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The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh

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Ahmed, Sayem, Sarker, Abdur Razzaque, Sultana, Marufa, Chakrovorty, Sanchita, Ahmed, Mohammad Wahid, Dorin, Farzana, Mirelman, Andrew J., Islam, Ziaul, Rahman, Mohammad Hafizur, Niessen, Louis ORCID: https://orcid.org/0000-0002-8639-5191, Rehnberg, Clas and Khan, Jahangir (2018) 'The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh'. PLoS ONE, Vol 13, Issue 7, e0200265.

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Abstract

We aimed to estimate the impact of a Community-Based Health Insurance (CBHI) scheme on utilization of healthcare from medically trained providers (MTP) by informal workers. A quasi-experimental study was conducted where insured households were included in the intervention group and uninsured households in comparison group. In total 1,292 (646 insured and 646 uninsured) households were surveyed from Chandpur district comprising urban and rural areas after 1 year period of CBHI introduction. Matching of the characteristics of insured and uninsured groups was performed using a propensity score matching approach to minimize the observed baseline differences among the groups. Multilevel logistic regression model, with adjustment for individual and household characteristics was used for estimating association between healthcare utilization from the MTP and insurance enrolment. The utilization of healthcare from MTP was significantly higher in the insured group (50.7%) compared to the uninsured group (39.4%). The regression analysis demonstrated that the CBHI beneficiaries were 2.111 (95% CI: 1.458–3.079) times more likely to utilize healthcare from MTP.CBHI scheme increases the utilization of MTP among informal workers. Ensuring such healthcare for these workers and their dependents is a challenge in many low and middle income countries. The implementation and scale-up of CBHI schemes have the potential to address this challenge of universal health coverage.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 74 Medical economics. Health care costs
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pone.0200265
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 12 Jul 2018 09:13
Last Modified: 12 Jul 2018 14:23
URI: http://archive.lstmed.ac.uk/id/eprint/8911

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