Abstract
The purpose of the current study was to model the health insurance coverage of Jamaicans; and to identify the determinants, strength and predictive power of the model in order to aid clinicians and other health practitioners in understanding those who have health insurance coverage. This study utilized secondary data taken from the dataset of the Jamaica Survey of Living Conditions which was collected between July and October 2002. It was a nationally representative stratified random sample survey of 25,018 respondents, with 50.7% females and 49.3% males. The data was collected by way of a self-administered questionnaire. The non-response rate for the survey was 29.7% with 20.5% not responding to particular questions, 9.0% not participating in the survey and another 0.2% being rejected due to data cleaning. The current research extracted 16,118 people 15 years and older from the survey sample of 25,018 respondents in order to model the determinants of private health insurance coverage in Jamaica. Data were stored, retrieved and analyzed using SPSS for Windows 15.0. A p-value of less than 0.05 was used to establish statistical significance. Descriptive analysis was used to provide baseline information on the sample, and cross-tabulations were used to examine some non-metric variables. Logistic regression was used to identify, determine and establish those factors that influence private health insurance coverage in Jamaica. This study found that approximately 12% of Jamaicans had private health insurance coverage, of which the least health insurance was owned by rural residents (7.5%). Using logistic regression, the findings revealed that twelve variables emerged as statistically significant determinants of health insurance coverage in this sample. These variables are social standing (two weal- thiest quintile: OR = 1.68, 95% CI = 1.23 – 2.30), income (OR = 1.00, 95%CI = 1.00 – 1.00), durable goods (OR = 1.16, 95% CI = 1.12 – 1.19), marital status (married: OR = 1.97, 95% CI = 1.61 – 2.42), area of residence (Peri-urban: OR = 1.45, 95% CI = 1.199 – 1.75; urban: OR = 1.83, 95% CI = 1.40 – 2.40), education (secondary: OR = 1.57, 95% CI = 1.20 – 2.06; tertiary: OR = 9.03, 95% CI = 6.47 – 12.59), social support (OR = 0.64, 95% CI = 0.53 – 0.76), crowding (OR = 1.14, 95% CI = 1.02 – 1.28), psychological conditions (negative affective: OR = 0.97, 95% CI = 0.94 – 1.00; positive affective: OR = 1.11, 95% CI = 1.06 – 1.16), number of males in household (OR = 0.85, 95% CI = 0.77 – 0.93), living arrangements (OR = 0.62, 95% CI = 0.41 – 0.92) and retirement benefits (OR = 1.55, 95% CI = 1.03 – 2.35). This study highlighted the need to address preventative care for the wealthiest, rural residents and the fact that social support is crucial to health care, as well as the fact that medical care costs are borne by the extended family and other social groups in which the individual is (or was) a member, which explains the low demand for health insurance in Jamaica. Private health care in Jamaica is substantially determined by affordability and education rather than illness, and it is a poor measure of the health care- seeking behaviour of Jamaicans.
Highlights
Literature on private health insurance or health insurance in the Caribbean, and in particular Jamaica, has been substantially on 1) population density–i.e. coverage, 2) coverage offerings, 3) cost of care–i.e. health economics, and 4) acceptance by health service providers of certain insurance coverage
The individual utilization pattern of health insurance coverage is highly associated over time with older adults [1,2] as they prepare for the degeneration of the body; but, what else do we know about those who have private health insurance in Jamaica? Do insurers attract healthy patients, and are high risk individuals more likely to become insured as against their low risk counterparts? Health insurance is a constituent of health seeking behaviour, suggesting that it is important in any study of health, quality of life, and wellbeing
This study found that health insurance coverage is influenced by social standing, durable goods, income, marital status, area of residence, education, social support, crowding, psychological conditions, retirement benefits, living arrangements and the number of males in the household, and that those with good health are more likely to purchase health insurance than those with poor health
Summary
Literature on private health insurance or health insurance in the Caribbean, and in particular Jamaica, has been substantially on 1) population density–i.e. coverage, 2) coverage offerings, 3) cost of care–i.e. health economics, and 4) acceptance (or lack of) by health service providers of certain insurance coverage. Despite the fact that Jamaica has instituted a free health-care service delivery programme for its child population (below 18 years in 2006), the quality of care which is relatively good is still surrounded by a certain socio-psychological milieu as well as inequality in health care offerings in the private versus the public sector This explains the rationale why some people seek private health care and by extension private health insurance coverage [3] to meet the impending higher medical cost of care [1,4,5,6,7] and a particular quality of service–environment, customer service and length of service. The current study will be examined within the theoretical framework used by Franc, Perronnin, & Pierre [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
