Determinants of Uptake of Health Insurance Cover Among Adult Patients Attending Bungoma County Referral Hospital
Nathan Lukhale Masengeli,
Wanja Mwaura-Tenambergen,
Joseph Mutai,
Ben Wafula Simiyu
Issue:
Volume 2, Issue 4, December 2017
Pages:
145-151
Received:
19 April 2017
Accepted:
15 May 2017
Published:
12 July 2017
DOI:
10.11648/j.hep.20170204.11
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Abstract: Health insurance is currently being considered as a mechanism for promoting progress to Universal health Coverage and reducing out-of-pocket payments in many African countries including Kenya which is prompting the use of NHIF. In Kenya, penetration of health insurance is 20% and 11% in Bungoma County. The main objective of the study was to establish the scheme-related factors influencing uptake of health insurance cover among patients attending Bungoma County Referral hospital. The study adopted across sectional descriptive survey of 300 systematically sampled patients, 4 purposively sampled departmental heads in Bungoma County Referral Hospital and all the 5 insurance company branch managers. Data was collected using questionnaires administered and Key Informant Interview schedule. Crude odds ratio was used to establish association between ownership of health insurance and scheme-related factors. Findings showed that 37% of patients owned health insurance covers mostly public health insurance cover (NHIF). Ownership of health insurance covers increased with age, household income, education levels, awareness of insurance benefits and concepts. Covers were also more prevalent among married patients. Ownership of health insurance covers increased 12.5 times with affordability of covers premiums. Stock-out of essential drugs and supplies and longer waiting time in covered health facilities discouraged enrollment to schemes.
Abstract: Health insurance is currently being considered as a mechanism for promoting progress to Universal health Coverage and reducing out-of-pocket payments in many African countries including Kenya which is prompting the use of NHIF. In Kenya, penetration of health insurance is 20% and 11% in Bungoma County. The main objective of the study was to establi...
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Irrational Use of Drugs, Healthcare Level and Healthcare Expenditure in Bangladesh
Issue:
Volume 2, Issue 4, December 2017
Pages:
152-158
Received:
23 January 2017
Accepted:
11 July 2017
Published:
11 October 2017
DOI:
10.11648/j.hep.20170204.12
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Abstract: The health sector of Bangladesh registered a significant improvement since the independence of Bangladesh in 1971. Life expectancy at birth which is one of the indicators of economic development increases to 70.65 years in 2014 from 46.88 years in 1972. Nevertheless, misuse of drugs is a common phenomenon in Bangladesh. This study is an attempt to investigate irrational use of drugs, health care level and healthcare expenditure in Bangladesh. The study uses simulated patients and they behaved like ordinary patients when they visited the doctors and collected prescriptions from them. The study finds that there exists a high rate of incorrect diagnosis and inappropriate prescription of drug(s) considering that 82.2% of patients were given more than 2 drugs and 71.2% patients were prescribed antibiotics drug. The rate indeed is very high especially when we consider the fact that the patients were simulated ones with good health. They just pretended being sick. In case of taking physical examination of patients, the situation is worse though the situation at sub-district levels and Dhaka urban area is much better than that in public hospitals. Study finds that cost of drugs per prescription is highest at sub-district level being TK. 301.81 and lowest at Dhaka urban area being TK. 265.20. In public hospital the cost is TK. 232.97 which appears higher than one would expect. All of these impose unnecessary costs on the patients’ healthcare expenditure, increase indebtedness due to income loss, and even employment. Thus, the illness and its related caring expenditures and consequent impacts can severely disrupt living standards. The national policies should emphasize the poverty reduction strategies through improved healthcare status of the country which will ultimately contribute to sustainable development.
Abstract: The health sector of Bangladesh registered a significant improvement since the independence of Bangladesh in 1971. Life expectancy at birth which is one of the indicators of economic development increases to 70.65 years in 2014 from 46.88 years in 1972. Nevertheless, misuse of drugs is a common phenomenon in Bangladesh. This study is an attempt to ...
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Willingness to Pay for the Newly Proposed Social Health Insurance among Health Workers at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
Yared Lasebew,
Yeshwondm Mamuye,
Semira Abdelmenan
Issue:
Volume 2, Issue 4, December 2017
Pages:
159-166
Received:
1 August 2017
Accepted:
14 August 2017
Published:
8 December 2017
DOI:
10.11648/j.hep.20170204.13
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Abstract: Social health insurance (SHI) is a financial mechanism that allows cross subsidization of the poor by the rich, and the sick by the healthy. Ethiopia is currently introducing SHI to achieve universal health care coverage, but there is no evidence concerning willingness to pay and factors associated with willingness to pay among health workers. The objective of this research was to determine willingness to pay for SHI among health workers and to determine factors associated with willingness to pay. An Institution-based, cross-sectional study was conducted from April- December, 2016, on 420 health workers who work at St. Paul’s Hospital Millennium Medical College. Data was collected using a semi-structured self-administered questionnaire, entered using EPI INFO version 7, and analyzed by SPSS version 20. Variables having p < 0.2 at bivariate analysis were fitted to multivariate analysis. Crude and adjusted odds ratios, P-values and 95% CI were computed to show the association of variables. The level of willingness to pay for SHI was 17% (95% CI 13.4-20.3%). Significant associations were found between willingness to pay and perceived quality of health care services under SHI (odds ratio [OR] = 2.74 (1.45-5.20)), perception that SHI will create workload for health workers (OR = 0.47 (0.26-0.87)) and history of large amount of out of pocket money for treatment (OR =1.84 (1.02-3.31)). The overall willingness to pay was 17%. Policy makers should devise a plan that promotes the level of willingness to pay and identify factors that affect willingness to pay. More studies are required to assess these factors.
Abstract: Social health insurance (SHI) is a financial mechanism that allows cross subsidization of the poor by the rich, and the sick by the healthy. Ethiopia is currently introducing SHI to achieve universal health care coverage, but there is no evidence concerning willingness to pay and factors associated with willingness to pay among health workers. The ...
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