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Community-Based Health Insurance Schemes

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Author Info

  • Mebratie, A.D.
  • Sparrow, R.A.
  • Alemu, G.
  • Bedi, A.S.

Abstract

Due to the limited ability of publicly financed health systems in developing countries to provide adequate access to health care, community-based health financing has been proposed as a viable option. This has led to the implementation of a number of Community- Based Health Insurance (CBHI) schemes, in several developing countries. To assess the ability of such schemes in meeting their stated objectives, this study systematically reviews the existing empirical evidence on three outcomes – access to schemes, effect on health care utilization and effect on financial protection. In addition to collating and summarizing the evidence we analyse the link between key scheme design characteristics and their effect on outcomes and comment on the role that may be played by study characteristics in influencing outcomes. The review shows that the ultra-poor are often excluded and at the same time there is evidence of adverse selection. The bulk of the studies find that access to CBHI is associated with increased health care utilization, especially with regard to the use of relatively cheaper outpatient care services as opposed to inpatient care. The schemes also appear to mitigate catastrophic healthcare expenditure. There are clear links between scheme design and effectiveness suggesting the importance of involving the target population in designing and implementing CBHI schemes.

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Bibliographic Info

Paper provided by International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague in its series ISS Working Papers - General Series with number 568.

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Date of creation: 30 Oct 2013
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Handle: RePEc:ems:euriss:50087

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Keywords: catastrophic health expenditure; community health insurance; low-income groups;

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References

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Cited by:
  1. Panda, P. & Chakraborty, A. & Dror, D.M. & Bedi, A.S., 2013. "Enrollment in community based health insurance schemes in rural Bihar and Uttar Pradesh, India," ISS Working Papers - General Series 555, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
  2. Derseh, A. & Sparrow, R.A. & Debebe, Z.Y. & Alemu, G. & Bedi, A.S., 2013. "Enrolment in Ethiopia’s Community Based Health Insurance Scheme," ISS Working Papers - General Series 578, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.

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