来自加纳农村的证据:医疗保险状况是否影响农村社区的就医行为?

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES
Emmanuel Kumah , Yussif Asana , Samuel Kofi Agyei , Collins Kokuro , Samuel E. Ankomah , Adam Fusheini
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引用次数: 0

摘要

导言:国家医疗保险计划被认为是确保公平获得和利用医疗服务的重要机制,它消除了与在医疗机构就医相关的经济障碍。尽管对许多中低收入国家(LMICs)医疗保险计划的研究表明,医疗保险状况与就医行为之间存在显著关系,但有关这一医疗融资政策对农村居民决定是否寻求正规医疗服务的影响的数据仍然有限。本研究以安徒生-纽曼医疗保健使用行为模型为基础,探讨了医疗保险状况对加纳农村居民医疗保健就医行为的影响。研究方法:本研究于 2022 年 9 月 8 日至 12 月 5 日对加纳 460 名农村居民进行了社区横断面研究。研究采用了卡方检验(Chi-square tests)来研究医疗保健行为与选定自变量之间的显著性水平和关联。结果受访者的平均年龄为 29.6 ± 6.8 岁。略高于半数的受访者(53.1%)表示自己有医疗保险,46.1%的受访者表示自己没有医疗保险。在就医行为方面,最常选择的治疗渠道是传统医士(37.2%),其次是公共医疗系统(28.3%)和自我治疗(18.2%)。选择最少的是私立医疗系统,只有 16.3%。虽然二元分析表明医疗保险状况与就医行为之间存在显著关系(p-0.001),但逻辑回归模型结果显示,医疗保险状况并非就医行为的独立预测因素(p = 0.069)。这项研究为政策制定者提供了重要信息,旨在增加农村和偏远地区获得和利用基于设施的正规医疗服务的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does health insurance status influence healthcare-seeking behavior in rural communities? evidence from rural Ghana

Introduction

National health insurance programs are considered important mechanisms for ensuring equity in access to and utilization of healthcare services by removing financial barriers associated with seeking treatment in healthcare facilities. Although studies on health insurance schemes in many low-and-middle-income countries (LMICs) have demonstrated a significant relationship between health insurance status and healthcare-seeking behavior, data on the influence of this health financing policy on the decision to seek formal healthcare among rural inhabitants remains limited. Underpinned by the Andersen-Newman behavioral model of healthcare use, this study examined the influence of health insurance status on healthcare-seeking behavior among rural dwellers in Ghana.

Methods

A community-based cross-sectional study was conducted among 460 rural residents in Ghana from 8th September to 5th December 2022. Chi-square tests were used to study the significance level and association between healthcare-seeking behavior and selected independent variables. A multiple logistic regression model was fitted to test the association between health insurance status and healthcare-seeking behavior, introducing other selected explanatory variables as controls.

Results

The mean age of the respondents was 29.6 ± 6.8 years. A little above half (53.1 %) disclosed having insurance, whereas 46.1 % stated they were without coverage. Regarding healthcare-seeking behavior, the most commonly chosen treatment source was traditional healers (37.2 %), followed by the public healthcare system (28.3 %) and self-treatment (18.2 %). The private healthcare system was the least preferred, with only 16.3 % opting for it. While the bivariate analysis demonstrated a significant relationship between health insurance status and healthcare-seeking behavior (p-0.001), the logistic regression model results showed that health insurance status was not an independent predictor of healthcare-seeking behavior (p = 0.069).

Conclusion

It could, therefore, not be concluded that the respondents with health insurance coverage were more likely than the uninsured to use formal healthcare providers as their most frequent source of treatment during illness. This study provides vital information for policymakers aiming at increasing access to and utilization of facility-based formal care in rural and remote settings.

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来源期刊
Health Policy Open
Health Policy Open Medicine-Health Policy
CiteScore
3.80
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0.00%
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21
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40 weeks
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