International Journal of Health Economics and Policy最新文献

{"title":"Assessing Factors Associated with Catastrophic Healthcare Expenditure in Côte d’Ivoire: Evidence from the Household Living Standard Survey 2015","authors":"Akissi Régine Attia-Konan, A. Oga, K. Koffi, J. Kouamé, A. Touré, L. Kouadio","doi":"10.11648/J.HEP.20190404.14","DOIUrl":"https://doi.org/10.11648/J.HEP.20190404.14","url":null,"abstract":"Catastrophic healthcare expenditure (CHE) occurs in all countries and is responsible for inequalities in access to health care, particularly in low- and middle-income countries. The objective of this work is to analyse the determinants of CHEs in households living in Cote d'Ivoire. The data for the study are from the national household living standards survey conducted from January 23 to March 25, 2015 by the National Statistics Institute of Cote d’Ivoire (Institut National de la Statistique de Cote d'Ivoire). A one-way analysis and logistic regression were conducted to measure the association between CHEs and the socio-demographic, economic and health characteristics of households. The sample consisted of 12,899 households. Nearly 4% of households had experienced CHEs after completing OOPs. CHEs were more frequent in households including people over 65 years of age (OR: 4.75; 95% CI: 1.66-13.58), with chronic disease (OR: 2.10; 95% CI: 1.43-3.08), with more comfortable living conditions. Households without health insurance experienced fewer CHEs (OR: 0.29; 95% CI: 0.09-0.85) with large households including people over 65 years of age (OR: 0.60 95% CI: 0.40-0.91). This work highlighted socio-demographic and health determinants of CHEs. The reduction of CHEs involves considering social and individual factors.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126836891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Access Among Cambodia’s Poor: An Econometric Examination of Rural Care-seeking and Out-of-Pocket Expenditure","authors":"R. Kolesar, Sambo Pheakdey, Bart Jacobs, R. Ross","doi":"10.11648/J.HEP.20190404.12","DOIUrl":"https://doi.org/10.11648/J.HEP.20190404.12","url":null,"abstract":"To inform efforts to improve Cambodia’s social health protection system and advance universal health coverage, health care-seeking and out-of-pocket expenditure (OOPE) were assessed using the 2016 Cambodia Socioeconomic Survey data. This study focuses on the poorest wealth quintile who reside in rural areas- the primary target population of Cambodia’s largest social health protection scheme, the Health Equity Fund (HEF). The study also estimates the proportion of poor with an Equity card which provides access to HEF benefits at public facilities. Overall, 76% of people who sought healthcare in the past 30 days went to private providers, paying, on average, US$39.43 for treatment. About 18% of patients first sought care from public facilities, paying, on average, US$38.15. Though HEF aims to provide free healthcare for the rural poor, this analysis found that 67.2% of such patients seeking first care at public health facilities pay, on average, US$11.61 after controlling for confounding factors. However, treatment expenditure among the rural poor is about 52% less compared to third wealth quintile patients (p<0.01). About 36% of people under the national poverty line do not hold an Equity card to access HEF benefits. Thus, we conclude that HEF is not yet fully reaching its intended impact of removing OOPE as a barrier to access among the poor. Finally, free access to healthcare should incentivize utilization of public services; however, this study was unable to isolate such an effect among patients from the poorest wealth quintile. Access to healthcare can be strengthened with policy directives focused on further reducing OOPE and addressing other challenges to improve patient demand for public services such as quality of care. Enrollment exclusion errors should be corrected by relaxing the eligibility criteria with population coverage expansion. In addition, health service access should be systematically monitored by integrating service utilization, OOPE, and quality indicators into national monitoring and evaluation systems.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128467982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Health Promotion on Healthy Behavior Viewed from Health Beliefe Model Perspective (Study in Kediri Regency, East Java Province)","authors":"Nurwulan Andadari, Andarini Andarini, S. Soemarno, E. Widjajanto","doi":"10.11648/J.HEP.20190404.11","DOIUrl":"https://doi.org/10.11648/J.HEP.20190404.11","url":null,"abstract":"Health promotion or health promotion is an important effort that must be done by health workers in collaboration with the community to create a healthy community both physically and mentally, especially in achieving the Healthy Indonesia target. But until now health promotion in Indonesia has not reached the maximum stage. There are still many people who are not health conscious. Preventing better than cure is also still a motto and cannot yet become a foundation of awareness in the community. If these constraints are not immediately found a solution, then it will gradually have an impact on the erosion of healthy living behavior of the community. In fact, the real form of this threat is the increase in mortality. The danger of this death will be more dangerous if it threatens pregnant women, because the threatened soul is not only the soul of a mother, but also her baby. Regarding these problems, the study was conducted to examine the impact of health promotion on healthy behavior in terms of the perspective of health beliefs. A positivist or scientific approach using SEM-AMOS analysis techniques. The data used are primary data distributed to 100 respondents. The results of this study indicate that Health promotion has a significant effect on perceived susceptibility, perceived severity, perceived benefits and perceived barriers. Perceived susceptibility and Perceived benefits have no significant effect on cues to action. While perceived severity & perceived barriers have a significant effect on cues to action, then Cues to action has a significant effect on self efficacy.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"249 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116166198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to Pay for Oral Health Care for 350 Users of Public Dental Offices in Abidjan in Côte d'Ivoire","authors":"S. Mamadou, Sangaré Abou Dramane, Meless Guanga David, Nzore Kangah Serge, Guinan Jean-Claude, Bakayoko-Ly Ramata","doi":"10.11648/j.hep.20190403.14","DOIUrl":"https://doi.org/10.11648/j.hep.20190403.14","url":null,"abstract":"In Cote d'Ivoire, the financial difficulties experienced by the population represent obstacles to the consumption of oral health care. Thus, insurance mechanisms based on the principle of cost sharing are recommended to improve financial accessibility to this care. The cross-sectional study was conducted with users of three public dental practices in the city of Abidjan. The data were collected using a questionnaire. The numbers and frequencies related to the modalities of the use of oral health care, as well as the users' perception of their costs were calculated. Also, the willingness of users to pay for oral care has been measured. 350 users participated in the study. More than one third of users (36%) felt that the cost of dental services was high. 80.1% and 57.1% of respondents reported spending less than 5 $ US to honor the cost of oral consultation and the purchase of medicines respectively. 74% of users were in favor of setting up an insurance system with a willingness to pay less than 10 $ US per month. This willingness to pay has been estimated for all users at 2 $ US per month. The willingness of populations to contribute to the financing of oral health care has been proven. Achieving universal health coverage based on solidarity requires the establishment of prepayment mechanisms by adjusting the amounts of contributions to each person's ability to pay.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126906428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Health Care Delivery Utilization on Under-5 Child Mortality in Myanmar","authors":"Nyaung Tai, S. Htut, T. Swe","doi":"10.11648/J.HEP.20190403.13","DOIUrl":"https://doi.org/10.11648/J.HEP.20190403.13","url":null,"abstract":"This paper examines the impact of healthcare delivery utilization on under-5 mortality in Myanmar. Reducing under-5 child mortality is the first target under the Sustainable Development Goal (SDG) Goal 3. In 2015, Myanmar registered anunder-5 mortality rate that was higher than the regional average. According to the World Health Statistics, Myanmar is a low-income country in the Southeastern Asian with high maternal deaths. This paper investigates the impact of the utilization of health care delivery on under-5 mortalities among states and region. In practice, all health factors are very important which relationships between utilization of health care delivery and under-5 mortalities. These results give strong evidence of the success of the main findings. In spite of all variables were not statistically significant with the outcome variable were included in the multivariate analysis. The risk of child mortality was significantly higher for children of 4-5 birth order number (OR: 1.85; 95% CI: 1.01-3.38; p=0.048) and above six or more birth order number (OR: 2.11; 95% CI: 1.04-4.28; p=0.039) respectively. Children who were treated by seeking health assistance that had reduced risk (OR: 0.06; 95% CI: 0.01-0.29; p=0.000) of childhood death compared with children who were no assistance of seeking health when children were no response. The risk of child mortality was significantly reduced for children whose mothers were accessible antenatal care facilities such as government hospital, private hospital, and mobile clinic (OR: 0.39; 95% CI: 1.06 -5.15; p=0.000). The paper efforts the relationship between utilization of health care delivery and under-5 child mortality by investigating of the socio-economic and demographic factors from first time Myanmar DHS (2015-2016). The main results highlighted the determinant of the main factors on under-5 child mortality among states and regions.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125946812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corruption Impede Access to Public Health Services in Benin","authors":"Denis Acclassato Houensou, Fidel Saliga","doi":"10.11648/J.HEP.20190403.12","DOIUrl":"https://doi.org/10.11648/J.HEP.20190403.12","url":null,"abstract":"Health care is one of the indispensable factors contributing to the improvement of productivity and the welfare of human capital. Indeed, most developed countries focus on improving the health status of populations. Despite significant improvements in the health status of human capital, there are disparities in equal access to health care. This finding is fundamentally linked to the structuring, organization and functioning of public hospitals in developing countries. The purpose of this article is to analyze the effect of corruption behavior on access to health care in public hospitals in Benin. The methodological approach adopted in this work explains the probability, for a user in contact with the health services of public hospitals, of developing corrupt behaviors [1, 2]. The estimation of selection model, based on survey data from users of public hospitals in Benin, shows that corruption behavior facilitates access to health care for applicant. But taking collectively, they slow down the normal functioning of health care services, create a congestion effect and increase the vulnerability of users of public health hospitals. In addition, the estimation results reveal a negative and significant effect between drug diversion and corrupt behavior on the one hand and the fact of not having social security coverage decreases the probability of developing corruption behaviors other. The study recommends, on the one hand, the establishment of surveillance mechanisms for public hospital actors and, on the other hand, an increase in penalties for corrupt behavior.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121089526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Transportation Service Quality on Customer Satisfaction: Evidence from Amhara Region, Ethiopia","authors":"G. Getachew","doi":"10.11648/J.HEP.20190402.13","DOIUrl":"https://doi.org/10.11648/J.HEP.20190402.13","url":null,"abstract":"The main objective of this study was to assess the impact of transportation service quality on customer satisfaction; in case of Debre Markos city. To achieve the objective of this study, data was collected through close-ended and open-ended questionnaires from 320 respondents who are Bajaj customers. Stratified random sampling was employed to categorize Bajaj associations into ten strata according to their beginning terminals and convenience sampling method was used to select sample population from each strata. Primary and secondary data were used for this study and quantitative and qualitative method also employed. This study was undertaken in one year and hence, used Cross-sectional method. This study has used transportation service quality dimensions like reliability, security, comfort, safety and convenience as independent variables and customer satisfaction as dependent variable. Data collected by using schedules were analyzed by using statistical analysis such as descriptive and inferential analysis. Descriptive statistic such as frequency, percentage, mean, standard deviation and inferential statistic such as correlation and multiple linear regressions were calculated by Statistical Package for Social Science (SPSS) version 20. The correlation result revealed that there is a significant relationship between independent variables and dependent variable. The result from regression analysis indicates that reliability, security, comfort, safety and convenience have a significant effect on customer satisfaction. The finding revealed that Bajaj customers are moderately satisfied with the current service supply. Recommendations for improvement in service quality resulting in customer satisfaction have been made.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124016820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Access to Oral Health Care for Precarious and Non-precarious Populations in Abidjan, Côte d'Ivoire","authors":"Sangaré Abou Dramane, S. Mamadou, Meless Guanga David, Adou Akpe Jonas, Traore Jules Fabrice, Guinan Jean-Claude, R. Bakayoko-Ly","doi":"10.11648/J.HEP.20190402.12","DOIUrl":"https://doi.org/10.11648/J.HEP.20190402.12","url":null,"abstract":"The situation of insecurity resulting from precariousness raises concerns about the oral health of the victims. The objective of this study was to compare the dental status and the modalities of the use of oral care of people in precarious situations to those of non-precarious. A cross-sectional survey was conducted among 256 users of the dental office of the University Hospital of Treichville, in precarious situation or not. Subjects in precarious situations were identified using a tracking tool to take into account the context of the intervention. The respondents were interviewed using a standardized questionnaire. The data collected made it possible to calculate percentages and comparisons of the modalities of oral health care use between \"precarious\" and \"not precarious\" using the Chi2 test. Subjects in precarious situations had more recourse to self-medication (84.6%) at first intention than subjects who were not precarious (p=0,011). Renunciation of oral health care was more common in the \"precarious\" group than in the \"non- precarious\" group (p=0,004). The number of missing teeth among people in precarious situations was twice as high as among \"not precarious\" subjects. On the other hand, the number of filled teeth (O) was 3 times higher in \"not precarious\" subjects than in \"precarious\" subjects. The results of this study show the need for awareness raising and the implementation of a social protection system guaranteeing greater accessibility to care for people in precarious situations and even for the population as a whole.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122257247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Implications of District Splitting on the Constitution and Functionality of District Service Commissions in Uganda: A Case Study of 8 Districts in Uganda","authors":"Aloysius Mutebi, X. Nsabagasani, F. Makumbi, E. Rutebemberwa","doi":"10.11648/J.HEP.20190402.11","DOIUrl":"https://doi.org/10.11648/J.HEP.20190402.11","url":null,"abstract":"In Uganda district splitting occurs when new districts are created out of old districts using existing boundaries which usually constitute a health sub district or county boundary. The Ugandan system of local governance is based on the district as a functional unit under which there are lower local governments and administrative units that follow the devolution system of decentralisation. The aim of this study was therefore to assess issues affecting constitution, functionality and operationalization (establishment and appointment) of District Service Commission (DSCs). This was an exploratory cross-sectional study that used qualitative methods about the implications of the phenomenon of district splitting (creation) in relation to constitution and functionality of the district service commissions and human resources for health management. We purposively collected data from 16 key informants based on their roles and responsibilities on the DSCs. Out of the eight districts in the study, only one district constituted a fully functional DSC while the remaining seven districts managed to constitute DSCs in a period between 6 and 12 months. This study shows that splitting negatively affected both the parent and child (new) districts in sense that they could not constitute a complete committee within the stipulated time of three months. Generally, all the districts have had challenges in constituting the DSCs of 5-7 commission committee members. Only one in the eight districts had managed to constitute a full committee within three months of post-splitting. After districts are split, majority of the DSCs especially in the child districts took over almost a year to be constituted and fully functional due to mainly lack of qualified members for example retired senior civil servants in these districts. All the eight districts had a challenge of political interference during the process of appointing the technical team, which delayed constitution of quorum of DSCs in the districts. Lack of resources to carry out most of the DSC functions was also mentioned in all districts as a major hindrance to the district councils which were responsible for appointing DSC members. The DSCs should be allowed to operate with no political interference and this can be enacted as a law by parliament.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126976992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude and Factors Affecting Out-of-Pocket Medical Expenditure among Outpatients in ST.Paul Hospital Millennium College, Addis Ababa, Ethiopia","authors":"Amelewerk Alemu, M. Aklilu, Wogayehu Tadele","doi":"10.11648/J.HEP.20190401.14","DOIUrl":"https://doi.org/10.11648/J.HEP.20190401.14","url":null,"abstract":"The Objectives of the study is to assess the magnitude and factor that affect out-of pocket medical expenditure among outpatients department in St Paul’s hospital Millennium College, Addis Ababa, Ethiopia. An Institution-based cross-sectional study in quantitative method was conducted among outpatient services. The required sample size is determined by single population and double population proportion formula. The final sample size was 422. A descriptive statistical analysis, binary and multivariable logistic regression model was used to describe the findings. Gender, marital status, educational status, occupation, family size, total income was statistically associated with TOOPME at Sig< 0.2. Statistically associated with TOOPME In multivariate analysis were marital status (B=.197; CI 95%190.2-585; sig .000), Occupation status (B=-.174; CI 95%-180—39.6; sig .002), family size (B=.229; CI 95%58-150; sig .000), and total income (B=.305; CI 95%10Table: 1 9-227; sig .000). The financing system of health care should be based on the principle of cost sharing so that there will be resource pooling among the poor and the rich. The financing mechanism should also move into prepayment schemes or insurance to protect the poor from unanticipated health care costs.","PeriodicalId":213187,"journal":{"name":"International Journal of Health Economics and Policy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130502345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}