Chronic Diseases and Health Services Utilization by Ethnic Minorities in Manaus Metropolitan Region

2018 ◽  
Vol 28 (1) ◽  
pp. 49 ◽  
Author(s):  
Raquel Rodrigues Ferreira Rocha de Alencar ◽  
Tais Freire Galvao ◽  
Bruno Vianei Real Antonio ◽  
Marcus Tolentino Silva
Keyword(s):  
Health Insurance ◽  
Chronic Diseases ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Population Based ◽  
Metropolitan Region ◽  
Care Utilization ◽  
Cross Sectional ◽  
Probabilistic Sampling ◽  
Significant Difference

<p class="Pa8"><strong>Objectives: </strong>To assess the prevalence of, and associated factors to, self-reported chronic diseases and health care utilization by eth­nicity in the Manaus Metropolitan Region.</p><p class="Pa8"><strong>Methods: </strong>We conducted a cross-sectional, population-based survey from May through August 2015. Using probabilistic sampling in three stages, we recruited adults aged ≥18 years. Ethnicity was self-identified as White, Black, Yellow, Brown (Brazilian mixed-race), and Indigenous. We calculated adjusted prevalence ratios (PR) and 95% CI of chronic diseases and health service utiliza­tion for each ethnic minority and compared the data using Poisson regression with data from White respondents.</p><p class="Pa8"><strong>Results: </strong>In this study, we interviewed 4,001 people. Of these, 15.9% were White, 7.5% Black, 3.4% Yellow, 72.1% Brown, and 1.0% Indigenous. Indigenous respondents had the highest prevalence of self-reported hypertension (29.4%), diabetes (12.3%) and hypercholesterolemia (17.0%) among the ethnic respondent groups. Compared with the White population, Browns had less health insurance coverage (PR=.76; 95% CI: .62-.93) and reported hypertension (PR=.84; 95% CI: .72-0.98) and diabetes (PR=.69; 95% CI: .51-.94) less frequently. Yellows visited the doctor more frequently than Whites (PR=1.13; 95% CI: 1.04-1.22), with no significant difference in prevalence of diseases.</p><p class="Default"><strong>Conclusions: </strong>Indigenous respondents had higher prevalence rates of the investigated diseases. Compared with Whites, Brown respondents had lower rates of self-reported arterial hypertension and diabetes, as well as lower rates of private health insurance coverage.</p><p class="Default"><em>Ethn Dis. </em>2018;28(1):49-54; doi:10.18865/ed.28.1.49</p>

scholarly journals Comparison of Retinal Sensitivity by Automated Perimetry in Middle Aged Type 2 Diabetic Patients with and without Diabetic Retinopathy - A Cross-Sectional Study in a Tertiary Care Centre in West Bengal

2021 ◽  
Vol 8 (13) ◽  
pp. 835-839
Author(s):  
Abhinav Marlapati ◽  
Sambuddha Ghosh ◽  
Swati Majumdar
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Retinal Sensitivity ◽  
Automated Perimetry ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Group 2

BACKGROUND We wanted to measure and compare retinal sensitivity in central 30 degree in diabetic patients, with and without diabetic retinopathy in different stages, evaluate changes in retinal sensitivity in relation to change in HbA1c values, measure and compare GCL thickness in various stages of DR with the help of optical coherence tomography (OCT). METHODS This observational, cross-sectional study involving 100 eyes of 100 middle aged (45 - 64 years) type 2 diabetes mellitus patients (50 eyes without DR - group 1 & 50 eyes with DR - group 2) without any other ocular abnormalities was conducted in the outpatient and in-patient departments of department of ophthalmology in a tertiary care centre in West Bengal. Non-randomised sequential sampling was performed with corrected visual acuity better than or equal to 6 / 12. Fasting and postprandial blood glucose and HbA1c were estimated. Detailed ocular examination was performed using direct and indirect ophthalmoscope with + 20 D lens and slit lamp bio-microscope using + 90D lens. Retinal sensitivity was assessed by Humphrey visual field analyser by Swedish Interactive Thresholding Algorithm (SITA) standard strategy (30 - 2 programme). Spectral domain optical coherence tomography (SD OCT) was performed in all patients. SPSS version 20 has been used for the analysis. RESULTS Among DR patients, 33 had mild non-proliferative diabetic retinopathy (NPDR) (male = 15, female = 18) and 17 had moderate NPDR (male = 7, female = 10). Mean age in DR (Gr. 2) and no DR (Gr. 1) group were 52.62 and 50.74 years respectively. Mean foveal sensitivity and mean retinal sensitivity decreased significantly (P-value 0.001 and 0.002 respectively) in group 2 patients. It further decreased with increased severity of DR. Mean ganglion cell + inner plexiform layer (GC + IPL) thickness in temporal quadrant decreased in DR group compared to no DR group with significant difference between the two (P-value < 0.001). Mean retinal nerve fibre layer (RNFL) thickness was significantly reduced in DR group (P-value < 0.001). HbA1c mean in no DR (6.7 %) and DR group (8.07 %) and in mild (7.5 %) and moderate NPDR (9.17 %) shows significant association of poor control of blood sugar with severity of DR. CONCLUSIONS Retinal sensitivity decreased significantly in diabetes even without retinopathy as detected by automated perimetry. Significant decrease in retinal thickness as detected by OCT suggested that neurodegeneration occurs in diabetes even without retinopathy. So automated perimetry and OCT could be helpful in identifying persons at an early stage who are at risk of future vision loss due to diabetes. KEYWORDS Diabetic Retinopathy, Retinal Neurodegeneration, Retinal Sensitivity, Automated Perimetry, GCL + IPL Thickness, RNFL Thickness

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