Does health insurance mitigate inequities in non-communicable disease treatment? Evidence from 48 low- and middle-income countries.
Health Policy
; 119(9): 1164-75, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-26271138
ABSTRACT
Non-communicable diseases (NCDs) are the greatest contributor to morbidity and mortality in low- and middle-income countries (LMICs). However, NCD care is limited in LMICs, particularly among the disadvantaged and rural. We explored the role of insurance in mitigating socioeconomic and urban-rural disparities in NCD treatment across 48 LMICs included in the 2002-2004 World Health Survey (WHS). We analyzed data about ever having received treatment for diagnosed high-burden NCDs (any diagnosis, angina, asthma, depression, arthritis, schizophrenia, or diabetes) or having sold or borrowed to pay for healthcare. We fit multivariable regression models of each outcome by the interaction between insurance coverage and household wealth (richest 20% vs. poorest 50%) and urbanicity, respectively. We found that insurance was associated with higher treatment likelihood for NCDs in LMICs, and helped mitigate socioeconomic and regional disparities in treatment likelihood. These influences were particularly strong among women. Insurance also predicted lower likelihood of borrowing or selling to pay for health services among the poorest women. Taken together, insurance coverage may serve as an important policy tool in promoting NCD treatment and in reducing inequities in NCD treatment by household wealth, urbanicity, and sex in LMICs.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Disparidades em Assistência à Saúde
/
Seguro Saúde
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Female
/
Humans
/
Male
Idioma:
En
Revista:
Health Policy
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
/
SAUDE PUBLICA
Ano de publicação:
2015
Tipo de documento:
Article