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健康保险资格能否改善儿童健康:来自尼日利亚国家健康保险计划(NHIS)的证据

Does Health Insurance Eligibility Improve Child Health: Evidence From the National Health Insurance Scheme (NHIS) in Nigeria.

作者信息

Ekhator-Mobayode Uche E, Gajanan Shailendra, Ekhator Chukwuyem

机构信息

Health Economics, The World Bank Group, Washington DC, USA.

Micro-Economics, University of Pittsburgh, Bradford, Pittsburgh, USA.

出版信息

Cureus. 2022 Sep 1;14(9):e28660. doi: 10.7759/cureus.28660. eCollection 2022 Sep.

Abstract

Favorable child health outcomes are important for sustainable growth and development, especially for developing economies. However, Nigeria has some of the worst health indicators. The problem seems to be inadequate access to affordable healthcare, especially for children. To improve policies aimed at improving access to affordable healthcare for children in Nigeria through health insurance, it is important to measure the extent to which health insurance affects child health. This study examines the effects of health insurance on child health and healthcare utilization in Nigeria using the implementation and expansion of the National Health Insurance Scheme (NHIS) to introduce the exogenous variation in health insurance eligibility, a natural experiment that fits a difference-in-difference model. The findings suggest that health insurance increases birth weight. It also increases the probability that children receive polio and diphtheria vaccines. The findings suggest that the NHIS in Nigeria is effective in improving the health outcomes of children. Policies strengthening the take-up of the NHIS should be encouraged across all sectors and socio-economic groups in the economy.

摘要

良好的儿童健康成果对于可持续增长和发展至关重要,特别是对于发展中经济体而言。然而,尼日利亚的一些健康指标是最差的。问题似乎在于难以获得负担得起的医疗保健,尤其是儿童。为了通过医疗保险改善旨在让尼日利亚儿童获得负担得起的医疗保健的政策,衡量医疗保险对儿童健康的影响程度很重要。本研究利用国家健康保险计划(NHIS)的实施和扩展来引入医疗保险资格的外生变化,这是一个适合差分模型的自然实验,考察了医疗保险对尼日利亚儿童健康和医疗保健利用的影响。研究结果表明,医疗保险会增加出生体重。它还增加了儿童接种脊髓灰质炎和白喉疫苗的可能性。研究结果表明,尼日利亚的国家健康保险计划在改善儿童健康成果方面是有效的。应鼓励经济中的所有部门和社会经济群体加强对国家健康保险计划的参与。

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1
Insuring Consumption Against Illness.保险抵御疾病消费。
Am Econ Rev. 2002;92(1):51-70. doi: 10.1257/000282802760015603.
2
Insuring against health shocks: Health insurance and household choices.抵御健康冲击:健康保险与家庭选择。
J Health Econ. 2016 Mar;46:16-32. doi: 10.1016/j.jhealeco.2016.01.002. Epub 2016 Jan 13.
9
The inequitable impact of health shocks on the uninsured in Namibia.纳米比亚卫生冲击对未参保人群的不平等影响。
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