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Heterogeneous effects of national health insurance scheme on healthcare utilisation: evidence from Ghana

Samuel Sekyi (SD Dombo University of Business and Integrated Development Studies, Wa, Ghana)
Senia Nhamo (University of South Africa, Pretoria, South Africa)
Edinah Mudimu (University of South Africa, Pretoria, South Africa)

International Journal of Social Economics

ISSN: 0306-8293

Article publication date: 11 December 2023

Issue publication date: 2 July 2024

156

Abstract

Purpose

This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.

Design/methodology/approach

The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership.

Findings

Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries.

Originality/value

To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330

Keywords

Acknowledgements

The authors are grateful to both the Economic Growth Centre at Yale University and the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana for the permission to use the Ghana Socioeconomic Panel Survey dataset.

Citation

Sekyi, S., Nhamo, S. and Mudimu, E. (2024), "Heterogeneous effects of national health insurance scheme on healthcare utilisation: evidence from Ghana", International Journal of Social Economics, Vol. 51 No. 8, pp. 1057-1075. https://doi.org/10.1108/IJSE-05-2023-0330

Publisher

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Emerald Publishing Limited

Copyright © 2023, Emerald Publishing Limited

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