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The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review / Arnab Acharya

World Bank Open Knowledge Repository (formerly "World Bank E-Library Publications") Available online

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Format:
Book
Government document
Author/Creator:
Acharya, Arnab
Contributor:
Acharya, Arnab
Burke, Margaret
Ebrahim, Shah
Masset, Edoardo
Satija, Ambika
Taylor, Fiona
Vellakkal, Sukumar
Series:
Policy research working papers.
World Bank e-Library.
Language:
English
Subjects (All):
Health Economics & Finance.
Health Insurance.
Health insurance.
Health Law.
Health Monitoring & Evaluation.
Health Systems Development & Reform.
Health-care utilization.
Insurance & Risk Mitigation.
Macroeconomics and Economic Growth.
Out-of-pocket expenditures.
Local Subjects:
Health Economics & Finance.
Health Insurance.
Health insurance.
Health Law.
Health Monitoring & Evaluation.
Health Systems Development & Reform.
Health-care utilization.
Insurance & Risk Mitigation.
Macroeconomics and Economic Growth.
Out-of-pocket expenditures.
Physical Description:
1 online resource (46 pages)
Other Title:
Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries
Place of Publication:
Washington, D.C., The World Bank, 2013
System Details:
data file
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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