Search results for: community based health insurance

Authors: Mohd Zuhair, Ram Babu Roy

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This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Keywords: health insurance, out of pocket expenditure, universal healthcare, sustainability

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Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

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The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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Authors: Kasman, Darmawansyah, Alimin Maidin, Amran Razak

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Background: In decentralization, advocacy is needed to increase the health budget in Parepare District. One of the advocacy methods recommended by the World Bank is the economic loss approach. Methods: This research is observational in the field of health economics that contributes directly to the magnitude of the economic loss of the community and the government and provides advocacy to the executive and legislative to see the harm it causes. Results: The research results show the amount of direct cost, which consists of household expenditure for transport Rp.295,865,500. Indirect Cost of YLD of Rp.14.688.000, and YLL of Rp.28.986.336.00, so the amount of DALY is Rp.43.674.336.000. The total economic loss of Rp.43.970.201.500. These huge economic losses can be prevented by increasing the allocation of health budgets for promotive and preventive efforts and expanding the coverage of health insurance for the community. Conclusion: There is a need to advocate the executive and legislative about the importance of guarantee on public health financing by conducting studies in terms of economic losses so that all strategic alliances believe that health is an investment.

Keywords: advocacy, economic lost, health insurance, economic losses

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Authors: Antoine F. Dedewanou, Eric N. Ekpinda

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We investigate whether and how deposit insurance program affects savings decisions in the Economic Community of Central African States (ECCAS). Specifically, using the World Bank’s 2014 and 2011 Global Financial Inclusion (Global Findex) databases, we apply special regressor approach. We find that the deposit insurance program increases significantly, everything else equal, the probability that people save their money at a financial institution by 11 percentage points in Gabon, by 22.2 percentage points in DR Congo and by 15.1 percentage points in Chad. These effects are matched with positive effects of age and education level. But in Cameroon, the effect of deposit insurance is not significant. The policies aimed at fostering financial inclusion will be more effective if there is a deposit insurance scheme in place, along with awareness among young people, and education programs. JEL Classification: G21, O12, O16

Keywords: deposit insurance, savings, special regressor, ECCAS countries

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Authors: Scarlet Tabot Enanga Longsti

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Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

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Authors: Zijiao Chai, Wangming Li

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Hangzhou is one of the cities with the most serious aging in China. Community home-based care for the aged is an important solution to old-age care in aging society. In this aspect, Europe, the United States and Japan are on the top in the world. As an East Asian country, Japan has similar cultural traditions in pension with China. So, there is much enlightenment China can get from Japan in the mode of community home-based care for the aged. This paper introduces the mode of community home-based care for the aged in Kishiwada, Japan and Hangzhou, China. Then compare the two modes in the aspects of insurance system for the aged, community service and facilities, support system and so on. Thereby the success experience of Kishiwada and weaknesses of Hangzhou are summarized. At last, the improvement strategy of facility plan and service mode of community home-based care for the aged in China are also proposed.

Keywords: community, comparison, elderly-oriented, home-based care for the aged, support system

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Authors: Harinder Singh

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The paper sheds light on the perceptions of the uninsured workers employed in the urban informal sector of India, towards the health insurance. In addition to this, it also explores the association of the identified perceptions with household decisions to enroll for health insurance schemes in India. Firstly the data taken from the primary survey of the uninsured workers employed in the urban informal sector was analyzed using exploratory factor analysis to evaluate the perceptions. Thereafter, logistic regression was employed to determine the association of the identified perceptions regarding the enrollment. Our study identifies twelve perceptions related to the health insurance enrollment of the uninsured workers employed in the urban informal sector of India. The study demonstrates that perceptions have the strongest association with the voluntary enrollment. These specifically relate to the lack of awareness about the need to buy health insurance; comprehensive coverage; income constraint; future contingencies and social obligations; lack of information; availability of subsidized government health care; linkage with government hospitals and preference for government schemes. Conclusions: Along with the food security, health security has become a crying need of the workers employed in the informal sector and the time has come to scale up the health insurance schemes for them in the country. Policy makers or marketers of health insurance policies should recognize the household perceptions as a potential barrier and try to develop a health insurance package as per the actual needs of the informal sector (low income) in India.

Keywords: association, enrollment, health insurance, informal sector, perceptions, uninsured

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Authors: Antonia Müller, Svend Reuse

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The Brexit referendum in June 2016 led to different publications analysing potential consequences for European and British insurance companies under the European Passport. This study addresses a research gap, regarding the measures taken by insurance companies based in the United Kingdom and thus on structural changes to the European insurance market by an innovative structured Solvency and Financial Condition Report content analysis. In scope are all insurance companies based in the United Kingdom, that fall under the Solvency II supervisory regime. The results show that the majority of British Solvency II insurance companies in scope, conducting cross-border business to the European Union, have applied and reported measures to be able to continue operating this cross-border business after Brexit. In addition, the study shows that 34 new insurance companies based in the European Union were established as a result of Brexit, indicating structural changes to the European insurance market.

Keywords: brexit, europe, insurance market, solvency and financial condition repot, structural changes

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Fawzia Mohammed Idris

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Zakat is an Islamic procedure for wealth distribution as a social protection mechanism for needy people. This study aimed to assess the possibility to expand the share of fund for national health insurance fund from zakat funds allocated for poor people by measuring the reduction of poverty that result from the investing on direct payment to the needy or by covering them in social health insurance. This study used stata regression as a statistical analysis tool and the finding clarified that there is no significant relationship between the poverty rate as the main indicator and, the number of poor people covered by national health insurance on one hand and the number of benefits poor people from the distribution of zakat fund. This study experienced many difficulties regarding the quality and the consistency of the data. The study suggested that a joint mission between national health insurance fund and zakat chamber to conduct study to assess the efficient use of zakat fund allocated to poor people.

Keywords: health finance, poverty, social health insurance, zakat

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Authors: Nihayatul Munaa, Nyoman A. Damayanti

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This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

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Authors: Shengdan Yang

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The outbreak of the COVID-19 pandemic in early 2020 has made public health issues to be re-examined. The value of green space configuration is an important measure of community health quality. By combining quantitative and qualitative methods, the structure and function of community green space can be better evaluated. This study selects Wuhan Kunhou Community as the site and proposes to analyze the daily health service function of the community's green infrastructure. Through GIS-based spatial analysis, case study, and field investigation, this study evaluates the accessibility of green infrastructure and discusses the ideal green space form based on health indicators. The findings show that Kunhou Community lacks access to green infrastructure and public space for daily activities. The research findings provide a bridge between public health indicators and community space planning and propose design suggestions for green infrastructure planning.

Keywords: accessibility, community health, GIS, green infrastructure

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Authors: Namrata Mishra

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Health of a person plays a vital role in the collective health of his community and hence the well-being of the society as a whole. But, in today’s fast paced technology driven world, health issues are increasingly being associated with human behaviors – their lifestyle. Social networks have tremendous impact on the health behavior of individuals. Many researchers have used social network analysis to understand human behavior that implicates their social and economic environments. It would be interesting to use a similar analysis to understand human behaviors that have health implications. This paper focuses on concepts of those behavioural analyses that have health implications using social networks analysis and provides possible algorithmic approaches. The results of these approaches can be used by the governing authorities for rolling out health plans, benefits and take preventive measures, while the pharmaceutical companies can target specific markets, helping health insurance companies to better model their insurance plans.

Keywords: breadth first search, directed graph, health behaviors, social network analysis

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Authors: Federica Di Marcantonio, Antoine Leblois, Wolfgang Göbel, Hervè Kerdiles

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Weather-related shocks can threaten the ability of farmers to maintain their agricultural output and food security levels. Informal coping mechanisms (i.e. migration or community risk sharing) have always played a significant role in mitigating the negative effects of weather-related shocks in Ethiopia, but they have been found to be an incomplete strategy, particularly as a response to covariate shocks. Particularly, as an alternative to the traditional risk pooling products, an innovative form of insurance known as Index-based Insurance has received a lot of attention from researchers and international organizations, leading to an increased number of pilot initiatives in many countries. Despite the potential benefit of the product in protecting the livelihoods of farmers and pastoralists against climate shocks, to date there has been an unexpectedly low uptake. Using information from current pilot projects on index-based insurance in Ethiopia, this paper discusses the determinants of uptake that have so far undermined the scaling-up of the products, by focusing in particular on weather data availability, price affordability and willingness to pay. We found that, aside from data constraint issues, high price elasticity and low willingness to pay represent impediments to the development of the market. These results, bring us to rethink the role of index insurance as products for enhancing smallholders’ response to covariate shocks, and particularly for improving their food security.

Keywords: index-based insurance, willingness to pay, satellite information, Ethiopia

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Authors: A. Kulprasutidilok

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In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.

Keywords: community-based participatory research, elderly, heath care, Thailand.

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Authors: J. B. Akshataeva, G. T. Aigarinova, A. Amankulova, D. S. Kalkanova

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This article examines some aspects of the insurance of agricultural activities, strategic documents on deepening investment opportunities. Insurance market development is before the society and the state. It also examines problems of agricultural insurance development in the market economy of Kazakhstan as the basis for food security.

Keywords: agriculture, food safety, insurance, privacy issues

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Authors: Ashenafi Sileshi Etefa, Bezawit Worku Yenealem

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Micro-insurance is a relatively new concept that is just being introduced in Ethiopia. For an agrarian economy dominated by small holder farming and vulnerable to natural disasters, mainly drought, the need for an Index-Based Micro Insurance (IBMI) is crucial. Since IBMI solves moral hazard, adverse selection, and access issues to poor clients, it is preferable over traditional insurance products. IBMI is being piloted in drought prone areas of Ethiopia with the aim of learning and expanding the service across the country. This article analyses the demand of IBMI and the barriers to demand and finds that the demand for IBMI has so far been constrained by lack of awareness, trust issues, costliness, and the level of basis risk; and recommends reducing the basis risk and increasing the role of government and farmer cooperatives.

Keywords: agriculture, index based micro-insurance (IBMI), drought, micro-finance institution (MFI)

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Authors: Drago Jakovčević, Maja Mihelja Žaja

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This paper provides an analysis of the insurance cycle in the Republic of Croatia and whether they are affected by catastrophic losses on a global level. In general, it is considered that insurance cycles are particularly pronounced in periods of financial crisis, but are also affected by the growing number of catastrophic losses. They cause the change of insurance cycle and premium growth and intensification and narrowing of the coverage conditions, so these variables move in the same direction and these phenomena point to a new cycle. The main goal of this paper is to determine the existence of insurance cycle in the Republic of Croatia and investigate whether catastrophic losses have an influence on insurance cycles.

Keywords: catastrophic loss, insurance cycle, premium, Republic of Croatia

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Authors: Mahsa Ghorbani Jazin

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The insurance industry has a prominent place in the economy of every country in the world. Fire insurance policies are types of non-life insurance, which protect insureds against financial losses of fire and related risks. In this paper, factors that are affecting the demand for fire insurance in Iran have been examined. Due to this reason, information and data have been collected during the period 1989-2019. In this research, the final model was estimated. The obtained results represent that as the population and literacy rate increase, people are more willing to purchase fire insurance. On the other hand, the actual per capita income has a negative influence on the demand for this type of insurance. Also, the amount of compensation that is paid in losses can be assumed as an indirect advertisement for fire insurance and attracts people to buy this policy. Finally, the new technology in the insurance industry is examined as a new underestimated way for increasing demand, especially in Iran.

Keywords: fire insurance, demand, per capita income, literacy rate, population, compensation paid, Insurtech

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Authors: Joseph Marfo Boaheng, Daniel Ansong, Eugenia Amporfo

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Health Insurance is proposed to provide financial protection against catastrophic health care cost arising from disease. Ghana has had a National Health Insurance Scheme (NHIS) since 2003 with the current enrolment/retention rate of 36%. The main goal of the scheme is to provide equity in the health sector as well as ensuring affordable health care for the poor. However, the current payment system is not flexible to attract significant proportion of the poor informal sector onto the scheme. Looking at the extensive use of mobiles in the Ghana where about 29,220,602.00 registered mobile phone lines are actively in used as of June 2014, paying health insurance premium through mobile phone could be feasible to attract larger proportion of the informal sector onto the scheme. Methodology: The quantitative cross-sectional survey was used to solicit the required information from 877 respondents living in Kumasi, the second capital city of Ghana. The magnitude of the effect of Pro-rata system (flexible payment terms) on NHIS enrollment rate was estimated with binary logistic regression model. Results: The odds for an individual to enroll onto NHIS with mobile phone increases about 2 times more when payment of insurance premium is on pro-rata basis ie. flexible payment terms (p=0.008, CI=1.212-3.565). Conclusion: The study advocates the National Health Insurance Authority consider this alternative payment system that has the potential of attracting a greater proportion of the informal sector to be enrolled or retained onto the scheme.

Keywords: enrollment, health insurance, mobile phone, pro-rata

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Authors: Olatokunbo Shoyemi, Mario Brito, Ian Dawson

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In recent times, the Nigerian motor insurers have experienced high volume of motor insurance claim pay-outs and insignificant contribution to the net premium income of the Nigerian insurance market, which has been a major concern for the shareholders/stakeholders. It has been argued that there are many factors that have brought about these concerns. However, anecdotal evidence (ongoing debates among industry practitioners) suggests prevalence of fraud due to poor practices in motor insurance business in Nigeria. This study is therefore aimed to carry out an assessment of fraud in motor insurance claims as perceived by experts in the Nigerian insurance market. This study adopted a descriptive research design, and the analysis was built on a survey among insurance experts in Nigeria using a designed questionnaire. A purposive and snowball sampling were used to select our sample (N = 120) - representing a selection of all professionally qualified insurance experts in Nigeria insurance industry. The study found that Nigerian insurance experts (i) largely agree that there is a problematic level of fraud in the Nigerian motor insurance industry; (ii) perceive soft fraud to be about 3 times more common than hard fraud in the Nigerian motor insurance industry, and (iii) strongly agree there are problematic impacts from fraud on the solvency of the Nigerian motor insurers. This paper has provided an empirical understanding of the existence, extent, and impact of fraud risks within the Nigerian insurance market based on expert knowledge and insights rather than, as has often been the case, a reliance on individual anecdotes.

Keywords: claims, net premium income, motor insurance, soft fraud, hard fraud

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Authors: Tamar Lazariashvili

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Introduction: The agro-insurance has great importance for agricultural development in the country. In the article, the insurance market of the Georgian agricultural sector has been studied, the level of interest of farmers with insurance products and the trend of demand for those products are revealed; also, the importance of insurance is substantiated. Methodology: The following research methods are applied in the presented paper: statistical (selection, grouping, observation, trend) and qualitative research (in-depth interview with farmers). They claim that the main reason for aggravation is the low level of trust, less awareness about the conditions of the insurance contract. In order to eradicate distrust towards agro-insurance, it is recommended to increase awareness of insured farmers in terms of an insurance agreement. In the case of disputable issues between insurance companies and the customers (farmers), it is advisable to enact the Mediation Service, which will be able to protect the rights of insured farmers. Main Findings: Insurance companies prefer to deal with large farmers, the number of them is very small in Georgia as the credit market. The government interference in this sector is also a very cautious topic. However, the government can strengthen the awareness of farmers about the characteristics and advantages of the insurance system in order to increase the number of insured and reduce insurance premiums for farmers. Conclusion: Enactment of agro-insurance will increase the interest and confidence of financial institutions in the farming sector, financial resources will be accessible to the farmers that will facilitate the stable development of the sector in the country. The size of the agro-insurance market in the country should be increased, and the new territories should be covered. The State must have an obligation to ensure the risk of farmers and subsidize insurance companies. Based on the analysis of the insurance market, the conclusions on agro-insurance issues and the relevant recommendations are proposed.

Keywords: Agro-insurance, agricultural product, Agro-market, farming

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Authors: Sitti Rahmawati

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Payment system of cataract surgery implemented by professional attendant of doctor and nurse has been increasing, through health insurance program and this has become one of the factors that affects a lot of government in the budget establishment. This system has been implemented in purpose of quality and expenditure control, i.e., controlling health overpayment to obtain benefit (moral hazard) by the user of insurance or health service provider. The increasing health cost becomes the main issue that hampers the society to receive required health service in cash payment-system. One of the efforts that should be taken by the government in health payment is by securing health insurance through society's health insurance. The objective of the study is to learn the capability of a patient to pay cataract eye operation for the elders. Method of study sample population in this study was patients who obtain health insurance board card for the society that was started in the first of tri-semester (January-March) 2015 and claimed in Indonesian software-Case Based Group as a purposive sampling of 40 patients. Results of the study show that total unit cost analysis of surgery service unit was obtained $75 for unit cost without AFC and salary of nurse and doctor. The operation tariff that has been implemented today at Anutapura hospitals in eye department is tariff without AFC and the salary of the employee is $80. The operation tariff of the unit cost calculation with double distribution model at $65. Conclusion, the calculation result of actual unit cost that is much greater causes incentive distribution system provided to an ophthalmologist at $37 and nurse at $20 for one operation. The surgery service tariff is still low; consequently, the hospital receives low revenue and the quality of health insurance in eye operation department is relatively low. In purpose of increasing the service quality, it requires adequately high cost to equip medical equipment and increase the number of professional health attendant in serving patients in cataract eye operation at hospital.

Keywords: economic evaluation, cataract operation, health attendant, health insurance system

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Authors: İbrahim Arslan, Mücahit Ünal

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An important issue to ensure justice is to simplify the right to seek justice. But there is a cost of seeking justice in civil law. It costs at least, attorneys' fees and judicial expenses during the beginning and in case of losing a trial. Indeed, most of the people refrain from seeking justice because of these expenses. Therefore, it is not inappropriate to say that the removal of obstacles staying on the way of seeking justice will increase the belief in justice. Legal expenses insurance is a private law contract of insurance in which the insurer is obliged to pay premiums of the insured, to provide the necessary services for the protection of legal interests of the insured person within the agreed scope. This type of insurance is being practiced in the Western world for a long time. The special rights, duties and obligations of the parties to a legal expenses insurance contract shall be governed by the Turkish Commercial Code (TCC) and the contractual agreements which are regularly closed in the form of general terms and conditions. If the number of the legal expenses insurance contracts concluded increase this will definitely improve the percentage of seeking justice before the courts. The general terms and conditions applicable in Turkey generally include litigation costs, referee fees, guarantee fund , enforcement costs , appeal costs borne decision corrections costs. In addition, besides the insured, other family members or the people specified in the policy are protected in the scope of personal/family legal expenses insurance. The commercial law disputes fall outside the scope of coverage in this insurance branch. The insured person chooses his own lawyer and the insurer is not allowed to give advice during the selection of a lawyer. In April 2015, the Prime Minister announced of a new era in the field of legal expenses insurance in Turkey and this announcement excited the insurance industry and legal community.

Keywords: insurance, in the Turkish law on legal protection insurance, legal protection insurance, legal protection

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Authors: Anjuman Antil, Anuj Kapoor, Neha Saini

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Purpose: The purpose of this paper is to study the evolution of insurance in India and the world. The paper also traced the historical basis of life insurance in the world and how it emerged as a major sector in India’s economy. The promotional strategies and distribution channel of top three companies in the Indian insurance sector are also discussed. Design/methodology/approach: The paper examined the secondary data which includes the reports issued by Insurance Regulatory Authority of India, websites of companies, books, and journals relevant to the study. Findings: The paper argued the role and importance of insurance in an emerging economy. The challenges and opportunities of the insurance sector are briefed out. The emerging areas in the insurance sector in terms of promotional strategies and distribution channel are also listed. Implications: The historical evolution can be studied by companies while formulating their strategies. It will help them analyse the insurance sector, how things have changed and how to change with the changing times. Originality/value: This paper gives comprehensive data regarding the background of the insurance sector. Along with historical perspective, marketing and distribution, current and future trends have been discussed.

Keywords: insurance, evolution, life insurance, marketing, distribution channels

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Authors: Amanda Kenny, Virginia Dickson-Swift, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

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Rural ECOH (Engaging Communities in Oral Health) is a collaborative project that connects policy makers, service providers and community members. The aim of the project is to empower community members to determine what is important for their community and to design the services that they need. This three-year project is currently underway in six rural communities across Australia. This study is specifically focused on Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. The findings highlight the complexities of community participation in health service planning. We assumed that people living in rural communities would welcome participation in oral health planning and engage with their community to discuss these issues. We found that to understand the relationships between community members and health service providers, it was essential to identify the formal and informal community leaders and to engage stakeholders from the various community governance structures. Our study highlights the sometimes ‘messiness’ of decision making in rural communities as well as ways to ensure that community members have the training and practical skills necessary to participate in community decision making.

Keywords: community participation, health planning, rural ECOH, Remote Services Futures

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Authors: Jiemiao Chen, Shuoxun Xu

Abstract:

The main goal of our research is to apply the Vine copula measuring dependency between price, temperature, and precipitation indices to calculate a fair crop insurance premium. This research is focused on Worth, Iowa, United States, over the period from 2000 to 2020, where the farmers are dependent on precipitation and average temperature during the growth period of corn. Our proposed insurance considers both the natural risk and the price risk in agricultural production. We first estimate the distributions of crops using parametric methods based on Goodness of Fit tests, and then Vine Copula is applied to model dependence between yield price, crop yield, and weather indices. Once the vine structure and its parameters are determined based on AIC/BIC criteria and forecasting price and yield are obtained from the ARIMA model, we calculate this crop insurance premium using the simulation data generated from the vine copula by the Monte Carlo Simulation method. It is shown that, compared with traditional crop insurance, our proposed insurance is more fair and thus less costly for the farmers and government.

Keywords: vine copula, weather index, crop insurance premium, insurance risk management, Monte Carlo simulation

Procedia PDF Downloads 170

Authors: Dorcas Matowe

Abstract:

Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

Procedia PDF Downloads 239

Authors: Shailender Kumar

Abstract:

Current health policy pronouncements in India advocate for insurance-based financing mechanism to achieve universal health coverage (UHC), while undermine the role of comprehensive healthcare provision system. UHC is achieved when all people receive the health services they need without suffering financial hardship. This study, using 68th & 71st NSS rounds data, examines their relative and combined strength in achieving the above objective. Health-insurance has been unsuccessful in reducing prevalence and catastrophic effects of out-of-pocket payment and even dismantle the effectiveness of traditional way of health financing system. Healthcare provision is the best way forward to enhance health and well-being of households in condition if India removes existing inadequacies and inequalities in service provision across districts/states and ensure free/low cost medicines/diagnostics to the citizens.

Keywords: health policy, demand-side financing, supply-side financing, incidence of health payment

Procedia PDF Downloads 230