The impact of health insurance in Africa and Asia: a systematic review

Spaan, Ernst; Mathijssen, Judith; Tromp, Noor; McBain, Florence; Have, Arthur ten; Baltussen, Rob

doi:10.2471/blt.12.102301

Cited by 248 publications

(265 citation statements)

References 32 publications

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“…Numerous prior studies have noted the importance of health insurance for healthcare utilization [12,35], including one study in Ghana [36]. The availability of health insurance increases healthcare utilization and is one of the means for achieving Universal Healthcare Coverage by removing user fees at the point of use [37].…”

Section: Discussionmentioning

confidence: 99%

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

Awoke

Negin

Möller

et al. 2017

Global Health Action

103

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Background: Previous studies investigating factors associated with healthcare utilization by older Ghanaians lack distinction between public and private health services. The present study examined factors associated with public and private healthcare service use, and the resulting perceived health system responsiveness. Objectives: To identify factors associated with public and private healthcare utilization among older adults aged 50 and older in Ghana; and to compare perceived differences in health system responsiveness between the private and public sectors. Methods: Cross-sectional data was analyzed from the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 in Ghana. Using Andersen’s conceptual framework, public and private outpatient care utilization was examined using multinomial logistic regression to estimate and identify predictor variables associated with the type of outpatient healthcare facility accessed. Health system responsiveness was compared using chi-square tests. Results: Of 2517 respondents who used outpatient care in the 12 months preceding interview, 51.7% of respondents used a public facility, 17.8% a private facility, and 30.5% used other facilities. Older age group, higher education and higher wealth were associated with the use of private outpatient healthcare services. Using public outpatient care facilities was associated with having health insurance. Respondents with two or more chronic conditions were more likely to use public and private outpatient care than other facilities. Perceived health system responsiveness was better in private for-profit than in public and private not-for-profit healthcare facilities. Conclusions: This study suggested that higher wealth and multimorbidity were significant predictors of public and private outpatient healthcare utilization; however, health insurance was a predictor only for the use of public facilities. Future mixed-method studies could further elucidate factors influencing the choice of public and private outpatient healthcare use.

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Section: Discussionmentioning

confidence: 99%

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

Awoke

Negin

Möller

et al. 2017

Global Health Action

103

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“…While health insurance improves access to health care for members, there will still be individuals who cannot afford the premiums [13,22]. Access to health care can also be restricted by other indirect financial and non-financial barriers, such as travel costs, loss of income, and other social and cultural values [23][24][25]. There are also some systemic barriers which also deter individuals from accessing insurance in the first place.…”

Section: Introductionmentioning

confidence: 99%

Determinants of enrolment in the NHIS for women in Ghana – a cross sectional study

Kusi¹,

Fenny

Arhinful

et al. 2018

IJSE

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent Abstract BackgroundThe National Health Insurance Scheme (NHIS) was introduced in 2005 to provide equitable access to healthcare. Furthermore, concessions were made for pregnant women, yet inequities in access continue to exist. This study explores whether dimensions of social exclusion explain why some groups of women are not benefitting from the scheme.

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“…1 Some of the debates around recent reform experiences, particularly those related to the interpretation of what is meant by "insurance", [2][3][4][5] suggest that there remains a lack of common understanding about the concept portrayed in The world health report 2010. This is not merely an academic debate; conceptual differences create operational differences in terms of the health financing policy choices made by countries, what they are advised to do, and how reforms are assessed.…”

Section: Introductionmentioning

confidence: 99%

Health financing for universal coverage and health system performance: concepts and implications for policy

Kutzin

2013

Bull. World Health Organ.

392

306

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The impact of health insurance in Africa and Asia: a systematic review

Cited by 248 publications

References 32 publications

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

Determinants of enrolment in the NHIS for women in Ghana – a cross sectional study

Health financing for universal coverage and health system performance: concepts and implications for policy

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