Heterogeneous effects of national health insurance scheme on healthcare utilisation: evidence from Ghana
International Journal of Social Economics
ISSN: 0306-8293
Article publication date: 11 December 2023
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. (2023), "Heterogeneous effects of national health insurance scheme on healthcare utilisation: evidence from Ghana", International Journal of Social Economics, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJSE-05-2023-0330
Publisher
:Emerald Publishing Limited
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