IDEAS home Printed from https://ideas.repec.org/p/adb/adbwps/2166.html
   My bibliography  Save this paper

Working Paper 225 - Measuring the Impact of Micro-Health Insurance on Healthcare Utilization: A Bayesian Potential Outcomes Approach

Author

Abstract

One of the primary reasons for low healthcare utilization rates in low-income countries is lack of affordable health insurance coverage. In recent years, Community-Based Health Insurance programs are widely implemented across developing countries aimed at increasing healthcare utilization and providing financial protection. This study investigates the causal effects of the program on utilization of healthcare services in Rwanda using nonrandomized household survey data. In a Bayesian potential outcomes framework with Markov Chain Monte Carlo simulation techniques, we address issues of selection bias on observable and unobservable dimensions. In addition, we address heterogeneity by estimating treatment effects at the individual-level. We find that Community-Based Health Insurance schemes significantly increase the likelihood of utilizing medical consultation and screening services but not utilization of drugs. We also find considerable heterogeneity in treatment effects with married women and under-five children benefiting the most.

Suggested Citation

  • Shimeles Abebe & Andinet Woldemichael, 2015. "Working Paper 225 - Measuring the Impact of Micro-Health Insurance on Healthcare Utilization: A Bayesian Potential Outcomes Approach," Working Paper Series 2166, African Development Bank.
    • Handle: RePEc:adb:adbwps:2166
    as

    Download full text from publisher

    File URL: https://www.afdb.org/fileadmin/uploads/afdb/Documents/Publications/WPS_No_225_Measuring_the_Impact_of_Micro-Health_Insurance_on_Healthcare_Utilization__A_Bayesian_Potential_Outcomes_Approach.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Binagwaho, Agnes & Hartwig, Renate & Ingeri, Denyse & Makaka, Andrew, 2012. "Mutual health insurance and its contribution to improving child health in Rwanda," Passauer Diskussionspapiere, Volkswirtschaftliche Reihe V-66-12, University of Passau, Faculty of Business and Economics.
    2. James J. Heckman, 2008. "Econometric Causality," International Statistical Review, International Statistical Institute, vol. 76(1), pages 1-27, April.
    3. Poirier, Dale J & Tobias, Justin L, 2003. "On the Predictive Distributions of Outcome Gains in the Presence of an Unidentified Parameter," Journal of Business & Economic Statistics, American Statistical Association, vol. 21(2), pages 258-268, April.
    4. Aradhna Aggarwal, 2010. "Impact evaluation of India's ‘Yeshasvini’ community‐based health insurance programme," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 5-35, September.
    5. Philipp Eisenhauer & James J. Heckman & Edward Vytlacil, 2015. "The Generalized Roy Model and the Cost-Benefit Analysis of Social Programs," Journal of Political Economy, University of Chicago Press, vol. 123(2), pages 413-443.
    6. A. D. Roy, 1951. "Some Thoughts On The Distribution Of Earnings," Oxford Economic Papers, Oxford University Press, vol. 3(2), pages 135-146.
    7. Shimeles, Abebe, 2010. "Community based health insurance schemes in Africa: The case of Rwanda," Working Papers in Economics 463, University of Gothenburg, Department of Economics.
    8. James H. Albert & Siddhartha Chib, 2001. "Sequential Ordinal Modeling with Applications to Survival Data," Biometrics, The International Biometric Society, vol. 57(3), pages 829-836, September.
    9. Donald B. Rubin, 2005. "Causal Inference Using Potential Outcomes: Design, Modeling, Decisions," Journal of the American Statistical Association, American Statistical Association, vol. 100, pages 322-331, March.
    10. Li, Mingliang & Tobias, Justin, 2008. "Bayesian Analysis of Treatment Effects in an Ordered Potential Outcomes Model," Staff General Research Papers Archive 12429, Iowa State University, Department of Economics.
    11. Poirier, Dale J., 1998. "Revising Beliefs In Nonidentified Models," Econometric Theory, Cambridge University Press, vol. 14(4), pages 483-509, August.
    12. James J. Heckman & Hedibert F. Lopes & Rémi Piatek, 2014. "Treatment Effects: A Bayesian Perspective," Econometric Reviews, Taylor & Francis Journals, vol. 33(1-4), pages 36-67, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mingliang Li & Dale J. Poirier & Justin L. Tobias, 2004. "Do dropouts suffer from dropping out? Estimation and prediction of outcome gains in generalized selection models," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(2), pages 203-225.
    2. Andrés Ramírez–Hassan & Rosember Guerra–Urzola, 2021. "Bayesian treatment effects due to a subsidized health program: the case of preventive health care utilization in Medellín (Colombia)," Empirical Economics, Springer, vol. 60(3), pages 1477-1506, March.
    3. Arthur Lewbel, 2019. "The Identification Zoo: Meanings of Identification in Econometrics," Journal of Economic Literature, American Economic Association, vol. 57(4), pages 835-903, December.
    4. Peter Z. Schochet, "undated". "Statistical Theory for the RCT-YES Software: Design-Based Causal Inference for RCTs," Mathematica Policy Research Reports a0c005c003c242308a92c02dc, Mathematica Policy Research.
    5. Ismaël Mourifié & Marc Henry & Romuald Méango, 2020. "Sharp Bounds and Testability of a Roy Model of STEM Major Choices," Journal of Political Economy, University of Chicago Press, vol. 128(8), pages 3220-3283.
    6. Anders Løland & Ragnar Bang Huseby & Nils Lid Hjort & Arnoldo Frigessi, 2013. "Statistical Corrections of Invalid Correlation Matrices," Scandinavian Journal of Statistics, Danish Society for Theoretical Statistics;Finnish Statistical Society;Norwegian Statistical Association;Swedish Statistical Association, vol. 40(4), pages 807-824, December.
    7. Murray D. Smith, 2005. "Using Copulas to Model Switching Regimes with an Application to Child Labour," The Economic Record, The Economic Society of Australia, vol. 81(s1), pages 47-57, August.
    8. Pereda-Fernández, Santiago, 2023. "Identification and estimation of triangular models with a binary treatment," Journal of Econometrics, Elsevier, vol. 234(2), pages 585-623.
    9. Martijn van Hasselt & Christopher R. Bollinger & Jeremy W. Bray, 2022. "A Bayesian approach to account for misclassification in prevalence and trend estimation," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 37(2), pages 351-367, March.
    10. James Heckman & Justin L. Tobias & Edward Vytlacil, 2001. "Four Parameters of Interest in the Evaluation of Social Programs," Southern Economic Journal, John Wiley & Sons, vol. 68(2), pages 210-223, October.
    11. James J. Heckman & Rodrigo Pinto, 2023. "Econometric Causality: The Central Role of Thought Experiments," NBER Working Papers 31945, National Bureau of Economic Research, Inc.
    12. Horvath, Akos & Lang, Peter, 2021. "Do loan subsidies boost the real activity of small firms?," Journal of Banking & Finance, Elsevier, vol. 122(C).
    13. Lee, Ji Hyung & Park, Byoung G., 2023. "Nonparametric identification and estimation of the extended Roy model," Journal of Econometrics, Elsevier, vol. 235(2), pages 1087-1113.
    14. Becher, Michael & Stegmueller, Daniel, 2019. "Cognitive Ability, Union Membership, and Voter Turnout," IAST Working Papers 19-97, Institute for Advanced Study in Toulouse (IAST).
    15. Li, Mingliang & Tobias, Justin L., 2011. "Bayesian inference in a correlated random coefficients model: Modeling causal effect heterogeneity with an application to heterogeneous returns to schooling," Journal of Econometrics, Elsevier, vol. 162(2), pages 345-361, June.
    16. Woldemichael, Andinet & Gurara, Daniel Zerfu & Shimeles, Abebe, 2016. "Community-Based Health Insurance and Out-of-Pocket Healthcare Spending in Africa: Evidence from Rwanda," IZA Discussion Papers 9922, Institute of Labor Economics (IZA).
    17. Antill, Samuel, 2022. "Do the right firms survive bankruptcy?," Journal of Financial Economics, Elsevier, vol. 144(2), pages 523-546.
    18. Liana Jacobi & Helga Wagner & Sylvia Frühwirth-Schnatter, 2014. "Bayesian Treatment Effects Models with Variable Selection for Panel Outcomes with an Application to Earnings Effects of Maternity Leave," NRN working papers 2014-12, The Austrian Center for Labor Economics and the Analysis of the Welfare State, Johannes Kepler University Linz, Austria.
    19. Michael Lechner & Ruth Miquel, 2010. "Identification of the effects of dynamic treatments by sequential conditional independence assumptions," Empirical Economics, Springer, vol. 39(1), pages 111-137, August.
    20. Mebratie, A.D. & Sparrow, R.A. & Alemu, G. & Bedi, A.S., 2013. "Community-Based Health Insurance Schemes," ISS Working Papers - General Series 568, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:adb:adbwps:2166. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Adeleke Oluwole Salami (email available below). General contact details of provider: https://edirc.repec.org/data/afdbgci.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.