Health Insurance Beneficiaries Research Articles

Incremental Healthcare Costs of Diabetes Mellitus in a Middle-Income Country Using Administrative Healthcare Data

ObjectivesTo estimate the incremental medical cost of diabetes mellitus using information from administrative databases in Colombia. MethodsWe carried out a retrospective cohort study with administrative health databases from Colombian population affiliated in the contributory health insurance scheme. We used an operative definition to select the cohort with diabetes. Incremental cost and cost ratio of diabetes were estimated using an inverse probability weighting of treatment approach to find the causal effect of having the disease. Weights were calculated by a propensity score method using a Random Forest model. The flexibility of this machine learning algorithm allows to have a better specification and bias reduction. Additionally, we reported incremental costs and cost ratios with confidence intervals using bootstrapping and analyzed costs by age groups and complications associated with diabetes. ResultsThe estimated prevalence of diabetes was 2834 per 100 000 cases, in 2018. The group with diabetes was comprised 634 015 people and the control group 1 524 808. The calculated annual direct medical cost was $860, for which the incremental cost was $493 and the cost ratio 2.34. The incremental annual cost for some type of complication ranges from $1239 to $2043, renal complication being the most expensive. Incremental cost by age groups ranges from $347 to $878, being higher in younger people. ConclusionsAlthough the cost of diabetes in Colombia ranges among the global averages and is similar to other Latin-American countries, a greater incremental cost was found in patients with renal, circulatory, and neurologic complications.

Analysis of The Increase In National Health Insurance Contributions on The Rights and Obligations of Participants at the Puput Community Health Center (Puskesmas Puput)

Analysis of The Increase In National Health Insurance Contributions on The Rights and Obligations of Participants at the Puput Community Health Center (Puskesmas Puput)

Analisis Iuran dan Kamar Rawat Inap Standar di Badan Penyelenggara Jaminan Sosial Kesehatan dalam Perspektif Maqashid Syariah

This research began with the issue of national health insurance contributions which basically became a polemic in society regarding obtaining health insurance by the Government in accordance with the mandate of the 1945 Constitution of the Republic of Indonesia. Health is an important aspect in fulfilling human rights and is a benchmark. welfare in society.The aim of this research is to analyze the implementation of contributionsSocial Security AdministratorHealth from the Maqashid Sharia Perspective. To analyze Maqasid Syariah's views on the increase in contributions for health insurance. To analyze Moaqasid Syariah's views on the implementation of standard inpatient rooms. Object of researchSocial Security AdministratorHealth, this type of research is normative qualitative, the data source used is secondary data in the form of regulations relating to BPJS Health, fatwas from the ulama council. The data analysis technique used in this research was descriptive analysis.First research results: Implementation of contributions from the Social Security Administering Agency Health from the Maqasid Syariah perspective is an important effort in realizing a just, equitable and sustainable health system. By continuing to improve efficiency, transparency and service quality, this system can be more effective in achieving the main objectives of Sharia, namely protecting and promoting the welfare of individuals and society as a whole. Second, from the Maqasid Syariah point of view, the increase in contributions in health insurance is acceptable and is even necessary if (1) It is carried out with the principles of justice and solidarity. (2) Increases access and quality of services. (3) Transparency and accountability, (4). Not burdening the underprivileged. Third, from the perspective of Maqasid Syariah, the implementation of inpatient class standards in the Social Security Administering Body supports the main objectives of Sharia in the following way: (1). Increasing Justice and Solidarity, (2). Guaranteeing Mental Health and Safety, (3) Improving Mental and Intellectual Well-being (4). Protecting the Health of Future Generations, (5). Managing Resources Efficiently.

Beyond reducing direct medical cost: examining health outcomes in tuberculosis through a difference-in-differences analysis of South Korea’s out-of-pocket payment exception policy

BackgroundUniversal health coverage and social protection are major global goals for tuberculosis. This study aimed to investigate the effects of an expanded policy to guarantee out-of-pocket costs on the treatment outcomes of patients with tuberculosis.MethodsBy linking the national tuberculosis report and health insurance data and performing covariate-adjusted propensity-score matching, we constructed data on health insurance beneficiaries (treatment group) who benefited from the out-of-pocket payment exemption policy and medical aid beneficiaries as the control group. Using difference-in-differences analysis, we analyzed tuberculosis treatment completion rates and mortality in the treatment and control groups.ResultsA total of 41,219 persons (10,305 and 30,914 medical aid and health insurance beneficiaries, respectively) were included in the final analysis (men 59.6%, women 40.4%). Following the implementation of out-of-pocket payment exemption policy, treatment completion rates increased in both the treatment and control groups; however, there was no significant difference between the groups (coefficient, −0.01; standard error, 0.01). After the policy change, the difference in mortality between the groups increased, with mortality decreasing by approximately 3% more in the treatment group compared with in the control group (coefficient: −0.03, standard error, 0.01).ConclusionThere are limitations to improving treatment outcomes for tuberculosis with an out-of-pocket payment exemption policy alone. To improve treatment outcomes for tuberculosis and protect patients from financial distress due to the loss of income during treatment, it is essential to proactively implement complementary social protection policies.

The Influence of National Health Insurance Participant Satisfaction in Mediating the Relationship of Service Quality and Brand Image Towards Participant Loyalty at RSU Balimed Denpasar

The irregularity of participants in paying National Health Insurance contributions shows that participants lack loyalty in paying contributions which are their routine obligations as participants in the National Health Insurance program. The aim of this research is to reveal the mediating impact of satisfaction on service quality and brand image on loyalty. This research is quantitative research conducted using a survey, using data samples from National Health Insurance participants with active membership and receiving services at the Bali Med Denpasar General Hospital, totaling 82 people with PLS-based SEM analysis. The research results showed that service quality had a positive and significant effect on satisfaction, brand image had no significant effect on satisfaction, service quality and brand image had a positive and significant effect on loyalty, and patient satisfaction was able to mediate the effect of service quality and brand image on patient loyalty. It is hoped that the results of the research can provide advice to related parties to improve the quality of health services, such as how to respond to existing complaints and communicate well with patients and this is expected to have a positive impact on the quality of services

Trends in varenicline use for tobacco cessation, and their implications

BackgroundTobacco use remains a leading cause of death in the U.S. Varenicline is a preferred medication for tobacco cessation, and a prior report in the literature showed its use fell dramatically after the voluntary recall of Chantix (brand) varenicline (name) in July 2021. ObjectivesWorking with data on prescriptions for varenicline and nicotine-replacement therapy (NRT), we studied use from 2018 to 2023 to determine if varenicline use had recovered or if there had been a compensatory increase in NRT use. MethodsData are yearly from state employees and their dependents who were ≥18 years of age and were health-insurance beneficiaries of the Washington Public Employees Benefits Board from July 2018 through June 2023. Data include numbers of tobacco users and numbers of prescriptions filled. ResultsThe 5-year prevalence of tobacco use among 224,816 beneficiaries was 4.6%. The percentage of tobacco users who filled a prescription for varenicline fell from highs of 9.5% and 9.6% in the 2018–2019 and 2019–2020 years to lows of 5.3% and 6.4% in the 2021–2022 and 2022–2023 years. For nicotine replacement therapy, prescriptions rose modestly over the 5 years, from 4.5% in 2018–2019% to 6.0% in 2022–2023. DiscussionVarenicline use dropped after the voluntary recall of Chantix by Pfizer in mid-2021 and has not returned to prerecall levels. ConclusionPharmacists and other clinicians should address this drop, in addition to addressing longer-term challenges to increasing varenicline use; these include the requirement for a prescription and the black-box warning by the Food and Drug Administration, rescinded in 2016.

Ograniczenia budżetowe gospodarstw domowych w Polsce – analiza z wykorzystaniem EUROMOD-u

The following important changes affecting Polish households’ disposable income were introduced in 2022: the personal income tax (PIT) threshold was increased and its rate lowered, the tax exempt amount was raised, the possibility of deducting health insurance contributions from PIT was abolished, and the rules for granting housing allowance were modified. The aim of the research discussed in the paper was to determine the total direct impact of the above-mentioned changes on the amount of disposable income of a single parent and an individual managing a one-person household. The research was based on the EUROMOD tax-benefit microsimulation model and the hypothetical household method. A comparison of the budget constraints of July 2021 and July 2022 shows a decrease in real disposable income among low-skilled part-time workers or those working part of the year. It was found that the changes introduced in the area of housing allowance eligibility may have negatively affected the income of individuals living in one-person households receiving wages of less than 40% of the average salary. The lack of indexation of benefits is also observed to have had a negative impact on single parents’ income.

'Hospitals Are Medicine and More….' An Assessment of Subsidised Health Insurance Beneficiaries' Experience in Western Kenya

Financial protection remains an important hurdle to overcome if Universal Health Coverage is to be achieved in sub-Saharan Africa. An innovative model of subsidised health insurance to vulnerable households was implemented in one level four and two primary health care facilities in Western Kenya. The project aimed to determine whether reduced insurance costs, socioeconomic empowerment, and the availability of drugs would improve patients' experience and encourage them to co-pay. This was a secondary analysis of a mixed methods study with a cross-sectional household survey consisting of 18 semi-structured interviews conducted with NHIF subsidy program beneficiaries. Most beneficiaries accessed care as a result of the program. However, challenges of stockouts and inadequate healthcare workers persisted and discouraged some of them from going to the participating facilities. Community Health Promoters were very instrumental in enlightening the community on the cover and getting the sick beneficiaries to go to the hospital. The socioeconomic empowerment programme was beneficial but was mostly long-term and required financial input from the community members before they could sell the poultry or agricultural produce. Most community members were willing to pay after receiving health services using the cover. The study recommends contextualisation of socioeconomic empowerment programs, which are very important in enabling families to generate income to pay for health insurance. Additionally, improving the service delivery experience is important by reducing stockouts, having sufficient healthcare workers, and eliminating facility-related delays, which would improve the confidence of communities in public health facilities, thus retaining health insurance

National health insurance contribution to family planning program funding in Indonesia: A fund flow analysis.

Launched in 2014, Indonesia's national health insurance system (JKN) aimed to provide universal health coverage, including contraceptive services, to its population. We aim to evaluate the contribution of JKN to the overall spending for the family planning program in Indonesia. Data from the Indonesian Demographic Health Survey, Survey on Financial Flows for Family Planning, Indonesia Motion Tracker Matrix, World Population Prospect, and Indonesian ministries' budget accountability reports were entered into the CastCost Contraceptive Projection Tool to define budgetary allocation and spending for the family planning program at the national level in 2019. Indonesia's family planning program in 2019 was financed mostly by the national budget (64.0%) and out-of-pocket payments (34.6%). There were three main ministries responsible for family planning financing: the National Population and Family Planning Board (BKKBN) (35.8%), the Ministry of Finance (26.2%), and the Ministry of Health (2.0%). Overall, JKN contributed less than 0.4% of the funding for family planning services in Indonesia in 2019. The majority of family planning spending was by public facilities (57.3%) as opposed to private facilities (28.6%). JKN's contribution to funding Indonesia's family planning programs in 2019 was low and highlights a huge opportunity to expand these contributions. A coordinated effort should be conducted to identify possible opportunities to realign BKKBN and JKN roles in the family planning programs and lift barriers to accessing family planning services in public and private facilities. This includes a concerted effort to improve integration of private family planning providers into the JKN program.

THE IMPACT OF HEALTH INSURANCE ON THE QUALITY OF HEALTHCARE SERVICES IN GOVERNMENT HOSPITALS IN DAMMAM CITY

This study aimed to investigate the impact of health insurance on healthcare services in Ministry of Health hospitals in Dammam City from the perspective of health insurance beneficiaries. The study examined various aspects, including the integration of healthcare services, the reliability of healthcare services, responsiveness to healthcare services, the treatment by healthcare service providers, healthcare service procedures and systems, and healthcare service awareness. The study also aimed to determine the significance of differences in the impact of health insurance on the quality of healthcare services related to variables such as gender, age, income level, and educational qualifications. The study employed a descriptive-analytical approach, with a sample consisting of 250 individuals selected through convenient sampling from health insurance beneficiaries in Ministry of Health hospitals in Dammam City.The study found statistically significant (p ≤ 0.05) positive impacts of health insurance on healthcare services in Ministry of Health hospitals in Dammam City in terms of integration of healthcare services, reliability of healthcare services, responsiveness to healthcare services, treatment by healthcare service providers, healthcare service procedures and systems, and healthcare service awareness. There were also statistically significant differences (α≤ 0.05) in the impact of health insurance on the quality of healthcare services related to gender (favoring males), monthly income (favoring those with monthly income less than 5000 Saudi Riyals), age (favoring individuals under 30 years old), and educational qualifications (favoring individuals with a high school diploma or lower).

Influence of Socioeconomic Status on the Presence of Obstructive Coronary Artery Disease and Cardiovascular Outcomes in Patients Undergoing Invasive Coronary Angiography.

This retrospective study investigated the impact of socioeconomic status (SES) on patients at high risk of cardiovascular disease, focusing on obstructive coronary artery disease (CAD) presence and long-term cardiovascular outcomes in individuals undergoing invasive coronary angiography (ICA). Analyzing data from 9530 patients categorized by health insurance type (medical aid beneficiaries (MABs) as the low SES group; national health insurance beneficiaries (NHIBs) as the high SES group), this research explores the relationship between SES and outcomes. Despite a higher prevalence of cardiovascular risk factors, the MAB group exhibited similar rates of obstructive CAD compared to the NHIB group. However, over a median 3.5-year follow-up, the MAB group experienced a higher incidence of composite cardiovascular events, including cardiac death, acute myocardial infarction, coronary revascularization, and ischemic stroke, compared with the NHIB group (20.2% vs. 16.2%, p < 0.001). Multivariable Cox regression analysis, adjusting for potential confounders, revealed independently worse clinical outcomes for the MAB group (adjusted odds ratio 1.28; 95% confidence interval 1.07-1.54; p = 0.006). Despite comparable CAD rates, this study underscores the fact that individuals with low SES encounter an elevated risk of composite cardiovascular events, emphasizing the association between socioeconomic disadvantage and heightened susceptibility to cardiovascular disease, even among those already at high risk.

Impact of Communication in the Success of Health Insurance Schemes in Nigeria: The Plateau State Contributory Healthcare Management Agency Perspective

The importance of communication in the success of health insurance has become glaring over the years. Communication principles are used today as Health communication control strategies, educating patients about medical care options on various disease prevention, advocacy on marketing health plans and products etc. This study evaluated the communication strategies of the Plateau State Contributory Health Insurance Agency (PLASCHEMA) on the Plateau citizens. The method of study was mixed; quantitative and qualitative approach. Both primary and secondary sources were employed in obtaining data. The population of the study consists of 6 Local Government Areas in Plateau State. Findings established that PLASCHEMA as an organization utilizes the corporate communication strategies and that there is good level of awareness of PLASCHEMA activities. The study concluded that the communication processes in place by PLASCHEMA have been yielding average level of outcomes. For better impact, the study recommended that the agency needs to diversify its communication approaches, adopt strategies to step down their campaigns in local languages, hire the services of information professional and public relation consultants as parts of the envisaged capacity building.

Inequalities in unmet health care needs under universal health insurance coverage in China

BackgroundExpanding health insurance is a critical step towards universal health coverage due to its positive effect on reducing unmet health care needs and enhancing equitable access to health care. Despite previous studies on the socioeconomic factors associated with unmet health care needs, few studies have analysed the inequalities in such needs and the impact of universal health insurance coverage on addressing them. This study aimed to measure the contribution of social health insurance (SHI) coverage to inequalities in financially and non-financially constrained unmet health care needs among middle-aged and elderly Chinese adults.MethodsThe study data were obtained from the China Health and Retirement Longitudinal Study (2011–2015). A total of 11,592 respondents reporting outpatient care needs and 6320 reporting inpatient care needs were included. The concentration index (CI) was employed to measure the extent of income-related inequalities in unmet health care needs. A decomposition method based on a probit model was used to investigate the contribution of SHI to the inequalities.ResultsThe incidence rates of unmet outpatient needs due to financial and non-financial constraints were 4.68% and 24.78%, respectively; these rates were 18.69% and 15.73% for unmet inpatient needs. The CIs of unmet outpatient needs due to financial and non-financial constraints were − 0.1872 and 0.0195, respectively; these values were − 0.1558 and 0.0352 for unmet inpatient needs. The percentages of the contribution of SHI to the CIs of financially constrained unmet outpatient and inpatient needs were 0.2639% and 1.8898%, respectively. Moreover, the percentages of the contribution of SHI to the CIs of non-financially constrained unmet outpatient and inpatient needs were − 0.4513% and − 6.4192%, respectively.ConclusionThe universal coverage of SHI in China increased pro-poor inequalities in financially constrained unmet health care needs but decreased pro-rich inequalities in non-financially constrained unmet needs. Additionally, the contribution of SHI to inequalities in financially constrained unmet needs for inpatient care was stronger than that for outpatient care. Policy-makers are advised to introduce favourable reimbursement policies for patients with poor socioeconomic conditions and address both financial and non-financial barriers to promote equitable access to health care for the entire population.

'Digitising health protection schemes in Ghana': An enquiry into factors associated with the use of a mobile phone-based health insurance contribution payment system among tertiary students.

In 2018, Ghana's National Health Insurance Scheme (NHIS) introduced a mobile money payment system for membership renewal and premium payments to enhance enrolment and retention rates. However, the adoption of such innovations depends on various factors, including personal traits and public perceptions. This study aims to explore the determinants of NHIS membership renewal and premium payment via the mobile renewal system. Conducted at Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana, the study used a survey design to gather data from 951 KNUST students. Employing logistic regression analysis, the study identified key factors influencing the use of the NHIS mobile renewal service. The findings revealed that individuals aged 19-21, 25-27 or above 27, without mobile money accounts, and those with no history of online purchases were less likely to adopt the mobile renewal system (P < .05). Conversely, those perceiving the system as useful and easy to use were more likely to utilise it for NHIS membership renewal (P < .05). In conclusion, policymakers should prioritise system quality, accessibility, perceived ease of use, and usefulness to facilitate the adoption and usage of the NHIS mobile payment system. These findings contribute valuable insights for enhancing the effectiveness of health insurance innovations.

Impact of COVID-19 pandemic on surgical activity in the Brazilian private healthcare system

Introduction Surgical volume was drastically reduced in many countries due to challenges imposed by the COVID-19 pandemic. Objectives We sought to estimate the number of cancelled surgical and diagnostic procedures within the Brazilian private healthcare system between 2020 and 2021 over the course of the COVID-19 pandemic, and to project the procedural backlog generated for specific elective and time-sensitive surgeries, and diagnostic procedures. Methods Data were systematically extracted from the Brazilian national regulatory agency for the private healthcare system and included (i) quarterly and annual surgical and diagnostic volume, and (ii) the number of private health insurance beneficiaries between January 2016 and June 2021. Based on pre-pandemic data we estimated the expected number of surgical and diagnostic procedures that failed to be performed between 2020 and 2021. Results The average quarterly surgical and diagnostic procedures declined by 29.5% in 2020 and by 21.5% in 2021 compared to 2019. In 2020, such reduction reflected a lower number of diagnostic procedures under anesthesia (-35.1%), as well as elective (-14.7%), time-sensitive (-18.8%), and urgent (-4.6%) surgeries. In the first half of 2021, though the surgical and diagnostic procedures increased compared to 2020, they remained significantly below their historical average. The estimated backlogs were 134.385,64 for total surgical procedures, 2.634,64 for bariatric surgery and arthroplasty revision (elective surgeries), 2.845,61 for oncologic (time-sensitive) surgeries, and 304.193,99 for diagnostic procedures, requiring 1.7, 15.9, and 6.8 years, respectively, to make up for such backlogs. Conclusion There was a major decline on the number of surgical and diagnostic procedures due to the COVID-19 pandemic. Despite a slight recovery of elective surgeries throughout the pandemic, many time-sensitive surgeries and diagnostic procedures were cancelled, with potential medium- to long-term consequences to patients and the system as a whole.

Trend of incidence rate of age-related diseases: results from the National Health Insurance Service–National Sample Cohort (NHIS-NSC) database in Korea: a cross- sectional study

BackgroundThis study aimed to identify and select age-related diseases (ARDs) in Korea, which is about to have a super-aged society, and to elucidate patterns in their incidence rates.MethodsThe National Health Insurance Service–National Sample Cohort, comprising 1 million health insurance and medical benefit beneficiaries in Korea from 2002 to 2019, was utilized. We selected 14 diseases with high disease burden and prevalence among Koreans from the 92 diseases defined in the Global Burden of Diseases, Injuries, and Risk Factors Study as ARDs. The annual incidence rate represented the number of patients newly diagnosed with an ARD each year from 2006 to 2019, excluding those with a history of ARD diagnosis from 2002 to 2005. The incidence rate by age was categorized into 10-year units based on age as of 2019. The number of patients with ARDs in each age group was used as the numerator, and the incidence rate for each age group was calculated with the age group as the denominator.ResultsRegarding the annual incidence rates of ARDs from 2006 to 2019, chronic obstructive pulmonary disease, congestive heart failure, and ischemic heart disease decreased annually, whereas dyslipidemia, chronic kidney disease, cataracts, hearing loss, and Parkinson's disease showed a significant increase. Hypertension, diabetes, cerebrovascular disease, osteoporosis, osteoarthritis, and age-related macular degeneration initially displayed a gradual decrease in incidence but exhibited a tendency to increase after 2015. Concerning age-specific incidence rates of ARDs, two types of curves emerged. The first type, characterized by an exponential increase with age, was exemplified by congestive heart failure. The second type, marked by an exponential increase peaking between ages 60 and 80, followed by stability or decrease, was observed in 13 ARDs, excluding congestive heart failure. However, hypertension, ischemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, and hearing loss in men belonged to the first type.ConclusionsFrom an epidemiological perspective, there are similar characteristics in age-specific ARDs that increase with age, reaching a peak followed by a plateau or decrease in Koreans.

Health Inequities in Cancer Incidence According to Economic Status and Regions Are Still Existed Even under Universal Health Coverage System in Korea: A Nationwide Population Based Study Using the National Health Insurance Database.

The purpose of this study is to determine the level of health equity in relation to cancer incidence. We used the National Health Insurance claims data of the National Health Insurance Service between 2005 and 2022 and annual health insurance and medical aid beneficiaries between 2011 and 2021 to investigate the disparities of cancer incidence. We calculated age-sex standardized cancer incidence rates by cancer and year according to the type of insurance and the trend over time using the annual percentage change. We also compared the hospital type of the first diagnosis by cancer type and year and cancer incidence rates by cancer type and region in 2021 according to the type of insurance. The total cancer incidence increased from 255,971 in 2011 to 325,772 cases in 2021. The absolute difference of total cancer incidence rate between the NHI beneficiaries and the medical aid (MA) recipients increased from 510.1 cases per 100,000 population to 536.9 cases per 100,000 population. The odds ratio of total cancer incidence for the MA recipients increased from 1.79 (95% confidence interval [CI], 1.77 to 1.82) to 1.90 (95% CI, 1.88 to 1.93). Disparities in access to hospitals and regional cancer incidence were profound. This study examined health inequities in relation to cancer incidence over the last decade. Cancer incidence was higher in the MA recipients, and the gap was widening. We also found that regional differences in cancer incidence still exist and are getting worse. Investigating these disparities between the NHI beneficiaries and the MA recipients is crucial for implementing of public health policies to reduce health inequities.

Dropout rate and associated factors of community-based health insurance beneficiaries in Ethiopia: a systematic review and meta-analysis

BackgroundEthiopia aims to achieve universal healthcare using health insurance. To do so, it has been implementing community-based health insurance since 2011. However, the retention of members by the scheme has not yet been evaluated nationally. The systematic review and meta-analysis aimed to evaluate the dropout rate and associated factors among the scheme’s beneficiaries in Ethiopia.MethodsOn December 19, 2022, searches were conducted in Scopus, Hinari, PubMed, Semantic Scholar, and Google Scholar. Searches were also conducted on the general web and electronic repositories, including the Ethiopian Health Insurance Service, the International Institute for Primary Health Care-Ethiopia, and various higher education institutions. The Joanna Briggs Institute’s tools and the “preferred reporting items for systematic reviews and meta-analyses 2020 statement” were used to evaluate bias and frame the review, respectively. Data were analyzed using Stata 17 and RevMan 5. To assess heterogeneity, we conducted subgroup analysis and used a random model to calculate odds ratios with a p value less than 0.05 and a 95% CI.ResultsIn total, 14 articles were included in the qualitative synthesis, of which 12 were selected for the quantitative analysis. The pooled estimate revealed that the dropout rate of beneficiaries from the scheme was 34.0% (95% CI: 23-44%), provided that the renewal rate was 66.0%, and was found to be influenced by socio-demographic, health status, length of enrolment, knowledge, attitude, the scheme, and health service-related variables. The southern and Oromia regions reported the lowest and highest dropout rates, with 27.0% (95% CI: 24-29%) and 48.0% (95% CI: 18-78%), respectively. The dropout rates increased from 12.3% in 2012–2015 to 34.4% in 2020–2021.ConclusionMore than one-third of the scheme’s beneficiaries were found to have dropped out, and this has been found to increase over time, dictating that a community-based strategy and intervention, from the supply, insurer, and demand sides, seem indispensable in minimizing this huge dropout rate.

The oral health component of «100% santé» reform: initial descriptive elements

The “100% Santé” (100% Health) reform constitutes a major change to oral health pricing and insurance practices in France. The objective of this study was to observe the evolution of dental care consumption, and in particular prosthetic care, over a period including the years before and after the reform. This exploratory study, based on descriptive data, provides the first elements of analysis useful for evaluating the oral health component of the “100% Santé” reform. The study is based on the health care consumption data of 3,466,764 state health insurance beneficiaries aged three to twenty-five years in Occitania, covering the period from January 1, 2016, to December 31, 2020. The descriptive analysis of this data revealed that prosthodontic care is the only area to show an increase in the average amount of care consumed between 2019 and 2020: a relative increase of +4 percent among 3–25-year-olds and +6.7 percent among 21–25-year-olds. Moreover, among 21–25-year-olds, we observe a drop in the share of prostheses in the care consumed in 2019, and then a recovery approaching 0.3 percent of the initial share in 2020. Although it is not possible to conclude that there is an impact, these results show a positive trend whereby the reform’s objective of increasing prosthodontic care consumption seems to have been achieved. This study highlights the importance of assessing the long-term impact of the COVID-19 crisis and the “100% Santé” reform on dental care consumption.

Prevalence of Dementia in Korea by Socioeconomic Status between Medical Aid Beneficiaries and National Health Insurance Beneficiaries

Prevalence of Dementia in Korea by Socioeconomic Status between Medical Aid Beneficiaries and National Health Insurance Beneficiaries