scholarly journals Factors Affecting the Utilization of Outpatient Health Services and Importance of Health Insurance

2017 ◽  
Vol 18 (8) ◽  
Author(s):  
Farhad Lotfi ◽  
Soraya Nouraei Motlagh ◽  
Ghadir Mahdavi ◽  
Khosro Keshavarz ◽  
Mohammad Hadian ◽  
...  
2019 ◽  
Vol 8 ◽  
pp. 1411
Author(s):  
Elham Shami ◽  
Jafar Sadegh Tabrizi ◽  
Shirin Nosratnejad

Insurance organizations are among the most influential organizations in the health system, which can lead to healthcare efficiency and patient satisfaction in case they are increasingly accessed. The main purpose of the present systematic review was to examine the effect of health insurance on the utilization of health services and also to examine the factors affecting it. The present study was a systematic review that aimed to examine the effect of health insurance on the utilization of health care services. The study was conducted in 2016 using Scopus, PubMed, Web of Science, Science Direct, and ProQuest databases. We examined the utilization rate of health insurance in insured people. The inclusion and exclusion criteria were included based on review and meta-analysis purposes. The utilization of health services increased for inpatient and outpatient services. The utilization rate of inpatient services increased by 0.51% whereas the utilization rate of outpatient services increased by 1.26%. We classified the variables affecting the utilization rate of insurance into three main categories and sub-categories: demographic variables of the household, socioeconomic status, and health status. Our study showed that insured people increased the utilization rate of health services, depending on the type of health services. Thus, health policymakers should consider the community’s health insurance as a priority for health programs. For now, implementing universal health insurance is a good solution. [GMJ.2019;8:e1411]


Author(s):  
Ashwaq Safar Al-shahrani

The aim of the research was to identify the factors influencing the decisions of determining the value of the insurance policy. The research used the analytical descriptive method. The questionnaire was used as a tool for gathering information from the study members. The comprehensive survey method was applied by applying all insurance companies in the Kingdom of Saudi Arabia. The sample of the study was 200 employees, and the research reveals several results, the most important of which is that the insurance policy is different according to the type of contract which affects its value Relative weight 0.83. The size of danger determines the type, value and period of the insurance policy Relative weight 82.20. This affects the value of the insurance policy, with higher the health service provided to the insured. The study recommends the need to pay attention to health insurance and the need to raise the awareness among citizens about importance of health insurance. Also, insurance companies should minimize the limit of installment and it should include a large part of health services costs. In addition, they need to clarify more about the covering limit by the premium insurance policy, which may help to reduce the price of the insurance policy to suit all members of society in order to obtain the appropriate health services for them.


2019 ◽  
Vol 16 (41) ◽  
pp. 378-384
Author(s):  
Nilaramba Adhikari ◽  
Rajendra Raj Wagle ◽  
Dilli Raman Adhikari ◽  
Puspa Thapa ◽  
Muna Adhikari

Background: Low income countries face considerable challenges in financing health care for their populations. As its consequences, poor people don’t have access to desired health services, drugs and medicine.To address the financial barriers to health services, Government of Nepal introduced Community Based Health Insurance scheme at selected health facilities. However, enrolment in the schemeis very low. This study aims to identify the associated factors affecting enrolment in the insurance scheme.Methods: A community based case-control study was conducted within the coverage area of CBHI scheme of Chandranigahapur Hospital. CBHI Scheme of Chandranigahapur Hospital was selected purposively. Altogether 416 households were interviewed using a structured questionnaire. The required number of sample size from the enrolled households as cases and equal number of non-enrolled households as controls were selected randomly in 1:1 ratio.Results: The odds of enrolment in the CBHI scheme among male-headed households were found lower than female-headed households (AOR 0.251, 95% CI 0.097 to 0.652). Similarly household head belonging to upper caste/ethnic groups (AOR 3.981, 95% CI 2.027 to 7.816) as well aseducated household head(AOR 6.184, 95% CI 3.137 to 12.188)were more likely to enrol in the CBHI scheme. Households having >60 years elderly were found significantly associated with enrolment in CBHI scheme(AOR 3.996, 95% CI 2.130 to 7.497). Time to reach health facility as well as affordability of premium of the insurance scheme was also found significantly associated with enrolment in the CBHI scheme.Conclusions: The enrolment in the CBHI scheme is determined by combination of householdhead, household and health service related factors.These determinants should be addressed to enhance the enrolment in the insurance scheme.Keywords: Community based health insurance; enrolment; health insurance; social health security.


2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen

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


2019 ◽  
Vol 22 (11) ◽  
pp. 485-491
Author(s):  
Arih Diyaning Intiasari ◽  
Budi Aji ◽  
Siti Masfiah ◽  
Laksono Trisnantoro ◽  
Julita Hendrartini

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Margareth Guimarães Lima ◽  
Silvânia Suely Caribé de Araújo ◽  
Marta Maria Alves da Silva ◽  
...  

ABSTRACT OBJECTIVE To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD). METHODS Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals. RESULTS The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53–1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78–3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24–1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. CONCLUSIONS NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.


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