scholarly journals Gender Disparity in Health Expenses, Health Insurance Financing and Out-of-Pocket Expenses for Inpatient Care in India

2019 ◽  
Vol 05 (03) ◽  
pp. 3-10
Author(s):  
Jugal Kishore ◽  
Keyword(s):  
Health Insurance ◽  
Inpatient Care ◽  
Gender Disparity ◽  
Out Of Pocket Expenses

scholarly journals Characteristics and implications of insurance-reimbursed inpatient care for gastric and oesophageal cancers in Anhui, China

2020 ◽  
Author(s):  
Anqi Yao ◽  
Xingrong Shen ◽  
Jing Chai ◽  
Jing Cheng ◽  
Rong Liu ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Regression Discontinuity ◽  
Medical System ◽  
Anhui Province ◽  
Disposable Income ◽  
Medical Systems ◽  
Start Time ◽  
Treatment Variable ◽  
Per Capita ◽  
Out Of Pocket Expenses

Abstract Background This study aimed to identify characteristics and trends in insurance-reimbursed inpatient care (NRIC) for gastric and oesophageal cancers and inform evaluation of medical systems reform. Methods The study extracted routinely collected records of claims for reimbursement from the New Rural Cooperative Medical System (NRCMS) in Anhui Province, China and performed descriptive and regression discontinuity analysis. Results From 2013 to 2017, NRIC in terms of person-time per million people (pmp) increased 5.60 and 20.62 times for gastric and oesophageal cancers, respectively. Total expense per episode for gastric and oesophageal cancers increased from 1130.25 and 22 697.99 yuan to 12 514.98 and 24 639.37 yuan, respectively. The ratio of out-of-pocket expenses per inpatient care episode to annual disposable income per capita was 0.43 for gastric cancer and 0.91 for oesophageal cancer and decreased by 0.17 and 0.47, respectively. Regression discontinuity modelling revealed that, when controlled for disposable income, illiteracy rate and months from start time, the treatment variable was significantly associated with person-times of NRIC pmp (β=0.613, p=0.000), length of stay per 105 people (β=−52.990, p=0.000) and total expenses per NRIC episode (β=2.431, p=0.000). Conclusions The study period witnessed substantial achievements in benefits to patients, inpatient care efficiency and equity. These achievements may be attributed mainly to the recent reforms launched in Anhui province, China.

scholarly journals The Electronic Health Insurance Card for Asylum-Seekers in Berlin: Effects on the Local Health System

2021 ◽  
Author(s):  
Nora Gottlieb ◽  
Vanessa Ohm ◽  
Miriam Knörnschild
Keyword(s):  
Health Insurance ◽  
Cost Analysis ◽  
Asylum Seekers ◽  
Inpatient Care ◽  
Local Health ◽  
Healthcare Provision ◽  
Barriers To Healthcare ◽  
Insurance Card ◽  
Local Health System ◽  
And Control

Background: In debates on asylum-seekers’ access to healthcare it is frequently claimed that restrictions are necessary to prevent unduly high health service utilization and costs. Within Germany, healthcare provision for asylum-seekers varies across the different states. Berlin’s authorities removed some barriers to healthcare for asylum-seekers by introducing an electronic health insurance card (HIC) in 2016. We used the HIC introduction in Berlin as an opportunity to investigate the effects of improved healthcare access for asylum-seekers on the local health system. Methods: The study applied a mixed-methods design. A cost analysis compared expenses for outpatient and inpatient health services for asylum-seekers before and after the HIC introduction, based on aggregate claims data and information on expenses for humanitarian healthcare provision that were retrieved from the Berlin authorities. Semi-structured interviews with 12 key informants explored organizational effects like administrative workloads and ethical dilemmas for staff. We performed a content analysis and used respondent validation to enhance the accuracy and trustworthiness of our results. Results: The HIC has reduced bureaucratic complexity and administrative workloads; it has enabled unprecedented financial transparency and control; and it has mitigated ethical tensions. All the while, average per person expenses for outpatient health services have declined since the HIC introduction. However, our cost analysis also indicates a rise in the utilization and costs of inpatient care. Conclusion: The HIC introduction in Berlin suggests that the removal of barriers to healthcare for asylum-seekers can create win-win-situations by reducing administrative workloads, advancing financial transparency, and mitigating ethical tensions, whilst cutting the costs of outpatient healthcare provision. Removing barriers to healthcare thus appears to be a more prudent policy choice than maintaining mechanisms of restriction and control. However, high inpatient care utilization and costs warrant further research.

scholarly journals Analisis Beban Biaya Sendiri Pasien Rawat Inap Peserta Askes di RSUD dr. Achmad Diponegoro, Putussibau, Kalimantan Barat

2008 ◽  
Vol 2 (4) ◽  
pp. 166
Author(s):  
Johanes Eko Kristiyadi
Keyword(s):  
Health Insurance ◽  
Length Of Stay ◽  
Influence Factor ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
West Kalimantan ◽  
Health Insurance Provider ◽  
Level 1 ◽  
Out Of Pocket Expenses ◽  
Interaction Test

PT. Askes asuradur yang mengelola asuransi wajib pegawai negeri sipil yang dalam peraturannya membolehkan peserta membayar beban biaya sendiri (out of pocket) karena perbedaan antara tarif rumah sakit dengan tarif paket Askes. Penelitian ini bertujuan untuk mengetahui berbagai faktor yang berpengaruh dan model prediksi beban biaya sendiri pasien rawat inap peserta Askes di RSUD dr. Achmad Diponegoro-Putussibau, Kabupaten Kapuas Hulu, Propinsi Kalimantan Barat, tahun 2005. Rancangan penelitian yang digunakan adalah survei dengan sampel sebesar 257 pasien rawat inap tahun 2005. Dfitemukan Rata-rata beban biaya sendiri sebesar Rp. 215.472atau 20,84 % dari rata-rata biaya perawatan sesuai tariff RSUD. Beban minimum dan maksimum adalah Rp. 25.000,- dan Rp. 2.784.000,- dipengaruhi oleh faktor lama hari rawat, penyakit penyulit, obat-obatan, peserta, peserta3(isteri), golongan pegawai, interaksi antara lama hari rawat dengan penyakit penyulit dan interaksi antara penyakit penyulit dengan obat-obatan. Interaksi antara lama hari rawat dengan penyakit penyulit merupakan faktor yang paling mempengaruhinya (nilai ? 0,624). Setelah dilakukan uji asumsi dan uji interaksi, maka diperoleh model prediksi beban biaya sendiri = 5,743 + 0,313*lama hari rawat - 0,785*tidak ada penyakit penyulit + 0,819*obat-obatan (Non DPHO) + 67,397*peserta + 0,179*istri + 1,489*golongan + 0,260*Interaksi penyakit penyulit dengan Obat-obatan + 37,353*Interaksi lama hari rawat dengan penyakit penyulit.Kata Kunci : Biaya sendiri, asuransi kesehatanAbstractPT Askes is the health insurance provider with mandatory membership for public officers in Indonesia. In reality, patient still have to cover some expenses from his or her pocket, due to the differences between hospital fare and the expenses that is covered by Askes. The objective of this research is to find out the determinant factors and the prediction model of out of pocket expenses among hospitalized patients with Askes membership at dr. Achmad Diponegoro Hospital in Putussibau, Kapuas Hulu District, West Kalimantan Province in 2005. This design used in this study is cross-sectional, using 257 samples of hospitalized patients in dr. Achmad Diponegoro Hospital in Putusibau, Kapuas Hulu District, West Kalimantan Province during the year of 2005. The average amount of out of pocket expenses of each patient is Rp 215,472.76 or 20.84 % out of the total expenses in the district hospital. the minimum fare is Rp 25,000.- and the maximum one is Rp 2,784,000.-, depend on the number of days in hospital, type of illness, medications, type of membership (member1=the person with the membership, member3=the spouse), level 1 employee, the interaction between length of stay with type of illness, and the interaction between complicated illness and drugs are the most influence factor ( the ? value are the highest, that is 0,624). The assumption and interaction test, resulted in the model: self expenses = 5,743 + 0,313*length of stay - 0,785*no complicated illness + 0,819*drugs (Non DPHO) + 67,397*member1 + 0,179*member3 + 1,489*employee1 + 0,260*interaction between complicated illness and drugs + 0,260*Interaction between length of stay and complicated illness.Key word : Out of pocket, health insurance

scholarly journals Variations in hip fracture inpatient care in Japan, Korea, and Taiwan: an analysis of health administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongsoo Kim ◽  
Shou-Hsia Cheng ◽  
Hayato Yamana ◽  
Seyune Lee ◽  
Nan-He Yoon ◽  
...  
Keyword(s):  
Health Insurance ◽  
Hip Fracture ◽  
East Asia ◽  
Health Systems ◽  
Resource Use ◽  
Inpatient Care ◽  
Term Outcome ◽  
Total Cost ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Abstract Background Little is known about hip fracture inpatient care in East Asia. This study examined the characteristics of patients, hospitals, and regions associated with delivery of hip fracture surgeries across Japan, Korea, and Taiwan. We also analyzed and compared how the resource use and a short-term outcome of the care in index hospitals varied according to factors in the respective health systems. Methods We developed comparable, nationwide, individual-level health insurance claims datasets linked with hospital- and regional-level statistics across the health systems using common protocols. Generalized linear multi-level analyses were conducted on length of stay (LOS) and total cost of index hospitalization as well as inpatient death. Results The majority of patients were female and aged 75 or older. The standardized LOS of the hospitalization for hip fracture surgery was 32.5 (S.D. = 18.7) days in Japan, 24.7 (S.D. = 12.4) days in Korea, and 7.1 (S.D. = 2.9) days in Taiwan. The total cost per admission also widely varied across the systems. Hospitals with a high volume of hip fracture surgeries had a lower LOS across all three systems, while other factors associated with LOS and total cost varied across countries. Conclusion There were wide variations in resource use for hip fracture surgery in the index hospital within and across the three health systems with similar social health insurance schemes in East Asia. Further investigations into the large variations are necessary, along with efforts to overcome the methodological challenges of international comparisons of health system performance.

Impact Evaluation of National Health Insurance toward Access Hospital Inpatient Care in Indonesia

2018 ◽  
Vol 9 (2) ◽  
pp. 196
Author(s):  
Wahyu P Nugraheni ◽  
Budi Hidayat ◽  
Mardiati Nadjib ◽  
Eko Setyo Pambudi ◽  
Soewarta Kosen ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Impact Evaluation ◽  
Inpatient Care ◽  
Hospital Inpatient ◽  
Hospital Inpatient Care

scholarly journals Factors Affecting the Perceived Quality of Service and Patient Satisfaction on Inpatient Care of Nabire Hospital Papua

2020 ◽  
Author(s):  
Agustina Utii ◽  
◽  
Bhisma Murti ◽  
Yulia Lanti Retno Dewi ◽  
Priscilla Jessica Pihahey ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Satisfaction ◽  
Health Insurance ◽  
Length Of Stay ◽  
Health Service ◽  
Inpatient Care ◽  
Patient Perception ◽  
Factors Affecting ◽  
Good Patient

ABSTRACT Background: The government’s efforts to improve public health level are by providing excellent health service facilities, including promotion, preventive, curative, and rehabilitative. The outcome of quality health service can be measured by patient perception and satisfaction. This study aimed to examine factors affecting the perceived quality of service and patient satisfaction on inpatient care of Nabire Hospital, Papua, Indonesia. Subjects and Method: A cross-sectional study was carried out at Nabire regional hospital, Papua, Indonesia, from March to Mey 2020. A sample of 207 inpatients was selected by stratified random sampling. The dependent variable was patient satisfaction. The independent variables were age, income, and length of stay type class health insurance, working, and patient perception toward doctor, nurse, and inpatients facilities. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Inpatients satisfaction decreased with age ≥50 years (OR= 0.72; 95% CI= 0.24 to 2.65; p= 0.720), income ≥Papua minimum wage (OR= 0.77; 95% CI= 0.22 to 2.73; p= 0.685), and length of stay ≥7 days (OR= 0.13; 95% CI= 0.03 to 0.53; p= 0.004). Inpatients satisfaction increased with class 2 and 3 (OR= 1.15; 95% CI= 0.43 to 3.07; p= 0.773), non national health insurance (OR= 1.21; 95% CI= 0.46 to 3.23; p= 0.700), working (OR= 2.13; 95% CI= 0.58 to 7.85; p= 0.258), good patient perception toward doctor (OR= 3.03; 95% CI= 1.15 to 7.99; p<0.001), good persepsi patient perception toward nurse (OR= 4.04; 95% CI= 1.15 to 14.17; p<0.001), and patient perception toward inpatients facilities (OR= 26.8; 95% CI= 11.0 to 65.32; p<0.001). Conclusion: Inpatients satisfaction decreases with age ≥50 years, income ≥Papua minimum wage, and length of stay ≥7 days. Inpatients satisfaction increases with class 2 and 3, non national health insurance, working, good patient perception toward doctor, good persepsi patient perception toward nurse, and patient perception toward inpatients facilities. Keywords: inpatients satisfaction, patient perception, health insurance Correspondence: Agustina Utii. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 081240051451. DOI: https://doi.org/10.26911/the7thicph.04.46

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: Does health insurance make a difference? A cross-sectional study

2020 ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract BackgroundResponsiveness has become an important health system performance indicator in evaluating the ability of health care systems to meet patients’ expectations. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania and to explore the association of health insurance (HI) with responsiveness in this population. MethodsA community-based cross-sectional study was conducted in 2017 where a pre-tested household survey, administered to the elderly (60 + years) living in Igunga and Nzega districts, was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and 12 months were selected. Responsiveness was measured based on the short version of the World Health Organization (WHO) multi-country responsiveness survey study, which included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance adjusted for sociodemographic factors.ResultsA total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used outpatient and inpatient health services, respectively. All domains were rated relatively highly but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (−1; 95% CI: −1.45, −0.45) and inpatient (−2; 95% CI: −2.69, −1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked poorly. Further research is necessary to reveal the reasons for the lower responsiveness noted among insured elderly. A continuous monitoring of health care system responsiveness is recommended.

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: Does health insurance make a difference? A cross-sectional study

2020 ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract Introduction Responsiveness has become an important health systems performance indicator in evaluating the ability of the health care systems to meet the expectations of the patients. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania, in order to contribute with relevant knowledge to improve the performance of the health care system among the elderly in the country. Methods A community-based cross-sectional study was conducted in 2017 where a pre-tested household survey administered to elderly (60 +) living in Igunga and Nzega districts was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and twelve months were selected. Responsiveness was measured based on the WHO-SAGE questionnaire that included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance and socio-demographic factors.Results A total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used the outpatient and inpatient health services respectively. All the different domains were rated relatively high but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (-1; 95% CI: -1.45, -0.45) and inpatient (-2; 95% CI: -2.69, -1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked low. Further research is necessary to reveal the reasons for the lower responsiveness among insured elderly. A continuous monitoring of the health care system responsiveness is recommended.

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