Effect of Universal Health Coverage On The Demand For Health Care In Togo
International Journal of Medical Science |
© 2021 by SSRG - IJMS Journal |
Volume 8 Issue 9 |
Year of Publication : 2021 |
Authors : Akom Ilessan Dossou |
How to Cite?
Akom Ilessan Dossou, "Effect of Universal Health Coverage On The Demand For Health Care In Togo," SSRG International Journal of Medical Science, vol. 8, no. 9, pp. 1-15, 2021. Crossref, https://doi.org/10.14445/23939117/IJMS-V8I9P101
Abstract:
The issue of universal health insurance is one of the orientations of the Togolese government's policy in the health sector. The objective of this study is to analyze the effect of health insurance on the demand for health care in Togo, approximately ten years after one of the first signs of this political will, which is the compulsory insurance of government employees. Using data from a nationally representative survey, with the help of an ordered logistic regression and a propensity score matching method to overcome endogeneity issues, we show an increase in the demand for health care, linked to health insurance. This effect is associated with a decrease in consultation costs for insured persons and is more accentuated for public care and the most vulnerable populations, calling for strong actions in favor of these groups who are the least covered.
Keywords:
Health insurance, Demand, health care, Matching, Ordered logistic model
References:
[1] Adu, K. O. Effects of national health insurance status on individual's choice of healthcare facility in selected Regions of Ghana. International Journal of Statistics and Economics, 21(1) (2020) 25-40.
[2] Agbanyo, R. Ghana's national health insurance, free maternal healthcare, and facility-based delivery services. African Development Review, 32(1) (2020) 27-41.
[3] Agbanyo, R., & Peprah, J. A.. National health insurance and the choice of delivery facility among expectant mothers in Ghana. International Journal of Health Economics and Management, 21(1) (2021) 27-49.
[4] Aheto, J. M. K. Simultaneous quantile regression and determinants of under-five severe chronic malnutrition in Ghana. BMC public health, 20 (2020) 1-12.
[5] Anderson, M., Dobkin, C., & Gross, T. The effect of health insurance coverage on the use of medical services. American Economic Journal: Economic Policy, 4(1) (2012) 1-27.
[6] Atake, E. H., & Amendah, D. D. Porous safety net: catastrophic health expenditure and its determinants among insured households in Togo. BMC health services research, 18(1) (2018) 1-12.
[7] Bagnoli, L. Does health insurance improve health for all? Heterogeneous effects on children in Ghana. World Development, 124 (2019) 104636.
[8] Baicker, Katherine, Sendhil Mullainathan, and Joshua Schwartzstein. Behavioral hazard in health insurance. The Quarterly Journal of Economics, 130(4) (2015) 1623-1667.
[9] Becker, S. O., & Caliendo, M. Sensitivity analysis for average treatment effects. The Stata Journal, 7(1) (2007) 71-83.
[10] Bernal, Noelia, Miguel A. Carpio, and Tobias J. Klein. The effects of access to health insurance: evidence from a regression discontinuity design in Peru. Journal of public economics, 154 (2017) 122-136.
[11] Boes, S., & Gerfin, M. Does full insurance increase the demand for health care? Health economics, 25(11) (2016) 1483-1496
[12] Caliendo, M., & Kopeinig, S. Some practical guidance for the implementation of propensity score matching. Journal of economic surveys, 22(1) (2008) 31-72.
[13] Comfort, A. B., Peterson, L. A., & Hatt, L. E. Effect of health insurance on the use and provision of maternal health services and maternal and neonatal health outcomes: a systematic review. Journal of health, population, and nutrition, 31(4 Suppl 2), S81 (2013).
[14] Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. Early effects of the Affordable Care Act on health care access, risky health behaviors, and self-assessed health. Southern Economic Journal, 84(3) (2018) 660-691.1.
[15] Cutler, David M., and Richard J. Zeckhauser, The Anatomy of Health Insurance. Handbook of Health Economics, aj Cuyler and jp newhouse 1(1) (2000).
[16] D'haultfoeuille, X., & Givord, P. Quantile regression in practice. Economics and Statistics, 471(1) (2014) 85-111.
[17] Deaton, A., & Cartwright, N. Understanding and misunderstanding randomized controlled trials. Social Science & Medicine, 210 (2018) 2-21.
[18] Duku, S. K. O., Asenso-Boadi, F., Nketiah-Amponsah, E., & Arhinful, D. K. Utilization of healthcare services and renewal of health insurance membership: evidence of adverse selection in Ghana. Health economics review, 6(1) (2016) 43.
[19] Dunn, Abe, Adam Shapiro, and Eli Liebman, .,Geographic Variation in Commercial Medical Care Expenditures: A Decomposition Between Price and Utilization.,, Journal of Health Economics, 32(6) (2013) 1153-1165.
[20] Dussault, G., Fournier, P., Letourmy, A., Preker, A., Velenyi, E., Carrin, G., ... & Brouillet, P. Health insurance in francophone Africa: improving access to care and fighting poverty The World Bank. 37149 (2006) 1-596.
[21] Erlangga, D., Suhrcke, M., Ali, S., & Bloor, K. The impact of public health insurance on health care utilization, financial protection and health status in low-and middle-income countries: A systematic review. PloS one, 14(8) (2019) e0219731.
[22] Finkelstein, A. The aggregate effects of health insurance: Evidence from the introduction of Medicare. The quarterly journal of economics, 122(1) (2007) 1-37.
[23] Finkelstein, A., Taubman, S., Wright, B., Bernstein, M., Gruber, J., Newhouse, J. P., ... & Oregon Health Study Group. The Oregon health insurance experiment: evidence from the first year. The Quarterly journal of economics, 127(3) (2012) 1057-1106.
[24] Fougère, D. Econometric evaluation methods. Revue française des affaires sociales, (1) (2010) 105-128.
[25] Garrido, M. M., Kelley, A. S., Paris, J., Roza, K., Meier, D. E., Morrison, R. S., & Aldridge, M. D.. Methods for constructing and assessing propensity scores. Health services research, 49(5) (2014) 1701-1720.
[26] Gertler, P. J., Martinez, S., Premand, P., Rawlings, L. B., & Vermeersch, C. M. Impact evaluation in practice. The World Bank (2011).
[27] Ghosh, A., Simon, K., & Sommers, B. D. The effect of health insurance on prescription drug use among low-income adults: evidence from recent Medicaid expansions. Journal of health economics, 63 (2019) 64-80.
[28] Huang, F., & Gan, L. The impacts of China's urban employee basic medical insurance on healthcare expenditures and health outcomes. Health economics, 26(2) (2017) 149163.
[29] Hurd, M. D., & McGarry, K. Medical insurance and the use of health care services by the elderly. Journal of Health Economics, 16(2) (1997) 129-154.
[30] Kang, C., Kawamura, A., & Noguchi, H. Benefits of knowing own health status: effects of health check-ups on health behaviors and labor participation. Applied Economics Letters, (2020) 1-6.
[31] Karan, A., Yip, W., & Mahal, A. Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out-of-pocket spending for healthcare. Social Science & Medicine, 181 (2017) 83-92.
[32] Koenker, R., & Bassett Jr, G. Regression quantiles. Econometrica: Journal of the Econometric Society, 33-50 (1978).
[33] Kuwawenaruwa, A., Ramsey, K., Binyaruka, P., Baraka, J., Manzi, F., & Borghi, J. Implementation and effectiveness of free health
Akom Ilessan Dossou / IJMS, 8(9), 1-15, 2021
15
insurance for the poor pregnant women in Tanzania: A mixed-methods evaluation. Social Science & Medicine, 225 (2019) 17-25.
[34] Lambon-Quayefio, M., & Owoo, N. S. Determinants and the impact of the National Health Insurance on neonatal mortality in Ghana. Health economics review (2017).
[35] Lecocq, A., Ammi, M., & Bellarbre, É. The propensity score: a methodological guide for experimental and quasi-experimental research in education. Measurement and Evaluation in Education, 37(2) (2014) 69-100.
[36] Levine, D., Polimeni, R., & Ramage, I. Ensuring health or insuring wealth? An experimental evaluation of health insurance in rural Cambodia. Journal of Development Economics, 119 (2016) 1-15.
[37] Levy, H., & Meltzer, D. The impact of health insurance on health. Annu. Rev. Public Health, 29 (2008) 399-409.
[38] Makate, C., Wang, R., Makate, M., & Mango, N. Crop diversification and livelihoods of smallholder farmers in Zimbabwe: adaptive management for environmental change. SpringerPlus, 5 (2016) 1-18.
[39] Mati, K., Adegoke, K. K., Michael-Asalu, A., & Salihu, H. M. Health insurance coverage and access to skilled birth attendance in Togo. International Journal of Gynecology & Obstetrics, 141(2) (2018) 181-188.
[40] Mebratie, A. D., Sparrow, R., Yilma, Z., Abebaw, D., Alemu, G., & Bedi, A. S. The impact of Ethiopia's pilot community-based health insurance scheme on healthcare utilization and cost of care. Social Science & Medicine, 220 (2019) 112-119.
[41] Munkin, M. K., & Trivedi, P. K. Bayesian analysis of a self-selection model with multiple outcomes using simulation-based estimation: an application to the demand for healthcare. Journal of Econometrics, 114(2) (2003) 197-220.
[42] Muzurura, J. A Binary Choice Model of the Demand for Health Care Services in Rural Areas of Developing Countries: Is Zimbabwe Different? International Journal of Business Management & Economic Research, 9(5) (2018).
[43] Newhouse, J. P. Free for all?: lessons from the RAND health insurance experiment. Harvard University Press (1993).
[44] Nyman, J. A. Evaluating health insurance: a review of the theoretical foundations. The Geneva Papers on Risk and Insurance-Issues and Practice, 31(4) (2006) 720-738.
[45] Oney, M., The effect of health insurance on sexual health: Evidence from the Affordable Care Act's dependent coverage mandate, Social Science & Medicine, (2018) DOI: 10.1016/ j.socscimed.2018.02.021.
[46] Payandeh, A., Mehrabi, Y., Zayeri, F., & Rezaei Ghahroodi, Z. . Health Expenditure Modelling in Southeast of Iran: A Population-Based Setting Using Quantile Regression Perspective. Health Scope, 6(4) (2017).
[47] Quantin, S. Estimation with the propensity score under R, INSEE.
[48] Roodman, D.. Fitting fully observed recursive mixed-process models with CMP. The Stata Journal, 11(2) (2011) (2018) 159-206.
[49] Rosenbaum, P. R., & Rubin, D. B. The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1) (1983) 41-55.
[50] Sengupta, R., & Rooj, D. The effect of health insurance on hospitalization: Identification of adverse selection, moral hazard and the vulnerable population in the Indian healthcare market. World Development, 122 (2019) 110-129.
[51] Thornton, R. L., Hatt, L. E., Field, E. M., Islam, M., Solís Diaz, F., & González, M. A. Social security health insurance for the informal sector in Nicaragua: a randomized evaluation. Health economics, 19(S1) (2010) 181-206.
[52] Wagner, N., Quimbo, S., Shimkhada, R., & Peabody, J. Does health insurance coverage or improved quality protect better against out-of-pocket payments? Experimental evidence from the Philippines. Social Science & Medicine, 204 ( 2018) 51-58.
[53] Wang, W., Temsah, G., & Mallick, L. The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia, and Rwanda. Health Policy and Planning, 32(3) (2017) 366-375.