Premium calculation on health insurance implementing deductible

Anggraini, Nessa Aqila; Nurrohmah, Siti; Sari, Syandra

doi:10.1088/1742-6596/1725/1/012081

Cited by 1 publication

(1 citation statement)

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“…Ex-post moral hazard means an increase in demand for health services due to price reduction, which indicates consumer price sensitivity [85]. Ex-ante moral hazard refers to a reduction in preventive behaviors and an increase in risky behaviors due to insurance coverage [88,89].…”

Section: Discussionmentioning

confidence: 99%

A systematic review of strategies used for controlling consumer moral hazard in health systems

Rostamkalaee

Jafari

Gorji

2022

BMC Health Serv Res

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Background Consumer moral hazard refers to an increase in demand for health services or a decrease in preventive care due to insurance coverage. This phenomenon as one of the most evident forms of moral hazard must be reduced and prevented because of its important role in increasing health costs. This study aimed to determine and analyze the strategies used to control consumer moral hazards in health systems. Methods In this systematic review. Web of Sciences, PubMed, Scopus, Embase, ProQuest, Iranian databases(Magiran and SID), and Google Scholar engine were searched using search terms related to moral hazard and healthcare utilization without time limitation. Eligible English and Persian studies on consumer moral hazard in health were included, and papers outside the health and in other languages were excluded. Thematic content analysis was used for data analysis. Results Content analysis of 68 studies included in the study was presented in the form of two group, six themes, and 11 categories. Two group included “changing behavior at the time of receiving health services” and “changing behavior before needing health services.” The first group included four themes: demand-side cost sharing, health savings accounts, drug price regulation, and rationing of health services. The second approach consisted of two themes Development of incentive insurance programs and community empowerment. Conclusion Strategies to control consumer moral hazards focus on changing consumer consumptive and health-related behaviors, which are designed according to the structure of health and financing systems. Since “changing consumptive behavior” strategies are the most commonly used strategies; therefore, it is necessary to strengthen strategies to control health-related behaviors and develop new strategies in future studies. In addition, in the application of existing strategies, the adaptation to the structure of the health and financing system, and the pattern of consumption of health services in society should be considered.

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Section: Discussionmentioning

confidence: 99%