Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Appl Health Econ Health Policy. 2012 Mar 1;10(2):99-111. doi: 10.2165/11594820-000000000-00000.
In many countries, health insurance coverage is the primary way for individuals to access care. Governments can support access through social insurance programmes; however, after a certain period, governments struggle to achieve universal coverage. Evidence suggests that complex individual behaviour may play a role.
Using a choice experiment, this research explored consumer preferences for health insurance in Colombia. We also evaluated whether preferences differed across consumers with differing demographic and health status factors.
A household field experiment was conducted in Bogotá in 2010. The sample consisted of 109 uninsured and 133 low-income insured individuals. Each individual evaluated 12 pair-wise comparisons of hypothetical health plans. We focused on six characteristics of health insurance: premium, out-of-pocket expenditure, chronic condition coverage, quality of care, family coverage and sick leave. A main effects orthogonal design was used to derive the 72 scenarios used in the choice experiment. Parameters were estimated using conditional logit models. Since price data were included, we estimated respondents' willingness to pay for characteristics.
Consumers valued health benefits and family coverage more than other attributes. Additionally, differences in preferences can be exploited to increase coverage. The willingness to pay for benefits may partially cover the average cost of providing them.
Policy makers might be able to encourage those insured via the subsidized system to enrol in the next level of the social health insurance scheme through expanding benefits to family members and expanding the level of chronic condition coverage.
在许多国家，健康保险覆盖是个人获得医疗服务的主要途径。政府可以通过社会保险计划来支持这种途径；然而，在一定时期之后，政府难以实现全民覆盖。有证据表明，复杂的个人行为可能起到了一定作用。
本研究使用选择实验，探讨了哥伦比亚消费者对健康保险的偏好。我们还评估了不同人口统计学和健康状况因素的消费者的偏好是否存在差异。
2010 年在波哥大进行了一项家庭实地实验。样本由 109 名未参保者和 133 名低收入参保者组成。每个个体评估了 12 对健康保险计划的假设性比较。我们关注健康保险的六个特征：保费、自付支出、慢性病覆盖范围、护理质量、家庭覆盖范围和病假。使用主效应正交设计得出选择实验中使用的 72 个情景。使用条件逻辑回归模型估计参数。由于包含了价格数据，我们估计了受访者对特征的支付意愿。
消费者更看重健康福利和家庭覆盖范围，而不是其他属性。此外，偏好的差异可以被利用来提高覆盖范围。对福利的支付意愿可能部分覆盖提供这些福利的平均成本。
政策制定者可能能够通过将福利扩大到家庭成员，并扩大慢性病覆盖范围，鼓励通过补贴系统参保的人加入下一级社会健康保险计划。
