Template-Type: ReDIF-Paper 1.0
Author-Name: Mebratie, A.D.
Author-Name-Last: Mebratie
Author-Name-First: Anagaw
Author-Name: Sparrow, R.A.
Author-Name-Last: Sparrow
Author-Name-First: Robert
Author-Person: psp22
Author-Name: Alemu, G.
Author-Name-Last: Alemu
Author-Name-First: Getnet
Author-Name: Bedi, A.S.
Author-Name-Last: Bedi
Author-Name-First: Arjun Singh
Author-Person: pbe710
Title: Community-Based Health Insurance Schemes
Abstract: Due to the limited ability of publicly financed health systems in developing countries to provide adequate access to health care, community-based health financing has been proposed as a viable option. This has led to the implementation of a number of Community- Based Health Insurance (CBHI) schemes, in several developing countries. To assess the ability of such schemes in meeting their stated objectives, this study systematically reviews the existing empirical evidence on three outcomes – access to schemes, effect on health care utilization and effect on financial protection. In addition to collating and summarizing the evidence we analyse the link between key scheme design characteristics and their effect on outcomes and comment on the role that may be played by study characteristics in influencing outcomes. The review shows that the ultra-poor are often excluded and at the same time there is evidence of adverse selection. The bulk of the studies find that access to CBHI is associated with increased health care utilization, especially with regard to the use of relatively cheaper outpatient care services as opposed to inpatient care. The schemes also appear to mitigate catastrophic healthcare expenditure. There are clear links between scheme design and effectiveness suggesting the importance of involving the target population in designing and implementing CBHI schemes.
Creation-Date: 2013-10-30
File-URL: https://repub.eur.nl/pub/50087/wp568.pdf
File-Format: application/pdf
Series: RePEc:ems:euriss
Number: 568
Keywords: catastrophic health expenditure, community health insurance, low-income groups
Handle: RePEc:ems:euriss:50087