scholarly journals Impacts of health insurance on healthcare in the poor and near-poor households in Vietnam

2021 ◽  
Vol 8 (6) ◽  
pp. 57-66
Author(s):  
Truong et al. ◽  
Keyword(s):  
Health Insurance ◽  
Healthcare Utilization ◽  
Outpatient Treatment ◽  
Inpatient Treatment ◽  
Healthcare Expenditure ◽  
Living Standard ◽  
Doctor Visit ◽  
Doctor Visits ◽  
The Poor ◽  
Poor Households

Improving health and reducing catastrophic healthcare expenditure for the poor and near-poor are the major concerns of the Vietnam Government. This research analyses the impacts of health insurance schemes for the poor and near-poor households in Vietnam on two aspects, including healthcare utilization and out-of-pocket expenditure. The study applies the zero-inflated model and pooled OLS regression on the data that is extracted from the Vietnam Household Living Standard Surveys in two years 2014 and 2016. The findings show that health insurance significantly increases the probability of having a doctor visit and the number of doctor visits for a health check or outpatient treatment. For inpatient treatment, insurance does not increase the probability of having a doctor visit or the number of doctor visits. Having insurance significantly reduces out-of-pocket expenditures for both inpatients and outpatients.

Socioeconomic inequality in catastrophic healthcare expenditures in Western Iran

2019 ◽  
Vol 46 (9) ◽  
pp. 1049-1060 ◽  
Author(s):  
Satar Rezaei ◽  
Mohammad Hajizadeh ◽  
Sina Ahmadi ◽  
Sadaf Sedghi ◽  
Bakhtiar Piroozi ◽  
...  
Keyword(s):  
Health Insurance ◽  
Healthcare Expenditure ◽  
Socioeconomic Inequality ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Content Type ◽  
The Poor ◽  
Poor Households

Purpose Financial protection of households against catastrophic healthcare expenditure (CHE) is defined as one of the main goals in health systems. The purpose of this paper is to measure and decompose socioeconomic inequality in CHE among households in Kermanshah province, Western of Iran. Design/methodology/approach This cross-sectional study was carried out among 1,188 households in 2017. Data were extracted from the Household Income and Expenditure Survey which is conducted by the Statistical Center of Iran. The CHE is defined as household healthcare expenditure greater than or equal to the 40 percent of household’s “capacity to pay.” The concentration curve and the Wagstaff (W) and Erreygers (E) indexes were used to illustrate and measure the extent of socioeconomic inequality in CHE. In addition, the authors decomposed the W and E indexes to identify the main determinants of socioeconomic inequality in CHE. Findings The results indicated that the prevalence of CHE among households was 4.12 percent (95% confidence interval (CI): 3.13 to 5.42 percent). The estimated value of the W and E indexes were −0.2849 (95% CI: −0.4493 to −0.1205) and −0.0451 (95% CI: −0.0712 to −0.0190), respectively; suggesting the concentration of CHE prevalence among the poor households. Decomposition analyses indicated socioeconomic status as the most important factor contributing to the concentration of CHE among the poor. In contrast, health insurance coverage was found to increase the concentration of CHE among the rich in Iran. Originality/value The current study demonstrated a higher concentration of CHE among the poor households in Kermanshah province. These results call for the government’s efforts to reduce healthcare expenditure among socioeconomically disadvantaged populations. Further studies are required to understand the mechanisms through which health insurance coverage increased the probability of CHE among rich in Kermanshah province.

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.

scholarly journals Rural Nonfarm Employment, Income, and Inequality: Evidence from Bhutan

2015 ◽  
Vol 32 (2) ◽  
pp. 65-94 ◽  
Author(s):  
Dil Bahadur Rahut ◽  
Pradyot Ranjan Jena ◽  
Akhter Ali ◽  
Bhagirath Behera ◽  
Nar Bahadur Chhetri
Keyword(s):  
Household Income ◽  
Sample Selection ◽  
Living Standard ◽  
Farm Income ◽  
Self Employment ◽  
The Poor ◽  
Poor Households ◽  
Education Levels ◽  
Nonfarm Income ◽  
Nonfarm Employment

Using the 2012 Bhutan Living Standard Survey, this paper finds that rural nonfarm activities comprise 60.7% of rural household income in Bhutan and this contribution increases with higher income and education levels. The poor and less educated participate less in the nonfarm sector. When they do, they are self-employed in petty nonfarm activities, which require little investment and little or no skills. Accounting for endogeneity and sample selection issues, we estimate the determinants of participation in nonfarm activities and nonfarm incomes. We find that a household's education and labor supply play an important role in accessing more remunerative nonfarm employment. Interestingly, we find that women play an important role in self-employment in nonfarm activities. Decomposition shows that nonfarm income has a disequalizing effect and farm income has an equalizing effect, indicating the need to increase the endowment of poor households to enable them to access the lucrative rural nonfarm sector. Further decomposition reveals that self-employment in petty nonfarm activities reduces inequality.

The Minimum Living Standard Guarantee System and Citizenship Cultivation among the Poor in China

2017 ◽  
Vol 45 (4-5) ◽  
pp. 483-506 ◽  
Author(s):  
Haomiao Zhang
Keyword(s):  
Transitional Period ◽  
Cash Transfer ◽  
Living Standard ◽  
Social Rights ◽  
Social Stability ◽  
Guarantee System ◽  
The Poor ◽  
Poor Households ◽  
The Social ◽  
Citizen Interactions

China’s Minimum Living Standard Guarantee System (MLSGS) provides an unconditional cash transfer to poor households to alleviate poverty. During China’s transitional period, the MLSGS has played an important role in the maintenance of social stability. However, beyond poverty alleviation and stability maintenance, other outcomes—particularly the strengthening of citizenship—have received little attention. This study explores the influence of the MLSGS on the perceptions of citizenship among aid recipients, and finds not only that the MLSGS has gradually promoted the social rights of the poor and strengthened state-citizen interactions, but also finds issues and challenges that may limit Chinese citizens’ ability to fully exercise their new rights.

Measuring Access of Microfinance on Poverty in India: Towards a Comprehensive Index

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Arindam Laha ◽  
Pravat Kumar Kuri
Keyword(s):  
Tamil Nadu ◽  
Andhra Pradesh ◽  
Composite Index ◽  
Well Being ◽  
The Poor ◽  
Comprehensive Index ◽  
Poor Households ◽  
Cross Country ◽  
Economic Well Being

The outreach of micro-finance programme is considered to be a means enhance the economic well-being among the member means to enhance households through poverty alleviation. A wide cross-country variation in the outreach of micro-finance programme to the poor households is observed in the world. Despite the significant growth of micro-finance institutions and its active borrowers, the penetration of micro-finance lending services to the poor households in India is observed to be limited. In addition, there is a wide inter-state disparity in the achievement of micro-finance outreach in India especially among the poor households. A composite index has been constructed using the penetration, availability and usage indicators of micro-finance outreach to examine the interstate variations in the level of its achievement. Subsequently, attempt has been made to analyse the role of micro-finance in alleviating poverty across the states of India. The result shows that out of 27 states and Union Territories, only in seven states (Kerala, Andhra Pradesh, Tamil Nadu, Goa, Himachal Pradesh, Tripura, and Karnataka) outreach of micro-finance programme has made a significant impact on the reduction of poverty.

scholarly journals Social health insurance for the poor: lessons from a health insurance programme in Karnataka, India

2018 ◽  
Vol 3 (1) ◽  
pp. e000582 ◽  
Author(s):  
Neeraj Sood ◽  
Zachary Wagner
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Tertiary Care ◽  
Substantial Reduction ◽  
Unmet Need ◽  
Social Health Insurance ◽  
Well Being ◽  
Poverty Line ◽  
Social Health ◽  
The Poor

Life-saving technology used to treat catastrophic illnesses such as heart disease and cancer is often out of reach for the poor. As life expectancy increases in poor countries and the burden from chronic illnesses continues to rise, so will the unmet need for expensive tertiary care. Understanding how best to increase access to and reduce the financial burden of expensive tertiary care is a crucial task for the global health community in the coming decades. In 2010, Karnataka, a state in India, rolled out the Vajpayee Arogyashree scheme (VAS), a social health insurance scheme focused on increasing access to tertiary care for households below the poverty line. VAS was rolled out in a way that allowed for robust evaluation of its causal effects and several studies have examined various impacts of the scheme on poor households. In this analysis article, we summarise the key findings and assess how these findings can be used to inform other social health insurance schemes. First, the evidence suggests that VAS led to a substantial reduction in mortality driven by increased tertiary care utilisation as well as use of better quality facilities and earlier diagnosis. Second, VAS significantly reduced the financial burden of receiving tertiary care. Third, these benefits of social health insurance were achieved at a reasonable cost to society and taxpayers. Several unique features of VAS led to its success at improving health and financial well-being including effective outreach via health camps, targeting expensive conditions with high disease burden, easy enrolment process, cashless treatment, bundled payment for hospital services, participation of both public and private hospitals and prior authorisation to improve appropriateness of care.

scholarly journals Inequalities in out-of-pocket health expenditure among women of reproductive age: after-effects of national health insurance scheme initiation in Ghana

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Michael Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Health Insurance ◽  
Healthcare Utilization ◽  
Health Expenditure ◽  
Concentration Index ◽  
Insurance Coverage ◽  
Healthcare Services ◽  
Socioeconomic Disadvantage ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Maternal Healthcare

Abstract Background Improvement in maternal healthcare is a public health priority. Unfortunately, in spite of the efforts made over time regarding universal coverage, there remain issues with accessibility and use of healthcare services up to now. In this study, we examined inequalities in out-of-pocket health expenditure among women of reproductive age in Ghana. We analyzed secondary data collected in Ghana Demographic and Health Survey (GDHS) - 2014. A total of 9,002 women of reproductive age were included in this study. Lorenz curves and the concentration index were used to examine neighborhood socioeconomic disadvantage inequalities in out-of-pocket expenditure for maternal healthcare utilization Results About two thirds (66.0%) of women of reproductive age in Ghana were covered by health insurance. In sum, women of high neighborhood socioeconomic disadvantage status had the least out-of-pocket expenditure for total healthcare utilization, laboratory investigations, antenatal care visits, post-natal care visits, care for new born for up to 3 months, and other healthcare services. The converse was however true for family planning service utilization. Using Concentration Index, we quantified the degree of neighborhood socioeconomic disadvantage inequalities in healthcare service utilizations. Conclusion This study showed a gap in health insurance coverage among women of reproductive age. There were also inequalities in out-of-pocket expenditure for healthcare services utilization. It is expedient for stakeholders in the healthcare system to make policies targeted at bridging the neighborhood socioeconomic differences in maternal healthcare use and develop programs to improve women’s financial protection. Moreover, enlightenment on health insurance availability and coverage should focus on women at risk of out-of-pocket expenditure.

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