Impact of national health insurance for the poor and the informal sector in low- and middle-income countries

Systematic review Impact of national health insurance for the poor and the informal sector in low- and middle-income countries by Arnab Acharya, Sukumar Vellakkal, Fiona Taylor, Edoardo Masset, Ambika Satija, Margaret Burke, Shah Ebrahim July 2012 The authors are part of London School of Hygiene and Tropical Medicine; Public Health Foundation of India; Institute of Development Studies; and University of Bristol and were supported by the Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre). The EPPI-Centre reference number for this report is 2006. Acharya A, Vellakkal S, Taylor F, Masset E, Satija A, Burke M and Ebrahim S (2012) Impact of national health insurance for the poor and the informal sector in low-and middle-income countries: a systematic review. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London. ISBN: 978-1-907345-34-0 © Copyright Authors of the systematic reviews on the EPPI-Centre website (http://eppi.ioe.ac.uk/) hold the copyright for the text of their reviews. The EPPI-Centre owns the copyright for all material on the website it has developed, including the contents of the databases, manuals, and keywording and data extraction systems. The centre and authors give permission for users of the site to display and print the contents of the site for their own non-commercial use, providing that the materials are not modified, copyright and other proprietary notices contained in the materials are retained, and the source of the material is cited clearly following the citation details provided. Otherwise users are not permitted to duplicate, reproduce, re-publish, distribute, or store material from this website without express written permission. Contents List of abbreviations.......................................................................... iv Abstract .........................................................................................5 Executive summary............................................................................7 1. Background ................................................................................ 10 1.1. Introduction.......................................................................... 10 1.2. Health insurance..................................................................... 11 1.3. Social health insurance and coverage for the poor............................. 11 1.4. Impact of health insurance and theory-based evaluation ..................... 13 1.5. Existing systematic reviews........................................................ 14 1.6. Potential limitations: considerations in conducting a review of evaluation studies...................................................................................... 15 2. Health insurance: theory and empirics................................................ 16 2.1. Theoretical issues ................................................................... 16 2.2. Empirical factors .................................................................... 16 3. Methodology............................................................................... 21 3.1. Search strategy and its result ..................................................... 21 3.2. Inclusion criteria..................................................................... 22 3.3. Data extraction...................................................................... 24 3.4. Summarising the data............................................................... 24 3.5. Classifying the studies.............................................................. 24 4. Findings: descriptions of the studies................................................... 26 4.1. Studies included, quality and classification ..................................... 26 4.2. Description of the insurance and data ........................................... 27 5. Findings: study results ................................................................... 47 5.1. Enrolment ............................................................................ 47 5.2. Utilisation ............................................................................ 51 5.3. Out-of-pocket expenditure......................................................... 53 5.4. Health status and other measures ................................................ 54 5.5. Evidence of impact on the poor................................................... 75 6. Discussion and conclusions .............................................................. 76 6.1. Policy summary...................................................................... 76 6.2. Strengths and weaknesses of the studies and the review ..................... 76 6.3. Non-scientific influence............................................................ 78 6.4. Checklist for policy makers and analysts ........................................ 78 6.5. Recommendations................................................................... 79 7. References................................................................................. 81 7.1. References to studies included in this review (34 studies).................... 81 ii 7.2. References to studies excluded from this review after seeing full text..... 83 7.3. Additionally cited and related studies ........................................... 85 Appendices.................................................................................... 90 Appendix 1.1: Authors of the report ................................................... 90 Appendix 2.1: The theory and empirics of the impact of health insurance ...... 92 Appendix 3.1: Search strategy .......................................................... 95 Appendix 3.2: Data abstraction form .................................................. 96 Appendix 5.1: Evidences of impact on poor..........................................107 iii Abbreviations List of abbreviations ATT CACE CBA CBHI CHF CHI CHNS CHSI CMS DFID DID FE GHIP GSCF H8BS HCFP HH HI HIP ILO IMR ISED ITT IV LATE LMIC LSS/LSMS MOH NCMS NGO NHIS NHSS OECD OLS OOP PHFI PHRplus PSM QIDS RCT RDD RMHC SANCD SES SHI SHIP SP SSHI VHCFP VHLSS VNHS WHO Average Treatment effect on the Treated Complier Average Causal Effect Controlled Before and After Study Community-based (Community) Health Insurance Community Health Funds Community Health Insurance China Health and Nutrition Survey Center for Health Statistics and Information Cooperative Medical System Department for International Development (UK) Difference in Difference Fixed Effects Guimaras Health Insurance Program Gansu Survey of Children and Families Health VIII Project Baseline Survey Health Care Fund for the Poor Households Health Insurance Health Insurance Program International Labour Organization Infant Mortality Rate; Inverse Mills Ratio Institute for Health and Development Intention to Treat Instrumental Variable Local Average Treatment Effect Low- and Middle-Income Countries Living Standard (Measurement) Survey Ministry of Health New Cooperative Medical System/Scheme Non-Governmental Organisation National Health Insurance Scheme National Health Service Survey Organisation for Economic Development and Cooperation Ordinary Least Square Out-of-pocket Public Health Foundation of India Partners for Health Reformplus Propensity Score Matching Quality Improvement Demonstration Study Randomised Controlled Trial Regression Discontinuity Design Rural Mutual Health Care South Asia Network for Chronic Diseases Socio-economic Status Social Health Insurance School Health Insurance Programme Seguro Popular Subsidised Social Health Insurance Vietnam Health Care Fund for the Poor Vietnam Household Living Standards Survey Vietnam National Health Survey World Health Organization iv ... - tailieumienphi.vn