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The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh

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journal contribution
posted on 11.07.2018, 00:00 authored by S Ahmed, A R Sarker, Marufa SultanaMarufa Sultana, S Chakrovorty, M W Ahmed, F Dorin, A J Mirelman, Z Islam, M H Rahman, L W Niessen, C Rehnberg, J A M Khan
We aimed to estimate the impact of a Community-Based Health Insurance (CBHI) scheme on utilization of healthcare from medically trained providers (MTP) by informal workers. A quasi-experimental study was conducted where insured households were included in the intervention group and uninsured households in comparison group. In total 1,292 (646 insured and 646 uninsured) households were surveyed from Chandpur district comprising urban and rural areas after 1 year period of CBHI introduction. Matching of the characteristics of insured and uninsured groups was performed using a propensity score matching approach to minimize the observed baseline differences among the groups. Multilevel logistic regression model, with adjustment for individual and household characteristics was used for estimating association between healthcare utilization from the MTP and insurance enrolment. The utilization of healthcare from MTP was significantly higher in the insured group (50.7%) compared to the uninsured group (39.4%). The regression analysis demonstrated that the CBHI beneficiaries were 2.111 (95% CI: 1.458–3.079) times more likely to utilize healthcare from MTP.CBHI scheme increases the utilization of MTP among informal workers. Ensuring such healthcare for these workers and their dependents is a challenge in many low and middle income countries. The implementation and scale-up of CBHI schemes have the potential to address this challenge of universal health coverage.

History

Journal

PLoS ONE

Volume

13

Issue

7

Article number

e0200265

Pagination

1 - 16

Publisher

PLOS

Location

San Francisco, CA

ISSN

1932-6203

eISSN

1932-6203

Language

English

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2018, Ahmed et al.