Publication: Health Insurance: Use of Health Care Services by the Poor - Efficiency and Equity Issues in the Province of Kon Tum
Loading...
Published
2009-05-15
ISSN
Date
2017-09-05
Author(s)
Editor(s)
Abstract
The study merged two databases: the database on patients' visits collected for claim control and reimbursement purpose and, the database on the insured that is used to issue the health insurance cards. This study investigated these issues through the analysis of individual's health insurance data of the Provincial Social Security (PSS) heath insurance of Kon Tum. One of the important political goals in the coming years is the achievement of universal coverage of health insurance. For that purpose the government is pursuing the strategy (started in 2005) to provide free health insurance cards to all the poor, the ethnic minority populations and the persons living in remote or mountainous areas. One of the important political goals in the coming years is the achievement of universal coverage of health insurance. For that purpose the government is pursuing the strategy (started in 2005) to provide free health insurance cards to all the poor, the ethnic minority populations and the persons living in remote or mountainous areas.
Link to Data Set
Citation
“Castel, Paulette. 2009. Health Insurance: Use of Health Care Services by the Poor - Efficiency and Equity Issues in the Province of Kon Tum. © World Bank. http://hdl.handle.net/10986/28102 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Establishing Private Health Care Facilities in Developing Countries : A Guide for Medical Entrepreneurs(2007)This book is a practical guide for medical professionals who are interested in establishing health care facilities in developing countries. It is intended for individuals and organizations with little or no business experience who are seeking guidance on how to turn a general idea into concrete reality. The author's goals in writing the book were modest. The guide does not provide an exact roadmap for building a hospital or other type of health care facility, nor is there any guarantee that the new entrepreneur who follows the approach described will be able to obtain financing from investors. Rather, the book is designed as an introductory resource with which to begin the process.Publication Jamkesmas Health Service Fee Waiver(World Bank, Jakarta, 2012-02)Macroeconomic growth and incomes have been on the rise since the Asian Financial Crisis (AFC), but health service utilization and health outcomes in Indonesia have been slower to improve. Jamkesmas could provide valuable benefits by allowing cardholders to acquire preventative, curative, and catastrophic health care services without fees. When it promotes healthy households, keeps students active, alert, and participating in their education, returns adults to work sooner, and saves households from the high costs of healthcare, Jamkesmas' sizeable individual benefits should be matched by increased social benefits resulting from a healthy and productive population. Jamkesmas has been provided to poor households, but many non-poor have also received Jamkesmas benefits due to dual central and local targeting processes which have led to frequent mismatches and errors in coverage. Health service providers find Jamkesmas difficult and costly to implement resulting in fewer services provided, and funds spent, on Jamkesmas beneficiaries. Local regulations regarding public health center management often conflict with Jamkesmas mandates, leaving health service providers confused and unwilling to use Jamkesmas funds to provide Jamkesmas beneficiaries with planned services. The future costs of an improved Jamkesmas program have not been adequately publicized and Jamkesmas' financial, fiscal, and political sustainability is uncertain.Publication The Nuts & Bolts of Jamkesmas, Indonesia’s Government-Financed Health Coverage Program for the Poor and Near-Poor(World Bank, Washington DC, 2013-01)This case study describes and assesses Jamkesmas, Indonesia's government-financed health coverage program for the poor and near-poor. It provides a detailed description of the scope, depth, and breadth of coverage provided under Jamkesmas, and highlights ways in which the program interacts with the rest of Indonesia's health system. It also summarizes and discusses evidence on whether Jamkesmas is attaining its stated objectives of removing financial barriers and improving access to health care by the poor and near-poor, what could be improved, and what lessons can be learned from the experience of Jamkesmas that could help inform Indonesia's quest for universal coverage. The primary theme underlying the study is that supply-side constraints and supply-side subsidies have not been leveraged to increase the effectiveness of the Jamkesmas program. There are significant geographic deficiencies in the availability and quality of the basic benefits package, especially for those living in relatively remote and rural locations of the country, and this limits the effective availability of benefits for many Jamkesmas beneficiaries. The remainder of the case study is organized as follows. Section two provides general background and information on health system outcomes in Indonesia. Section three is an overview of health care financing and delivery. Section four describes the institutional architecture of Jamkesmas. Section five highlights the process of targeting, identification, and enrolment of beneficiaries under the program. Section six focuses on the role of public financing. Section seven outlines the basic benefits package. Section eight provides an overview of the information environment of Jamkesmas. Section nine discusses the special theme of supply-side constraints and supply-side subsidies that dilute the effectiveness of the Jamkesmas program. Section ten discusses the pending agenda around some of the architectural and operational features of Jamkesmas in the context of universal coverage.Publication Public Spending in Russia for Health Care : Issues and Options(Washington, DC, 2008-08)This report examines three critically important areas to inform discussions on the appropriate level of health care spending in the Russian Federation: (i) the efficiency of spending on health care services; (ii) distributional impacts of spending on health care services; and (iii) the key factors that will influence the growth in health care spending over the next 20 years. There are few data showing how spending in health care in the Russian Federation translates into better health outcomes such as improved mortality, improved morbidity, increased economic output and productivity, improvements in the number of life years gained, or more sophisticated composite measures such as Quality Adjusted Life Years (QALYs). There is also limited data on outputs of hospitals and other healthcare providers which allow controlling for case mix, socioeconomic status, supply-side variables, and quality of care. Therefore, it is difficult to assess the efficiency or distributional impacts of health interventions. While the analysis draws on primary data specifically collected for the study, the absence of detailed output and outcome data necessarily limits the scope of the study and its findings.Publication Health Provider Payment Reforms in China(Washington, DC, 2010)This paper examines health provider payment reforms in China the present system and how it evolved, and changes that will improve it in the context of ongoing health reform. The paper begins with a brief introduction and background discussion followed by two substantive sections experiments with case-based payment systems, and experiments with alternative government budget payment methods. This is followed by an examination of what has worked in China and elsewhere. The concluding discussion considers lessons for China and next steps. Many policy instruments and reforms have been implemented to use National Cooperative Medical System (NCMS), Basic Medical Insurance (BMI), and government health budgets more efficiently. These include alternative payment systems, reduced drug prices, essential drug lists, controlled use of high technologies, and strengthening the primary healthcare system.
Users also downloaded
Showing related downloaded files
Publication Niger's Infrastructure : A Continental Perspective(2011-06-01)Between 2000 and 2005 infrastructure made a net contribution of less than a third of a percentage point to the improved per capita growth performance of Niger, one of the lowest contributions in Sub-Saharan Africa. Raising the country's infrastructure endowment to that of the region s middle-income countries could boost annual growth in Niger by about 4.5 percentage points. Niger has made significant progress in some areas of its infrastructure, including water and telecommunications. But the country still faces a number of important infrastructure challenges, the most pressing of which is probably in the water and sanitation sector, as 82 percent of Nigeriens still practice open defecation, the highest in the continent. Niger also faces significant challenges in the power sector, as only 8 percent of the population is electrified. Niger currently spends about $225 million per year on infrastructure, leaving an annual funding gap of $460 million even after savings from curing inefficiencies are taken into account. Niger can close that gap by tapping alternative sources of financing or by adopting lower-cost technologies. There is plenty of room for private-sector participation in Niger's infrastructure sectors, and the adoption of lower-cost technologies could reduce the funding gap by almost half.Publication Creating Shared Value through Basic Business Strategy(World Bank, 2008-06-01)Demonstrates how Nestle's milk district model achieves a balance between meeting the needs of the poor and expanding Nestle's own business.Publication Reducing Inequalities in Water Supply, Sanitation, and Hygiene in the Era of the Sustainable Development Goals(World Bank, Washington, DC, 2017-08)The Sustainable Development Goals (SDGs) and the World Bank’s corporate goals of ending extreme poverty and boosting shared prosperity call for specific attention to the poor and vulnerable. The overarching objective of the SDGs is to end poverty in all its forms, but their key difference from the earlier Millennium Development Goals (MDGs) is the integration of social, economic, and environmental goals (UN 2015). This has significant implications for reforms aimed at improving service delivery. With this understanding as its guiding compass, the Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic Initiative focuses on what it would take to reduce existing inequalities in WASH services worldwide. This report, a synthesis of that global initiative, offers new insights on how data can be used to inform allocation decisions to reduce inequalities and prioritize investment in WASH to boost human capital. It also offers a fresh perspective on service delivery that considers how institutional arrangements affect the incentives of a range of actors.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication The Impact of the COVID-19 Pandemic on Women-Led Businesses(World Bank, Washington, DC, 2021-10)The COVID-19 pandemic has struck businesses across the globe with unprecedented impacts. The world economy has been hit hard and firms have experienced a myriad of challenges, but these challenges have been heterogeneous across firms. This paper examines one important dimension of this heterogeneity: the differential effect of the pandemic on women-led and men-led businesses. The paper exploits a unique sample of close to 40,000 mainly formal businesses from 49 countries covering the months between April and September 2020. The findings show that women-led micro-businesses, women-led businesses in the hospitality industry, and women-led businesses in countries more severely affected by the COVID-19 shock were disproportionately hit compared with businesses led by men. At the same time, women-led micro-firms were markedly more likely to report increasing the use of digital platforms, but less likely to invest in software, equipment, or digital solutions. Finally, the findings also show that women-led businesses were less likely to have received some form of public support although they have been hit harder in some domains. In a crisis of the magnitude of the COVID-19 pandemic, evidence tracing the impact of the shock in a timely fashion is desperately needed to help inform the design of policy interventions. This real-time glimpse into women-led businesses fills this need for robust and policy-relevant evidence, and due to the large country coverage of the data, it is possible to identify patterns that extend beyond any one country, region, or sector, but at the cost of some granularity for testing more complex economic theories.