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标题：Factors Associated to the Enrollment in Health Insurance: An Experience from Selected Districts of Nepal
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作者：Devaraj Acharya ; Bhimsen Devkota ; Bishnu Prasad Wagle 等
期刊名称：Asian Social Science
印刷版ISSN：1911-2017
电子版ISSN：1911-2025
出版年度：2019
卷号：15
期号：2
页码：90-99
DOI：10.5539/ass.v15n2p90
出版社：Canadian Center of Science and Education
摘要：The enrollment in Health Insurance (HI) is considered as a sustainable way of financing for health and preparedness for catastrophic health care cost during receiving health services. Various socio-demographic factors are still unanswered regarding their influence. A study aiming to assess the factors associated with the enrollment of HI was conducted in 2018 in two districts of Nepal namely Kailali and Baglung. The study was cross-sectional covering 810 (405 enrolled and 405 not-enrolled) randomly selected households (HH). Socio-demographic variables were considered as independent variables and enrollment in HI as dependent variable. An interview schedule was used as a tool for data collection. Univariate, bivariate and multivariate analyses were performed to analyze the data. The data show that various socio-demographic characteristics are associated with the enrollment of HI. A significant statistical difference is seen between enrollment to HI and HH headship, age group of respondents, ability to feed the family, presence of chronic diseases in family, knowledge on HI, willingness to pay (WTP) for HI, having HI guidelines or books, participation in HI related training, interactions with neighbours, access to communication media: the radio/FM and TV, hoarding boards (HB), newspapers, posters/pamphlets/brochures; and access to health facilities. The results further show that female heads appear more likely to enroll (aOR = 1.47) in HI than the male. HH headship of the respondents also seem more likely to enroll. Higher age respondents are less likely to enroll. Interestingly, literate respondents and joint families are less likely to enroll than illiterate and nuclear families respectively. However, respondents having knowledge in HI seem more likely to enroll (aOR = 28.97, p<0.001) than those who are unaware about HI. Those with higher WTP for HI are more likely to enroll (aOR = >1.673, p<0.05) than low WTP. Respondents having guidelines or books, interactions with neighbours or relatives, exposure to the radio/FM, TV and HB seem significantly more likely to enroll. Respondents who feel susceptible to diseases are more likely to enroll (aOR = 1.484, p<0.05) compared to those who do not. Knowledge on HI, WTP, having HI related books or guidelines, exposure to the media (the radio/FM, TV, HB), interactions with neighbours appear to be the positive predictors for enrollment. Appropriate interventions should be implemented considering the factors for increased participation in HI.
关键词：health insurance; enrollment; Nepal; socio-demographic variables