sultana-effectofacommunity-2020.pdf (456.33 kB)
The effect of a community-based health insurance on the out-of-pocket payments for utilizing medically trained providers in Bangladesh
journal contribution
posted on 2020-07-01, 00:00 authored by J A M Khan, S Ahmed, Marufa SultanaMarufa Sultana, A R Sarker, S Chakrovorty, M H Rahman, Z Islam, C Rehnberg, L W NiessenBackground 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.
History
Journal
International healthVolume
12Issue
4Pagination
287 - 298Publisher
Oxford University PressLocation
Oxford, Eng.Publisher DOI
Link to full text
ISSN
1876-3413eISSN
1876-3405Language
engPublication classification
C1 Refereed article in a scholarly journalUsage metrics
Categories
No categories selectedKeywords
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC