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...

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Main Authors: Acharya, Arnab, Vellakkal, Sukumar, Taylor, Fiona, Masset, Edoardo, Satija, Ambika, Burke, Margaret, Ebrahim, Shah
Format: Policy Research Working Paper
Language:English
en_US
Published: World Bank, Washington, DC 2013
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
id okr-10986-12163
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic ACCESS TO HEALTH CARE
ACCESS TO HOSPITAL
ADVERSE SELECTION
AGING
AGRICULTURAL INSURANCE
ANXIETY
AVAILABILITY OF CARE
BASIC HEALTH CARE
BENEFICIARIES
CATASTROPHIC EXPENDITURES
CATASTROPHIC HEALTH EXPENDITURE
CHECK UPS
CHILD HEALTH
CHILDREN
CHOICE
COINSURANCE
COMMUNITY HEALTH
COMMUNITY INSURANCE
COMPULSORY INSURANCE
COOPERATION
COST-SHARING ARRANGEMENTS
COSTS
CREDIT
DEATH
DIABETES
DOCTORS
DRUGS
ECONOMIC REVIEW
ECONOMICS OF HEALTH
EMPLOYMENT
EPIDEMIOLOGY
EQUILIBRIUM
EQUITY
EQUITY IN ACCESS
EVALUATION
EXPENDITURES
EXPERT OPINIONS
FAMILIES
FEES
FINANCIAL PROTECTION
FINANCIAL RISK
FINANCIAL RISK PROTECTION
FINANCING
FREE CARE
GLUCOSE
GOVERNMENT INSURANCE
HEALTH
HEALTH AFFAIRS
HEALTH CARE
HEALTH CARE CENTERS
HEALTH CARE COSTS
HEALTH CARE COVERAGE
HEALTH CARE FACILITIES
HEALTH CARE FINANCE
HEALTH CARE FINANCING
HEALTH CARE NEEDS
HEALTH CARE PROVISION
HEALTH CARE SYSTEM
HEALTH CARE USE
HEALTH CARE UTILIZATION
HEALTH CENTERS
HEALTH CONDITIONS
HEALTH COSTS
HEALTH ECONOMICS
HEALTH EXPENDITURE
HEALTH EXPENDITURES
HEALTH FINANCING
HEALTH INSURANCE
HEALTH INSURANCE PROGRAM
HEALTH INSURANCE SCHEME
HEALTH INSURANCE SCHEMES
HEALTH ORGANIZATION
HEALTH OUTCOMES
HEALTH POLICY
HEALTH PROFESSIONALS
HEALTH PROJECT
HEALTH SERVICE
HEALTH SERVICES
HEALTH STATUS
HEALTH SYSTEM
HEALTH SYSTEMS
HEALTH WORKERS
HEALTH-CARE
HOSPITAL CARE
HOSPITAL SERVICES
HOSPITALIZATION
HOSPITALS
HUMAN DEVELOPMENT
HYGIENE
ILLNESS
IMPACT EVALUATIONS
IMPERFECT INFORMATION
IMPLEMENTATION
INCENTIVE STRUCTURES
INCENTIVES
INCIDENCE
INCOME
INCOME COUNTRIES
INCOME GROUPS
INFANT MORTALITY
INFANT MORTALITY RATES
INFORMAL SECTOR
INFORMAL SECTOR WORKERS
INPATIENT CARE
INPATIENT HOSPITAL
INSURANCE MARKETS
INSURANCE PREMIUMS
INSURANCE PRODUCTS
INSURANCE SYSTEM
INTEREST
KNOWLEDGE
LIVING STANDARDS
LOSS
LOW INCOME
LOW-INCOME COUNTRIES
MANAGED CARE
MARGINAL COST
MEASUREMENT
MEDICAL CARE
MEDICAL EXPENSES
MEDICAL INSURANCE
MORAL HAZARDS
MORBIDITY
MORTALITY
NATIONAL HEALTH
NATIONAL HEALTH INSURANCE
NATIONAL HEALTH SERVICE
NUTRITION
ORAL HEALTH
OUTPATIENT CARE
OUTPATIENT SERVICES
PATIENT
PATIENTS
PHYSICIAN
POLICY DISCUSSIONS
POLICY RESEARCH
POPULATION
POVERTY
PREGNANCY
PREGNANT WOMEN
PREVENTIVE CARE
PRICE OF HEALTH CARE
PRICES
PRIMARY CARE
PRIMARY HEALTH CARE
PRIVATE CARE
PRIVATE HEALTH INSURANCE
PRIVATE INSURANCE
PRIVATE SECTOR
PROBABILITY
PROGRAMS
PUBLIC HEALTH
PUBLIC HEALTH INSURANCE
PUBLIC HEALTH POLICY
PUBLIC PROVIDERS
PUBLIC SECTOR
RANDOMIZED CONTROLLED TRIALS
RISK AVERSION
RISK SHARING
SAVINGS
SCHOOL HEALTH
SOCIAL HEALTH INSURANCE
SOCIAL INSURANCE
SOCIAL RESEARCH
SOCIAL SECURITY
SOCIAL SECURITY HEALTH INSURANCE
SOCIAL SECURITY HOSPITALS
SOCIAL STUDIES
SURGERY
UNINSURED PEOPLE
USE OF HEALTH CARE SERVICES
USE OF HEALTH SERVICES
VISITS
WELFARE
WORKERS
spellingShingle ACCESS TO HEALTH CARE
ACCESS TO HOSPITAL
ADVERSE SELECTION
AGING
AGRICULTURAL INSURANCE
ANXIETY
AVAILABILITY OF CARE
BASIC HEALTH CARE
BENEFICIARIES
CATASTROPHIC EXPENDITURES
CATASTROPHIC HEALTH EXPENDITURE
CHECK UPS
CHILD HEALTH
CHILDREN
CHOICE
COINSURANCE
COMMUNITY HEALTH
COMMUNITY INSURANCE
COMPULSORY INSURANCE
COOPERATION
COST-SHARING ARRANGEMENTS
COSTS
CREDIT
DEATH
DIABETES
DOCTORS
DRUGS
ECONOMIC REVIEW
ECONOMICS OF HEALTH
EMPLOYMENT
EPIDEMIOLOGY
EQUILIBRIUM
EQUITY
EQUITY IN ACCESS
EVALUATION
EXPENDITURES
EXPERT OPINIONS
FAMILIES
FEES
FINANCIAL PROTECTION
FINANCIAL RISK
FINANCIAL RISK PROTECTION
FINANCING
FREE CARE
GLUCOSE
GOVERNMENT INSURANCE
HEALTH
HEALTH AFFAIRS
HEALTH CARE
HEALTH CARE CENTERS
HEALTH CARE COSTS
HEALTH CARE COVERAGE
HEALTH CARE FACILITIES
HEALTH CARE FINANCE
HEALTH CARE FINANCING
HEALTH CARE NEEDS
HEALTH CARE PROVISION
HEALTH CARE SYSTEM
HEALTH CARE USE
HEALTH CARE UTILIZATION
HEALTH CENTERS
HEALTH CONDITIONS
HEALTH COSTS
HEALTH ECONOMICS
HEALTH EXPENDITURE
HEALTH EXPENDITURES
HEALTH FINANCING
HEALTH INSURANCE
HEALTH INSURANCE PROGRAM
HEALTH INSURANCE SCHEME
HEALTH INSURANCE SCHEMES
HEALTH ORGANIZATION
HEALTH OUTCOMES
HEALTH POLICY
HEALTH PROFESSIONALS
HEALTH PROJECT
HEALTH SERVICE
HEALTH SERVICES
HEALTH STATUS
HEALTH SYSTEM
HEALTH SYSTEMS
HEALTH WORKERS
HEALTH-CARE
HOSPITAL CARE
HOSPITAL SERVICES
HOSPITALIZATION
HOSPITALS
HUMAN DEVELOPMENT
HYGIENE
ILLNESS
IMPACT EVALUATIONS
IMPERFECT INFORMATION
IMPLEMENTATION
INCENTIVE STRUCTURES
INCENTIVES
INCIDENCE
INCOME
INCOME COUNTRIES
INCOME GROUPS
INFANT MORTALITY
INFANT MORTALITY RATES
INFORMAL SECTOR
INFORMAL SECTOR WORKERS
INPATIENT CARE
INPATIENT HOSPITAL
INSURANCE MARKETS
INSURANCE PREMIUMS
INSURANCE PRODUCTS
INSURANCE SYSTEM
INTEREST
KNOWLEDGE
LIVING STANDARDS
LOSS
LOW INCOME
LOW-INCOME COUNTRIES
MANAGED CARE
MARGINAL COST
MEASUREMENT
MEDICAL CARE
MEDICAL EXPENSES
MEDICAL INSURANCE
MORAL HAZARDS
MORBIDITY
MORTALITY
NATIONAL HEALTH
NATIONAL HEALTH INSURANCE
NATIONAL HEALTH SERVICE
NUTRITION
ORAL HEALTH
OUTPATIENT CARE
OUTPATIENT SERVICES
PATIENT
PATIENTS
PHYSICIAN
POLICY DISCUSSIONS
POLICY RESEARCH
POPULATION
POVERTY
PREGNANCY
PREGNANT WOMEN
PREVENTIVE CARE
PRICE OF HEALTH CARE
PRICES
PRIMARY CARE
PRIMARY HEALTH CARE
PRIVATE CARE
PRIVATE HEALTH INSURANCE
PRIVATE INSURANCE
PRIVATE SECTOR
PROBABILITY
PROGRAMS
PUBLIC HEALTH
PUBLIC HEALTH INSURANCE
PUBLIC HEALTH POLICY
PUBLIC PROVIDERS
PUBLIC SECTOR
RANDOMIZED CONTROLLED TRIALS
RISK AVERSION
RISK SHARING
SAVINGS
SCHOOL HEALTH
SOCIAL HEALTH INSURANCE
SOCIAL INSURANCE
SOCIAL RESEARCH
SOCIAL SECURITY
SOCIAL SECURITY HEALTH INSURANCE
SOCIAL SECURITY HOSPITALS
SOCIAL STUDIES
SURGERY
UNINSURED PEOPLE
USE OF HEALTH CARE SERVICES
USE OF HEALTH SERVICES
VISITS
WELFARE
WORKERS
Acharya, Arnab
Vellakkal, Sukumar
Taylor, Fiona
Masset, Edoardo
Satija, Ambika
Burke, Margaret
Ebrahim, Shah
The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review
relation Policy Research Working Paper; No. 6324
description 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.
format Publications & Research :: Policy Research Working Paper
author Acharya, Arnab
Vellakkal, Sukumar
Taylor, Fiona
Masset, Edoardo
Satija, Ambika
Burke, Margaret
Ebrahim, Shah
author_facet Acharya, Arnab
Vellakkal, Sukumar
Taylor, Fiona
Masset, Edoardo
Satija, Ambika
Burke, Margaret
Ebrahim, Shah
author_sort Acharya, Arnab
title The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review
title_short The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review
title_full The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review
title_fullStr The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review
title_full_unstemmed The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review
title_sort impact of health insurance schemes for the informal sector in low- and middle-income countries : a systematic review
publisher World Bank, Washington, DC
publishDate 2013
url 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
_version_ 1764422113202012160
spelling okr-10986-121632021-04-23T14:03:06Z The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries : A Systematic Review Acharya, Arnab Vellakkal, Sukumar Taylor, Fiona Masset, Edoardo Satija, Ambika Burke, Margaret Ebrahim, Shah ACCESS TO HEALTH CARE ACCESS TO HOSPITAL ADVERSE SELECTION AGING AGRICULTURAL INSURANCE ANXIETY AVAILABILITY OF CARE BASIC HEALTH CARE BENEFICIARIES CATASTROPHIC EXPENDITURES CATASTROPHIC HEALTH EXPENDITURE CHECK UPS CHILD HEALTH CHILDREN CHOICE COINSURANCE COMMUNITY HEALTH COMMUNITY INSURANCE COMPULSORY INSURANCE COOPERATION COST-SHARING ARRANGEMENTS COSTS CREDIT DEATH DIABETES DOCTORS DRUGS ECONOMIC REVIEW ECONOMICS OF HEALTH EMPLOYMENT EPIDEMIOLOGY EQUILIBRIUM EQUITY EQUITY IN ACCESS EVALUATION EXPENDITURES EXPERT OPINIONS FAMILIES FEES FINANCIAL PROTECTION FINANCIAL RISK FINANCIAL RISK PROTECTION FINANCING FREE CARE GLUCOSE GOVERNMENT INSURANCE HEALTH HEALTH AFFAIRS HEALTH CARE HEALTH CARE CENTERS HEALTH CARE COSTS HEALTH CARE COVERAGE HEALTH CARE FACILITIES HEALTH CARE FINANCE HEALTH CARE FINANCING HEALTH CARE NEEDS HEALTH CARE PROVISION HEALTH CARE SYSTEM HEALTH CARE USE HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH CONDITIONS HEALTH COSTS HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROJECT HEALTH SERVICE HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTH WORKERS HEALTH-CARE HOSPITAL CARE HOSPITAL SERVICES HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT HYGIENE ILLNESS IMPACT EVALUATIONS IMPERFECT INFORMATION IMPLEMENTATION INCENTIVE STRUCTURES INCENTIVES INCIDENCE INCOME INCOME COUNTRIES INCOME GROUPS INFANT MORTALITY INFANT MORTALITY RATES INFORMAL SECTOR INFORMAL SECTOR WORKERS INPATIENT CARE INPATIENT HOSPITAL INSURANCE MARKETS INSURANCE PREMIUMS INSURANCE PRODUCTS INSURANCE SYSTEM INTEREST KNOWLEDGE LIVING STANDARDS LOSS LOW INCOME LOW-INCOME COUNTRIES MANAGED CARE MARGINAL COST MEASUREMENT MEDICAL CARE MEDICAL EXPENSES MEDICAL INSURANCE MORAL HAZARDS MORBIDITY MORTALITY NATIONAL HEALTH NATIONAL HEALTH INSURANCE NATIONAL HEALTH SERVICE NUTRITION ORAL HEALTH OUTPATIENT CARE OUTPATIENT SERVICES PATIENT PATIENTS PHYSICIAN POLICY DISCUSSIONS POLICY RESEARCH POPULATION POVERTY PREGNANCY PREGNANT WOMEN PREVENTIVE CARE PRICE OF HEALTH CARE PRICES PRIMARY CARE PRIMARY HEALTH CARE PRIVATE CARE PRIVATE HEALTH INSURANCE PRIVATE INSURANCE PRIVATE SECTOR PROBABILITY PROGRAMS PUBLIC HEALTH PUBLIC HEALTH INSURANCE PUBLIC HEALTH POLICY PUBLIC PROVIDERS PUBLIC SECTOR RANDOMIZED CONTROLLED TRIALS RISK AVERSION RISK SHARING SAVINGS SCHOOL HEALTH SOCIAL HEALTH INSURANCE SOCIAL INSURANCE SOCIAL RESEARCH SOCIAL SECURITY SOCIAL SECURITY HEALTH INSURANCE SOCIAL SECURITY HOSPITALS SOCIAL STUDIES SURGERY UNINSURED PEOPLE USE OF HEALTH CARE SERVICES USE OF HEALTH SERVICES VISITS WELFARE WORKERS 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. 2013-01-25T22:37:04Z 2013-01-25T22:37:04Z 2013-01 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 English en_US Policy Research Working Paper; No. 6324 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research