IDEAS home Printed from https://ideas.repec.org/a/bla/afrdev/v33y2021i3p492-505.html
   My bibliography  Save this article

Effect of the Ghana National Health Insurance Scheme on exit time from catastrophic healthcare expenditure

Author

Listed:
  • Albert Opoku Frimpong
  • Eugenia Amporfu
  • Eric Arthur

Abstract

Catastrophic healthcare expenditure (CHE) can plunge households into poverty. Faced with CHE, the question that becomes relevant is how long it will take the household to exit CHE. This paper examines the effect of the Ghana National Health Insurance Scheme (NHIS) on exit time from CHE. The paper uses the Cox proportional hazard model for the analysis, with data sourced from round six of the Ghana Living Standard Survey and World Development Indicators. The results show that households that spend 40% (20%) of their non‐food incomes on healthcare, on average, exit CHE after 10 months and 4 days (13 months and 24 days) being in CHE and those with NHIS coverage exit CHE 19 days (30 days) earlier than those without NHIS coverage. Policy implications arising from this paper include the need to expand NHIS enrolment to mitigate impoverishment due to out‐of‐pocket healthcare payments. Households with higher risks of severe CHE and longer exit time from CHE should be identified and provided with comprehensive NHIS coverage than those with lower risks.

Suggested Citation

  • Albert Opoku Frimpong & Eugenia Amporfu & Eric Arthur, 2021. "Effect of the Ghana National Health Insurance Scheme on exit time from catastrophic healthcare expenditure," African Development Review, African Development Bank, vol. 33(3), pages 492-505, September.
    • Handle: RePEc:bla:afrdev:v:33:y:2021:i:3:p:492-505
    DOI: 10.1111/1467-8268.12585
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/1467-8268.12585
    Download Restriction: no
    File URL: https://libkey.io/10.1111/1467-8268.12585?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Steven F Koch & Naomi Setshegetso, 2020. "Catastrophic health expenditures arising from out-of-pocket payments: Evidence from South African income and expenditure surveys," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-14, August.
    2. Patrick Royston, 2014. "Tools for checking calibration of a Cox model in external validation: Approach based on individual event probabilities," Stata Journal, StataCorp LP, vol. 14(4), pages 738-755, December.
    3. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896.
    4. Bloom, David E. & Canning, David & Sevilla, Jaypee, 2004. "The Effect of Health on Economic Growth: A Production Function Approach," World Development, Elsevier, vol. 32(1), pages 1-13, January.
    5. Marwa Farag & A. NandaKumar & Stanley Wallack & Dominic Hodgkin & Gary Gaumer & Can Erbil, 2012. "The income elasticity of health care spending in developing and developed countries," International Journal of Health Economics and Management, Springer, vol. 12(2), pages 145-162, June.
    6. Jaison Chireshe & Matthew K. Ocran, 2020. "Health care expenditure and health outcomes in sub‐Saharan African countries," African Development Review, African Development Bank, vol. 32(3), pages 349-361, September.
    7. Morduch, Jonathan, 1998. "Poverty, economic growth, and average exit time," Economics Letters, Elsevier, vol. 59(3), pages 385-390, June.
    8. George Schieber & Cheryl Cashin & Karima Saleh & Rouselle Lavado, 2012. "Health Financing in Ghana," World Bank Publications - Books, The World Bank Group, number 11977.
    9. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    10. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
    11. Sarah Ssewanyana & Ibrahim Kasirye, 2012. "Causes of Health Inequalities in Uganda: Evidence from the Demographic and Health Surveys," African Development Review, African Development Bank, vol. 24(4), pages 327-341.
    12. Oluyele Akinkugbe & Chitalu Chama-Chiliba & Naomi Tlotlego, 2012. "Health Financing and Catastrophic Payments for Health Care: Evidence from Household-level Survey Data in Botswana and Lesotho," African Development Review, African Development Bank, vol. 24(4), pages 358-370.
    13. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan‐Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184, November.
    14. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    15. Yongjian Xu & Jie Ma & Na Wu & Xiaojing Fan & Tao Zhang & Zhongliang Zhou & Jianmin Gao & Jianping Ren & Gang Chen, 2018. "Catastrophic health expenditure in households with chronic disease patients: A pre-post comparison of the New Health Care Reform in Shaanxi Province, China," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-13, March.
    16. Hannah Bower & Michael J. Crowther & Paul C. Lambert, 2016. "strcs: A command for fitting flexible parametric survival models on the log-hazard scale," Stata Journal, StataCorp LP, vol. 16(4), pages 989-1012, December.
    17. Richard Mussa, 2016. "Exit from catastrophic health payments: a method and an application to Malawi," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 163-174, June.
    18. Richard Agbanyo, 2020. "Ghana's national health insurance, free maternal healthcare and facility‐based delivery services," African Development Review, African Development Bank, vol. 32(1), pages 27-41, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Tao Li & Yi-Tong Zhang & He-Wen Zhu & Peng-Ju Liu, 2022. "Floating Population, Housing Security and Family Medical Economic Risk," Sustainability, MDPI, vol. 14(18), pages 1-17, September.

    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. Kossi Atsutsè Dziédzom Tsomdzo & Yacobou Sanoussi & Kodjo Evlo, 2022. "Investissement en santé et état de santé dans les pays de l'UEMOA: entre contribution publique et privée?," African Development Review, African Development Bank, vol. 34(2), pages 244-254, June.
    2. Chen, Mingsheng & Xu, Lizheng & Si, Lei & Wang, Zhonghua & Jan, Stephen, 2023. "Examining the level and distribution of catastrophic health expenditure from 2013 to 2018: A province-level study in China," Economic Modelling, Elsevier, vol. 121(C).
    3. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    4. Rahman, Md Mizanur & Jung, Jenny & Islam, Md Rashedul & Rahman, Md Mahfuzur & Nakamura, Ryota & Akter, Shamima & Sato, Motohiro, 2022. "Global, regional, and national progress in financial risk protection towards universal health coverage, 2000–2030," Social Science & Medicine, Elsevier, vol. 312(C).
    5. Tomson Ogwang & Germano Mwabu, 2024. "Adaptation of the Foster‐Greer‐Thorbecke poverty measures for the measurement of catastrophic health expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 33(10), pages 2419-2436, October.
    6. Richard Mussa, 2016. "Exit from catastrophic health payments: a method and an application to Malawi," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 163-174, June.
    7. Micheal Kofi Boachie & Tatjana Põlajeva & Albert Opoku Frimpong, 2020. "Infant Mortality in Low- and Middle-income Countries: Does Government Health Spending Matter?," Journal of Development Policy and Practice, , vol. 5(1), pages 54-73, January.
    8. Powell-Jackson, Timothy & Hanson, Kara & Whitty, Christopher J.M. & Ansah, Evelyn K., 2014. "Who benefits from free healthcare? Evidence from a randomized experiment in Ghana," Journal of Development Economics, Elsevier, vol. 107(C), pages 305-319.
    9. repec:aer:wpaper:391 is not listed on IDEAS
    10. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    11. Chantzaras, Athanasios E. & Yfantopoulos, John N., 2018. "Financial protection of households against health shocks in Greece during the economic crisis," Social Science & Medicine, Elsevier, vol. 211(C), pages 338-351.
    12. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.
    13. Steven F. Koch & Naomi Setshegetso, 2021. "Progressivity of out-of-pocket payments and its determinants decomposed over time," Development Southern Africa, Taylor & Francis Journals, vol. 38(5), pages 731-749, September.
    14. Nadide Halıcı-Tülüce & İbrahim Doğan & Cüneyt Dumrul, 2016. "Is income relevant for health expenditure and economic growth nexus?," International Journal of Health Economics and Management, Springer, vol. 16(1), pages 23-49, March.
    15. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    16. Allanson, Paul & Petrie, Dennis, 2013. "Longitudinal methods to investigate the role of health determinants in the dynamics of income-related health inequality," Journal of Health Economics, Elsevier, vol. 32(5), pages 922-937.
    17. Essosinam Franck Karabou & Komlan Ametowoyo Adeve & Kossi Atsutsè Dziédzom Tsomdzo, 2021. "Dépenses publiques de santé, état de santé et croissance en Afrique Subsaharienne: Cas de l'Afrique de l'Est et de l'Ouest," African Development Review, African Development Bank, vol. 33(2), pages 397-407, June.
    18. Kjellsson, Gustav, 2014. "Extending Decomposition Analysis to Account for Socioeconomic Background: Income-Related Smoking Inequality among Swedish Women," Working Papers 2014:29, Lund University, Department of Economics.
    19. Lim, Kyoung Mook, 2020. "Public provision of health insurance and aggregate saving in an overlapping generations model with endogenous health risk: The South Korean case," Economic Modelling, Elsevier, vol. 91(C), pages 233-246.
    20. Makate, Marshall & Makate, Clifton, 2016. "The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011," MPRA Paper 83897, University Library of Munich, Germany, revised 12 Jan 2018.
    21. Thuong, Nguyen Thi Thu, 2021. "Catastrophic health expenditure and impoverishment in Vietnam: Evidence from national Household Living Standards Surveys 2008–2018," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 668-684.

    More about this item

    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:bla:afrdev:v:33:y:2021:i:3:p:492-505. 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: Wiley Content Delivery (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.