Department of Health Systems Financing, World Health Organization, 20, Avenue Appia 1211 Geneva 27, Switzerland.
Health Policy. 2011 Mar;99(3):203-9. doi: 10.1016/j.healthpol.2010.09.009. Epub 2010 Oct 20.
Rwanda has expanded mutual health insurance considerably in recent years, which has a great potential for making health services more accessible. In this paper, we examine the effect of mutual health insurance (MHI) on utilization of health services and financial risk protection.
We used data from a nationally representative survey from 2005-2006. We analysed this data through summary statistics as well as regression models.
Our statistical modelling shows that MHI coverage is associated with significantly increased utilization of health services. Indeed, individuals in households that had MHI coverage used health services twice as much when they were ill as those in households that had no insurance coverage. Additionally, MHI is also associated with a higher degree of financial risk protection and the incidence of catastrophic health expenditure was almost four times less than in households with no coverage. Nonetheless, the limitations of the MHI coverage also become apparent.
These promising results indicate that MHI has had a strong positive impact on access to health care and can continue to improve health of Rwandans even more if its limitations are addressed further.
卢旺达近年来大幅扩大了互助医疗保险的覆盖范围，这为使医疗服务更易获得提供了巨大的潜力。本文研究了互助医疗保险对卫生服务利用和财务风险保护的影响。
我们使用了 2005-2006 年全国代表性调查的数据。我们通过汇总统计数据和回归模型对这些数据进行了分析。
我们的统计模型表明，互助医疗保险覆盖范围与卫生服务利用率的显著提高有关。实际上，在生病时，参加了互助医疗保险的家庭的人使用卫生服务的次数是没有保险覆盖的家庭的两倍。此外，互助医疗保险还与更高程度的财务风险保护有关，没有保险覆盖的家庭发生灾难性医疗支出的情况几乎是其四倍。然而，互助医疗保险覆盖范围的局限性也变得明显。
这些有希望的结果表明，互助医疗保险对获得医疗保健产生了强烈的积极影响，如果进一步解决其局限性，它甚至可以为改善卢旺达人民的健康状况做出更大的贡献。
