Factors affecting the Utilization of Social Health Insurance by the General Population in Bhaktapur Municipality

Abstract


 
 
 
 Introduction: For the reduction of financial burden and to achieve universal health care, Government of Nepal launched a security program called as Social Health Insurance Program. This study aimed to find the factors associated with the utilization of the social health insurance scheme.
 Methods: Descriptive cross-sectional study was conducted in the Bhaktapur Municipality ward no 2. 422 households were chosen using systematic random sampling. Questionnaires were used to measure the factors affecting the utilization. The collected data was entered in Epidata and analyzed in SPSS version 16. The data were presented in the frequency and percentage. Bivariate analysis was done to identify factors utilizing social health insurance. Factors having p value less than 0.05 was taken as significantly associated. Multivariate analysis was done to examine the association between the outcome variables.
 Results: Almost half of the general population (42.4 %) were utilizing social health insurance scheme and reason for not utilizing includes lack of confidence in the scheme and the services of the scheme, followed by high premium cost. Age (p=0.044), occupation (p= 0.049), wealth quintiles (p=<0.001) were found to be significantly associated with utilization of social health insurance. Logistic regression analysis showed that the odds of enrollment among very rich population group were lower than the medium (AOR 0.550, 95% CI 0.305-0.993) and rich population (AOR 0.557, 95% CI 0.316-0.981).
 Conclusions: Multiple factors were found to be associated with the utilization of the health insurance scheme which includes age of the household head, occupation of the household head, economic status, availability of the drugs and charge paid during their visit in the health care services, behavior showed by the health care provider, confidence in the scheme, satisfaction in the services that have been providing and source of the information.
 
 
 

Health Insurance Utilization Pattern among Community People of Jutpani Kalika Municipality of Chitwan Nepal

“…A similar result was found in other studies done in Bhaktapur by Karanjit P et al 4 Some of the studies showed significantly positive findings of marital status and enrolment in insurance schemes. [10][11][12] Enrollment of family in SHSS makes it secure and prevents out-of-pocket expenditure.…”

“…A study done in Bhaktapur Municipality and the study of Devraj et al showed that the majority of the enrolled families were joint families. 4,3 The reason would be that metropolitan cities mainly consist of nuclear families and old cities have still value for a joint family system. The majority of families followed the Hindu religion 79.9%, similar findings were found in the study of Karanjit P et al 4 The study done in India comparing enrolled and non-enrolled found 86.7% of enrolled households were Hindu religion and were significantly associated with the Rashtriya Swasthya Bima Yojana.…”

“…4,3 The reason would be that metropolitan cities mainly consist of nuclear families and old cities have still value for a joint family system. The majority of families followed the Hindu religion 79.9%, similar findings were found in the study of Karanjit P et al 4 The study done in India comparing enrolled and non-enrolled found 86.7% of enrolled households were Hindu religion and were significantly associated with the Rashtriya Swasthya Bima Yojana. 13 This would be due to the thick density of the Hindu population in Nepal and India.…”

“…3 Trial was done on 2072/73. 4 Under the Scheme a family of 5 members has to contribute Rs 3,500 per annum. 5 Several nations are implementing new financing models as Health Insurance Schemes in their countries.…”