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社区医疗保险对乌干达农村地区预防保健服务利用的影响:倾向评分匹配方法。

Impact of community-based health insurance on utilisation of preventive health services in rural Uganda: a propensity score matching approach.

机构信息

Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53117, Bonn, Germany.

Institute for Food and Resource Economics, University of Bonn, Nussallee 19, 53115, Bonn, Germany.

出版信息

Int J Health Econ Manag. 2021 Jun;21(2):203-227. doi: 10.1007/s10754-021-09294-6. Epub 2021 Feb 10.

Abstract

The effect of voluntary health insurance on preventive health has received limited research attention in developing countries, even when they suffer immensely from easily preventable illnesses. This paper surveys households in rural south-western Uganda, which are geographically serviced by a voluntary Community-based health insurance scheme, and applied propensity score matching to assess the effect of enrolment on using mosquito nets and deworming under-five children. We find that enrolment in the scheme increased the probability of using a mosquito net by 26% and deworming by 18%. We postulate that these findings are partly mediated by information diffusion and social networks, financial protection, which gives households the capacity to save and use service more, especially curative services that are delivered alongside preventive services. This paper provides more insight into the broader effects of health insurance in developing countries, beyond financial protection and utilisation of hospital-based services.

摘要

自愿健康保险对预防保健的影响在发展中国家受到的关注有限,尽管这些国家深受可预防疾病的困扰。本文调查了乌干达西南部农村的家庭,这些家庭在地理上受益于一个自愿的社区为基础的健康保险计划,并应用倾向得分匹配来评估参保对使用蚊帐和为五岁以下儿童驱虫的影响。我们发现,该计划的参保增加了 26%使用蚊帐和 18%驱虫的概率。我们推测,这些发现部分是通过信息传播和社会网络、财务保护来实现的,这使家庭有能力储蓄并更多地使用服务,特别是与预防服务一起提供的治疗服务。本文提供了更多关于健康保险在发展中国家的更广泛影响的见解,不仅仅是财务保护和利用医院服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3044/8192361/83ebd13c1d90/10754_2021_9294_Fig1_HTML.jpg

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