Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial
No hay miniatura disponible
Fecha
Título de la revista
ISSN de la revista
Título del volumen
Editor
World Bank, Washington, DC
Resumen
Descripción
Subsidized voluntary enrollment in
government-run health insurance schemes is often proposed as
a way of increasing coverage among informal sector workers
and their families. This paper reports the results of a
cluster randomized control trial in which 3,000 households
in 20 communes in Vietnam were randomly assigned at baseline
to a control group or one of three treatments: an
information leaflet about Vietnam s government-run scheme
and the benefits of health insurance; a voucher entitling
eligible household members to 25 percent off their annual
premium; and both. The four groups were balanced at
baseline. In the control group, 6.3 percent (82/1296) of
individuals were enrolled in the endline, compared with 6.3
percent (79/1257), 7.2 percent (96/1327), and 7.0 percent
(87/1245) in the information, subsidy, and combined
intervention groups; the adjusted odds ratios were 0.94,
1.12, and 1.15, respectively. Only among those reporting
poor health were any significant intervention effects found,
and only for the combined intervention: an enrollment rate
of 16.3 percent (33/202) compared with 8.3 percent (18/218)
in the control group, and an adjusted odds ratio of 2.50.
The results suggest limited opportunities to raise voluntary
health insurance enrollment through information campaigns
and subsidies, and that these interventions exacerbate
adverse selection.
Palabras clave
ADVERSE SELECTION, CHEMOTHERAPY, COMMUNES, COMMUNITIES, COMMUNITY HEALTH, DEMAND FOR HEALTH, DEMAND FOR INSURANCE, DIALYSIS, DISTRICTS, ENROLLEES, EXPECTED LOSS, FAMILIES, FINANCIAL INCENTIVES, FINANCIAL PROTECTION, HEALTH CARE, HEALTH COVERAGE, HEALTH ECONOMICS, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INSURANCE, HEALTH INSURANCE ENROLLMENT DECISION, HEALTH INSURANCE PROGRAM, HEALTH INSURANCE SCHEME, HEALTH INSURANCE SCHEMES, HEALTH ORGANIZATION, HEALTH PLANNING, HEALTH POLICY, HEALTH STRATEGY, HEALTH SYSTEM, HEALTH SYSTEM PERFORMANCE, HEALTH SYSTEMS, HEALTH-CARE, HOUSEHOLD INCOME, HOUSEHOLDS, HUMAN DEVELOPMENT, INCOME COUNTRIES, INFORMAL SECTOR, INFORMAL SECTOR WORKERS, INFORMATION CAMPAIGNS, INFORMATION PACK, INSURANCE COVERAGE, INSURANCE PREMIUM, INTERVENTION, INTERVENTIONS, LIVING STANDARDS, LOCALITIES, MEDICAL PERSONNEL, PHYSICIAN, POLICY DISCUSSIONS, POLICY RESEARCH, PRIMARY CARE, PROBABILITY, PUBLIC HOSPITAL, SOCIAL HEALTH INSURANCE, SOCIAL SCIENCE, SOCIAL SECURITY, SOCIAL SECURITY HEALTH INSURANCE, TREATMENTS, UNIVERSAL HEALTH INSURANCE COVERAGE, WORKERS