Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal

Sanjeeb Shah; Nilambar Jha; Vijay Kumar Khanal; Gyanu Nepal Gurung; Mausam Shrestha; Bibek Shah

doi:doi:10.11648/j.hep.20220703.14

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Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal

Sanjeeb Shah, Nilambar Jha, Vijay Kumar Khanal, Gyanu Nepal Gurung, Mausam Shrestha, Bibek Shah

Published in International Journal of Health Economics and Policy (Volume 7, Issue 3)

Received: 16 July 2022 Accepted: 1 August 2022 Published: 10 August 2022

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Abstract

Nepal remains committed to achieving universal health coverage, to ensure that government introduced social health insurance program in Illam district with objective that everyone should get health services they need and in doing so they should not go under the financial hardship. The study aims to assess the achievement of the program objective by determining the catastrophic health expenditure. A cross-sectional study was conducted in Illam district of Nepal, among 300 insured households whose date of service had come into effect. Face to face interview was done to collect the data using pretested semi-structured questionnaire with the sample selected through multi-stage random sampling technique. Binary logistic regression analysis was used to identify the factors associated with catastrophic health expenditure. The prevalence of catastrophic health expenditure was 13.2%. Additionally, univariate analysis showed household income and saving were mostly used for coping with out-of-pocket health payment while multivariate analysis revealed that No. of working Member in household, Presence of Under five children, Presence of chronic illness, Poverty line of household were significant factors associated with catastrophic health expenditure. Despite of the high utilization, social health insurance has not reduced the catastrophic health expenditure however, it has contained it. Thus, to further decrease the financial hardship, government needs to redesign the benefit package with wider scope and control the provider side moral hazard.

Published in	International Journal of Health Economics and Policy (Volume 7, Issue 3)
DOI	10.11648/j.hep.20220703.14
Page(s)	65-70
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Social Health Insurance, Catastrophic Health Expenditure, Illam, Nepal

References

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APA Style

Sanjeeb Shah, Nilambar Jha, Vijay Kumar Khanal, Gyanu Nepal Gurung, Mausam Shrestha, et al. (2022). Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal. International Journal of Health Economics and Policy, 7(3), 65-70. https://doi.org/10.11648/j.hep.20220703.14

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ACS Style

Sanjeeb Shah; Nilambar Jha; Vijay Kumar Khanal; Gyanu Nepal Gurung; Mausam Shrestha, et al. Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal. Int. J. Health Econ. Policy 2022, 7(3), 65-70. doi: 10.11648/j.hep.20220703.14

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AMA Style

Sanjeeb Shah, Nilambar Jha, Vijay Kumar Khanal, Gyanu Nepal Gurung, Mausam Shrestha, et al. Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal. Int J Health Econ Policy. 2022;7(3):65-70. doi: 10.11648/j.hep.20220703.14

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@article{10.11648/j.hep.20220703.14,
  author = {Sanjeeb Shah and Nilambar Jha and Vijay Kumar Khanal and Gyanu Nepal Gurung and Mausam Shrestha and Bibek Shah},
  title = {Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal},
  journal = {International Journal of Health Economics and Policy},
  volume = {7},
  number = {3},
  pages = {65-70},
  doi = {10.11648/j.hep.20220703.14},
  url = {https://doi.org/10.11648/j.hep.20220703.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20220703.14},
  abstract = {Nepal remains committed to achieving universal health coverage, to ensure that government introduced social health insurance program in Illam district with objective that everyone should get health services they need and in doing so they should not go under the financial hardship. The study aims to assess the achievement of the program objective by determining the catastrophic health expenditure. A cross-sectional study was conducted in Illam district of Nepal, among 300 insured households whose date of service had come into effect. Face to face interview was done to collect the data using pretested semi-structured questionnaire with the sample selected through multi-stage random sampling technique. Binary logistic regression analysis was used to identify the factors associated with catastrophic health expenditure. The prevalence of catastrophic health expenditure was 13.2%. Additionally, univariate analysis showed household income and saving were mostly used for coping with out-of-pocket health payment while multivariate analysis revealed that No. of working Member in household, Presence of Under five children, Presence of chronic illness, Poverty line of household were significant factors associated with catastrophic health expenditure. Despite of the high utilization, social health insurance has not reduced the catastrophic health expenditure however, it has contained it. Thus, to further decrease the financial hardship, government needs to redesign the benefit package with wider scope and control the provider side moral hazard.},
 year = {2022}
}

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TY  - JOUR
T1  - Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal
AU  - Sanjeeb Shah
AU  - Nilambar Jha
AU  - Vijay Kumar Khanal
AU  - Gyanu Nepal Gurung
AU  - Mausam Shrestha
AU  - Bibek Shah
Y1  - 2022/08/10
PY  - 2022
N1  - https://doi.org/10.11648/j.hep.20220703.14
DO  - 10.11648/j.hep.20220703.14
T2  - International Journal of Health Economics and Policy
JF  - International Journal of Health Economics and Policy
JO  - International Journal of Health Economics and Policy
SP  - 65
EP  - 70
PB  - Science Publishing Group
SN  - 2578-9309
UR  - https://doi.org/10.11648/j.hep.20220703.14
AB  - Nepal remains committed to achieving universal health coverage, to ensure that government introduced social health insurance program in Illam district with objective that everyone should get health services they need and in doing so they should not go under the financial hardship. The study aims to assess the achievement of the program objective by determining the catastrophic health expenditure. A cross-sectional study was conducted in Illam district of Nepal, among 300 insured households whose date of service had come into effect. Face to face interview was done to collect the data using pretested semi-structured questionnaire with the sample selected through multi-stage random sampling technique. Binary logistic regression analysis was used to identify the factors associated with catastrophic health expenditure. The prevalence of catastrophic health expenditure was 13.2%. Additionally, univariate analysis showed household income and saving were mostly used for coping with out-of-pocket health payment while multivariate analysis revealed that No. of working Member in household, Presence of Under five children, Presence of chronic illness, Poverty line of household were significant factors associated with catastrophic health expenditure. Despite of the high utilization, social health insurance has not reduced the catastrophic health expenditure however, it has contained it. Thus, to further decrease the financial hardship, government needs to redesign the benefit package with wider scope and control the provider side moral hazard.
VL  - 7
IS  - 3
ER  -

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Author Information

Sanjeeb Shah

School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
Nilambar Jha

School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
Vijay Kumar Khanal

School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
Gyanu Nepal Gurung

School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
Mausam Shrestha

Karuna Foundation Nepal, Biratnagar, Nepal
Bibek Shah

ICU Department, Chitwan Medical College, Bharatpur, Nepal

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APA Style

Sanjeeb Shah, Nilambar Jha, Vijay Kumar Khanal, Gyanu Nepal Gurung, Mausam Shrestha, et al. (2022). Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal. International Journal of Health Economics and Policy, 7(3), 65-70. https://doi.org/10.11648/j.hep.20220703.14

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ACS Style

Sanjeeb Shah; Nilambar Jha; Vijay Kumar Khanal; Gyanu Nepal Gurung; Mausam Shrestha, et al. Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal. Int. J. Health Econ. Policy 2022, 7(3), 65-70. doi: 10.11648/j.hep.20220703.14

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AMA Style

Sanjeeb Shah, Nilambar Jha, Vijay Kumar Khanal, Gyanu Nepal Gurung, Mausam Shrestha, et al. Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal. Int J Health Econ Policy. 2022;7(3):65-70. doi: 10.11648/j.hep.20220703.14

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@article{10.11648/j.hep.20220703.14,
  author = {Sanjeeb Shah and Nilambar Jha and Vijay Kumar Khanal and Gyanu Nepal Gurung and Mausam Shrestha and Bibek Shah},
  title = {Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal},
  journal = {International Journal of Health Economics and Policy},
  volume = {7},
  number = {3},
  pages = {65-70},
  doi = {10.11648/j.hep.20220703.14},
  url = {https://doi.org/10.11648/j.hep.20220703.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20220703.14},
  abstract = {Nepal remains committed to achieving universal health coverage, to ensure that government introduced social health insurance program in Illam district with objective that everyone should get health services they need and in doing so they should not go under the financial hardship. The study aims to assess the achievement of the program objective by determining the catastrophic health expenditure. A cross-sectional study was conducted in Illam district of Nepal, among 300 insured households whose date of service had come into effect. Face to face interview was done to collect the data using pretested semi-structured questionnaire with the sample selected through multi-stage random sampling technique. Binary logistic regression analysis was used to identify the factors associated with catastrophic health expenditure. The prevalence of catastrophic health expenditure was 13.2%. Additionally, univariate analysis showed household income and saving were mostly used for coping with out-of-pocket health payment while multivariate analysis revealed that No. of working Member in household, Presence of Under five children, Presence of chronic illness, Poverty line of household were significant factors associated with catastrophic health expenditure. Despite of the high utilization, social health insurance has not reduced the catastrophic health expenditure however, it has contained it. Thus, to further decrease the financial hardship, government needs to redesign the benefit package with wider scope and control the provider side moral hazard.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Social Health Insurance and Its Role in Catastrophic Health Expenditure: A Cross-Sectional Study in Illam District, Nepal
AU  - Sanjeeb Shah
AU  - Nilambar Jha
AU  - Vijay Kumar Khanal
AU  - Gyanu Nepal Gurung
AU  - Mausam Shrestha
AU  - Bibek Shah
Y1  - 2022/08/10
PY  - 2022
N1  - https://doi.org/10.11648/j.hep.20220703.14
DO  - 10.11648/j.hep.20220703.14
T2  - International Journal of Health Economics and Policy
JF  - International Journal of Health Economics and Policy
JO  - International Journal of Health Economics and Policy
SP  - 65
EP  - 70
PB  - Science Publishing Group
SN  - 2578-9309
UR  - https://doi.org/10.11648/j.hep.20220703.14
AB  - Nepal remains committed to achieving universal health coverage, to ensure that government introduced social health insurance program in Illam district with objective that everyone should get health services they need and in doing so they should not go under the financial hardship. The study aims to assess the achievement of the program objective by determining the catastrophic health expenditure. A cross-sectional study was conducted in Illam district of Nepal, among 300 insured households whose date of service had come into effect. Face to face interview was done to collect the data using pretested semi-structured questionnaire with the sample selected through multi-stage random sampling technique. Binary logistic regression analysis was used to identify the factors associated with catastrophic health expenditure. The prevalence of catastrophic health expenditure was 13.2%. Additionally, univariate analysis showed household income and saving were mostly used for coping with out-of-pocket health payment while multivariate analysis revealed that No. of working Member in household, Presence of Under five children, Presence of chronic illness, Poverty line of household were significant factors associated with catastrophic health expenditure. Despite of the high utilization, social health insurance has not reduced the catastrophic health expenditure however, it has contained it. Thus, to further decrease the financial hardship, government needs to redesign the benefit package with wider scope and control the provider side moral hazard.
VL  - 7
IS  - 3
ER  -

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