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The effect of a community-based health insurance on the out-of-pocket payments for utilizing medically trained providers in Bangladesh

Khan, Jahangir AM, Ahmed, Sayem, Sultana, Marufa, Sarker, Abdur Razzaque, Chakrovorty, Sanchita, Rahman, Mohammad Hafizur, Islam, Ziaul, Rehnberg, Clas and Niessen, Louis W 2020, The effect of a community-based health insurance on the out-of-pocket payments for utilizing medically trained providers in Bangladesh, International health, vol. 12, no. 4, pp. 287-298, doi: 10.1093/inthealth/ihz083.

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Title The effect of a community-based health insurance on the out-of-pocket payments for utilizing medically trained providers in Bangladesh
Author(s) Khan, Jahangir AM
Ahmed, Sayem
Sultana, Marufa
Sarker, Abdur Razzaque
Chakrovorty, Sanchita
Rahman, Mohammad Hafizur
Islam, Ziaul
Rehnberg, Clas
Niessen, Louis W
Journal name International health
Volume number 12
Issue number 4
Start page 287
End page 298
Total pages 12
Publisher Oxford University Press
Place of publication Oxford, Eng.
Publication date 2020-07
ISSN 1876-3413
1876-3405
Keyword(s) Bangladesh
community-based health insurance
healthcare financing
informal workers
out-of-pocket payments
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Summary Background We aimed to estimate the effect of the community-based health insurance (CBHI) scheme on the magnitude of out-of-pocket (OOP) payments for the healthcare of the informal workers and their dependents. The CBHI scheme was piloted through a cooperative of informal workers, which covered seven unions in Chandpur Sadar Upazila, Bangladesh. Methods A quasi-experimental study was conducted using a case-comparison design. In total 1292 (646 insured and 646 uninsured) households were surveyed. Propensity score matching was done to minimize the observed baseline differences in the characteristics between the insured and uninsured groups. A two-part regression model was applied using both the probability of OOP spending and magnitude of such spending for healthcare in assessing the association with enrolment status in the CBHI scheme while controlling for other covariates. Results The OOP payment was 6.4% (p < 0.001) lower for medically trained provider (MTP) utilization among the insured compared with the uninsured. However, no significant difference was found in the OOP payments for healthcare utilization from all kind of providers, including the non-trained ones. Conclusions The CBHI scheme could reduce OOP payments while providing better quality healthcare through the increased use of MTPs, which consequently could push the country towards universal health coverage.
Language eng
DOI 10.1093/inthealth/ihz083
Indigenous content off
Field of Research 11 Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30145543

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.