scholarly journals Equity of Social Health Insurance Coverage for Migrants in Thailand: A Concentration Index Analysis

2021 ◽  
Vol 19 (1) ◽  
pp. 64
Author(s):  
Peeraya Piancharoen ◽  
Hathairat Kosiyaporn ◽  
Rapeepong Suphanchaimat
Keyword(s):  
Health Insurance ◽  
Migrant Workers ◽  
Concentration Index ◽  
Statistical Significance ◽  
Insurance Coverage ◽  
Industrial Sector ◽  
Cross Sectional ◽  
Industrial Sectors ◽  
Index Analysis ◽  
Per Capita

Thailand is attempting to implement an effective health insurance scheme to cover all migrant workers in the country. One of the remarkable policies is the Social Security Scheme (SSS). This study aims to assess the equity of SSS coverage among migrant workers in Thailand, sorted by types of businesses (agriculture, services and industrial sectors) and Gross Provincial Product (GPP) per capita. A secondary data analysis on time series cross-sectional data was employed. The dataset comprised: (1) the number of migrant insurees under the SSS; (2) the volume of migrant insurees in formal and informal sectors; and (3) provincial economic level and provincial population by years from 2015–2018. Descriptive statistics, Spearman’s rank correlation, and concentration index analysis on the ratio of SSS insurees to all migrants ranked by GPP per capita and business types from 2015–2018 were performed. Results showed that the ratio of SSS insurees to all migrants increased from 38.5% to 58.9%. Spearman’s correlation found a positive relationship between the SSS coverage and GPP per capita and business types in 2018. The statistical significance (p < 0.001) was found only in the industrial sector (rs = 0.346). Significant CIs were found in SSS coverage in the industrial sector in 2016 (CI = 0.147, p < 0.001), and SSS coverage in the industrial sector in 2017 (CI = 0.137, p < 0.001). In conclusion, the trend of CIs displayed a movement towards zero for all business types. This implied that the distribution of migrants in SSS shifted toward the equitable distribution across provinces in Thailand. A possible explanation was a major change in Thai politics in 2014 and a change in employment legislation for migrants in 2017. To expand the insurance coverage, the government should use the CI as a guide to consider specific provinces or target specific economic sectors as a priority to expedite the insurance enrolment for migrants.

PARTICIPATING IN HEALTH INSURANCE AND FACTORS AFFECTING AMONG PERSONS WHOSE ENROLMENT IS VOLUNTARY IN THUA THIEN HUE PROVINCE

2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Factors Affecting ◽  
The People ◽  
Universal Health Insurance Coverage ◽  
The Social

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue

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.

scholarly journals Public health insurance and birth outcomes: evidence from Punjab, Pakistan

2020 ◽  
Author(s):  
Najam uz Zehra Gardezi
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Fixed Effects ◽  
Insurance Coverage ◽  
Birth Certificate ◽  
Household Survey ◽  
Public Health Insurance ◽  
Health Seeking ◽  
Cross Sectional

Abstract Public health insurance targeted towards low-income households has gained traction in many developing countries. However, there is limited evidence as to the effectiveness of these programs in countries where institutional constraints may limit participation by the eligible population. This paper evaluates a recent health insurance initiative introduced in Pakistan and discusses whether eligibility for the programme improves maternal health seeking behaviour. The Prime Minister National Health Program provides free insurance coverage to low-income families. The programme is in the early phases of implementation and has, since 2016, only been rolled out in a few eligible districts within the country. This allows for a comparison of eligible households in districts where the programme has been introduced to those that are eligible to receive insurance at a future date. Using repeated cross-sectional data from multiple rounds of representative household survey, a difference-in-difference model has been estimated. Results show that at least for a specific beneficiary group (i.e. pregnant women), there has been a positive increase in utilization of hospital services. Furthermore, we provide evidence using mother fixed effects that the programme increased the likelihood of a child’s birth being documented. Since possession of a birth certificate can secure civic rights for a child, this is an unintended but positive outcome of the programme.

scholarly journals Prevalence and factors associated with health insurance coverage in resource-poor urban settings in Nairobi, Kenya: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031543 ◽  
Author(s):  
Peter O Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri F Mohamed ◽  
Hermann Pythagore Pierre Donfouet ◽  
Martin K Mutua
Keyword(s):  
Health Insurance ◽  
Primary Outcome ◽  
Insurance Coverage ◽  
Scale Up ◽  
Household Head ◽  
Health Insurance Coverage ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Insurance Cover

ObjectiveTo determine the prevalence of health insurance and associated factors among households in urban slum settings in Nairobi, Kenya.DesignThe data for this study are from a cross-sectional survey of adults aged 18 years or older from randomly selected households in Viwandani slums (Nairobi, Kenya). Respondents participated in the Lown scholars’ study conducted between June and July 2018.SettingThe Lown scholars’ survey was nested in the Nairobi Urban Health and Demographic Surveillance System in Viwandani slums in Nairobi, Kenya.ParticipantsA total of 300 randomly sampled households participated in the survey. The study respondents comprised of either the household head, their spouses or credible adult household members.Primary outcome measureThe primary outcome of this study was enrolment in a health insurance programme. The households were classified into two groups: those having at least one member covered by health insurance and those without any health insurance cover.ResultsThe prevalence of health insurance in the sample was 43%. Being unemployed (adjusted OR (aOR) 0.17; p<0.05; 95% CI 0.06 to 0.47) and seeking care from a public health facility (aOR 0.50; p<0.05; 95% CI 0.28 to 0.89) was significantly associated with lower odds of having a health insurance cover. The odds of having a health insurance cover were significantly lower among respondents who perceived their health status as good (aOR 0.62; p<0.05; 95% CI 1.17 to 5.66) and those who were unsatisfied with the cost of seeking primary care (aOR 0.34; p<0.05; 95% CI 0.17 to 0.69).ConclusionsHealth insurance coverage in Viwandani slums in Nairobi, Kenya, is low. As universal health coverage becomes the growing focus of Kenya’s ‘Big Four Agenda’ for socioeconomic transformation, integrating enabling and need factors in the design of the national health insurance package may scale-up social health protection.

scholarly journals Factors Influencing Nonrenewal of Health Insurance Membership in Ejisu-Juaben Municipality of Ashanti Region, Ghana

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kwawukume Mawumenyo Aku ◽  
Kofi Akohene Mensah ◽  
Peter Twum ◽  
Peter Agyei-Baffour ◽  
Daniel Opoku ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Statistical Significance ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Systemic Factors ◽  
The Government

Background. In the quest to prevent households from making catastrophic expenditures at the point of seeking healthcare, the government of Ghana introduced the National Health Insurance in 2003. However, people are reluctant to renew their membership. This study was, therefore, conducted to identify factors influencing the nonrenewal of National Health Insurance membership in the Ejisu-Juaben Municipality. Methods. A cross-sectional study was conducted among 427 respondents in the Ejisu-Juaben Municipality to ascertain factors influencing the nonrenewal of health insurance membership status. Data were entered and analyzed using Stata version 14. Univariate and multivariate analyses were performed to determine sociodemographic factors, household factors, and systemic factors influencing the nonrenewal of health insurance status. Statistical significance for all testing was set as p ≤ 0.05 . Results. Sociodemographic factors such as gender (AOR = 0.531; CI = 0.287–0.985) and educational level (AOR = 5.268; CI = 1.130–24.551)) were associated with the nonrenewal of health insurance membership. Income levels in Ghana Cedis were 500–1000 (AOR = 0.216; CI = 0.075–0.617) and 1001–2000 (AOR = 0.085; CI = 0.019–0.383). Systemic decision on factors such as clients’ satisfaction (AOR = 0.149; CI = 0.035–0.640), making copayment (AOR = 0.152; CI = 0,068–0.344), acquiring all prescribed drugs (AOR = 4.191; CI = 2.027–8.668), and awareness of mobile renewal (AOR = 3.139; CI = 1.462–6.739) was associated with nonrenewal of membership. Conclusions. The nonrenewal of health insurance membership was influenced by sociodemographic, household, and systemic factors. Therefore, the Municipal Health Directorate and the National Health Insurance Authority have to work on these factors to reach the target of 100% active coverage in the municipality.

scholarly journals Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis

2019 ◽  
Author(s):  
Shanquan Chen ◽  
Yingyao Chen ◽  
Zhanchun Feng ◽  
Xi Chen ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Migrant Workers ◽  
Gap Analysis ◽  
Central Government ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cochrane Library ◽  
Job Stability ◽  
Urban Migrant

Abstract Objective: To review China’s healthcare policies and their applications to rural-to-urban migrant workers (RUMWs) in China, to identify problems faced by RUMWs and the policy gaps that need to be addressed in future, and to facilitate better implementation of the UHC on RUMWs. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total 71 articles were reviewed. Findings: (1) Chinese RUMWs have a high work mobility and low job stability; (2) Barriers faced by RUMWs to have effective health insurance coverage are mainly due to the reluctancy of employers to provide insurance for all employees and a disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote the effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision over employers, and (5) providing more vocational trainings and other supports to increase RUMW’s job stability.

scholarly journals Health Insurance Uptake and Affordability of Care Among Patients with Hypertension in a Federal Teaching Hospital in Southwestern Nigeria

2021 ◽  
Author(s):  
Tope Michael Ipinnimo ◽  
Demilade Olusola Ibirongbe ◽  
Motunrayo Temidayo Omowaye ◽  
Paul Oladapo Ajayi ◽  
Taiwo Samuel Ogunleye
Keyword(s):  
Health Insurance ◽  
Teaching Hospital ◽  
Financial Burden ◽  
Insurance Coverage ◽  
Sampling Technique ◽  
Southwestern Nigeria ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Significance Level ◽  
Insurance Cover

This study aims to assess health insurance uptake and affordability of care among patients with hypertension in a Federal Teaching Hospital in Southwestern Nigeria. This was a cross sectional study involving 138 hypertensive patient selected through systematic random sampling technique from the cardiology clinic of a Federal Teaching Hospital. A semi-structured, interviewer administered questionnaire was used to collect data. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21. A significance level of 5% was used. The mean age (standard deviation) of the patients was 57.4 (12.8) years with median (interquartile range) monthly income of ₦46,500.00 (₦55,000.00) [US$129 (US$152.78)]. The health insurance uptake among them was 26.8%. Out of those who had no health insurance cover, 87.2% of them believed it could make their financial burden less and wish to be registered. Hypertensive patients enrolled under health insurance were significantly less likely to face financial difficulty when paying for drugs (p&lt;0.001) and investigations (p&lt;0.001). Additionally, these patients were significantly less likely to deny or defer project(s) in order to pay for their illness (p=0.004) and to have their source of livelihood being negatively affected by this illness (p=0.002). This study found a low health insurance uptake among hypertensive patients, even though most of the patients who had no health insurance cover were ready to enroll. Additionally, health insurance was identified to promote affordability of care among these patients. It is therefore crucial to put in place measures that will increase health insurance coverage among these patients.

scholarly journals Kemandirian dan Ketersediaan Obat Era Jaminan Kesehatan Nasional (JKN): Kebijakan, Harga, dan Produksi Obat

2018 ◽  
Vol 28 (4) ◽  
pp. 219-228
Author(s):  
Raharni Raharni ◽  
Sudibyo Supardi ◽  
Ida Diana Sari
Keyword(s):  
Health Insurance ◽  
Drug Price ◽  
Raw Materials ◽  
Generic Drugs ◽  
Insurance Coverage ◽  
Round Table ◽  
Round Table Discussion ◽  
Cross Sectional ◽  
Table Discussion ◽  
The Government

National Health Insurance (JKN) is a guarantee program that provides health protection to participants to obtain health care benefits and protection in meeting the basic health needs provided to everyone who pays contributions or whose contributions are paid by the government. Health insurance coverage includes promotive, preventive, curative and rehabilitative including medicines and medical devices. Since the enactment of JKN on 1 January 2014, the demand for generic drugs has greatly increased. JKN drug independence is needed in terms of drug availability, access and affordability of JKN drug.The aimed of this research is to find out the independence and availability of drugs in the JKN era. The study design was cross sectional by conducting interviews, Round Table Discussion, and tracking secondary data documents.The results of this study obtained government policies related to JKN drug price, especially generic drugs, have not fully considered the interest of community and the interest of the pharmaceutical industry, as well as drug price control policies to ensure the availability of drugs both in number and type in the JKN era, especially generic drugs that have not been optimally accessed by the public.The government needs to encourage the independence of JKN drugs, especially generic drugs that have not been fulfilled, with the development of domestic production of medicinal raw materials to support JKN, which is currently mostly imported and the price of imported raw materials continue to rise.The priority of production of medicinal raw materials based on local extractive and fermentative. Abstrak Jaminan Kesehatan Nasional (JKN), merupakan program jaminan yang memberikan perlindungan kesehatan kepada peserta untuk memperoleh manfaat pemeliharaan kesehatan dan perlindungan dalam memenuhi kebutuhan dasar kesehatan yang diberikan kepada setiap orang yang membayar iuran atau yang iurannya dibayar oleh pemerintah. Jaminan pelayanan kesehatan meliputi promotif, preventif, kuratif, dan rehabilitatif, termasuk obat dan alat kesehatan. Sejak diberlakukannya JKN pada 1 Januari 2014, permintaan obat generik sangat meningkat pesat. Kemandirian obat JKN diperlukan dalam hal ketersediaan obat, akses, dan keterjangkauan obat JKN. Tujuan penelitian ini untuk mengetahui kemandirian dan ketersediaan obat era JKN. Desain penelitian adalah cross sectional, dengan melakukan wawancara, round table discussion, dan penelusuran dokumen data sekunder. Hasil penelitian diperoleh kebijakan pemerintah terkait harga obat JKN khususnya obat generik, belum sepenuhnya mempertimbangkan kepentingan masyarakat dan kepentingan industri farmasi,serta kebijakan pengendalian harga obat untuk menjamin ketersediaan obat baik jumlah dan jenisnya di era JKN, khususnya obat generik, belum optimal diakses oleh masyarakat. Pemerintah perlu mendorong kemandirian obat JKN khususnya obat generik yang belum terpenuhi, dengan pengembangan produksi bahan baku obat dalam negeri untuk mendukung JKN, yang saat ini sebagian besar masih impor dan harga bahan baku impor yang terus naik. Prioritas produksi bahan baku obat yaitu berbasis sumber daya lokal, ekstraktif, dan fermentatif

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