TY - JOUR
T1 - The impact of community-based health insurance on the utilization of medically trained healthcare providers among informal workers in Bangladesh
AU - Ahmed, Sayem
AU - Sarker, Abdur Razzaque
AU - Sultana, Marufa
AU - Chakrovorty, Sanchita
AU - Ahmed, Mohammad Wahid
AU - Dorin, Farzana
AU - Mirelman, Andrew J.
AU - Islam, Ziaul
AU - Rahman, Mohammad Hafizur
AU - Niessen, Louis W.
AU - Rehnberg, Clas
AU - Khan, Jahangir A.M.
N1 - Funding Information:
This study was funded by the Grand Challenge Canada (Grant number: GR01009). The donor was not involved in any study related activities such as proposal development, study design, data collection, analysis and manuscript drafting. The authors thank the Grand Challenge Canada for funding this study. icddr,b acknowledges with gratitude the commitment of Grand Challenge Canada to its research efforts. icddr,b is also thankful to the Governments of Bangladesh, Canada, Sweden and the UK for providing core/unrestricted support. Gratitude goes to Mr. Khandaker Mohammad Zahid and other field workers for their cordial cooperation for conducting this study.
Publisher Copyright:
© 2018 Ahmed et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2018/7
Y1 - 2018/7
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85049663306&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049663306&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0200265
DO - 10.1371/journal.pone.0200265
M3 - Article
C2 - 29995899
AN - SCOPUS:85049663306
SN - 1932-6203
VL - 13
JO - PloS one
JF - PloS one
IS - 7
M1 - e0200265
ER -