The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review
This paper summarizes the literature on the impact of state subsidized or social health insurance schemes that have been offered, mostly on a voluntary basis, to the informal sector in low- and middle-income countries. A substantial number of paper...
Main Authors: | , , , , , , |
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Language: | English en_US |
Published: |
World Bank, Washington, DC
2013
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Subjects: | |
Online Access: | http://documents.worldbank.org/curated/en/2013/01/17187939/impact-health-insurance-schemes-informal-sector-low--middle-income-countries-systematic-review http://hdl.handle.net/10986/12163 |
Summary: | This paper summarizes the literature on
the impact of state subsidized or social health insurance
schemes that have been offered, mostly on a voluntary basis,
to the informal sector in low- and middle-income countries.
A substantial number of papers provide estimations of
average treatment on the treated effect for insured persons.
The authors summarize papers that correct for the problem of
self-selection into insurance and papers that estimate the
average intention to treat effect. Summarizing the
literature was difficult because of the lack of (1)
uniformity in the use of meaningful definitions of outcomes
that indicate welfare improvements and (2) clarity in the
consideration of selection issues. They find the uptake of
insurance schemes, in many cases, to be less than expected.
In general, we find no strong evidence of an impact on
utilization, protection from financial risk, and health
status. However, a few insurance schemes afford significant
protection from high levels of out-of-pocket expenditures.
In these cases, however, the impact on the poor is weaker.
More information is needed to understand the reasons for low
enrollment and to explain the limited impact of health
insurance among the insured. |
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