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首页> 外文学位 >Trust matters: Villagers' trust in providers and insurers in the context of a community-based health insurance scheme in Cambodia.
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Trust matters: Villagers' trust in providers and insurers in the context of a community-based health insurance scheme in Cambodia.

机译：信任问题：在柬埔寨基于社区的健康保险计划的背景下，村民对提供者和保险公司的信任。

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摘要

Objective. To measure villagers' trust levels and examine the association between enrollment in Community-Based Health Insurance (CBHI) and villagers' trust in a health insurer and healthcare providers in Cambodia. This represents the first study measuring and modeling villagers' trust in public and private providers and a CBHI insurer in a low-income, post-conflict country.;Background. CBHI schemes have been launched in recent years to reduce poverty associated with healthcare and improve access to health services in low- and middle-income countries. These schemes have gained international recognition as part of a solution to healthcare financing problems. Nevertheless, increasing local CBHI enrollment remains a challenge. This study hypothesized that trust influences CBHI enrollment where villagers have little experience with and poor confidence in public providers, financial institutions and the practice of prepaying for healthcare.;Methods. This study was conducted in Thmar Pouk, Cambodia, where a CBHI scheme operates with the highest enrollment rate (19%) in the country. A mixed methods approach was applied to measure villagers' trust in public providers, the CBHI insurer and private providers who are not covered by the scheme, and assess whether this affects their decisions to enroll in CBHI schemes. Focus group discussions and household surveys were carried out to identify villagers' relationships with healthcare providers and the insurer, measure trust levels, and explore the association between provider trust, insurer trust and enrollment in CBHI schemes.;Results. After controlling for demographic factors, healthcare utilization and household socio-economic status, the study found that greater trust in the CBHI insurer and public healthcare providers is associated with higher CBHI enrollment. Villagers' trust in private providers did not affect CBHI enrollment. Trust in public and private providers were listed as the fifth and second most important consideration for choosing the healthcare provider, respectively.;Conclusions. This study found statistically significant relationships between villagers' trust in public providers/insurers and their decision to enroll in CBHI schemes. The results underscore the importance of increasing and maintaining villagers' trust in the operation of CBHI schemes, and highlight the need for public providers and health insurers to place greater emphasis on building trusting relationships with villagers.
机译：目的。衡量村民的信任度，并检查加入基于社区的健康保险（CBHI）与村民对柬埔寨的健康保险公司和医疗保健提供者的信任之间的关联。这是对低收入，冲突后国家中的村民对公共和私人提供者以及CBHI保险公司的信任进行测量和建模的第一项研究。近年来推出了CBHI计划，以减少与医疗保健相关的贫困并改善中低收入国家的医疗服务。这些计划已作为解决医疗保健融资问题的一部分而获得国际认可。然而，增加本地CBHI入学率仍然是一个挑战。这项研究假设，信任会影响CBHI的注册，因为村民对公共服务提供者，金融机构和预付医疗费用的实践经验很少，信心不足。这项研究是在柬埔寨的Thmar Pouk进行的，该国的CBHI计划在该国的入学率最高（19％）。采取了一种混合方法的方法来衡量该计划未涵盖的村民对公共服务提供者，CBHI保险人和私人提供者的信任，并评估这是否影响他们加入CBHI计划的决定。进行了焦点小组讨论和家庭调查，以确认村民与医疗服务提供者和保险公司的关系，测量信任水平，并探索提供者信任，保险公司信任与加入CBHI计划之间的关联。在控制了人口因素，医疗保健利用和家庭社会经济状况之后，研究发现，对CBHI保险公司和公共医疗保健提供者的更大信任与CBHI入学率更高有关。村民对私人提供者的信任并没有影响CBHI的注册。在选择医疗保健提供者时，对公共和私人提供者的信任分别被列为第五和第二重要的考虑因素。这项研究发现，村民对公共服务提供者/保险公司的信任与他们加入CBHI计划的决定之间存在统计学上的显着关系。结果强调了增加和保持村民对CBHI计划运作的信任的重要性，并强调了公共服务提供者和健康保险公司必须更加重视与村民建立信任关系。

著录项

  • 作者

    Ozawa, Sachiko.;

  • 作者单位

    The Johns Hopkins University.;

  • 授予单位 The Johns Hopkins University.;
  • 学科 Economics General.;Health Sciences Public Health.;Health Sciences Health Care Management.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 408 p.
  • 总页数 408
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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