Health Economics Review最新文献

{"title":"Cost-benefit analysis of the quarantine policy during the outbreak of the Covid-19 virus in Iran.","authors":"Morteza Tahamipour Zarandi, Kimia Haghbandeh","doi":"10.1186/s13561-025-00626-7","DOIUrl":"10.1186/s13561-025-00626-7","url":null,"abstract":"<p><strong>Background: </strong>The outbreak of COVID-19 posed significant health and economic challenges worldwide, prompting governments to implement various containment measures, including quarantine policies. This study examines the cost-benefit analysis of Iran's quarantine policy during the pandemic, evaluating its economic impact, public health outcomes, and overall effectiveness. The research explores the direct and indirect costs of quarantine, including reduced economic activity, government expenditures, and social consequences, while assessing the benefits in terms of lives saved, healthcare system relief, and long-term economic stability. Findings suggest that while quarantine measures imposed substantial financial burdens, they played a crucial role in controlling the virus's spread and preventing a greater economic and human toll. The study highlights the necessity of balancing public health interventions with economic sustainability, offering insights for future pandemic response strategies.</p><p><strong>Methods: </strong>This study has used the cost-benefit analysis method. In the financial evaluation, benefits such as the reduction of fuel costs, gratuitous payments, and the benefit of credits paid to employees have been compared to expenses such as the average cost of corona treatment in the hospital and at home for the population of employees who have contracted the disease. Also, in the economic evaluation, the benefits of reducing electricity costs and food for employees, the willingness of people to pay the government for protective measures, and reducing overtime payments to employees compared to costs such as food for hospitalized employees, paying subsidies to employees and reducing GDP Has been studied.</p><p><strong>Results: </strong>Application of quarantine is optimal from the view of government employees (financial point of view) with a benefit-cost ratio of 1.98, and the government's point of view (economic point of view) is cost-effective with a benefit-cost ratio of 2.68.</p><p><strong>Conclusions: </strong>These results indicate that applying quarantine for employees benefits both the people and the government. Thus, the results of this study can be a guide for policymakers in managing similar disasters or the spread of other strains of the Coronavirus in the future.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"67"},"PeriodicalIF":3.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the construction of high-speed rail crowding out the market for medical care services at county? Quasi-experimental evidence from China.","authors":"Liu Yang, Zhongliang Zhou, Yawei Huang, Sha Lai, Chi Shen","doi":"10.1186/s13561-025-00661-4","DOIUrl":"10.1186/s13561-025-00661-4","url":null,"abstract":"<p><strong>Background: </strong>Public transportation, including high-speed rail (HSR), exerts a significant influence on people's health and health-related behaviors in various ways around the world. Several studies have investigated the impact of HSR on patients' health-seeking behavior, however, many issues regarding the impact of HSR remain to be investigated in depth. We aim to explore whether the effect of HSR on patients' health-seeking behavior crowds out the market for medical services in county regions based on China's practice.</p><p><strong>Methods: </strong>The opening of two important HSR lines connecting two megacities in western China, Xi'an to Chengdu (opened on December 6, 2017) and Yinchuan to Xi'an (opened on December 26, 2020), were considered as quasi-experimental intervention, and Event Study and Synthetic Difference-in-Differences (DID) research design were applied in this study. A monthly report database about county-level hospitals of the health statistical data collection from 2017 to 2018 and 2020 to 2021 was used.</p><p><strong>Results: </strong>There is no significant change in the total number of visits (TOV) and the number of bed days occupied by discharged persons (BDODP) in county-level hospitals before and after the opening of two major HSR lines being observed. The estimates of TOV from synthetic DID were 319.38 (95% CI, -761.01, 1399.77) and -915.69 (95% CI, -5079.07, 3247.68) for the two HSR lines, respectively. The estimates of BDODP from synthetic DID were -581.34 (95% CI, -1555.27, 392.59) and -960.62 (95% CI, -3932.40, 2011,17) for the two HSR lines, respectively. The results from the event study DID estimates are in line with the synthetic DID.</p><p><strong>Conclusions: </strong>Our findings suggest that the construction of HSR does not substantially modify the utilization of medical services at the county level. Moreover the effect of the construction of HSR on the flow of patients to large hospitals may be an incremental effect. These findings hold important implications for infrastructure policy, suggesting that improvements in transportation can coexist with and perhaps even bolster local healthcare services without compromising their usage.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"66"},"PeriodicalIF":3.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health shocks and households' vulnerability to poverty in Nigeria: a quasi-experimental analysis.","authors":"Paul Eze, Chimere O Iheonu","doi":"10.1186/s13561-025-00660-5","DOIUrl":"10.1186/s13561-025-00660-5","url":null,"abstract":"<p><p>Health shocks are a critical driver of poverty in low- and middle-income countries (LMICs). This study investigates the impact of health shocks on household poverty risk in Nigeria and evaluates the protective capacity of existing health insurance mechanisms, using data from the 2023/2024 General Household Survey (n = 4,779 households). We first estimated household vulnerability using Chaudhuri's (2003) Vulnerability as Expected Poverty framework, addressing heteroskedasticity in consumption estimation via feasible generalized least squares. We then modeled the probability of household vulnerability following health shocks using probit regression. Finally, we implemented propensity score matching to isolate the effect of health shocks on households' vulnerability. Our results indicate that 56.1% and 59.2% of Nigerian households are vulnerable to poverty, using the international ($2.15/day) and national ($2.48/day) poverty lines, respectively. Vulnerable households are more prevalent in northern regions, rural areas, larger households, and poorer households. We found evidence that, based on the international poverty line, health shocks significantly increased the probability of household vulnerability (ATT = 0.053, SE = 0.023) compared to matched households without health shocks, with a slightly higher impact (ATT = 0.054, SE = 0.023) if using the national poverty line. Household size, dependency ratio, household head's education and employment status, and residence were significant predictors of vulnerability. Despite their potential, health insurance, covering only 2.2% of households, did not offer adequate protection against health shocks. This study provides robust evidence that health shocks increase households' vulnerability to poverty and perpetuate existing poverty. Financial protection measures need to be considered in broader poverty reduction policies.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"65"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability of national health insurance scheme in Ghana: what is the effect of enrolment on retention and what are the constraints?","authors":"Nicholas Kwame Essah","doi":"10.1186/s13561-025-00619-6","DOIUrl":"10.1186/s13561-025-00619-6","url":null,"abstract":"<p><strong>Background: </strong>Globally, health remains an important issue on governments agenda. Subsequently, the health insurance scheme was introduced in Ghana to reduce out-of-pocket payments for healthcare delivery. However, there are several challenges facing the scheme including continuous membership (retention) and financial constraints. These issues pose threat to the sustainability of the scheme. This study examined the effect of NHIS enrolment status on NHIS retention status in Ghana. The study further assesses the socio-demographic determinants of the NHIS retention and the major constraints in Ghana.</p><p><strong>Methods: </strong>The expected utility theory of decision-making on health insurance underpins the study. The study's sample is drawn from the Ghana Living Standards Survey Round 7 (2016/2017) and the Heckman probit estimation technique is used to address the potential endogeneity in the sample selection process.</p><p><strong>Results: </strong>There is positive effect of NHIS enrolment on the NHIS retention decision. Again, the study shows that the NHIS retention is driven by factors such as being female, being married, higher education, urban locality and household expenditure affect NHIS retention status positively. However, younger age and household size were found to deter NHIS retention status. The study further identified finance as the main constraint for the NHIS non- retention in Ghana (66.6%) followed by poor service delivery (12.5%). The financial constraint was higher for females (69.1%) than males (64.0%). It is also higher for rural areas (75.4%) than urban areas (48.8%).</p><p><strong>Conclusions: </strong>Government should continue to strengthen efforts towards improving the quality of NHIS service delivery and monitor the implementation particularly in the rural areas. Again, government should continue to subsidize the health insurance premium particularly for the poor and the youth in Ghana. Also, public education should continue to be strengthened on the NHIS renewal process in Ghana.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"64"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calculating willingness-to-pay with discrete cost and random coefficients in discrete choice experiments.","authors":"Clarence Ong, Alex R Cook, Ker-Kan Tan, Yi Wang","doi":"10.1186/s13561-025-00658-z","DOIUrl":"10.1186/s13561-025-00658-z","url":null,"abstract":"<p><strong>Objectives: </strong>This study provides step-by-step guidance to calculate willingness-to-pay (WTP) in discrete choice experiments that involve discrete cost. It highlights the limitations of assuming a linear disutility for cost in WTP calculation.</p><p><strong>Methods: </strong>Five mixed-logit models were considered. Log-normal distributions were applied to cost parameters for four models under the assumption that utility (disutility) for cost should be negative (positive) or at least non-positive (non-negative) for all individuals. Piecewise linear utility in cost, using an iterative process, was proposed to calculate the WTP for the discrete cost models. Individual level simulations - considering individual random preference - were conducted to obtain the median WTP across all individuals and compared with the population mean WTP. A case study exploring preferences for colorectal cancer screening was used to demonstrate these models and methods.</p><p><strong>Results: </strong>Models utilising discrete cost exhibited higher disutilities in cost at lower costs relative to models using continuous cost, but lower disutilities in cost at higher costs. Modelling using continuous cost tended to overestimate the WTP at low costs and underestimate the WTP at high costs. Adding a quadratic cost term only partially solved the problem, as the quadratic functional form may not capture the sharp change in preference for cost at low-cost levels. Divergent policy recommendations emerged when comparing results from continuous and discrete cost models. Although WTP was calculated using the population mean and the median across individuals, no systematic pattern was identified.</p><p><strong>Conclusion: </strong>This study highlights the importance of incorporating discrete cost and selecting appropriate distribution assumptions for cost parameters to accurately derive the WTP.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"63"},"PeriodicalIF":2.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural insights in the underuse of cardiac resynchronisation therapy in heart failure: a pilot survey on incentive perceptions among referring cardiologists.","authors":"Joan Costa-I-Font, Georgiana Miler-Raicu, Elena Arbelo, Ruben Casado-Arroyo, Aya Sami, Eric Wei Seong Tee, Joseph Hazel, Laurent Roten, Tobias Reichlin, Haran Burri, Khaled Albouaini, Nikola Kozhuharov","doi":"10.1186/s13561-025-00657-0","DOIUrl":"10.1186/s13561-025-00657-0","url":null,"abstract":"<p><strong>Aims: </strong>Heart failure is a leading cause of hospitalisation in patients over 50, significantly impacting both quality of life and survival. Despite the well-established benefits of Cardiac Resynchronisation Therapy (CRT), its utilisation in clinical practice remains suboptimal. Traditional incentives, have shown limited effectiveness in increasing CRT referrals. This manuscript explores how behavioural economics can offer a novel framework for improving CRT uptake by leveraging behavioural incentives, particularly choice architecture and social incentives, to influence physician referral patterns.</p><p><strong>Methods and results: </strong>We underscore key concepts of behavioural economics, including choice architecture (nudges, reference points, sludges), cognitive biases (status quo bias, overconfidence bias, availability bias), and social incentives, which are applied in designing incentives to promote CRT referrals. A survey was conducted with 51 physicians from six European countries, including electrophysiologists, heart failure specialists, and general cardiologists, recruited through cardiology networks and personal contacts. Participants rated their perceptions of five incentive strategies using a Likert scale (1-5). Behavioural incentives, such as peer comparison through league tables (social incentive) and decision prompts in electronic health records (choice architecture nudge), were perceived as more effective than traditional financial incentives, with a median Likert score of 4.0 [IQR 3.0-5.0] versus 2.5 [IQR 1.5-3.0] for traditional incentives (p < 0.001).</p><p><strong>Conclusions: </strong>These findings suggest that interventions drawing on behavioural economics, particularly those utilising social incentives and choice architecture redesign, may offer more effective to increasing CRT referrals than traditional incentives. Such interventions could enhance CRT uptake and outcomes for heart failure patients.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"62"},"PeriodicalIF":2.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of penpulimab plus carboplatin-paclitaxel as first-line treatment for metastatic squamous non-small-cell lung cancer in China.","authors":"Luwei Wang, Jiasheng Chen, Lihui Lin, Xiaowei Huang","doi":"10.1186/s13561-025-00656-1","DOIUrl":"10.1186/s13561-025-00656-1","url":null,"abstract":"<p><strong>Purpose: </strong>Squamous NSCLC (sqNSCLC), a subtype with few targetable mutations, is often diagnosed at advanced stages. Platinum-based chemo-therapy, the first-line treatment, yields median overall survival (OS) of less than or equal to one year, underscoring the need for better therapies. Penpulimab, a novel PD-1 inhibitor developed in China, is a humanized IgG1 antibody with a modified Fc region. Phase III trial data (AK105-302) showed penpulimab + carboplatin-paclitaxel (PEN-CP) significantly improved progression-free survival (PFS) and OS in metastatic sqNSCLC vs. placebo (CP), with a favorable safety profile. However, its high cost and lack of cost-effectiveness analyses warrant further study. This research evaluates PEN-CP's cost-effectiveness vs. CP from the Chinese healthcare perspective.</p><p><strong>Methods: </strong>A three-state Markov model was developed to evaluate the cost-effectiveness of PEN-CP as a first-line treatment for metastatic sqNSCLC. Clinical efficacy data were sourced from the AK105-302 trial, while drug costs were derived from national tender prices. Additional costs and health utilities were obtained from published literature. The primary outcomes included total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). To assess the robustness of the findings, both one-way and probabilistic sensitivity analyses were conducted.</p><p><strong>Results: </strong>Compared to CP, the ICER for PEN-CP was $14,918.81 per QALY. The ICER values were below the willingness-to-pay (WTP) threshold of $38,060.00 per QALY. The key drivers of the model outcomes were the price of penpulimab, the PFS stage utility value, and the cost of optimal supportive care.</p><p><strong>Conclusions: </strong>From the perspective of the Chinese healthcare system, penpulimab combined with first-line chemotherapy demonstrates is cost-effective at a willingness-to-pay threshold of $38,060.00 per QALY for patients with metastatic sqNSCLC and represents a promising first-line treatment option.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"60"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring patient and provider perspectives on health insurance effectiveness in cameroon: a qualitative study.","authors":"Adanze Nge Cynthia, Bülent Kılıç","doi":"10.1186/s13561-025-00655-2","DOIUrl":"10.1186/s13561-025-00655-2","url":null,"abstract":"<p><strong>Background: </strong>The global push to achieve universal health coverage (UHC) by 2030 has gained widespread attention, with many countries, including low- and middle-income nations like Cameroon, striving to implement reforms. However, financial, infrastructural, and systemic barriers make achieving UHC in Cameroon challenging. In pursuit of this goal, health insurance systems, particularly private health insurance, have been increasingly promoted to reduce out-of-pocket health expenses. However, the key question remains whether patients receive value for their money. This study aimed to examine the perspectives of patients and healthcare providers on the effectiveness of health insurance in Cameroon, with a focus on awareness, satisfaction, and the challenges influencing its accessibility and functionality.</p><p><strong>Method: </strong>Following ethical approvals, this study employed a qualitative exploratory design, using key informant interviews (KII) to examine the perspectives of patients and healthcare providers on the effectiveness of health insurance in Cameroon. The study focused on awareness, satisfaction, and challenges influencing accessibility and functionality. Reflective thematic analysis was used to identify important aspects of our study.</p><p><strong>Result: </strong>To ensure that the identified themes accurately represented the data and remained distinct, they were systematically reviewed and refined. This process resulted in five main themes: (1) Accessibility and Quality of Healthcare Services, (2) The Financial Paradox of Health Insurance, (3) Structural and Operational Challenges in the Health Insurance Framework, (4) Information Gaps and Awareness about Health Insurance, and (5) Divergent Experiences and Perspectives on Health Insurance Effectiveness. All participants agreed that health insurance reduces out-of-pocket health costs. Uninsured patients cited high premiums, distrust in the healthcare system, and insufficient knowledge about insurance options as reasons for not enrolling. Insured patients expressed significant dissatisfaction with their insurance packages, particularly with lengthy reimbursement processes and inadequate medical coverage.</p><p><strong>Conclusion: </strong>The findings indicate a general agreement on the benefits of health insurance in Cameroon. To improve enrolment and satisfaction, premiums need to be made affordable across all socioeconomic levels, and consider increasing information dissemination and publicity about insurance options. Streamlining reimbursement processes is also crucial.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"59"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public perceptions of high-cost cancer drugs and the implications for reimbursement decisions.","authors":"Youran Noh, Kyung-Bok Son","doi":"10.1186/s13561-025-00659-y","DOIUrl":"10.1186/s13561-025-00659-y","url":null,"abstract":"<p><strong>Background: </strong>Reimbursing high-cost cancer drugs presents challenges in managing uncertainty, setting appropriate prices, and controlling pharmaceutical expenditures. We examined the perspectives of the South Korean public on high-cost cancer drugs and policy options to improve reimbursement for these treatments.</p><p><strong>Methods: </strong>We conducted a self-rated, web-based survey from November to December 2023. We used a quota sampling method based on South Korean census data to recruit study participants. The questionnaire comprised four sections: socio-demographics, definitions of high-cost cancer drugs and reasons for their reimbursement, uncertainties associated with high-cost cancer drugs, and policy options to improve reimbursement for these treatments.</p><p><strong>Results: </strong>Of the 11,974 invitations sent, 1,000 participants completed the survey, resulting in a response rate of 8.35%. Three-quarters of the respondents agreed or strongly agreed that high-cost cancer drugs should be reimbursed. More than 70% accepted the need for price negotiations, even if they lead to drug withdrawals or delays in reimbursement decisions. A similar proportion agreed that new policy options, such as dual pricing and additional funding, should be introduced with caution.</p><p><strong>Conclusion: </strong>The South Korean public perceives the reimbursement of high-cost cancer drugs as both a human rights measure and a government responsibility. However, they support reimbursement only when they are confident that the drug is safe, effective, and cost-effective.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"61"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of the impacts of health insurance coverage on wealth stratification in some selected sub-Saharan countries.","authors":"Amaama Abdul Malik, Muhittin Kaplan","doi":"10.1186/s13561-025-00629-4","DOIUrl":"10.1186/s13561-025-00629-4","url":null,"abstract":"<p><strong>Background: </strong>Health is a crucial component of an economy, influencing the performance of various sectors. As a result, nearly every country has implemented health policies to achieve the United Nations Development Goals and Universal Health Coverage (UHC) targets, which focus on providing universal access to necessary, sufficient, and quality healthcare without financial barriers. Implementing such policies in the sub-Saharan region led Burundi, Gabon, Ghana, and Rwanda to emerge as the only four countries in the region to have healthcare coverage over 20%. This study sought to investigate whether the health insurance policies implemented impact the wealth stratification of households in these countries.</p><p><strong>Methods: </strong>The study used data from the sub-Saharan region section of the Demographic and Health Surveys (DHS) Program by the U.S. Agency for International Development (USAID) with Robust Ordered Probit Estimation Technique.</p><p><strong>Results: </strong>The results show that health insurance negatively impacts the Wealth levels of those in the poorest, poorer, and middle-income levels in Burundi and Rwanda more than those in the wealthiest group. Community-based insurance in Gabon and national health insurance in Ghana positively impact the income of lower households.</p><p><strong>Conclusions: </strong>The government should improve social amenities, especially in rural areas. Also, the study identified limited information as one reason for the outcome. We propose increasing education on the importance of health and the benefit package when one subscribes to a health insurance scheme to encourage patronage and decrease out-of-pocket expenditure.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"58"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}