insurance program
Recently Published Documents


TOTAL DOCUMENTS

906
(FIVE YEARS 196)

H-INDEX

36
(FIVE YEARS 3)

2022 ◽  
pp. 1-20
Author(s):  
Alan Hernández-Soto ◽  
Jhair López-López ◽  
Antonio Yúnez-Naude ◽  
Yatziry Govea-Vargas

The health crisis caused by the spread of COVID-19 has caused a profound social and economic disruption in Mexico. Our purpose in this paper is to contribute to the knowledge about the economic impact of the pandemic in Mexico and to evaluate social policy options to mitigate its effects. We do so based on a multisectoral-multiplier model and the most recent Social Accounting Matrix for Mexico, with which we estimate the direct and indirect impacts of COVID-19 as well the likely effects of two alternatives for mitigating them: an unconditional cash transfer scheme for households living in poverty, and the establishment of an unemployment insurance program for workers who have lost their jobs during the pandemic. We find that the first alternative alleviates more value added and loss of income, and thus has a greater effect in reducing inequality and the incidence of poverty.


Author(s):  
Prabin Sharma ◽  
Dipendra Kumar Yadav ◽  
Niranjan Shrestha ◽  
Prabesh Ghimire

Background: Nepal’s national social health insurance (SHI) program, which started in 2016, aims to achieve universal health coverage (UHC), but it faces severe challenges in achieving adequate population coverage. By 2018, enrolment and dropout rates for the scheme were 9 percent and 38 percent respectively. Despite government's efforts, retaining the members in SHI scheme remains a significant challenge. The current study therefore aimed to assess the factors associated with social health insurance program dropout in Pokhara, Nepal. Methods: A cross-sectional household survey of 355 households enrolled for at least one year in the national social health insurance program was conducted. A structured questionnaire was used to conduct face-to-face interviews with household heads were conducted using a structured questionnaire. Data was entered in Epi-Data and analysed using SPSS. The factors associated with social health insurance program dropout were identified using bivariate and multiple logistic regression analyses. Results: The findings of the study revealed a dropout prevalence of 28.2% (95% confidence interval: 23.6%-33.2%). Households having more than five members [adjusted odds ratio (aOR) 2.19, 95% CI: 1.22-3.94], belonging to underprivileged ethnic groups (Dalit/Janajati) (aOR 2.36, 95% CI: 1.08-5.17), living on rented homes (aOR: 4.53, 95%CI 1.87-10.95), absence of chronic illness in family (aOR 1.95, 95%CI: 1.07-3.59), perceived good health status of the family (aOR 4.21, 95%CI: 1.21-14.65), having private health facility as first contact point (aOR 3.75, 95%CI: 1.93-7.27), poor availability of drugs (aOR 4.75, 95%CI: 1.19-18.95) and perceived unfriendly behaviour of service providers (aOR 3.09, 95%CI: 1.01- 9.49) were statistically significant factors associated with SHI dropout. Conclusion: In Pokhara, more than one-fourth of households have dropped out of the Social Health Insurance Scheme, which is a significant number. Dropping out of SHI is most commonly associated with a lack of drugs, followed by rental housing, family members’ reported good health status and unfriendly service provider behaviour. Efforts to reduce SHI dropout must focus on addressing drugs availability issues and improving providers’ behaviour towards scheme holders. Increasing insurance awareness, including provisions to change first contact points, may help to reduce dropouts among rented households, which make up a sizable proportion of the Pokhara metropolitan area.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Frédéric Bizard ◽  
Thierry Boudemaghe ◽  
Laurent Delaunay ◽  
Lucas Léger ◽  
Karem Slim

Abstract Background Study of the medico economic impact of enhanced rehabilitation after surgery (ERAS), by comparing the cost of patient care with or without ERAS, both from the point of view of the hospitals and the Social Security Health Insurance Program. Methods Retrospective longitudinal study on matched data from March 1, 2019 to December 31, 2019. The data are extracted from the French prospective payment system. We studied 12 of the most commonly performed in ERAS business segments. The primary outcome was the reduction of the average length of hospital stay and its implications on production costs and excess capacity. We also studied the impact on hospital incomes and Social Security Insurance Program expenses. The potential gain in hospital days was computed by comparing the length of stay of ERAS and non-ERAS cases. The cost reduction was estimated using the mean number of avoidable days of hospitalization, and the mean cost of the stays obtained from the national cost study. Finally, we studied an approximation of the additional expense for the Social Security Health Insurance Program on costs standardized by applying public sector rates. Results The average length of stay reduction attributed to ERAS is 1.45 (CI 95% 1.42 to 1.48) day per stay, translating to a cost reduction for the hospitals of € 1060 (CI 95% 995 to 1125) per patient and a total of €65 million (CI 95% 61 to 69). At the same time, the additional expenses for the Social Security Insurance Program can conservatively be approximated to € 1.6 million, breaking into a € 2.2 million increase partially compensated by cost savings of € 0.6 million over subsequent stays for complications. Overall, for each percent of additional ERAS activity over the scope of the study, the marginal cost reduction for the hospitals can be estimated to € 1.8 million (CI 95% 1.7 million to 2.0 million). Conclusions Associated with previously known clinical benefits for the patients, these convincing results in terms of economic gain strongly support expanding the adoption of ERAS.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 421-421
Author(s):  
Tomoko Wakui

Abstract Japan has faced numerous issues in the last twenty years with its mandatory long-term care (LTC) insurance program. This LTC insurance program obviously affected older adults’ informal support exchanges, reducing support from family and the community, which became more valuable, subjectively. Furthermore, changes in support have impacted older adults’ subjective well-being and children’s perceived care motivation. Additionally, a mandatory uniform system challenges the issue of tolerance of diversity, meaning how non-traditional families’ opinions be involved LTC situations. This symposium discusses unexpected shifting issues in Japan in the implementation of a public LTC program with a focus on older adults’ support exchanges. The first paper examines the long-term impacts of formal and informal support by examining the effects of implementing formal services. The second paper assesses a community’s role in relation to family in the presence of a public LTC program. The third paper examines the subjective impacts of older parents, who provided support to adult children and their reciprocal expectations of receiving LTC. The fourth paper, on the other hand, articulates reciprocal impacts on sons’ care motivation, which has become more important, since the introduction of the LTC program reinforced men’s participation in LTC. Finally, the fifth paper clarifies how a public uniform program accommodates informal support from non-traditional families when the program premises the presence of family in advanced care planning. Our findings have long-term implications for aging societies in relation to formal and informal support exchanges.


2021 ◽  
Vol 58 (1&2) ◽  
pp. 157-184
Author(s):  
Carlos Antonio Tan Jr. ◽  
Narisa Sugay ◽  
Maria Sylvia Nachura ◽  
Katrina Miradora ◽  
Abba Marie Moreno ◽  
...  

This paper examines the state of National Health Insurance Program (NHIP) financing during the COVID-19 pandemic in the Philippines, an event which coincides with the implementation of the Universal Health Care (UHC) mandates on restructuring the NHIP premium schedule, providing immediate eligibility to NHIP benefits, and expanding member benefits. Using the ratio of total expenditures to total revenues as the measure of financial viability, it shows that the NHIP remains financially viable during the COVID-19 pandemic year of 2020. Projections for 2021 however show that NHIP financial viability may be adversely affected by the significantly higher number of COVID-19 cases with the negative effect mitigated only if COVID-19 benefit claim patterns remain as weak as observed for 2020. On the revenue side, the potential for a lower premium is observed to be offset by the higher rates in the UHC mandated premium schedule. On the expenditure side, potential increases associated with the implementation of immediate eligibility and the introduction of COVID-19 benefits are mitigated by lower NHIP benefit utilization due to reduced mobility and access to health facilities. Secondary analysis on who has to bear the burden of paying for NHIP benefits, however, shows that the implementation of UHC financing initiatives may heighten adverse incentives on members’ willingness to pay premiums. Using the benefit expenditure-premium contribution ratio as the measure for the burden of paying for NHIP benefits, it is shown that the Formal Economy sector shoulders the burden of funding the NHIP benefits of the Informal Economy and Sponsored sectors.


Sign in / Sign up

Export Citation Format

Share Document