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Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

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Global Health Journal 2024年第2期8卷 83-90页

作者： zecharias fetene anteneh Anagaw D.Mebratie Zemzem Shigute Getnet Alemu Arjun S.Bedi Center for Health Economics University of YorkYorkUnited Kingdom School of Public Health College of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia International Institute of Social Studies Erasmus University Rotterdamthe Haguethe Netherlands Institute of Development and Policy Research Addis Ababa UniversityAddis AbabaEthiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness *** is growing concern about the financial sustainability of CBHI schemes in developing ***,few empirical studies have identified potential contributors,including ex-ante and ex-post moral *** We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in *** The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before ***,CBHI significantly increases delay in treatment-seeking behaviour for diseases ***,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured *** While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health *** delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor ***,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

关键词： Community-based health insurance Financial sustainability Preventive care Treatment-seeking behavior Household fixed effect Ethiopia

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