scholarly journals Does health insurance matters to the use of health service for elderly in urban China? A nationwide cross-sectional study

2019 ◽  
Author(s):  
Wenhui Mao ◽  
Yaoguang Zhang ◽  
Ling Xu ◽  
Zhiwen Miao ◽  
Di Dong ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Multivariate Regression ◽  
Regression Models ◽  
Hospital Admissions ◽  
Perceived Health ◽  
Health Needs ◽  
Income Groups ◽  
Outpatient Visits ◽  
Use Of Health Services

Abstract Background China’s rapidly aging population is raising many challenges for the delivery and financing of health care. The Urban Residents Basic Medical Insurance (URBMI) has provided financial protection for the urban elderly population not covered by other health insurance schemes since 2007. We conducted a national level assessment to measure on the perceived health needs of this population as well as their use of health services. Methods Data on individuals over the age of 60 were extracted from two National Health Service Surveys conducted in 2008 and 2013. Multivariate regression models were used to estimate associations of socioeconomic factors and perceived health needs with the use of health services while controlling for demographic characteristics and year of survey. Findings Perceived health needs increased significantly between 2008 and 2013, regardless of insurance enrollment, age group or income level. In 2013, over 75% of individuals reported having at least one Non-communicable disease (NCD). Outpatient services decreased for those without insurance but increased for those with insurance. Middle- and high-income groups with insurance experienced a faster growth in outpatient visits and hospital admissions than the low-income group. Proportion of forgone hospital admissions, and proportion of forgone hospital admissions due to financial difficulties decreased. Yet there were still over 20% elderly forgone necessary hospital admissions, among which more than 40% were caused by financial barriers in 2013. Multivariate regression models found an increase of outpatient visits and hospital admissions from 2008 to 2013 when controlling for socioeconomic and health need factors. Conclusion Perceived health needs among the elderly increased at an alarming rate, and results showed a high prevalence of NCDs. Use of overall services increased and forgone necessary admissions decreased after the implementation of URBMI, indicating the improvement of access to health services. However, high-income groups had the highest increase in service use calling for further attention to issues related to equity. The service benefit packages offered by health insurance schemes should provide more support to the care of NCD patients.

scholarly journals Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Margareth Guimarães Lima ◽  
Silvânia Suely Caribé de Araújo ◽  
Marta Maria Alves da Silva ◽  
...  
Keyword(s):  
Higher Education ◽  
Health Insurance ◽  
Health Services ◽  
Sex Education ◽  
National Health ◽  
Health Survey ◽  
National Health Survey ◽  
Education Level ◽  
Noncommunicable Diseases ◽  
Use Of Health Services

ABSTRACT OBJECTIVE To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD). METHODS Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals. RESULTS The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53–1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78–3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24–1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. CONCLUSIONS NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.

Social Inequalities in Perceived Health and the Use of Health Services in a Southern European Urban Area

1999 ◽  
Vol 29 (4) ◽  
pp. 743-764 ◽  
Author(s):  
Carme Borrell ◽  
Izabella Rohlfs ◽  
Josep Ferrando ◽  
M. Isabel Pasarín ◽  
Felicitas Domínguez-Berjón ◽  
...  
Keyword(s):  
Health Services ◽  
Urban Area ◽  
Social Inequalities ◽  
Perceived Health ◽  
Use Of Health Services

scholarly journals Inequality in Health Services for Internal Migrants in China: A National Cross-Sectional Study on the Role of Fund Location of Social Health Insurance

2020 ◽  
Vol 17 (17) ◽  
pp. 6327
Author(s):  
Qiang Yao ◽  
Chaojie Liu ◽  
Ju Sun
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Health Insurance Coverage ◽  
Social Health ◽  
Local Health ◽  
Public Health Services ◽  
Internal Migrants ◽  
Use Of Health Services

On-the-spot settlements of medical bills for internal migrants enrolled with a social health insurance program outside of their residential location have been encouraged by the Chinese government, with the intention to improve equality in healthcare services. This study compared the use of health services between the internal migrants who had local health insurance coverage and those who did not. Data (n = 144,956) were obtained from the 2017 China Migrants Dynamic Survey. Use of health services was assessed by two indicators: visits to physicians when needed and registration (shown as health records) for essential public health services. Multi-level logistic regression models were established to estimate the effect size of fund location on the use of health services after controlling for variations in other variables. The respondents who enrolled with a social health insurance scheme locally were more likely to visit physicians when needed (adjusted odds ratio (AOR) = 1.18, 95% CI = 1.06–1.30) and to have a health record (AOR = 1.47, 95% CI = 1.30–1.65) compared with those who enrolled outside of their residential location: a gap of 3.5 percentage points (95% CI: 1.3%–5.8%) and 6.1 percentage point (95% CI: 4.3%–7.8%), respectively. The gaps were larger in the rural-to-urban migrants than those in the urban-to-urban migrants (AOR = 1.17, 95% CI = 0.93–1.48 for visiting physicians when needed; AOR = 0.71, 95% CI = 0.54–0.93 for having a health record). The on-the-spot medical bill settlement system has yet to fully achieve its proposed potential as inequalities in both medical and public health services remain between the internal migrants with and without local health insurance coverage. Further studies are needed to investigate how on-the-spot settlements of medical bills are implemented through coordination across multiple insurance funds.

The Consequences of Universalizing Health Services: Children's Use of Health Services in Catalonia

1998 ◽  
Vol 28 (4) ◽  
pp. 777-791 ◽  
Author(s):  
Luis Rajmil ◽  
Barbara Starfield ◽  
Antoni Plasència ◽  
Andreu Segura
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Multiple Regression ◽  
Universal Access ◽  
Health Needs ◽  
Regression Equations ◽  
Access To Health Services ◽  
Socioeconomic Characteristics ◽  
Number Of Visits ◽  
Use Of Health Services

The purpose of this study was to assess the role of needs and social factors in the use of health services among children under age 15 in Catalonia, Spain, where health care reform was explicitly designed to facilitate universal access to primary care according to health needs. Data from the Catalan Health Interview Survey of 1994, a multistage probability sample (2,433 children under 15 years old), were analyzed. Multiple regression examined the relationship between health needs and number of visits in the last year, controlling for the effect of sociodemographic characteristics. Two logistic regression equations were selected to predict heavy (more than seven visits per year) and light (less than two visits) utilization of services. The multiple regression model explained 14.3 percent of the variance in number of visits, with health status perception, disability, reported chronic condition, restriction of activities, and having had a recent accident by far the most important determinants. No familial socioeconomic characteristics, including social class, education, or family size, influenced the extent of use. In contrast to health systems not designed to achieve either universal access according to need or strong primary care, universal access to health services in Catalonia appears to enhance the use of services among children with health needs, regardless of socioeconomic characteristics.

The effect of universal health insurance for children in Vietnam

2017 ◽  
Vol 14 (3) ◽  
pp. 299-314 ◽  
Author(s):  
Binh T. Nguyen ◽  
Anthony T. Lo Sasso
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Outcomes ◽  
Hospital Admissions ◽  
Living Standard ◽  
Universal Health Insurance ◽  
Public And Private ◽  
Outpatient Visits ◽  
Reported Health ◽  
Universal Health

AbstractOur research investigates the effects of the 2005 universal health insurance program for children under age 6 in Vietnam on health care utilization, household out-of-pocket (OOP) spending and self-reported health outcomes using data from the Vietnam Household Living Standard Survey in 2002–2004–2006–2008. We use difference-in-differences to compare children eligible for the program to older children who are ineligible for the program. Results indicate that the program increased insurance coverage by 250% for children age 0–5 relative to the pre-policy period. We found large increases in both outpatient visits and hospital admissions. Health insurance availability also increased outpatient visits at both public and private facilities, suggesting that public and private health care services are complements. Although health insurance was associated with a decrease in inpatient OOP spending for children aged 3–5, it did not reduce outpatient OOP spending for children in general. Health insurance was associated with modest improvements in self-reported health outcomes. Our research suggests that expanded access to insurance among Vietnamese children improved access to care and health outcomes, though it did not necessarily reduce OOP spending.

Social Inequalities in Perceived Health and the use of Health Services in a Southern European Urban Area

2020 ◽  
pp. 273-294
Author(s):  
Carme Borrell ◽  
Izabella Rohlfs ◽  
Josep Ferrando ◽  
M. Isabel Pasarín ◽  
Felicitas Domínguez-Berjón ◽  
...  
Keyword(s):  
Health Services ◽  
Urban Area ◽  
Social Inequalities ◽  
Perceived Health ◽  
Use Of Health Services

Use of Health Services by Diabetic Persons. II. Hospital Admissions

Diabetes Care ◽  
1985 ◽  
Vol 8 (1) ◽  
pp. 43-47 ◽  
Author(s):  
R. S. Scott ◽  
L. J. Brown ◽  
P. Clifford
Keyword(s):  
Health Services ◽  
Hospital Admissions ◽  
Use Of Health Services

scholarly journals Awareness of Health Insurance among Unorganized Industrial Sample Workers in Coimbatore

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
A Sangamithra ◽  
P Sindia
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Medical Care ◽  
Health Needs ◽  
Industrial Workers ◽  
Industrial Sample ◽  
Important Method ◽  
Principal Reason ◽  
Personal Savings

Health insurance is an important method of financing the increased costs of medical care. The high cost of health services coupled with the randomness of health needs and the inadequacy of personal savings is the principal reason for the importance of insurance as a means of financing health services. The aim of the study is the awareness about health insurance among unorganized industrial workers in Coimbatore. The study states that people are aware of insurance but probably unaware of schemes and types of insurance.

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