Assessment of the medical expenditure of the basic health insurance in Morocco.

INTRODUCTION: The health care consumption for the population insured by the Basic Health Insurance in Morocco are paid directly to the care providers for the health care or health products from the health insurance funds. The level of expenditure recorded is changing at an accelerated rate than the financial resources. The objective of this study is to evaluate the health care consumption care by the insured population under the Basic Health Insurance. METHODS: This is a cross-sectional study analysis of the economic data collected by the National Moroccan Health Insurance Agency Related to the expenditures from the health insurance fund for both public and private sectors to identify the behavior of the consumption of health care by the insured population under the Basic Health Insurance. RESULTS: The medical expenditure of the covered population by the basic Health Insurance in Morocco has almost doubled from 354800 to 652500 US Dollars between 2009 and 2014 with significant increase in the public sector than the private sector. The share of expenditures in the public ambulatory care sector under Basic Health Insurance is higher relative to the hospital care. Although in the private sector the share of expenditures for both types of care varies. In 2014, the drug item expenditure accounted for 33% of Health Insurance expenses for both sectors. The level of health care consumption among the population in Long-Term Illness (LTI) represents 49,29% of the total expenditure by the Health Insurance whereas its insured covered population does not exceed 2,78%. CONCLUSION: Controlling the medical expenditure of the health insurance requires strengthening and the development of regulatory measures that contribute to the health reforms. For chronic diseases, it is necessary to put in place prevention actions.

[Corrigendum: The characteristics of the population covered by Compulsory Health Insurance (CMI) in Morocco]. / Corrigendum: Les caractéristiques de la population couverte par le régime de l'assurance maladie obligatoire au Maroc.

[This corrects the article DOI: 10.11604/pamj.2018.30.266.13209.][This corrects the article DOI: 10.11604/pamj.2018.30.266.13209.].

Impact of Disparities in Reimbursement Rules Between Public and Private Sectors on Accessibility to Care in Moroccan Mandatory Health Insurance: A Cross-Sectional Study.

BACKGROUND: Disparities in the reimbursement rules between the 2 funds that manage mandatory health insurance in Morocco could negatively affect the accessibility of insured persons to healthcare services and products. OBJECTIVE: The objective is to analyze the impact of these disparities on access to care and to assess the insured's copayment difference between the 2 funds. METHODS: Healthcare utilization rates of the insured population in the 2 funds were analyzed by sector, sex, and age groups for 2014. We also looked at the percentage of copayment paid by the insured depending on the fund, methods of reimbursement, type of care, and nature of diseases. The analysis was based on data retrieved and aggregated at the National Agency for Health Insurance. RESULTS: The healthcare utilization rate differs significantly between the 2 funds. It is higher for the insured in the public sector (45%) compared with those in the private sector (18.5%) (P < .001). The healthcare utilization rate differs significantly according to the age groups in the 2 sectors (P < .001, respectively), and according to the sex of the insured in the 2 sectors (the healthcare utilization rate is higher for women than for men [P < .001, respectively]). The copayment percentage incurred by insured persons was 32.1% for employees in the public sector and 36.4% for employees in the private sector. CONCLUSION: Differences in reimbursement rules between the 2 funds may be the cause of inequity in access to care between insured persons. This situation can jeopardize the objectives of a universal and equitable health insurance scheme.

[Corrigendum: The characteristics of the population covered by Compulsory Health Insurance (CMI) in Morocco]. / Corrigendum: Les caractéristiques de la population couverte par le régime de l'assurance maladie obligatoire au Maroc.

[This corrects the article DOI: 10.11604/pamj.2018.30.266.13209.][This corrects the article DOI: 10.11604/pamj.2018.30.266.13209.].