scholarly journals Effect of Micro Health Insurance on Access and Utilization of Health Services in Karnataka

2014 ◽  
Vol 1 (1) ◽  
pp. 96-103 ◽  
Author(s):  
S. Savitha
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Positive Impact ◽  
Public Hospitals ◽  
Horizontal Equity ◽  
Poor People ◽  
Micro Health Insurance ◽  
Utilization Of Health Services ◽  
The Poor ◽  
The Impact

Background:Lack of sustainable and affordable health financing mechanisms in India has exposed the poor ininformal sector to iatrogenic poverty. Hardship financing of health services has negative financial consequences on thefuture income of these households. This can be mitigated through micro health insurance (MHI) because it aims to removefinancial barriers to access and utilize health services.Objectives:Recognizing the dearth of studies on impact of MHI schemes in India, we carried out an in-depth study onSampoorna Suraksha Programme (SSP) in Karnataka to assess the effect on access and utilization of healthcare services.Methods:We designed a descriptive cross sectional household survey that collected data from 1146 households toevaluate the impact using logistic regression analysis.Results:Insured individuals were more likely to access and utilize inpatient services compared to uninsured individuals.Moral hazard measured as length of stay in the hospital was absent. Horizontal equity in utilization based on gender andincome was observed. Insured used private providers than public hospitals or self-medicine. The results of the studysupport the positive impact of MHI on access and utilization of health services.Conclusion:The findings of the study enhance our understanding of the positive role of MHI in the promotion of betterhealth behavior of the poor people who usually forego treatment during illness. This would reinforce policymakers toadvocate MHI to mitigate iatrogenic poverty in India, the land of villages.

The impact of health insurance on health services utilization and health outcomes in Vietnam

2014 ◽  
Vol 9 (4) ◽  
pp. 359-382 ◽  
Author(s):  
G. Emmanuel Guindon
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Health Outcomes ◽  
Health Services Utilization ◽  
Living Standard ◽  
Outpatient Services ◽  
Services Utilization ◽  
The Poor ◽  
Inpatient Services ◽  
The Impact

AbstractIn recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam’s recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam’s commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam’s unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance – for the poor, for children and for students – impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services.

Role of NGOs in Promoting Micro Health Insurance: A Study with Reference to ‘Sampoorna Suraksha’ Health Insurance Scheme by SKDRDP, Mangalore (India)

2015 ◽  
Vol 4 (2) ◽  
pp. 251-261 ◽  
Author(s):  
Vishal Pinto
Keyword(s):  
Health Insurance ◽  
Health Insurance Scheme ◽  
Poor People ◽  
Insurance Scheme ◽  
Micro Health Insurance ◽  
Insurance Sector ◽  
Rural Development Programme ◽  
The Poor ◽  
Hospitalization Costs

The insurance sector has penetrated towards many of the high-income individuals and families but was unable to reach to those poor who do not have the capacity to purchase these insurance products. Thus, it is has created a huge gap between the rich and the poor. Micro health insurance is a new phenomenon in the Indian insurance sector which is specifically designed for the poor. This insurance programme is very essential for the individuals to protect them from various uncertainties and risk. The insurance is normally a product designed for the convenience of the middle- and higher-income groups of people. The lower segments of the people are alienated from taking the insurance policies as the prices of the policies are too high and unaffordable for them. Microfinancial institutions and non-governmental organizations (NGOs) that work with urban and rural poor felt the need for the security of these people. Thus, many such institutions have come forward to offer insurance facilities to the poor. They have kept policy prices low and the premium was priced according to their level of income. The Shri Kshetra Dharmasthala Rural Development Programme (SKDRDP) is one such institution which has focused on medical and hospitalization costs of the poor people. Accordingly, they designed a favourable micro health insurance product named as ‘Sampoorna Suraksha’ health insurance scheme. The scheme was introduced in the year 2004 and has witnessed tremendous progress over the years. In this article, we have analyzed the concept of micro-insurance, its development in India, its delivery models etc. We have also evaluated the ‘Sampoorna Suraksha’ scheme of SKDRDP and the progress of the insurance scheme in terms of enrolment, claim settlement, premium collection etc. The main objective of this article is to analyze the role of NGOs towards micro health insurance. In order to make an appropriate study, we have used exploratory and descriptive research methodology by taking the SKDRDP as a unit of the case study.

scholarly journals Publicly Financed Health Insurance Schemes and Horizontal Inequity in Inpatient Service Use in India

2021 ◽  
Vol 16 (1) ◽  
pp. 52-63
Author(s):  
Vanita Singh ◽  
Amit Garg ◽  
Arnab Kumar Laha ◽  
Stephen O'Neill
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Service Use ◽  
Horizontal Equity ◽  
Equal Treatment ◽  
Sample Survey ◽  
Inpatient Service ◽  
Policy Objective ◽  
Utilization Of Health Services

Equity is a major policy objective of health care reforms across nations. Publicly Financed Health Insurance (PFHI) schemes are one major health care reform that have been adopted across developing countries to address inequity. Existing literature on the effect of PFHIs focuses on out-of-pocket expenditure and utilization of health services, while the effect of PFHIs on equity in health service use remains understudied, particularly in the Indian context. This study addresses this knowledge gap. In 2008 India launched a PFHI scheme with an aim to achieve horizontal equity, that is the equal treatment for equal needs, in the utilization of health services. Using data from the National Sample Survey Organization (NSSO), we analyze the extent of inequity in the utilization of inpatient services before (2004) and after (2014) the implementation of the PFHI. The annual hospitalization rate increased from 2.4 percent in 2004 to 4.4 percent in 2014 and the increase is higher for rural population. The proportion of population covered by any health insurance scheme increased from 0.5 percent to 15.3 percent post-PFHI implementation. The study finds that PFHIs were associated with reduced inequalities in inpatient service use, but the extent of reduction varied across states and across urban/rural areas. Our inter-state analysis shows that the States with a higher concentration of PFHIs among richer quintiles, a possible leakage and exclusion errors, have failed to ensure the needed access for their poor population. This failure reflects in their higher levels of income-based inequity in inpatient service use. This study has implications for the implementers of social security programs adopting targeted approach. There is a need for better strategies for the identification of beneficiaries and ensuring that they receive scheme benefits to have intended welfare effects.

scholarly journals Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Austad ◽  
Michel Juarez ◽  
Hannah Shryer ◽  
Patricia L. Hibberd ◽  
Mari-Lynn Drainoni ◽  
...  
Keyword(s):  
Health Workers ◽  
Positive Impact ◽  
Qualitative Evaluation ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Future Research ◽  
Care Seeking ◽  
Structured Interviews ◽  
The Impact

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.

scholarly journals Changes in Catastrophic Health Expenditures Depending on Health Policies in Turkey

2021 ◽  
Vol 8 ◽  
Author(s):  
Guvenc Kockaya ◽  
Gülpembe Oguzhan ◽  
Zafer Çalşkan
Keyword(s):  
Health Services ◽  
Health Expenditure ◽  
Positive Impact ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Health Policies ◽  
World Health ◽  
Positive Health ◽  
Catastrophic Health Expenditures ◽  
The Impact

Without any financial protection out of pocket health expenses are essential both because their increase causes difficulties in accessing higher quality health services for households and more importantly because it complicates access to most basic health services. As a result of the Health Transformation Program in practice in the Turkish healthcare system since 2003, significant changes have been done in all layers of the health system. Turkish Statistics Institute (TurkStat) publishes the ratio of households that bear catastrophic health expenditures since 2002. According to TurkStat data, the ratio of households with catastrophic expenditure has fallen from 0.81% in 2002 to 0.17% in 2011 with the health transformation project. However, it has started to rise since 2012 and has reached 0.31% in 2014. This study aims to evaluate the expenditure items that may have caused the rise of the ratio of households with catastrophic health expenditures since 2012, which had previously dropped with the Health Transformation Program that has caused fundamental changes in health policies. Methodology and definitions presented in the article named “Distribution of health payments and catastrophic expenditures: Methodology” by Ke Xu published by the World Health Organization in 2005 have been used. Percentages of health expenditure items among the total expenditure of households with positive health expenditure and households with catastrophic health expenditure between 2007 and 2014 have been evaluated using descriptive analysis. Findings have been interpreted in light of the health policies in practice between 2007 and 2014. An overview of the impact of the health policies reveals that medicine expenditures have decreased both for household and public health expenditures. Despite the impact of policies on the pharmaceutical industry was criticized by the industry, the positive impact can be seen by the decrease in the spending on medicine for households spending on health. Hospital service with positive health expenditure is seen to decrease health expenditure. The reasons for the increase in households with catastrophic health expenditure need further research. As a result, the study strives to discuss the possible policy reasons for the observed effects.

scholarly journals Identifikasi Dampak Penggunaan Sistem Informasi Rumah Sakit (SIRS) Terhadap Pelayanan Kesehatan Menggunakan Hot-Fit Model 2006

2020 ◽  
Vol 4 (1) ◽  
pp. 216
Author(s):  
Frendy Rocky Rumambi ◽  
Salahudin Robo ◽  
Citra Amalia
Keyword(s):  
Information System ◽  
Health Services ◽  
Positive Impact ◽  
Employee Performance ◽  
Net Benefit ◽  
The North ◽  
North Sulawesi ◽  
Management Processes ◽  
The Impact ◽  
It Personnel

Hospital Information System (SIRS) is an integrated information system that aims to handle all hospital management processes, ranging from diagnostic services, medical data measures, medical records, pharmaceuticals, pharmaceutical warehouses, billing, personnel databases, payroll, and accounting to the control management. Based on Indonesian Constitution No. 44 Article 52 year 2009, paragraph 1 states that "Indonesian hospitals are required to record and report all activities that occur within a hospital". On the Indonesia ministry regulation, PERMENKES No. 1171 year of 2011, Article 1 paragraph 1 states that "Each hospital is required to apply SIRS". Therefore Dr. Samratulangi Tondano District Hospital of Minahasa Regency in the North Sulawesi uses SIRS to improve employee performance in providing health services to the community. The paper discussed how to identify the impact of the use of Hospital Information Systems (SIRS) on health services. The purpose of this study is to look at the impact of the use of the SIRS system based on four indicators contained in the 2006 Human Organizational Technology (HOT-Fit) method in addition to the DeLone and McLean Success 2003 methods. By taking 150 respondents of SIRS users randomly, data were collected and analyzed using SPSS and AMOS software.The four hypotheses derived from three components namely "Technology", "Human" and "Organization" have a positive impact and provide a net benefit to the use of the system. In short, the majority of users SIRS only focuses on functions for registration and administration rather than clinical functions. The availability of IT units and IT personnel influences the use of SIRS as well.

What Shapes Political Participation of the Poorest Citizens?

2021 ◽  
pp. 23-43
Author(s):  
Carew Boulding ◽  
Claudio A. Holzner
Keyword(s):  
Civil Society ◽  
Political Parties ◽  
Political Behavior ◽  
Positive Impact ◽  
Theoretical Explanation ◽  
Political Activity ◽  
The Political ◽  
Poor People ◽  
The Poor ◽  
Democratic Rights

This chapter presents the theoretical explanation that links core institutional features of democracy (political parties, competitive elections, civil society, and protection of democratic rights) to the political behavior of the poorest citizens. The focus is not only on those factors that boost the political activity of the poor, but those that have a disproportionately strong positive impact on poor people’s activism. The chapter argues that where civil society is strong, where political parties have the capacity and incentives to focus mobilization efforts on the poor, and where democratic institutions are strong, poor people will be able to participate at high levels.

scholarly journals Impact of the Health Transformation Plan on the Number of Surgical Operations and Their Cancelation

2019 ◽  
Vol 56 ◽  
pp. 004695801984638
Author(s):  
MahmoodReza Miri Bonjar ◽  
Mohammad Khammarnia ◽  
Mahdie Bakhshi ◽  
Alireza Ansari-Moghaddam ◽  
Hassan Okati–Aliabad ◽  
...  
Keyword(s):  
Health Insurance ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Outpatient Service ◽  
Public Hospitals ◽  
Inpatient Service ◽  
Treatment Needs ◽  
Study Population ◽  
The Impact ◽  
Surgical Operations

Operation cancelations are a serious problem with undesirable consequences. The Health Transformation Plan was launched in the health system of Iran on May 5, 2014, to enhance the efficiency and quality of services in public hospitals. Comprehensive coverage of patients’ basic treatment needs and reduction of patients’ out-of-pocket expenditures through insurance for all are other objectives of Health Transformation Plan as well. Then, the present study aimed to determine the impact of the Health Transformation Plan on the number of surgical operations and the cancelation of elective surgeries within public hospitals of Iran. This retrospective comparative study was conducted in 2017 within 2 tertiary public hospitals in the South-East of Iran. Using systematic random sampling method and census, 8138 scheduled surgical files and all canceled operations files were reviewed from April 2012 to March 2017, respectively. A standard checklist was used for data collection. The data were analyzed using χ2 test and a logistic regression model in SPSS, version 21. The study population was 8138 patients with mean age of 33 ± 19 years. Female patients comprised about 51% of the study population (n = 4115), and nearly two-third of them were married (n = 5192 [63.79%]). Coverage by Iranian health insurance was reported in more than half of patients (n = 4415 [54.79%]). The common reason for surgeries was injury and poisoning (n = 2814 [34.52%]) followed by delivery (n = 1747 [21.46%]). The number of operations increased from 26 677 before Health Transformation Plan (cancelation rate = 1.5%) to 33 190 after Health Transformation Plan (cancelation rate = 2.0%). The cancelation rate had a significant relationship with age (odds ratio = 1.009; confidence interval: 1.00-1.01), health insurance status (odds ratio = 2.12; confidence interval: 1.33-3.38), outpatient service referrals (odds ratio = 0.5; confidence interval: 0.43-0.62), inpatient service referrals (odds ratio = 1.5; confidence interval: 1.36-1.77), and surgical types ( P < .05). In general, the Health Transformation Plan was markedly associated with a rise in the number of surgeries and cancelation rate in the public hospitals. The information obtained in the present study concerning the causes of operation cancelations can be used to decrease the number of future cancelations.

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