IDEAS home Printed from https://ideas.repec.org/a/pal/palcom/v8y2021i1d10.1057_s41599-021-00984-7.html
   My bibliography  Save this article

Effect of the National Health Insurance Scheme on Healthcare Utilization and Out-of-Pocket Payment: Evidence from GLSS 7

Author

Listed:
  • Adu Owusu Sarkodie

    (University of Ghana, Legon)

Abstract

The Ghana National Health Insurance Scheme (NHIS) was established in 2003, Act, 2003 (Act 650), but was later replaced with the National Health Insurance Act, 2012 (Act 852) to get rid of the then “cash and carry” system of paying for healthcare. The aim of the scheme was to reduce the cost of healthcare provision and increase access to healthcare. This paper investigates the effect of the National Health Insurance Scheme (NHIS) on healthcare utilization and out-of-pocket payment, from the providers’ perspective. The study uses data from the seventh round of the Ghana Living Standards Survey (GLSS 7) conducted in 2016/2017 and employs the estimation method of Propensity Score Matching (PSM). The findings are that enrollment onto Ghana’s National Health Insurance Scheme (NHIS) increases healthcare utilization by 26% and decreases out-of-pocket payment by 4%. However, about 48% of the population are still not enrolled, citing various reasons. Even those who enrolled, about 30% had dropped out for several reasons. The study identifies age, income, education, sex, and location of residence as the main determinants of enrolling onto the NHIS. I show that the National Health Insurance Scheme increases healthcare utilization and reduces out-of-pocket payment in Ghana. A number of Ghanaians have either not registered or registered but have stopped enrolling citing no money, no need for NHIS, and no confidence in the system’ as reasons. Any policy to invigorate the public confidence in NHIS and increases enrollment should be targeted at the young, poor, less educated, males, and rural dwellers.

Suggested Citation

  • Adu Owusu Sarkodie, 2021. "Effect of the National Health Insurance Scheme on Healthcare Utilization and Out-of-Pocket Payment: Evidence from GLSS 7," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-10, December.
    • Handle: RePEc:pal:palcom:v:8:y:2021:i:1:d:10.1057_s41599-021-00984-7
    DOI: 10.1057/s41599-021-00984-7
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1057/s41599-021-00984-7
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1057/s41599-021-00984-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Stephen Kwasi Opoku Duku & Francis Asenso-Boadi & Edward Nketiah-Amponsah & Daniel Kojo Arhinful, 2016. "Utilization of healthcare services and renewal of health insurance membership: evidence of adverse selection in Ghana," Health Economics Review, Springer, vol. 6(1), pages 1-12, December.
    2. Marco Caliendo & Sabine Kopeinig, 2008. "Some Practical Guidance For The Implementation Of Propensity Score Matching," Journal of Economic Surveys, Wiley Blackwell, vol. 22(1), pages 31-72, February.
    3. A. D. Roy, 1951. "Some Thoughts On The Distribution Of Earnings," Oxford Economic Papers, Oxford University Press, vol. 3(2), pages 135-146.
    4. Monica Lambon-Quayefio & Nkechi S. Owoo, 2017. "Determinants and the impact of the National Health Insurance on neonatal mortality in Ghana," Health Economics Review, Springer, vol. 7(1), pages 1-16, December.
    5. Nkechi Owoo & Monica Lambon-Quayefio, 2013. "National health insurance, social influence and antenatal care use in Ghana," Health Economics Review, Springer, vol. 3(1), pages 1-12, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Irene Bertschek & Joern Block & Alexander S. Kritikos & Caroline Stiel, 2024. "German financial state aid during Covid-19 pandemic: Higher impact among digitalized self-employed," Entrepreneurship & Regional Development, Taylor & Francis Journals, vol. 36(1-2), pages 76-97, January.
    2. Kölling, Arnd, 2013. "Wirtschaftsförderung, Produktivität und betriebliche Arbeitsnachfrage - Eine Kausalanalyse mit Betriebspaneldaten -," VfS Annual Conference 2013 (Duesseldorf): Competition Policy and Regulation in a Global Economic Order 79843, Verein für Socialpolitik / German Economic Association.
    3. Marco Caliendo & Stefan Tübbicke, 2020. "New evidence on long-term effects of start-up subsidies: matching estimates and their robustness," Empirical Economics, Springer, vol. 59(4), pages 1605-1631, October.
    4. Kwame Adjei-Mantey & Charles Yuji Horioka, 2023. "Determinants of health insurance enrollment and health expenditure in Ghana: an empirical analysis," Review of Economics of the Household, Springer, vol. 21(4), pages 1269-1288, December.
    5. repec:dau:papers:123456789/1912 is not listed on IDEAS
    6. Schmidl, Ricarda, 2015. "The Effectiveness of Early Vacancy Information in the Presence of Monitoring and ALMP," IZA Discussion Papers 9575, Institute of Labor Economics (IZA).
    7. Rodríguez-Planas, Núria, 2007. "What Works Best for Getting the Unemployed Back to Work: Employment Services or Small-Business Assistance Programmes? Evidence from Romania," IZA Discussion Papers 3051, Institute of Labor Economics (IZA).
    8. Khan, Zazy, 2015. "Activist Hedge Funds: Evidence from the Recent Financial Crisis," MPRA Paper 72025, University Library of Munich, Germany, revised 27 May 2016.
    9. Caliendo, Marco & Künn, Steffen & Weißenberger, Martin, 2016. "Personality traits and the evaluation of start-up subsidies," European Economic Review, Elsevier, vol. 86(C), pages 87-108.
    10. Jérôme Ronchetti & Anthony Terriau, 2019. "Impact of unemployment on self-perceived health," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 879-889, August.
    11. Volpe Martincus, Christian & Carballo, Jerónimo, 2010. "Beyond the average effects: The distributional impacts of export promotion programs in developing countries," Journal of Development Economics, Elsevier, vol. 92(2), pages 201-214, July.
    12. John Addison & Paulino Teixeira & Katalin Evers & Lutz Bellmann, 2014. "Indicative and Updated Estimates of the Collective Bargaining Premium in Germany," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 53(1), pages 125-156, January.
    13. Edlira Shehu & Tim Prostka & Christina Schmidt-Stölting & Michel Clement & Eva Blömeke, 2014. "The influence of book advertising on sales in the German fiction book market," Journal of Cultural Economics, Springer;The Association for Cultural Economics International, vol. 38(2), pages 109-130, May.
    14. Manuela Deidda & Adriana Di Liberto & Marta Foddi & Giovanni Sulis, 2015. "Employment subsidies, informal economy and women’s transition into work in a depressed area: evidence from a matching approach," IZA Journal of Labor Policy, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 4(1), pages 1-25, December.
    15. Caliendo, Marco & Mahlstedt, Robert & Mitnik, Oscar A., 2017. "Unobservable, but unimportant? The relevance of usually unobserved variables for the evaluation of labor market policies," Labour Economics, Elsevier, vol. 46(C), pages 14-25.
    16. Katharina Dengler, 2019. "Effectiveness of sequences of classroom training for welfare recipients: what works best in West Germany?," Applied Economics, Taylor & Francis Journals, vol. 51(1), pages 1-46, January.
    17. Marco Caliendo, 2009. "Start‐up subsidies in East Germany: finally, a policy that works?," International Journal of Manpower, Emerald Group Publishing Limited, vol. 30(7), pages 625-647, November.
    18. Hohmeyer, Katrin & Wolff, Joachim, 2010. "Direct job creation in Germany revisited: Is it effective for welfare recipients and does it matter whether participants receive a wage?," IAB-Discussion Paper 201021, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    19. Christian Volpe Martincus & Jerónimo Carballo, 2010. "Entering new country and product markets: does export promotion help?," Review of World Economics (Weltwirtschaftliches Archiv), Springer;Institut für Weltwirtschaft (Kiel Institute for the World Economy), vol. 146(3), pages 437-467, September.
    20. Marco Caliendo & Steffen Künn, 2015. "Getting back into the labor market: the effects of start-up subsidies for unemployed females," Journal of Population Economics, Springer;European Society for Population Economics, vol. 28(4), pages 1005-1043, October.
    21. Sophie Guthmuller & Florence Jusot & Jérôme Wittwer & Caroline Despres, 2010. "Le recours à l’Aide complémentaire santé : les enseignements d’une expérimentation sociale à Lille," Working Papers DT36, IRDES institut for research and information in health economics, revised Dec 2010.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pal:palcom:v:8:y:2021:i:1:d:10.1057_s41599-021-00984-7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: https://www.nature.com/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.