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Xue S, Zeng W, Yang X, Li J, Zhu L, Zou G. Factors associated with the enrollment of commercial medical insurance in China: Results from China General Social Survey. PLoS One 2024; 19:e0303997. [PMID: 38781252 PMCID: PMC11115273 DOI: 10.1371/journal.pone.0303997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The Chinese government has been promoting commercial medical insurance (CMI) in recent decades as it plays an increasingly important role in addressing disease burden, health inequities, and other healthcare challenges. However, compared with developed countries, the CMI is still less fledged with low coverage. OBJECTIVE This study aims to explore the factors associated with enrollment in CMI, with regards to explicit characteristics (including sociodemographic characteristics and family economic status), latent characteristics (including social security status), and the global incentive compatibility index (including health status), to inform the design of CMI to improve its coverage in China. METHODS Based on the principal-agent model, we summarized and classified the factors associated with the enrollment in CMI, and then analyzed the data generated from the Chinese General Social Survey in 2015,2018 and 2021 respectively. A comparison of factors regarding sociodemographic characteristics, family economic status, social security status, and health status was conducted between individuals enrolled and unenrolled in CMI using Mann-Whitney U test and Chi-square test. Binary logistic regression analysis was used to explore factors influencing the enrollment status of CMI. RESULTS Of all individuals, the proportion of enrolled individuals shows an increasing trend year by year, with 8.7%,11.8% and 14.1% enrolled in CMI in 2015,2018 and 2021, respectively. The binary regression analysis further suggested that the factors associated with the enrollment in CMI were consistent in 2015,2018 and 2021.We found that individuals divorced, obese, who had a higher level of education, had non-agricultural household registration, perceived themselves as the upper social status, conducted daily exercise, had more family houses, had a car, had investment activities, or did not have basic health insurance were more likely to be enrolled in CMI. CONCLUSIONS We identified multidimensional factors associated with the enrollment of CMI, which help inform the government and insurance industry to improve the coverage of CMI.
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Affiliation(s)
- Songyue Xue
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wu Zeng
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaocong Yang
- School of Public Administration, Guangzhou University, Guangzhou, China
| | - Jianguo Li
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lei Zhu
- School of Postgraduate Studies, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guanyang Zou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
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2
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Fan C, Li C, Song X. The relationship between health insurance and economic performance: an empirical study based on meta-analysis. Front Public Health 2024; 12:1365877. [PMID: 38633240 PMCID: PMC11021690 DOI: 10.3389/fpubh.2024.1365877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Health insurance stands as a pivotal facet of social wellbeing, with profound implications for the overarching landscape of economic development. The existing research, however, lacks consensus on the relationship between health insurance and economic performance and provides no evidence about the magnitude of the correlation. This lack of information seriously impedes the high-quality development of the healthcare system. Therefore, to scientifically elucidate the relationship between the two, this study involved a meta-analysis, analyzing 479 effect values derived from 34 independent research samples. The results reveal a strongly positive correlation between health insurance and economic performance [r = 0.429, 95% CI = (0.381, 0.475)]. Findings show that health insurance in developed countries more effectively fosters economic performance than in developing countries. Moreover, public health insurance exerts a stronger promoting effect on economic performance than commercial health insurance. The relationship between health insurance and economic performance is moderated by data type, research method, country of sample origin, literature type, journal impact factor, publication year, type of health insurance, and the research populations. Based on meta-analysis, this study not only scientifically responds to the controversy of the relationship between health insurance and economic performance, and the magnitude of a correlation, but also further reveals the inner conduction mechanism between the two. Our research findings are meaningful for policymakers to choose an appropriate healthcare strategy according to their unique attributes, propelling sustainable economic development.
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Affiliation(s)
| | - Chunyan Li
- Shanghai International College of Intellectual Property, Tongji University, Shanghai, China
| | - Xiaoting Song
- Shanghai International College of Intellectual Property, Tongji University, Shanghai, China
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Ng’ambi WF, Mwase T, Zyambo C, Chigaru F, Banda AJ, Mfutso-Bengo J. Uptake of health insurance in Malawi in 2019-2020: evidence from the multiple indicator cluster survey. Pan Afr Med J 2023; 46:85. [PMID: 38314236 PMCID: PMC10837274 DOI: 10.11604/pamj.2023.46.85.38836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/12/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction although countries in sub-Sahara Africa (SSA) show progress in implementing various forms of health insurance, there is a dearth of information regarding health insurance in settings like Malawi. Therefore, we conducted this study to determine the uptake of health insurance and describe some of the factors associated with the prevailing uptake of health insurance in Malawi using the 2019-2020 Multiple Indicator Cluster Survey (MICS). Methods this was a secondary analysis of the 2019-2020 MICS data. Data were analysed using frequencies and weighted percentages in Stata v.17. Furthermore, since the number of persons with health insurance is very small, we were unable to perform multivariate analysis. Results a total of 205 (1%) of the 31259 had health insurance in Malawi in 2019-2020. Of the 205 individuals who owned health insurance, 118 (47%) had health insurance through their employers while 39 (16%) had health insurance through mutual health organizations or community-based. Men had a higher uptake of health insurance than women. The residents from urban areas were more likely to have health insurance than those in rural areas. Persons with media exposure were more likely to own health insurance as compared to their counterparts. There was an increasing trend in the uptake of health insurance by wealth of the individual with the poorest being less likely to have health insurance compared to the richest. The persons with no education were least likely to have health insurance while those with tertiary education were most likely to have health insurance. Conclusion the uptake of health insurance in Malawi was extremely low. In order to increase the uptake of health insurance, there is a need to increase insurance coverage amongst those in formal employment, and consider minimizing the geographic, economic, and demographic barriers in accessing the health insurance.
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Affiliation(s)
- Wingston Felix Ng’ambi
- Kamuzu University of Health Sciences, Department of Health Systems and Policy, Health Economics and Policy Unit, Lilongwe, Malawi
| | - Takondwa Mwase
- Kamuzu University of Health Sciences, Department of Health Systems and Policy, Health Economics and Policy Unit, Lilongwe, Malawi
| | - Cosmas Zyambo
- University of Zambia, Department of Public Health and Family Medicine, Lusaka, Zambia
| | - Farai Chigaru
- Kamuzu University of Health Sciences, Department of Health Systems and Policy, Health Economics and Policy Unit, Lilongwe, Malawi
| | | | - Joseph Mfutso-Bengo
- Kamuzu University of Health Sciences, Department of Health Systems and Policy, Health Economics and Policy Unit, Lilongwe, Malawi
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Aguiar-Díaz I, Ruiz-Mallorquí MV. Financial Knowledge and Private Health Insurance: Does Age Matter? Healthcare (Basel) 2023; 11:2738. [PMID: 37893812 PMCID: PMC10606321 DOI: 10.3390/healthcare11202738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: The paper focuses on the relationship between financial knowledge (FK) and holding private health insurance (PHI), and also focuses on the effect of age on the aforementioned relationship. (2) Method: The study was carried out on a sample of 8055 individuals taken from the 2016 Financial Competences Survey (the only one available), prepared by the Bank of Spain. Unlike previous studies that limited themselves to considering numeracy as a proxy for FK, in this study, two levels of FK-basic and advanced-are considered. (3) Results: The results indicate that a higher level of FK, specifically advanced FK, increases the probability of an individual holding PHI. Regarding age, it has been observed that the relationship between FK and PHI is only relevant in middle and older age, but not in younger and adults. Therefore, it is appropriate to differentiate between basic and advanced FK, and we confirm that age exerts a moderating effect on the influence of FK on PHI. (4) Conclusion: We conclude that FK-specifically, advanced FK for middle-aged and older people-is relevant to the likelihood of an individual holding PHI, which can improve health and financial wellbeing.
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Affiliation(s)
| | - María Victoria Ruiz-Mallorquí
- Department of Financial Economics and Accounting, Faculty of Economy, Business and Tourism, University of Las Palmas de Gran Canaria, 35001 Las Palmas, Spain;
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Lavaste K. Private health insurance in the universal public healthcare system: The role of healthcare provision in Finland. Health Policy 2023; 132:104820. [PMID: 37071960 DOI: 10.1016/j.healthpol.2023.104820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/26/2023] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Abstract
Voluntary private health insurance (VPHI) has gained popularity in universal public healthcare systems. We studied how the local provision of healthcare services correlated with VPHI take-up in Finland. Nationwide register data from a Finnish insurance company was aggregated to the local level and augmented with high-quality data on public and private primary care providers' geographical closeness and fees. We found that the sociodemographic characteristics explained the VPHI take-up more than public or private healthcare provision. The VPHI take-up was negatively associated with distance to the nearest private clinic, while the associations with distance to public health stations were statistically weak. Fees and co-payments for healthcare services were not associated with insurance take-up, meaning that the geographical closeness of providers explained the take-up more than the price of services. On the other hand, we found that VPHI take-up was higher when local employment, income and education levels were higher.
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Affiliation(s)
- Konsta Lavaste
- Jyväskylä University School of Business and Economics, University of Jyväskylä, PO Box 35, FI-40014 Finland.
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Sun D, Chen W, Dou X. Formation mechanism of residents' intention to purchase commercial health insurance: the moderating effect of environmental pollution perception. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-14. [PMID: 37361276 PMCID: PMC10020756 DOI: 10.1007/s10389-023-01870-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/24/2023] [Indexed: 03/19/2023]
Abstract
Aim With the development of the social economy, commercial health insurance in China has gradually been recognized by residents, but it is still in the initial stage of the market. To identify influencing factors of residents' intention to purchase commercial health insurance and to explore the influencing mechanism and heterogeneity of intention, this study aimed to reveal the formation mechanism of intention to purchase commercial health insurance. Methods This study introduced water and air pollution perceptions as moderating variables and, constructed a theoretical framework combining the stimulus-organism-response model and the theory of reasoned action models. The structural equation model was developed, and multigroup analysis and moderating effect analysis were carried out. Results The results show that advertising marketing and the behavior of relatives and friends positively influence cognition. Cognition, as well as advertising marketing and behavior of relatives and friends, has a positive impact on attitude. Furthermore, purchase intention is positively affected by cognition and attitude. Both gender and residence play a significant moderating role in influencing purchase intention. Air pollution perceptions positively moderate the path from attitude to purchase intention. Conclusion The validity of the constructed model was verified and could be used to predict the willingness of residents to purchase commercial health insurance. Furthermore, policy recommendations to promote the further development of commercial health insurance were proposed. This study provides a valuable reference for insurance companies to expand the market and for the government to improve commercial insurance policies.
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Affiliation(s)
- Dongying Sun
- School of Management, Jiangsu University, Zhenjiang, 212013 China
| | - Wen Chen
- School of Management, Jiangsu University, Zhenjiang, 212013 China
| | - Xiaoyu Dou
- School of Management, Jiangsu University, Zhenjiang, 212013 China
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Zhao T, Wanyan R, Suo L. Research on the Effect of Commercial Health Insurance Development on Economic Efficiency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5178. [PMID: 36982088 PMCID: PMC10048854 DOI: 10.3390/ijerph20065178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
In the process of comprehensively promoting the construction of a multi-level medical security system in China, it is very important to clarify the impact of commercial health insurance. In order to better promote the development of commercial health insurance, we explore the effect of commercial health insurance development on economic efficiency. Theoretical analysis shows that, in addition to providing health risk protection for residents, commercial health insurance can also promote the coordinated development of the health industry chain, promote risk reduction, accumulate capital, and contribute to high-quality economic development. Empirically, this study indexes a commercial health insurance development index that is more in line with China's development reality. In addition, this study compiles the economic efficiency index from the three dimensions of economic development basis, social benefits and industrial changes. We measure the commercial health insurance development index and economic efficiency index in 31 regions from 2007 to 2019, and further econometric analysis is carried out on this basis. It is found that the development of commercial health insurance can promote economic efficiency, and this result is robust. Meanwhile, the impact of commercial health insurance on economic efficiency is restricted by the economic environment itself, and the more developed the economy is, the more obvious this effect will be. Therefore, the development of commercial health insurance will significantly benefit the construction of China's multi-level medical security system and promote regional economic efficiency.
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Affiliation(s)
- Tongpu Zhao
- School of Insurance and Economics, University of International Business and Economics, Beijing 100029, China
| | - Ruiyun Wanyan
- Institute of Chinese Financial Studies, Southwestern University of Finance and Economics, Chengdu 610074, China
| | - Lingyan Suo
- School of Economics, Peking University, Beijing 100871, China
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Shi HY, Yeh SCJ, Chou HC, Wang WC. Long-term care insurance purchase decisions of registered nurses: Deep learning versus logistic regression models. Health Policy 2023; 129:104709. [PMID: 36725380 DOI: 10.1016/j.healthpol.2023.104709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/03/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The purpose of this study was to use a deep learning model and a traditional statistical regression model to predict the long-term care insurance decisions of registered nurses. METHODS We Prospectively surveyed 1,373 registered nurses with a minimum of 2 years of full-time working experience at a large medical center in Taiwan: 615 who already owned long-term care insurance (LTCI), 332 who had no intention to purchase LTCI (group 1), and 426 who intended to purchase LTCI (group 2). RESULTS After inverse probability of treatment weighting (IPTW), no statistically significant differences were identified in the study characteristics of the two groups. All the performance indices for the deep neural network (DNN) model were significantly higher than those of the multiple logistic regression (MLR) model (P<0.001). The strongest predictor of an individual's long-term care insurance decision was their risk propensity score, followed by their caregiving responsibilities, whether they live with older adult relatives, their experiences of catastrophic illness, and their openness to experience. CONCLUSIONS The DNN model is useful for predicting long-term care insurance decisions. Its prediction accuracy can be increased through training with temporal data collected from registered nurses. Future research can explore designs for two-level or multilevel models that explain the contextual effects of the risk factors on long-term care insurance decisions.
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Affiliation(s)
- Hon-Yi Shi
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Technological and Vocational Education, National Pingtung University of Science and Technology, Pingtung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Shu-Chuan Jennifer Yeh
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Hsueh-Chih Chou
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan; Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen Chun Wang
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan
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Aguiar-Díaz I, Ruiz-Mallorqui MV. Private Health Insurance and Financial Risk Taking in Spain-The Moderating Effect of Subjective Risk Tolerance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16248. [PMID: 36498322 PMCID: PMC9741262 DOI: 10.3390/ijerph192316248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
This study focuses on the effect of private health insurance on financial risk taking in Spanish households. According to the arguments related to the background risk, we propose two hypotheses: the first predicts a positive relationship between health insurance and risk taking and the second asserts that attitude to risk moderates this relationship. Spain is a good laboratory because it has a National Health System (NHS) that offers healthcare coverage to the entire population, which could eliminate the effect of health insurance on risk taking. Based on a sample of 6110 households obtained from the Household Finance Survey (EFF), our results confirm both hypotheses. Specifically, we show that private health insurance significantly increases a household's portfolio risk, especially in households with greater risk aversion. The results are concordant with the scarce amount of previous empirical evidence obtained in other contexts and are robust for different subsamples and estimation methods.
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Casabianca MS, Gallego JM, Góngora P, Rodríguez-Lesmes P. Price elasticity of demand for voluntary health insurance plans in Colombia. BMC Health Serv Res 2022; 22:618. [PMID: 35534891 PMCID: PMC9082854 DOI: 10.1186/s12913-022-07899-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/04/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Since 1993, Colombia has had a mandatory social health insurance scheme that aims to provide universal health coverage to all citizens. However, some contributory regime participants purchase voluntary private health insurance (VPHI) to access better quality health services (i. e., physicians and hospitals), shorter waiting times, and a more extensive providers' network. This article aims to estimate the price elasticity of demand for the VPHI market in Colombia. METHODS We use data from the 2016-2017 consumer expenditure national survey and apply a Heckman selection model to address the selection problem into purchasing private insurance. Using the estimation results to further estimate the price semi-elasticity for VPHI, we then calculate the price elasticity for the households' health expenditure and acquisition of VHPI. RESULTS Our main findings indicate that a 1% VPHI price increase reduces the proportion of households affiliated to a VPHI in the country by about 2.32% to 4.66%, with robust results across sample restrictions. There are relevant differences across age groups, with younger households' heads being less responsive to VPHI price changes. CONCLUSIONS We conclude that the VPHI demand in Colombia is noticeably elastic, and therefore tax policy changes can have a significant impact on public health insurance expenditures. The government should estimate the optimal VPHI purchase in order to reduce any welfare loss that the current arrangement might be generating.
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Affiliation(s)
- María Sofía Casabianca
- School of Economics, Universidad del Rosario, Calle 12 C No. 4 – 69, 111711 Bogotá, Colombia
| | - Juan Miguel Gallego
- School of Economics, Universidad del Rosario, Calle 12 C No. 4 – 69, 111711 Bogotá, Colombia
| | - Pamela Góngora
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Rodríguez-Lesmes
- School of Economics, Universidad del Rosario, Calle 12 C No. 4 – 69, 111711 Bogotá, Colombia
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Al-Sanaani EA, Ismail A, Abdul Manaf MR, Suddin LS, Mustafa N, Sukor N, Alabed AAA, Alkhodary AA, Aljunid SM. Health insurance status and its determinants among patients with type 2 diabetes mellitus in a tertiary teaching hospital in Malaysia. PLoS One 2022; 17:e0267897. [PMID: 35511889 PMCID: PMC9070921 DOI: 10.1371/journal.pone.0267897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/18/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
Even in a country with a tax-based healthcare financing system, health insurance can play an important role, especially in the management of chronic diseases with high disease and economic burden such as Type 2 Diabetes Mellitus (T2DM). The insurance coverage among T2DM patients in Malaysia is currently unclear. The aim of this study was to determine the insurance status of T2DM patients in public and private healthcare facilities in Malaysia, and the association between this status and patients’ sociodemographic and economic factors.
Methods
A cross-sectional study among T2DM patients seeking inpatient or outpatient treatment at a public tertiary hospital (Hospital Canselor Tuanku Muhriz) and a private tertiary hospital (Universiti Kebangsaan Malaysia Specialist Centre) in Kuala Lumpur between August 2019 and March 2020. Patients were identified via convenience sampling using a self-administered questionnaire. Data collection focused on identifying insurance status as the dependent factor while the independent factors were the patients’ sociodemographic characteristics and economic factors.
Results
Of 400 T2DM patients, 313 responded (response rate, 78.3%) and 76.0% were uninsured. About 69.6% of the respondents had low monthly incomes of <RM5000. Two-thirds of participants (59.1%) spent RM100–500 for outpatient visits whilst 58.5% spent <RM100 on medicines per month (RM1 = USD0.244). Patients who visited a private facility had five times more likely to have insurance than patients who visited a public facility. Participants aged 18–49 years with higher education levels were 4.8 times more likely to be insured than participants aged ≥50 years with low education levels (2 times).
Conclusions
The majority of T2DM patients were uninsured. The main factors determining health insurance status were public facilities, age of ≥ 50 years, low education level, unemployment, and monthly expenditure on medicines.
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Affiliation(s)
- Essam Ali Al-Sanaani
- Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Ministry of Public Health and Population, Sana’a, Yemen
| | - Aniza Ismail
- Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- * E-mail:
| | - Mohd Rizal Abdul Manaf
- Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Leny Suzana Suddin
- Faculty of Medicine, Department of Community Health, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
| | - Norlaila Mustafa
- Faculty of Medicine, Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norlela Sukor
- Faculty of Medicine, Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Alabed Ali A. Alabed
- Faculty of Medicine, Department of Community Medicine, Lincoln University College, Kota Bharu, Malaysia
| | - Ahmed Abdelmajed Alkhodary
- Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Faculty of Medicine, International Centre for Casemix and Clinical Coding, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Syed Mohamed Aljunid
- Faculty of Medicine, International Centre for Casemix and Clinical Coding, National University of Malaysia, Kuala Lumpur, Malaysia
- Faculty of Public Health, Department of Health Policy and Management, Kuwait University, Kuwait, Kuwait
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Wulandari RD, Laksono AD, Sillehu S, Khoiri A. Health Insurance Ownership among Moluccans in Indonesia. Indian J Community Med 2022; 47:332-335. [PMID: 36438532 PMCID: PMC9693947 DOI: 10.4103/ijcm.ijcm_593_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 09/20/2021] [Accepted: 10/19/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Expanding the reach of health insurance in Maluku aims to increase public access with the archipelago topography to healthcare facilities. OBJECTIVE The study aimed to analyze factors related to health insurance ownership among Moluccans. MATERIALS AND METHODS The study employed 788 respondents. The variables analyzed included health insurance, age, gender, education, and employment. The study used multinomial logistic regression in the final stage. RESULTS The age group ≤19 years was 0.182 times more likely than the ≥50 years of age group to have government-run type health insurance. The 20-29 years of age group was 0.219 times more likely than the ≥50 years of age group to have government-run health insurance. On the other hand, Moluccans with primary education were 0.196 times more likely than Moluccans with higher education to have a government-run type of health insurance. Moluccans with secondary education were 0.415 times more likely than Moluccans with higher education to have government-run health insurance. Unemployed have a probability of 0.358 times than employed to have the government-run health insurance type. Finally, unemployed is 0.056 times more likely than employed to have private-run health insurance. CONCLUSIONS Three variables prove associated with health insurance ownership among Moluccans in Indonesia, namely age, education, and employment.
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Affiliation(s)
- Ratna Dwi Wulandari
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia,The Airlangga Centre for Health Policy Research Group, Surabaya, Indonesia,Address for correspondence: Dr. Ratna Dwi Wulandari, Faculty of Public Health, Universitas Airlangga, Universitas, Airlangga Campus, C Mulyosari, Surabaya 60115, Indonesia. E-mail:
| | - Agung Dwi Laksono
- The Airlangga Centre for Health Policy Research Group, Surabaya, Indonesia,Research Centre for Public Health and Nutrition, The National Agency for Research and Innovation of the Republic of Indonesia, Jakarta, Indonesia
| | - Sahrir Sillehu
- Study Program of Public Health, Institute of Health Science Maluku Husada, Ambon, Maluku, Indonesia
| | - Abu Khoiri
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Jember, Jember, Indonesia
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Pérez-Ardanaz B, Peláez-Cantero MJ, González-Cano-Caballero M, Gutiérrez-Rodríguez L, Gómez-González AJ, Lupiáñez-Pérez I, Morales-Asencio JM, Canca-Sánchez JC. Utilization of Parallel Resources and Sociodemographic Factors in Treating Children with Complex Chronic Diseases: A Cross-Sectional Study. CHILDREN 2021; 8:children8110973. [PMID: 34828686 PMCID: PMC8624513 DOI: 10.3390/children8110973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
Background: Children with complex chronic conditions have a high need for health and social care resources. Many parents explore parallel resources such as alternative therapies, associations, psychological support, private medical consultations, and other out-of-pocket expenses for healthcare. The use of these alternative health resources is sometimes unclear and may lead to health inequalities. To characterize the use made of alternative healthcare resources for children with complex chronic conditions. Additionally, we evaluate the influence of sociodemographic factors on the distribution of this utilization of resources; (2) Methods: Cross-sectional study. Children with complex chronic diseases were treated at a tertiary hospital in Granada, Spain in 2016. We analyzed their use of healthcare resources and socioeconomic variables. This research complies with STROBE guidelines for observational studies; (3) Results: In total, 265 children were analyzed (mean age 7.3 years, SD 4.63). A total of 105 children (39.6%) attended private consultations with specialists, and 12.1% (n = 32) of the children had additional private health insurance. One out three parents belonged to a mutual support association (n = 78), and 26% (n = 69) of the children used alternative therapies. Furthermore, 75.4% (n = 199) of the children received no psychological support. Children whose parents had a higher educational level and occupations status made greater use of parallel healthcare resources.; (4) Conclusions: A significant proportion of children used multiple health resources in addition to the public healthcare system depending on sociodemographic determinants. Studies are needed to determine whether the use of these alternative services achieves better levels of health.
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Affiliation(s)
- Bibiana Pérez-Ardanaz
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
| | | | | | - Laura Gutiérrez-Rodríguez
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
| | - Alberto José Gómez-González
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
| | - Inmaculada Lupiáñez-Pérez
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
| | - José Miguel Morales-Asencio
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
- Correspondence: ; Tel.: +34-951-952-833
| | - José Carlos Canca-Sánchez
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
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