scholarly journals Does the self-employment status affect the rural migrants’ health in China: the transmission channel of social health insurance?

2020 ◽  
Author(s):  
Zicheng Wang ◽  
Qiushi Wu ◽  
Juan Ming
Keyword(s):  
Health Insurance ◽  
Chronic Disease ◽  
Health Status ◽  
Causal Effect ◽  
Social Health Insurance ◽  
The Self ◽  
Social Health ◽  
Transmission Channel ◽  
Rural Migrants ◽  
Self Employment

Abstract Background There are growing attentions paid on rural migrants’ health. Previous studies found that rural migrants are more exposed to disease risks. The present study aims to explore the causal effect of self-employment behavior on the rural migrants’ health status, two issues are addressed to discuss: Does self-employment status affect the health of rural migrants? What is the potential mechanism linking the self-employment behavior and health status? Methods The dataset from the 2017 National Migrants Population Dynamic Monitoring Survey (NMPDMS-2017) is applied to explore the causal effect; the Logit regression is performed to make baseline estimation, while the IV-LPM estimation is applied to correct the endogeneity of self-employment. Additionally, the Logit regression is conducted to explore the transmission channel. Results The self-employed are more susceptible to sub-health status (OR= 1.042; 95% CI= 1.001, 1.084) and chronic disease (OR= 1.394; 95% CI= 1.317, 1.476), even when correcting the endogeneity, the causal effect estimation also demonstrates that the self-employed are more vulnerable to suffer sub-health status (Coefficient= 0.067; 95% CI= 0.050, 0.084) and chronic disease (Coefficient= 0.020; 95% CI= 0.008, 0.032). The self-employed are less likely to participate in social health insurance (OR= 0.057; 95% CI= 0.053, 0.061). Conclusion The self-employed are more likely to suffer sub-health status and chronic disease, the self-employment behavior take harmful effect on the rural migrants’ health. Social health insurance may serve as transmission channel linking self-employment and rural migrants’ health, that is, the self-employed are less prone to participate in the urban health insurance program, which induce to an insufficient health service to maintain health.

scholarly journals Effect of self-employment on the sub-health status and chronic disease of rural migrants in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian Zhou ◽  
Qiushi Wu ◽  
Zicheng Wang
Keyword(s):  
Health Insurance ◽  
Chronic Disease ◽  
Health Status ◽  
Causal Effect ◽  
Social Health Insurance ◽  
Social Health ◽  
Transmission Channel ◽  
Rural Migrants ◽  
Logit Regression ◽  
Self Employment

Abstract Background Rural migrants usually suffer from major disease risks, but little attention had been paid toward the relationship between self-employment behavior and health status of rural migrants in China. Present study aims to explore the causal effect of self-employment behavior on rural migrants’ sub-health status and chronic disease. Two research questions are addressed: does self-employment status affect the sub-health status and chronic disease of rural migrants? What is potential mechanism that links self-employment behavior and health status among rural migrants in China? Methods The dataset from the 2017 National Migrants Population Dynamic Monitoring Survey (NMPDMS-2017) was used to explore the causal effect. Logit regression was performed for the baseline estimation, and linear probability model with instrument variable estimation (IV-LPM) was applied to correct the endogeneity of self-employment. Additionally, logit regression was conducted to explore the transmission channel. Results Self-employed migrants were more susceptible to sub-health status and chronic disease, even when correcting for endogeneity. Moreover, self-employed migrants were less likely to enroll in social health insurance than their wage-employed counterparts in urban destinations. Conclusion Self-employed migrants were more likely to suffer from sub-health status and chronic disease; thus, their self-employment behavior exerted a harmful effect on rural migrants’ health. Social health insurance may serve as a transmission channel linking self-employment and rural migrants’ health status. That is, self-employed migrants were less prone to participate in an urban health insurance program, a situation which leaded to insufficient health service to maintain health.

Serbia

2021 ◽  
pp. 918-928
Author(s):  
Tamara Popic
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Waiting Lists ◽  
The Self ◽  
Social Health ◽  
Healthcare Provision ◽  
Health Politics ◽  
Insurance System ◽  
Insurance Model ◽  
Universal Health

This chapter offers an in-depth look at health politics and the universal health system in Serbia based on compulsory social health insurance. It traces the development of the Serbian healthcare system after the breakup of Socialist Federal Republic of Yugoslavia, characterized by a move from the self-managed insurance model to a more standard Bismarckian health insurance system combined with passive privatization. Despite efforts to restructure healthcare provision through a reform in 2005, the system’s two-tier structure remains firmly entrenched, protected by professional interests. The chapter highlights other healthcare issues including long waiting lists and corruption.

scholarly journals Dropout Analysis of a National Social Health Insurance Program at Pokhara Metropolitan City, Kaski, Nepal

2021 ◽  
Author(s):  
Prabin Sharma ◽  
Dipendra Kumar Yadav ◽  
Niranjan Shrestha ◽  
Prabesh Ghimire
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Social Health Insurance ◽  
Good Health ◽  
Social Health ◽  
Factors Associated ◽  
Insurance Program ◽  
Health Insurance Program ◽  
First Contact ◽  
Structured Questionnaire

Background: Nepal’s national social health insurance (SHI) program, which started in 2016, aims to achieve universal health coverage (UHC), but it faces severe challenges in achieving adequate population coverage. By 2018, enrolment and dropout rates for the scheme were 9 percent and 38 percent respectively. Despite government's efforts, retaining the members in SHI scheme remains a significant challenge. The current study therefore aimed to assess the factors associated with social health insurance program dropout in Pokhara, Nepal. Methods: A cross-sectional household survey of 355 households enrolled for at least one year in the national social health insurance program was conducted. A structured questionnaire was used to conduct face-to-face interviews with household heads were conducted using a structured questionnaire. Data was entered in Epi-Data and analysed using SPSS. The factors associated with social health insurance program dropout were identified using bivariate and multiple logistic regression analyses. Results: The findings of the study revealed a dropout prevalence of 28.2% (95% confidence interval: 23.6%-33.2%). Households having more than five members [adjusted odds ratio (aOR) 2.19, 95% CI: 1.22-3.94], belonging to underprivileged ethnic groups (Dalit/Janajati) (aOR 2.36, 95% CI: 1.08-5.17), living on rented homes (aOR: 4.53, 95%CI 1.87-10.95), absence of chronic illness in family (aOR 1.95, 95%CI: 1.07-3.59), perceived good health status of the family (aOR 4.21, 95%CI: 1.21-14.65), having private health facility as first contact point (aOR 3.75, 95%CI: 1.93-7.27), poor availability of drugs (aOR 4.75, 95%CI: 1.19-18.95) and perceived unfriendly behaviour of service providers (aOR 3.09, 95%CI: 1.01- 9.49) were statistically significant factors associated with SHI dropout. Conclusion: In Pokhara, more than one-fourth of households have dropped out of the Social Health Insurance Scheme, which is a significant number. Dropping out of SHI is most commonly associated with a lack of drugs, followed by rental housing, family members’ reported good health status and unfriendly service provider behaviour. Efforts to reduce SHI dropout must focus on addressing drugs availability issues and improving providers’ behaviour towards scheme holders. Increasing insurance awareness, including provisions to change first contact points, may help to reduce dropouts among rented households, which make up a sizable proportion of the Pokhara metropolitan area.

scholarly journals Urban Self-employed Social Health Insurance Program as an Option in Financing Health Care within the Informal Sector? An Insight into the Acceptability of the Scheme by the Self-employed in Rivers State, Nigeria

2019 ◽  
pp. 1-9
Author(s):  
Ikeokwu E. Anderson ◽  
Foluke O. Adeniji
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
The Self ◽  
Social Health ◽  
Insurance Scheme ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Rivers State

Introduction: Health care financing in the Nigerian health sector has been a major impediment within the sector due to increasing healthcare costs. Various forms of financing mechanisms are employed within the country with majority tilting to out-of-pocket payment, which led to the launch of the National Health Insurance Scheme in 2005. The National Health Insurance Scheme has the ambition to provide universal coverage to the population in 15-20 years, but the scheme had its limitations in achieving universal health coverage because it is limited to federal government civil servants neglecting the informal sector, which includes self-employed individuals. Although other forms of social health insurance scheme are being implemented within the country such as the Community Based Health Insurance Scheme. There is no sufficient evidence on the actualization of a health insurance program specifically for the self-employed despite its presence in the health insurance package known as Urban Self-Employed Social Health Insurance Program. This study aims to ascertain the perceived impact and acceptability of the Urban Self-employed Social Health Insurance Program as a viable option in financing healthcare among the self-employed. Methodology: This was a cross-sectional descriptive study of 204 self-employed individuals who were selected from seven different trade associations in Port Harcourt using semi-structured interviewer-administered pre-tested questionnaires. A Socio-Economic Status index was used to divide the households into quintile. The respondents rated their perception about the possible benefits of health insurance from 1 (none) to 4 (high) and the willingness of respondents to enrol in a community-based health insurance scheme (elicited as a binary ‘yes’ or ‘no’ variable) was also used as a proxy of acceptability data collected were analysed using the statistical package for social science (SPSS), version 23 software. Result: A majority 201 (98.5%) of the respondents perceived that having any form of insurance has the potential to improve access to health care and affordable. Respondents gave responses rated with an average mean of 3, which translates to medium impact on financial protection, improved access to healthcare, affordability and improving quality of treatment. Most respondents 183 (89.7%) accepted the urban self-employed health insurance scheme as a strategy for financing healthcare. Conclusion: Urban Self-Employed Social Health Insurance Program appears to be a viable and acceptable method of paying for healthcare among the self-employed in Port Harcourt city of Rivers State, Nigeria.

scholarly journals Willingness to Pay for Social Health Insurance by the Self-employed in Port Harcourt, Rivers State; A Contingent Valuation Approach

2019 ◽  
pp. 1-15
Author(s):  
Ikeokwu E. Anderson ◽  
Foluke O. Adeniji
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Contingent Valuation ◽  
Contingent Valuation Method ◽  
Social Health Insurance ◽  
The Self ◽  
Government Support ◽  
Social Health ◽  
Trade Association ◽  
Port Harcourt

Background/Aim: Urban Self-Employed Social Health Insurance (USSHIP), which is similar to Community-based health insurance schemes CBHI, USSHIP, is a package in the National Health Insurance Scheme NHIS specific but is not limited to self-employed individuals in Nigeria which has been rarely explored as instrument in financing healthcare in Nigeria. This study was aimed to assess the Willingness-to-Pay (WTP) for USSHIP and its determinants amongst the self-employed in Port Harcourt. Methodology: This was a cross-sectional descriptive study of 204 self-employed individuals selected from various trade association in Port Harcourt using semi-structured interviewer-administered pre-tested questionnaires. An iterative bidding approach of the contingent valuation method was used to elicit maximum WTP for the schemes. A multivariate logistic regression analysis was done to determine predictors to WTP. Data collected were analysed using the Statistical Package for Social Science (SPSS), version 23 software. Results: The results show that 89.7% were willing to enrol into the program; the median WTP for the scheme per person/per month is ₦300 ($0.83). The predictors of WTP were marital status, level of education and mode of payment of healthcare. Conclusion: Sequel to the findings of this study, the WTP amount for social health insurance program by the self-employed is too small, the implications for these findings imply that with the amount stated, the program cannot be successfully implemented. Recognizing this low amount stated for WTP for USSHIP, which is insufficient to scale up the scheme, the government support for the program is highly recommended.

scholarly journals Factors Affecting the Purchase of Commercial Health Insurance: Based on Personal Health Status and the Substitution Effect of Social Insurance

2021 ◽  
Author(s):  
Wenguang Yu ◽  
Qi Wang ◽  
Guofeng Guan ◽  
Yujuan Huang
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Social Insurance ◽  
Regression Coefficient ◽  
Social Health Insurance ◽  
Poor Health ◽  
Social Health ◽  
Self Rated Health ◽  
Health Level ◽  
Commercial Health Insurance

Abstract Background: How health status affects residents’ purchase of commercial health insurance and whether social insurance will crowd out the demand of commercial health insurance are important issues related to the development of commercial health insurance. Further, this paper also attempts to answer why people with worse health buy less commercial health insurance through mechanism analysis. Methods: We used Logit model to analyze the impact of self-rated health level on the purchase of commercial health insurance and the crowding out effect of participating in social health insurance on the purchase of commercial health insurance. In addition, we also successively introduced the respondents with worse and worse health status for regression analysis and analyzed the reasons why the poor health groups reduce the purchase of commercial medical insurance. Results: When performing regression analysis on whether to purchase commercial health insurance, the regression coefficient of having social health insurance is -0.497 and the regression coefficient of self-rated health level is -0.182, but the health status has no significant impact on whether to have social health insurance. Conclusions: The expansion of social basic health insurance has a restraining effect on the promotion of commercial health insurance, and self-rated health level has a negative impact on the purchase of commercial health insurance. The reason why individuals with poor health buy less commercial health insurance is that commercial insurance companies often refuse to cover individuals in poor health.JEL: I11, G22

scholarly journals Acceptance of the proposed social health insurance among government-owned company employees in Northwest Ethiopia: implications for starting social health insurance implementation

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Abuneh Zemene ◽  
Adane Kebede ◽  
Asmamaw Atnafu ◽  
Tsegaye Gebremedhin
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Work Experience ◽  
Social Health Insurance ◽  
Quality Of Healthcare ◽  
Northwest Ethiopia ◽  
Social Health ◽  
Related Factors ◽  
The Government ◽  
Owned Company

Abstract Background Ethiopia is currently planning to introduce Social Health Insurance (SHI) that will lead to universal health coverage and assist a country to achieve its health system’s objectives and to prevent the catastrophic health expenditure. But there is no evidence until now about the level of acceptance of the proposed SHI among government-owned companies’ employees. Therefore, this study was intended to assess the acceptance of SHI and associated factors among government-owned companies’ employees in northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from February 1 to April 30, 2019. A randomly selected 541 government-owned companies’ employees were participated in the study. A pretested self-administered structured questionnaire was used that consisted sociodemographic and economic, health status-related factors, attitude (measured by 12 items), organizational related factors and knowledge about SHI (measured by 11 items). Finally, binary logistic regression analysis was performed and in the multivariable logistic regression analysis, a significant level at a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) were used to identify factors statistically associated with SHI acceptance. Results Overall, 32% (95% CI: 27.7–36.2) of the government-owned companies’ employees accepted the proposed Ethiopian SHI scheme. Self-perceived health status (AOR: 8.55, 95% CI: 2.69–27.13), heard about SHI (AOR: 1.69, 95% CI: 1.12–2.54), coverage of medical healthcare cost (AOR: 0.60, 95% CI: 0.39–0.92), work experience (AOR: 0.49, 95% CI: 0.26–0.89) and quality of healthcare service at the facilities (AOR: 0.17, 95% CI: 0.04–0.71) were significantly associated with acceptance of SHI among government-owned companies’ employees. Conclusions One-third of the study participants accepted the proposed Ethiopian SHI scheme. Self-perceived health status, quality of healthcare service at health facilities, coverage of the medical cost by their organization, heard about SHI and work experience were the factors that affect acceptance of the proposed SHI among the government-owned company employees. Therefore, policymakers should devise a plan to promote the benefit packages of SHI for the formal sector employees to start the implementation.

Which Therapeutic Progress Shall be Paid by Social Health Insurance?

2007 ◽  
Author(s):  
Jürgen Wasem ◽  
Hans-Dieter Nolting ◽  
Yvonne Grabbe ◽  
Stefan Loos
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health
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