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Universal health insurance

Lauren Suchman, Elizabeth Hart, Dominic Montagu
Social health insurance (SHI), one mechanism for achieving universal health coverage, has become increasingly important in low- and middle-income countries (LMICs) as they work to achieve this goal. Although small private providers supply a significant proportion of healthcare in LMICs, integrating these providers into SHI systems is often challenging. Public-private partnerships in health are one way to address these challenges, but we know little about how these collaborations work, how effectively, and why...
June 13, 2018: Health Policy and Planning
Sebastian Olikira Baine, Alex Kakama, Moses Mugume
BACKGROUND: Kisiizi Hospital Health Insurance scheme started in 1996 to; improve access to health services, and provide a stable source of funding and reduce bad debts to Kisiizi hospital. Objectives of this study were; to describe Kisiizi Hospital Health Insurance scheme and to document lessons learned and implications for universal health coverage. METHODS: This was a descriptive cross-sectional study. Data from different sources were triangulated and thematically analysed...
June 15, 2018: BMC Health Services Research
Samia Laokri, Rieza Soelaeman, David R Hotchkiss
BACKGROUND: The goal of universal health coverage is challenging for chronically under-resourced health systems. Although household out-of-pocket payments are the most important source of health financing in low-income countries, relatively little is known about the drivers of primary health care expenditure and the predictability of the burden associated with high fee-for-service payments. This study describes out-of-pocket health expenditure and investigates demand- and supply-side drivers of excessive costs in the Democratic Republic of Congo (DRC), a central African country in the midst of a process of reforming its health financing system towards universal health coverage...
June 15, 2018: BMC Health Services Research
Sarah Mantovani, Nora Allan, Risa Pesapane, Laurie Brignolo, Janet Foley
  Staff at a university laboratory responsible for management of a captive insurance colony of endangered Amargosa voles ( Microtus californicus scirpensis) discovered an outbreak of tropical rat mites ( Ornithonyssus bacoti) infesting 106 voles. This bloodsucking mesostigmatid mite typically occurs in laboratory settings and can cause weight loss, wounds, or other negative impacts on health. The source of the infestation was likely feral rodents, and the route was suspected to be straw bedding. Twenty-nine of the 106 (27...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Caroline Roveri Marin, Renata Cristina Gasparino, Ana Claudia Puggina
OBJECTIVES: 1) To identify the patient's perception of invasion of territorial and personal space and 2) to evaluate whether personal characteristics, housing conditions and characteristics of the hospital unit affect this perception. METHODS: Analytical, cross-sectional and quantitative study. An adapted version of the "Anxiety Due to Territory and Space Intrusion Questionnaire" was applied with patients hospitalized in the internal medicine and maternity wards and in the ward for patients with private health insurance of a university hospital in the state of São Paulo...
2018: PloS One
Ushma D Upadhyay, Alice F Cartwright, Nicole E Johns
PURPOSE: A proposed California law will require student health centers at public universities to provide medication abortion. To understand its potential impact, we sought to describe current travel time, costs, and wait times to access care at the nearest abortion facilities. METHODS: We projected total medication abortion use based on campus enrollment figures and age- and state-adjusted abortion rates. We calculated distance and public transit time from campuses to the nearest abortion facility...
June 9, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Hye Yin Park, Yun-Chul Hong, Ichiro Kawachi, Juhwan Oh
BACKGROUND: While controversies on limitation of coverage by the national health insurance and relatively high direct or "out-of-pocket" household payments by the national health insurance in South Korea still remain, potential unfavorable influence of the insufficiency of the universal health coverage on depression has not yet been evaluated. METHODS AND FINDINGS: Baseline information were obtained from a community cohort (The Korean Genome and Epidemiology Study) of middle-aged subjects without depression at enrollment period (2001-2002)...
2018: PloS One
Andres Pichon-Riviere, Natalie Soto, Federico Augustovski, Laura Sampietro-Colom
OBJECTIVES: Latin American countries are taking important steps to expand and strengthen universal health coverage, and health technology assessment (HTA) has an increasingly prominent role in this process. Participation of all relevant stakeholders has become a priority in this effort. Key issues in this area were discussed during the 2017 Latin American Health Technology Assessment International (HTAi) Policy Forum. METHODS: The Forum included forty-one participants from Latin American HTA agencies; public, social security, and private insurance sectors; and the pharmaceutical and medical device industry...
June 11, 2018: International Journal of Technology Assessment in Health Care
Juliet Okoroh, Samuel Essoun, Anthony Seddoh, Hobart Harris, Joel S Weissman, Lydia Dsane-Selby, Robert Riviello
BACKGROUND: Approximately 150 million people suffer from financial catastrophe annually because of out-of-pocket expenditures (OOPEs) on health. Although the National Health Insurance Scheme (NHIS) of Ghana was designed to promote universal health coverage, OOPEs as a proportion of total health expenditures remains elevated at 26%, exceeding the WHO's recommendations of less than 15-20%. To determine whether enrollment in the NHIS reduces the likelihood of OOPEs and catastrophic health expenditures (CHEs) in Ghana, we undertook a systematic review of the published literature...
June 7, 2018: BMC Health Services Research
Adebayo Aremu Ibikunle, Abdurrazaq Olanrewaju Taiwo, Ramat Oyebunmi Braimah
BACKGROUND: There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no published audit of the surgeries performed exist. This study aims to present the pattern and types of major surgeries done by oral and maxillofacial surgeons in our hospital as well as the indications for such surgeries. It is hoped that the findings will assist in formulating informed policies and improving healthcare delivery...
June 7, 2018: BMC Health Services Research
Chih-Hsien Liao, Ning Lu, Chao-Hsiun Tang, Hui-Chih Chang, Kuo-Cherh Huang
Background: There is still significant uncertainty as to whether market competition raises or lowers clinical quality in publicly funded healthcare systems. We attempted to assess the effects of market competition on inpatient care quality of stroke patients in a retrospective study of the universal single-payer health insurance system in Taiwan. Methods: In this 11-year population-based study, we conducted a pooled time-series cross-sectional analysis with a fixed-effects model and the Hausman test approach by utilizing two nationwide datasets: the National Health Insurance Research Database and the National Hospital and Services Survey in Taiwan...
June 4, 2018: European Journal of Public Health
Clara Piffaretti, Vincent Looten, Sylvie Rey, Jeanne Fresson, Anne Fagot-Campagna, Philippe Tuppin
OBJECTIVE: This study was designed to further our knowledge of the management of pregnant women based on the national health data system (SNDS). MATERIAL AND METHODS: Women covered by the national health insurance general scheme, who delivered in 2015. RESULTS: Among the 672,182 women included (mean age: 31 years, SD 5.3), 0.3% were under the age of 18 years, 4% lived in a French overseas department (<18 years: 21%), 17% had complementary universal health insurance coverage (<18 years: 75%), 1...
June 2, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Karen Mulligan, Julia Thornton Snider, Phyllis Arthur, Gregory Frank, Mahlet Tebeka, Amy Walker, Jason Abrevaya
BACKGROUND: Immunization against numerous potentially life-threatening illnesses has been a great public health achievement. In the United States, the Vaccines for Children (VFC) program has provided vaccines to uninsured and underinsured children since the early 1990s, increasing vaccination rates. In recent years, some states have adopted Universal Purchase (UP) programs with the stated aim of further increasing vaccination rates. Under UP programs, states also purchase vaccines for privately-insured children at federally-contracted VFC prices and bill private health insurers for the vaccines through assessments...
June 1, 2018: Vaccine
Hyungtae Kim, Cheol-Hyeong Lee, Sung-Hun Kim, Yeon-Dong Kim
Chronic regional pain syndrome (CRPS) is an inflammatory and neuropathic pain disorder characterized by the involvement of the autonomic nervous system with sensory, autonomic, motor, skin, and bone changes. At present, universally accepted consensus criteria for CRPS are not yet established, despite the diagnostic criteria proposed by the International Association for the Study of Pain (IASP). Various hypotheses for the pathophysiology of CRPS have been proposed; as a result, current therapeutic modalities are varied...
2018: PloS One
Pei-Chien Tsai, Ta-Wei Liu, Chung-Feng Huang, Ming-Lun Yeh, Chia-Yen Dai, Wan-Long Chuang, Jee-Fu Huang, Ming-Lung Yu
BACKGROUND: A direct-acting antiviral (DAA) era in hepatitis C virus (HCV) treatment is fast approaching; unfortunately, the availability and affordability of DAAs in Asia-Pacific areas vary, making it difficult to develop universal HCV practice guidelines appropriate for the all Asian populations. This study aimed to evaluate the real-world cost-effectiveness of IFN-based therapy according to the current strategies with PegIFN/RBV for "easy-to-treat" to provide a reference for application of future DAA development for IFN-eligible, treatment naïve HCV patients...
May 31, 2018: Journal of the Chinese Medical Association: JCMA
Falk Schwendicke, Joachim Krois, Christian H Splieth, Nicola Innes, Mark Robertson, Julian Schmoeckel, Ruth M Santamaria
OBJECTIVES: The Hall Technique (HT), Non-Restorative Cavity Control (NRCC) and conventional carious tissue removal and restoration (CR) are strategies for managing cavitated caries lesions in primary molars. A randomized controlled three-arm parallel group trial in a university clinic in Germany was used to measure the cost-effectiveness of these strategies. METHODS: 142 children (HT: 40; NRCC: 44; CR: 58) were followed over a mean 2.5 years. A German healthcare perspective was chosen...
May 30, 2018: Journal of Dentistry
Thomas Rice, Lynn Y Unruh, Ewout van Ginneken, Pauline Rosenau, Andrew J Barnes
Since the election of Donald Trump as President, momentum towards universal health care coverage in the United States has stalled, although efforts to repeal the Affordable Care Act (ACA) in its entirety failed. The ACA resulted in almost a halving of the percentage of the population under age 65 who are uninsured. In lieu of total repeal, the Republican-led Congress repealed the individual mandate to purchase health insurance, beginning in 2019. Moreover, the Trump administration is using its administrative authority to undo many of the requirements in the health insurance exchanges...
May 22, 2018: Health Policy
Nele Van der Wielen, Andrew Amos Channon, Jane Falkingham
BACKGROUND: Population ageing presents considerable challenges for the attainment of universal health coverage (UHC), especially in countries where such coverage is still in its infancy. Ghana presents an important case study on the effectiveness of policies aimed at achieving UHC in the context of population ageing in low and middle-income countries. It has witnessed a profound recent demographic transition, including a large increase in the number of older adults, which coincided with the development and implementation of a National Health Insurance Scheme (NHIS), designed to help achieve UHC...
May 24, 2018: BMC Public Health
John M McLaughlin, Qin Jiang, Raul E Isturiz, Heather L Sings, David L Swerdlow, Bradford D Gessner, Ruth M Carrico, Paula Peyrani, Timothy L Wiemken, William A Mattingly, Julio A Ramirez, Luis Jodar
Background: Following universal recommendation for use of 13-valent pneumococcal conjugate vaccine (PCV13) in US adults aged ≥65 years in September 2014, we conducted the first real-world evaluation of PCV13 vaccine effectiveness (VE) against hospitalized vaccine-type community-acquired pneumonia (CAP) in this population. Methods: Using a test-negative design, we identified cases and controls from a population-based surveillance study of adults in Louisville, Kentucky, who were hospitalized with CAP...
May 21, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ki Yong Hong, Yoosung Son, Hak Chang, Ung Sik Jin
BACKGROUND: Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. METHODS: Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database...
May 2018: Archives of Plastic Surgery
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