Department of Health Care Policy, Harvard University, Boston, MA, USA.
Health Policy. 2011 Oct;102(2-3):286-94. doi: 10.1016/j.healthpol.2011.06.015. Epub 2011 Aug 4.
To evaluate provider responsiveness and beneficiary satisfaction with insurance carriers participating in the Republic of Georgia's Medical Insurance for the Poor.
A dedicated survey of approximately 3500 households in two types of regions--with different eligibility thresholds--in November and December 2008.
Regression-based estimation of responsiveness ratings by beneficiaries and non-beneficiaries of the insurance program and estimation of mean satisfaction scores for beneficiaries.
In the high-threshold regions, provider responsiveness toward beneficiaries and non-beneficiaries is comparable. In the low-threshold regions, beneficiary status is associated with lower responsiveness of outpatient providers. Inpatient providers may have become less responsive toward beneficiaries during the program's transition from public to private administration. While satisfaction of beneficiaries with carriers is above average, there are reports of difficulties in obtaining reimbursements and information about benefits.
The results suggest that relying on private insurance companies to deliver public programs in middle-income settings may impact provider responsiveness and indicate the need for continuous monitoring and regulation.
评估参与格鲁吉亚医疗扶贫保险的供应商的响应性和受益人的满意度。
2008 年 11 月至 12 月，在两种类型的地区（有不同的资格门槛）进行了一项针对约 3500 户家庭的专门调查。
通过保险计划的受益人和非受益人的回归估计响应性评分，并对受益人的平均满意度评分进行估计。
在高门槛地区，供应商对受益人和非受益人的响应性相当。在低门槛地区，受益人的身份与门诊供应商响应性较低有关。在该计划从公共管理向私人管理过渡期间，住院供应商对受益人的响应性可能降低。尽管受益人的保险满意度高于平均水平，但有报道称在获得报销和了解福利方面存在困难。
研究结果表明，在中等收入国家，依靠私营保险公司来提供公共项目可能会影响供应商的响应性，并表明需要持续监测和监管。
