Factors affecting knowledge of National Health Insurance Policy among out-patients in Lao PDR: an exit interview study.

Autor: Chaleunvong K; Institute of Research and Education Development, University of Health Sciences , Vientiane, Lao PDR., Phoummalaysith B; Lao National Health Insurance, Ministry of Health , Vientiane, Lao PDR., Phonvixay B; Lao National Health Insurance, Ministry of Health , Vientiane, Lao PDR., Sychareun V; Institute of Research and Education Development, University of Health Sciences , Vientiane, Lao PDR., Durham J; School of Public Health, Queensland University of Technology , Brisbane, Australia., Essink DR; Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit , Amsterdam, Netherlands.
Jazyk: angličtina
Zdroj: Global health action [Glob Health Action] 2020 Jul; Vol. 13 (sup2), pp. 1791414.
DOI: 10.1080/16549716.2020.1791414
Abstrakt: Background: Universal health coverage is target 3.8 of the Sustainable Development Goals. In many lower-middle-income countries, however, major coverage gaps exist. Those who do receive services often experience high out-of-pocket expenses. To achieve universal health coverage, Lao PDR, a lower-middle-income country in South-East Asia, is shifting from a fragmented model of health financing to a national health insurance scheme.
Objective: The objective of this cross-sectional survey was to assess the knowledge of the NHI in Lao PDR among insured in- and out-patients using health services at selected public health facilities at provincial, district and health centre level in six provinces.
Methods: This was a cross-sectional survey. Healthcare facilities were selected based on the rate of use of health services at the health facility and participants selected using systematic random sampling. Exit interviews were conducted with in- and out-patients of each selected health facility, using a pre-tested structured questionnaire. Descriptive statistics were generated including means (median), frequency and percentages. Poisson regression was applied to determine the factors associated with knowledge of the insurance scheme.
Results: In total 326 participants were recruited (response rate 93%). Of these, less than two-thirds (62.3%) said they had their eligibility documents with them. Only 23.6% knew the co-payment fee at the health centre level; while 18.1% and 18.7% knew about the co-payment fee at the district and provincial healthcare level, respectively. A key determinant of accessing NHI and health services was knowledge of the scheme and its benefits.
Conclusion: This study suggests in Lao PDR, awareness about health insurance is low. More innovative demand-side strategies are needed to create awareness and understanding of the NHI and its benefits. Without an understanding of what insurance policies mean, universal health coverage cannot be achieved, even where appropriate and acceptable services are accessible.
Databáze: MEDLINE
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