IDEAS home Printed from https://ideas.repec.org/a/vrs/jecman/v44y2022i1p38-63n10.html
   My bibliography  Save this article

Health insurance and Out-of-Pocket health care expenditure in Kenya

Author

Listed:
  • Kamba Urbanus Kioko

    (Department of Economics, Population and Development Studies Faculty of Social Sciences, University of Nairobi, Kenya)

Abstract

Aim/purpose – The aim of this study was to estimate the effect of health insurance on Out-of-Pocket (OOP) health care expenditure in Kenya. It is informed by persistence in the challenges of access and utilization of quality and affordable health care services. Previously, researchers have estimated the effects of different forms of health care financing on its demand and shown that affordability not only enhances access and use of health services but also cushions people against adverse financial risks associated with catastrophic health care spending. Design/methodology/approach – The study used the Kenya Household Health Expenditure and Utilization Survey (KHHEUS) 2013 data, and employed the two-part model estimation approach. The sample size considered in the estimation was 6,961 with the unit of analysis being an individual household member. Findings – The overall results of this study showed that having a health insurance cover did not exclude one from using OOP payments. However, the probability of such spending was low for people with insurance compared to those without insurance. Additionally, if any cash was paid for any health care service, having insurance did not have a significant effect on the level of that spending. Research implications/limitations – The findings of this study imply that uptake of health insurance does not fully cushion people from both using cash payments when seeking health services and ramifications of catastrophic health care spending. The study however, encountered challenges of unavailability of more recent data in the KHHEUS series. In addition, the sample size was relatively small to the population after data cleaning. Originality/value/contribution – Potential effect of health insurance on OOP health care payments had not been explored in Kenya. As such, this study filled this gap. In addition, the two-part model estimation technique was also employed with the latest household health survey data.

Suggested Citation

  • Kamba Urbanus Kioko, 2022. "Health insurance and Out-of-Pocket health care expenditure in Kenya," Journal of Economics and Management, Sciendo, vol. 44(1), pages 38-63, January.
    • Handle: RePEc:vrs:jecman:v:44:y:2022:i:1:p:38-63:n:10
    DOI: 10.22367/jem.2022.44.03
    as

    Download full text from publisher

    File URL: https://doi.org/10.22367/jem.2022.44.03
    Download Restriction: no
    File URL: https://libkey.io/10.22367/jem.2022.44.03?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. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    2. John Cullis, 1993. "Economics of health care financing—the visible hand by Cam Donaldson and Karen Gerard Macmillan: Basingstoke, 1993. No. of pages: ix & 217. ISBN 0‐333‐53870‐6," Health Economics, John Wiley & Sons, Ltd., vol. 2(3), pages 291-291, October.
    3. Winnie Yip & Peter Berman, 2001. "Targeted health insurance in a low income country and its impact on access and equity in access: Egypt's school health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 207-220, April.
    4. Partha Deb & Murat K. Munkin & Pravin K. Trivedi, 2006. "Bayesian analysis of the two‐part model with endogeneity: application to health care expenditure," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(7), pages 1081-1099, November.
    5. Germano Mwabu, 2008. "The Production of Child Health in Kenya: A Structural Model of Birth Weight," Working Papers 963, Economic Growth Center, Yale University.
    6. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    7. Mwabu, Germano, 2008. "The Production of Child Health in Kenya: A Structural Model of Birth Weight," Working Papers 52, Yale University, Department of Economics.
    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. 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).
    2. Arnab Acharya & Sukumar Vellakkal & Fiona Taylor & Edoardo Masset & Ambika Satija & Margaret Burke & Shah Ebrahim, 2013. "The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review," The World Bank Research Observer, World Bank, vol. 28(2), pages 236-266, August.
    3. Andinet Woldemichael & Daniel Gurara & Abebe Shimeles, 2019. "The Impact of Community Based Health Insurance Schemes on Out-of-Pocket Healthcare Spending: Evidence from Rwanda," IMF Working Papers 2019/038, International Monetary Fund.
    4. repec:eid:wpaper:3/09 is not listed on IDEAS
    5. Hendrik P. van Dalen, 2006. "When Health Care Insurance does not make a Difference – The Case of Health Care ‘Made in China’," Tinbergen Institute Discussion Papers 06-091/1, Tinbergen Institute.
    6. Lim, Sung Soo, 2020. "Parental chronic illness and child education: Evidence from children in Indonesia," International Journal of Educational Development, Elsevier, vol. 73(C).
    7. Levine, David & Polimeni, Rachel & Ramage, Ian, 2016. "Insuring health or insuring wealth? An experimental evaluation of health insurance in rural Cambodia," Journal of Development Economics, Elsevier, vol. 119(C), pages 1-15.
    8. Ramses H. Abul Naga & Karine Lamiraud, 2008. "Catastrophic Health ExpenditureandHousehold Well-Being," STICERD - Distributional Analysis Research Programme Papers 098, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE.
    9. Lamichhane, Dirga Kumar & Mangyo, Eiji, 2011. "Water accessibility and child health: Use of the leave-out strategy of instruments," Journal of Health Economics, Elsevier, vol. 30(5), pages 1000-1010.
    10. Laura Rodríguez, 2022. "Violence and newborn health: Estimates for Colombia," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 112-136, January.
    11. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    12. Limwattananon, Supon & Neelsen, Sven & O'Donnell, Owen & Prakongsai, Phusit & Tangcharoensathien, Viroj & van Doorslaer, Eddy & Vongmongkol, Vuthiphan, 2015. "Universal coverage with supply-side reform: The impact on medical expenditure risk and utilization in Thailand," Journal of Public Economics, Elsevier, vol. 121(C), pages 79-94.
    13. He, Huajing & Nolen, Patrick J., 2019. "The effect of health insurance reform: Evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 168-179.
    14. Fredah Guantai & Yoko Kijima, 2020. "Ethnic Violence and Birth Outcomes: Evidence From Exposure to the 1992 Conflict in Kenya," Demography, Springer;Population Association of America (PAA), vol. 57(2), pages 423-444, April.
    15. Budi Aji & Manuela De Allegri & Aurelia Souares & Rainer Sauerborn, 2013. "The Impact of Health Insurance Programs on Out-of-Pocket Expenditures in Indonesia: An Increase or a Decrease?," IJERPH, MDPI, vol. 10(7), pages 1-19, July.
    16. Lau, Siew Yee & Parinduri, Rasyad & Lee, Yoong Hon, 2019. "Does Social Health Insurance Help Owners of Micro- and Small Firms Cope with Family Hardships? Evidence from Indonesia," MPRA Paper 95295, University Library of Munich, Germany.
    17. David Mmopelwa, 2019. "Prenatal care utilization and infant health in Botswana," Discussion Papers 2019-09, University of Nottingham, CREDIT.
    18. Bernal Lobato, N., 2014. "Essays in applied microeconomics," Other publications TiSEM 9b638b3d-2f83-452a-b2c8-c, Tilburg University, School of Economics and Management.
    19. Sarah Alkenbrack & Magnus Lindelow, 2015. "The Impact of Community‐Based Health Insurance on Utilization and Out‐of‐Pocket Expenditures in Lao People's Democratic Republic," Health Economics, John Wiley & Sons, Ltd., vol. 24(4), pages 379-399, April.
    20. Fink, Günther & Robyn, Paul Jacob & Sié, Ali & Sauerborn, Rainer, 2013. "Does health insurance improve health?," Journal of Health Economics, Elsevier, vol. 32(6), pages 1043-1056.
    21. Tankari, Mahamadou & Badiane, Ousmane & Montaud, Jean-Marc, 2013. "When social goals meet economic goals: the double dividend of extending access to healthcare for farmers in Uganda," Conference papers 332430, Purdue University, Center for Global Trade Analysis, Global Trade Analysis Project.

    More about this item

    Keywords

    health insurance; Out-of-Pocket; health care; two-part model; Kenya;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

    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:vrs:jecman:v:44:y:2022:i:1:p:38-63:n:10. 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: Peter Golla (email available below). General contact details of provider: https://www.sciendo.com .

    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.