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基于社区的医疗保险是否能保护家庭资产?来自非洲农村的证据。

Does community-based health insurance protect household assets? Evidence from rural Africa.

机构信息

Institute of Public Health, INF 324, Heidelberg University, Heidelberg, Germany.

出版信息

Health Serv Res. 2012 Apr;47(2):819-39. doi: 10.1111/j.1475-6773.2011.01321.x. Epub 2011 Sep 23.

Abstract

OBJECTIVE

To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa.

DATA SOURCES

Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007(n = 890).

STUDY DESIGN

The study area was divided into 33 clusters and CBHI was randomly offered to these clusters during 2004-2006. We applied different strategies to control for selection bias-ordinary least squares with covariates, two-stage least squares with instrumental variable, and fixed-effects models.

DATA COLLECTION

Household members were interviewed in their local language every year, and information was collected on demographic and socio-economic indicators including ownership of assets, and on self-reported morbidity.

PRINCIPAL FINDINGS

Fixed-effects and ordinary least squares models showed that CBHI protected household assets during 2004-2007. The two-stage least squares with instrumental variable model showed that CBHI increased household assets during 2004-2005.

CONCLUSIONS

In this study, we found that CBHI has the potential to not only protect household assets but also increase household assets. However, similar studies from developing countries that evaluate the impact of health insurance on household economic indicators are needed to benchmark these results with other settings.

摘要

目的

评估非洲布基纳法索农村的社区健康保险(CBHI)是否能保护家庭资产。

数据来源

数据来自一个家庭面板调查,该调查于 2004-2007 年期间从随机选择的家庭收集了原始数据,涵盖了 41 个村庄和一个城镇(n=890)。

研究设计

研究区域被分为 33 个集群,在 2004-2006 年期间,CBHI 被随机提供给这些集群。我们应用了不同的策略来控制选择偏差——带有协变量的普通最小二乘法、带有工具变量的两阶段最小二乘法和固定效应模型。

数据收集

每年都以当地语言对家庭成员进行访谈,收集包括资产所有权在内的人口和社会经济指标的信息,以及自我报告的发病率。

主要发现

固定效应和普通最小二乘法模型表明,2004-2007 年期间 CBHI 保护了家庭资产。带有工具变量的两阶段最小二乘法模型表明,2004-2005 年期间 CBHI 增加了家庭资产。

结论

在这项研究中,我们发现 CBHI 不仅有潜力保护家庭资产,还有潜力增加家庭资产。然而,需要来自发展中国家的类似研究来评估健康保险对家庭经济指标的影响,以便将这些结果与其他环境进行基准比较。

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