BACKGROUND A public hospital in New Mexico required collection of 50% of estimated costs prior to elective surgeries for self-pay patients. This study assesses the impact of this policy on access to elective surgical procedures. METHODS Chi-square tests determined if there was a statistically significant difference between the number of self-pay and insured patient cancellations for financial...

This paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims' data gathered by a major Swiss health insurer, over a period of 6 years and involving 160 000 insured adults. In Switzerland, health insurance is mandatory, but everyone has the option of choosing between a managed care plan and a fee-for-service plan. This paper focuses on...

BACKGROUND In 2003, Ghana introduced the national health insurance scheme (NHIS) to promote access to healthcare. This study determines consumer and provider factors which most influence the NHIS at a municipal health facility in Ghana. METHOD This is an analytical cross-sectional study at the Winneba Municipal Hospital (WHM) in Ghana between January-March 2010. A total of 170 insured and 175...

BACKGROUND Community-based health insurance has been associated with increased hospitalisation in low-income settings, but with limited analysis of the illnesses for which claims are submitted. A review of claims submitted to VimoSEWA, an inpatient insurance scheme in Gujarat, India, found that fever, diarrhoea and hysterectomy, the latter at a mean age of 37 years, were the leading reasons for...

Hypertension awareness, treatment, and control are lower among uninsured than insured adults. Time trends in differences and underlying modifiable factors are important for informing strategies to improve health equity. National Health and Nutrition Examination Surveys 1988 to 1994, 1999 to 2004, and 2005 to 2010 data in adults aged 18 to 64 years were analyzed to explore this opportunity. The ...

BACKGROUND Medicare spending after age 65 years may be higher for previously uninsured adults if suboptimal care before this age leads to irreversible complications, persistently elevated clinical risks, or delay of costly elective procedures. OBJECTIVE To compare Medicare spending for previously uninsured and insured adults by using Medicare claims data. DESIGN Longitudinal survey data and...

Uninsured individuals receive fewer health care services for at least three reasons: higher prices, responsibility for the entire bill, and potential provider reductions for concern of nonpayment. This study isolates differences in service levels between insured and uninsured individuals that are attributed to different effective prices; the uninsured pay the bill without a contribution from an...

The impact of information distribution on optimal risk-sharing between different parties has been an important field of research over the past 30 years. In the literature of insurance, however, the focus has remained essentially on one configuration: insurers (the principal) propose a contract to insured (the agent), but are unable to observe perfectly the risk of their insured who can. This as...

A L M O S T 3 4 mi l l ion persons are estimated to have been insured 1 under Federal old-age and survivors insurance at the beginning of 1 9 4 4 . Tha t is, there were about 3 4 mi l l ion persons whose deaths could result i n the award of benefits under the program. A l most a mi l l ion were ful ly insured workers who had attained age 6 5 and therefore could have been entit led to pr imary b...

BACKGROUND In Switzerland, basic health insurance is mandatory for all inhabitants, but a rising number of insured have arrears in premium payments, potentially leading to coverage suspension. We aimed at characterizing insured with debt enforcement proceedings with respect to socio-demographic and health utilization aspects. METHODS Cross-sectional analysis of 508.000 insured with basic heal...