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首页> 外文期刊>Health Research Policy and Systems >The impact of health insurance on outpatient utilization and expenditure: evidence from one middle-income country using national household survey data
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The impact of health insurance on outpatient utilization and expenditure: evidence from one middle-income country using national household survey data

机译：健康保险对门诊病人使用和支出的影响：一个中等收入国家使用全国家庭调查数据得出的证据

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Background Achieving universal health insurance coverage by means of different types of insurance programs may be a pragmatic and feasible approach. However, the fragmentation of the health financing system may imply costs in terms of varying ability of the insurance programs to improve access to and reduce spending on care across different population groups. This study looks at the effect of different types of health insurance programs on the probability of utilizing care, the intensity of utilization, and individual spending on care in Jordan. Methods Using national household survey data collected in 2000 with a sub-sample of around 8,300 individuals, the study applies econometric techniques to a set of specified models along the two-part model approach to the demand for health care. By means of particular tests and other procedures, the robustness of the results is controlled. Results Around 60 percent of the population is covered by some type of insurance. However, the distribution varies across income groups, and importantly, the effect of insurance on the outcome indicators differ substantially across the various programs. Generally, insurance is found to increase the intensity of utilization and reduce out-of-pocket spending, while no general insurance effect on the probability of use is found. More specifically, however, these effects are only found for some programs and not for all. The best performing programs are those to which the somewhat better off groups have access. Conclusion Notwithstanding the empirical nature of the issues, the results point at the need to assess the effect of insurance coverage more profoundly than what is commonly done. Applying rigorous analysis to survey data in other settings will contribute to bringing out better evidence on what types of programs perform most effectively and equitably in different contexts.
机译：背景技术通过不同类型的保险计划实现全民健康保险可能是一种务实可行的方法。但是，医疗筹资体系的分散化可能暗示着保险计划改变能力的成本，这些能力提高了不同人群在医疗服务上的获取和减少的支出。这项研究着眼于不同类型的健康保险计划对约旦利用医疗服务的可能性，利用强度和个人医疗支出的影响。方法利用2000年收集的全国住户调查数据以及大约8,300人的子样本，该研究将经济计量学技术应用于医疗保健需求的两部分模型方法的一组指定模型。通过特定的测试和其他程序，可以控制结果的健壮性。结果大约60％的人口享受某种类型的保险。但是，收入组之间的分配有所不同，重要的是，保险对结果指标的影响在各个计划中都存在很大差异。通常，发现保险可以提高使用强度并减少自付费用，而没有发现一般保险对使用概率的影响。但是，更具体地说，这些效果仅在某些程序中发现，而并非在所有程序中都发现。表现最好的程序是那些较富裕的群体可以访问的程序。结论尽管这些问题具有实证性质，但结果表明有必要比通常所做的更深入地评估保险范围的影响。将严格的分析应用于其他环境中的调查数据将有助于提供更好的证据，以证明哪些类型的程序在不同情况下最有效和最公平地执行。

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