Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana's National Health Insurance Scheme
| Autor: | Ernst Spaan, Rob Baltussen, Irene Akua Agyepong, Judith Westeneng, Caroline Jehu-Appiah, Genevieve Cecilia Aryeetey |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Employment medicine.medical_specialty National Health Programs Self-insurance Poverty reduction Ghana 03 medical and health sciences 0302 clinical medicine Health insurance Environmental health Surveys and Questionnaires Health care Catastrophic expenditure medicine Economics Humans 030212 general & internal medicine Income protection insurance Poverty Health policy Social policy Aged Family Characteristics Medically Uninsured Insurance Health business.industry 030503 health policy & services Public health Health Policy Research Public Health Environmental and Occupational Health Out-of-pocket expenditure Middle Aged Health promotion lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Income Demographic economics Female Health Expenditures 0305 other medical science business Anthropology and Development Studies Delivery of Health Care |
| Zdroj: | International Journal for Equity in Health, 15 International Journal for Equity in Health International Journal for Equity in Health, 15, 1 |
| ISSN: | 1475-9276 |
| Popis: | Contains fulltext : 170048.pdf (Publisher’s version ) (Open Access) BACKGROUND: Ghana since 2004, begun implementation of a National Health Insurance Scheme (NHIS) to minimize financial barriers to health care at point of use of service. Usually health insurance is expected to offer financial protection to households. This study aims to analyze the effect health insurance on household out-of-pocket expenditure (OOPE), catastrophic expenditure (CE) and poverty. METHODS: We conducted two repeated household surveys in two regions of Ghana in 2009 and 2011. We first analyzed the effect of OOPE on poverty by estimating poverty headcount before and after OOPE were incurred. We also employed probit models and use of instrumental variables to analyze the effect of health insurance on OOPE, CE and poverty. RESULTS: Our findings showed that between 7-18 % of insured households incurred CE as a result of OOPE whereas this was between 29-36 % for uninsured households. In addition, between 3-5 % of both insured and uninsured households fell into poverty due to OOPE. Our regression analyses revealed that health insurance enrolment reduced OOPE by 86 % and protected households against CE and poverty by 3.0 % and 7.5 % respectively. CONCLUSION: This study provides evidence that high OOPE leads to CE and poverty in Ghana but enrolment into the NHIS reduces OOPE, provides financial protection against CE and reduces poverty. These findings support the pro-poor policy objective of Ghana's National Health Insurance Scheme and holds relevance to other low and middle income countries implementing or aiming to implement insurance schemes. 11 p. |
| Databáze: | OpenAIRE |
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