The effect of community-based health insurance on the utilization of modern health care services: Evidence from Burkina Faso

Abstract Objective To quantify the impact of community-based health insurance (CBI) on utilization of health care services in rural Burkina Faso. Methods Propensity score matching was used to minimise the observed baseline differences in the characteristics of insured and uninsured groups such that...

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Bibliographic Details
Published in:Health policy (Amsterdam) 2009-05, Vol.90 (2), p.214-222
Main Authors: Gnawali, Devendra Prasad, Pokhrel, Subhash, Sié, Ali, Sanon, Mamadou, De Allegri, Manuela, Souares, Aurélia, Dong, Hengjin, Sauerborn, Rainer
Format: Article
Language:English
Subjects:
Access to health care
Adult
Aged
Burkina Faso
Community based
Community health services
Community Networks
Community-based health insurance
Community-based health insurance Propensity score Utilization Health care services Burkina Faso
Comparative analysis
Female
Health administration
Health care
Health care services
Health insurance
Health policy
Health services
Health Services - utilization
Helpseeking
Humans
Insurance, Health
Internal Medicine
Local communities
Male
Middle Aged
Patient care
Propensity score
Rural areas
Socioeconomic status
Uninsured persons
Utilization
Young Adult
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Summary:Abstract Objective To quantify the impact of community-based health insurance (CBI) on utilization of health care services in rural Burkina Faso. Methods Propensity score matching was used to minimise the observed baseline differences in the characteristics of insured and uninsured groups such that the observed difference in healthcare utilisation could generally be attributed to the CBI. Results Compared with those who were not enrolled in the CBI, the overall increase in outpatient visits given illness in the insured group was about 40% higher, while the differential effect on utilization of inpatient care between insured and non-insured groups was insignificant. Not only were the very poor less likely to enroll in CBI, but even once insured, they were less likely to utilize health services compared to their wealthier counterparts. Conclusions The overall effect of CBI on health care utilization is significant and positive but the benefit of CBI is not equally enjoyed by all socioeconomic groups. The policy implications are: (a) there is a need to subsidize the premium to favor the enrolment of the very poor; and (b) various measures need to be placed in order to maximize the population’s capacity to enjoy the benefits of insurance once insured.
ISSN:0168-8510
1872-6054
DOI:10.1016/j.healthpol.2008.09.015