scholarly journals Financial Burden and Health-seeking Behaviors Related to Chronic Diseases Under the National Health Insurance Scheme in Bolikhamxay Province, Lao PDR: A Cross-sectional Study

2021 ◽  
Author(s):  
TOMOO ITO ◽  
Sengchanh Kounnavong ◽  
Chiaki Miyoshi
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Expenditure ◽  
Financial Burden ◽  
Lao Pdr ◽  
Health Seeking ◽  
Chronic Patients ◽  
National Health Insurance System ◽  
Cross Sectional

Abstract BackgroundFinancial protection is a key dimension of universal health coverage. In 2016, Lao PDR implemented a National Health Insurance system covering the entire population of certain provinces. This cross-sectional study investigated the health-seeking behavior and financial burden of households, including those with chronic patients, post coverage. MethodThe study was conducted in Bolikhamxay province from January 15 to February 13, 2019. In total, 487 households, selected via stratified random sampling, were surveyed, and questionnaire-based interviews were conducted. Health care service utilization and financial burden were examined.ResultsA total of 370 households had at least one member with some type of self-reported health problem within the last 3 months prior to the interview, while 170 had at least one member with a chronic condition. More than 75% of the households accessed a health facility when a member experienced health problems. The prevalence of catastrophic health expenditure (health expenditure/income between 20% and 40%) was 25.1% (threshold of 20%) and 16.2% (threshold of 40%). Through logistic regression, we found that the major factors determining financial catastrophes owing to health problems were household members with chronic illness, hospitalization, household poverty status, family size (both 20% and 40% thresholds), visiting a private facility (20% threshold), and distance from the province to the referral hospital (40% threshold).ConclusionsThe National Health Insurance system has positively impacted households’ access to health facilities. However, catastrophic health expenditure remains high, especially among chronic patients. Facilities under the National Health Insurance should be strengthened to provide more services, including care for chronic conditions.

scholarly journals Financial Burden and Health-seeking Behaviors Related to Chronic Diseases Under the National Health Insurance Scheme in Bolikhamxay Province, Lao PDR: a Cross-sectional Study

2021 ◽  
Author(s):  
Tomoo Ito ◽  
Chiaki Miyoshi ◽  
Sengchanh Kounnavong
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Expenditure ◽  
Financial Burden ◽  
Lao Pdr ◽  
Health Seeking ◽  
Chronic Patients ◽  
National Health Insurance System ◽  
Cross Sectional

Abstract Background: Financial protection is a key dimension of universal health coverage. In 2016, Lao PDR implemented the National Health Insurance system covering the entire population of certain provinces. This cross-sectional study investigated households’ health-seeking behavior and their financial burden with chronic patients, post coverage. Method: The study was conducted in Bolikhamxay province from January 15 to February 13, 2019. In total, 487 households, selected via stratified random sampling, were surveyed, and questionnaire-based interviews conducted. Health care service utilization and financial burden were examined.Results: Totally, 370 households had at least one member with some type of self-reported health problem within the last 3 months prior to the interview, while 170 had at least one member with a chronic condition. More than 75% of the households accessed a health facility when a member experienced health problems. We observed that the prevalence of catastrophic health expenditure (health expenditure/income between 20% and 40%) was 25.1% (threshold of 20%) and 16.2% (threshold of 40%). Through logistic regression, we found that the major factors determining financial catastrophes owing to health problems were household members with chronic illness, hospitalization, household poverty status, family size (both 20% and 40% thresholds), visiting a private facility (20% threshold), and distance from provincial top referral hospital (40% threshold).Conclusions: The National Health Insurance system has positively impacted households’ access to health facilities. However, catastrophic health expenditure remains high, especially among chronic patients. Facilities under National Health Insurance should be strengthened to provide more services, including care for chronic conditions.

scholarly journals [WITHDRAWN] The importance of increasing cigarette prices on National Health Insurance financing in Indonesia

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Renny Nurhasana ◽  
Risky Kusuma Hartono ◽  
Faizal Rahmanto Moeis ◽  
Suci Puspita Ratih
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Financial Burden ◽  
Public Support ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Phone Survey ◽  
High Prevalence ◽  
Cigarette Prices

Indonesia faces the combined challenges of a high prevalence of active smokers and an increased financial burden of smoking-related Non-Communicable Diseases (NCDs) on National Health Insurance (NHI). This study aims to assess the importance of increasing cigarette prices for NHI funding. It was a cross-sectional study conducted through a phone survey. The survey was administered to 1,000 respondents aged 18 and over from various telecommunications operators in Indonesia. We performed the multivariate analysis and the framework of the importance of increasing cigarette prices for funding NHI. The result shows that the majority of the public supports the increase of cigarette price for funding NHI except for active smokers at Odds Ratio=0.529. The importance of increasing cigarette prices for funding NHI is supported by society, able to reduce the prevalence of active smokers, and it raises the government’s tax income. With the current strong public support, cigarette prices should be increased which will then be tagged to fund the NHI consistently. This is also seen as a means to compensate the high NCD-related claims of the NHI which are caused by smoking behavior.JEL Classification  H51; I13; I18 

scholarly journals Estimating the effectiveness of national health insurance in covering catastrophic health expenditure: Evidence from South Korea

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255677
Author(s):  
Hyunwoo Jung ◽  
Junhyup Lee
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Expenditure ◽  
Low Cost ◽  
Financial Burden ◽  
Insurance Coverage ◽  
Catastrophic Health Expenditure ◽  
Cost Burden ◽  
Out Of Pocket Payments

The catastrophic health expenditure (CHE) indicator has been used to measure the medical cost burden of households. Many countries have institutionalized their health insurance systems to reduce out-of-pocket payments, the main contributor to the financial burden. However, there is no method to estimate how the insurance coverage reduces the CHE. This study proposes an approach to evaluate the effectiveness of insurance in reducing the CHE impacts in terms of incidence and gap, which are based on a modified calculation method of CHE. Additionally, we apply these methods to data from the Korea Health Panel Survey (2011–2016). The results are as follows. First, under the setting of a threshold of 10%, the CHE incidence rate was 19.26% when the Korean national health insurance benefits reduced the CHE’s incidence for 15.17% of the population in 2017. Second, the results of the concentration index of CHE showed that the intensity approach of CHE is better than the incidence approach. Third, the new approach we applied revealed that health insurance reduces the burden of CHE to some degree, although it was not an efficient way to reduce CHE. In conclusion, this study provides new policy approaches to save the finances of national health insurance and reduce the intensity of CHE at the same time by raising the low-cost burden of medical services and lowering that of high cost. Moreover, we suggest that policymakers should focus on income level of the households rather than specific diseases.

Cases of Dispute and Pending Claims in Hospitals in the Era of National Health Insurance

2022 ◽  
Vol 2 (1) ◽  
pp. 32-38
Author(s):  
Mrs. Yastori
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance System ◽  
Quality Health ◽  
Icd 10 ◽  
Data Collection Technique ◽  
Observation Method

Background: Indonesia began to implement a National Health Insurance System based on the National Social Security System in 2014 with the support of government regulations which states that Indonesia requires every citizen to have access to comprehensive and quality health services so that can continue their life through the National Health Insurance. Pending and dispute claims are problems that often occur in the era of national health insurance that can affect hospital budget allocation and planning policies, increasing the high cost burden for hospitals which will affect the quality of health services provided. The purpose of this study was to determine pending cases and dispute claims in hospitals in the Era of National Health Insurance.Methods: The study used a descriptive method with a qualitative approach. The data collection technique used is the observation method, namely directly to the e-claim file at several hospitals. 15 e-claim files taken in total from April – July 2021.Results: Obtained 13 cases of pending claims and 2 cases of dispute claims. Cases pending claims are caused by not complying with the code with evidence or resources, not in accordance with medical clinical practice guidelines and the rules of the health insurance provider.Conclusions: In coding, it is necessary to match the theory on the ICD-10, update the ICD-10. It is necessary to understand the rules and provisions made by the insurer and the related guidelines and rules. Please be aware of every latest code update.

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