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The Effects of Health Insurance on Demand for Healthcare Services in Tanzania

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DOI: 10.18535/sshj.v8i10.1306· Pages: 5210-5223· Vol. 8, No. 10, (2024)· Published: October 6, 2024
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Abstract

ABSTRACT: Consistent healthcare financing systems within a particular nation or community have been regarded as vital for making universal healthcare access. This study intended to examine the influence of health insurance on the demand for healthcare services and the influence of socio-economic, demographic and hospital-related factors on demand for health care services in Tanzania context. The study employed secondary data, which were analysed by descriptive statistics and the results were presented in tables and percentages. Econometric analysis was also done using binary probit regression model to determine the factors influencing demand for health care services in Tanzania.  The instrumental variable was applied to address the problem of endogeneity of health insurance. The regression results revealed that gender, education level, household size, income, treatment cost, perceived health quality and health insurance type were significant and positively linked with demand for health care services. However, marital status was also significant but negatively associated with the demand for healthcare services. The study concluded that, despite of the efforts made by the government and other stakeholders on emphasis over having health insurance, the enrolment to health insurance schemes is still low although it has been noted to significantly influence the demand for health care services. Lastly, the paper recommends that the government and other stakeholders are required to formulate or strengthen the formulated policy in practice, purposively to improve access, affordability and the quality of health care services. Governmental and non-governmental organizations (NGO`s) and other stakeholders should put more effective strategies to improve coverage but also reduce the financial burden caused by illness. Also, the government needs to subsidize the healthcare sector, especially to the poor and provide subsidies to private healthcare facilities, improvement of insurance type, specifically, the NHIF which needs to increase coverage. Furthermore, health care managers should educate other people and make a clear observation on factors that make individuals demand for health care because they have a great role in the health care sector as well as strategies to improve household`s income to meet the health needs in Tanzania.

Keywords

health insurancehealth caredemand for healthcareinstrumental variablesendogeneityuniversal health coverage

References

  1. Achandi, E. L., & Mujawamariya, G. (2016). Market participation by smallholder rice farmers in Tanzania: A double hurdle analysis. Studies in Agricultural Economics, 118(2), 112–115.Google Scholar ↗
  2. https://doi.org/10.7896/j.1528DOI ↗Google Scholar ↗
  3. Aggrey, M., & Appiah, S. C. Y. (2014). The influence of clients’ perceived quality on health care utilization. 9(2).Google Scholar ↗
  4. Ajakaiye, O., & Mwabu, G. (n.d.). The Demand for Reproductive Health Services: An Application of Control Function Approach.Google Scholar ↗
  5. Akazili, J., Garshong, B., Aikins, M., Gyapong, J., & McIntyre, D. (2012). Progressivity of health care financing and incidence of service benefits in Ghana. Health Policy and Planning, 27(suppl 1), i13–i22. https://doi.org/10.1093/heapol/czs004.DOI ↗Google Scholar ↗
  6. Aryeetey, G. C., Westeneng, J., Spaan, E., Jehu-Appiah, C., Agyepong, I. A., & Baltussen, R. (2016). Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana’s National Health Insurance Scheme. International Journal for Equity in Health, 15(1), 116. https://doi.org/10.1186/s12939-016-0401-1.DOI ↗Google Scholar ↗
  7. Bakar, A. A. (2016). The Effect Of Health Insurance On Health Care Utilization: Evidence From Malaysia. 362–368. https://doi.org/10.15405/epsbs.2016.08.51.DOI ↗Google Scholar ↗
  8. Bascle, G. (2008). Controlling for endogeneity with instrumental variables in strategic management research. Strategic Organization, 6(3), 285–327. https://doi.org/10.1177/1476127008094339.DOI ↗Google Scholar ↗
  9. Chomi, E., Mujinja, P. G., Enemark, U., Hansen, K., & Kiwara, A. (2014). Health care seeking behaviour and utilisation in a multiple health insurance system: Does insurance affiliation matter? International Journal for Equity in Health, 13(1), 25.Google Scholar ↗
  10. https://doi.org/10.1186/1475-9276-13-25.DOI ↗Google Scholar ↗
  11. Demissie, B., & Gutema Negeri, K. (2020). Effect of Community-Based Health Insurance on Utilization of Outpatient Health Care Services in Southern Ethiopia: A Comparative Cross-Sectional Study. Risk Management and Healthcare Policy, Volume 13, 141–153.Google Scholar ↗
  12. https://doi.org/10.2147/RMHP.S215836.DOI ↗Google Scholar ↗
  13. Dixon-Woods, M., Leslie, M., Tarrant, C., & Bion, J. (2013). Explaining Matching Michigan: An ethnographic study of a patient safety program. Implementation Science, 8(1), 70. https://doi.org/10.1186/1748-5908-8-70.DOI ↗Google Scholar ↗
  14. Gakii, J. (n.d.). Demand for Health Care in Kenya: The Effect of Health Insurance.Google Scholar ↗
  15. Guo, Z., Kang, H., Cai, T. T., & Small, D. S. (n.d.). Testing Endogeneity with Possibly Invalid Instruments and High Dimensional Covariates.Google Scholar ↗
  16. Honore, B. E., & Lewbel, A. (2002). Semiparametric Binary Choice Panel Data Models Without Strictly Exogeneous Regressors. Econometrica, 70(5), 2053–2063.Google Scholar ↗
  17. https://doi.org/10.1111/1468-0262.00363.DOI ↗Google Scholar ↗
  18. Jung, J., & Streeter, J. L. (n.d.). Does Health Insurance Decrease Health Expenditure Risk in Developing Countries? The Case of China.Google Scholar ↗
  19. Kihaule, A. (2014). Analysis of the Impact of Rural Households Membership in the Micro Health Insurance on the Utilization of Health Services in Tanzania. GSTF Journal of Nursing and Health Care, 1(2).Google Scholar ↗
  20. https://doi.org/10.5176/2345-718X_1.2.51.DOI ↗Google Scholar ↗
  21. Kutzin, J. (2013). Health financing for universal coverage and health system performance: Concepts and implications for policy. Bulletin of the World Health Organization, 91(8), 602–611. https://doi.org/10.2471/BLT.12.113985DOI ↗Google Scholar ↗
  22. Lee, B., Tarimo, K., & Dutta, A. (n.d.). Tanzania’s Improved Community Health Fund: An Analysis of Scale-Up Plans and Design.Google Scholar ↗
  23. Mtei, G., Mulligan, J., Palmer, N., Kamuzora, P., Ally, M., & Mills, A. (n.d.). An Assessment of the Health Financing System in Tanzania: Implications for Equity and Social Health Insurance.Google Scholar ↗
  24. Mbwile, E. (2024). Investigation of the Relationship between Family Business Success and Marital Failure in Tanzania. Social Science and Humanities Journal (SSHJ), 8(07), 4452-4457.Google Scholar ↗
  25. Osei Asibey, B., & Agyemang, S. (2017). Analysing the Influence of Health Insurance Status on Peoples’ Health Seeking Behaviour in Rural Ghana. Journal of Tropical Medicine, 2017, 1–7. https://doi.org/10.1155/2017/8486451.DOI ↗Google Scholar ↗
  26. Owusu-Sekyere, E., & Chiaraah, A. (2014). Demand for Health Insurance in Ghana: What Factors Influence Enrollment? American Journal of Public Health Research, 2(1), 27–35. https://doi.org/10.12691/ajphr-2-1-6.DOI ↗Google Scholar ↗
  27. Rashad, I., & Markowitz, S. (n.d.). Incentives in Obesity and Health Insurance.Google Scholar ↗
  28. Ruhara, M. C. (2016). Effect of Health Insurance on Demand for Outpatient Medical Care in Rwanda: An Application of the Control Function Approach. Rwanda Journal, 3(1), 77. https://doi.org/10.4314/rj.v3i1.6B.DOI ↗Google Scholar ↗
  29. Shin, J., Lee, T.-J., Cho, S., & Choe, S. A. (2015). Factors Determining Children’s Private Health Insurance Enrolment and Healthcare Utilization Patterns: Evidence From the 2008 to 2011 Health Panel Data. Journal of Preventive Medicine and Public Health, 48(6), 319–329. https://doi.org/10.3961/jpmph.15.057.DOI ↗Google Scholar ↗
  30. Sohn, M., & Jung, M. (2016). Effects of public and private health insurance on medical service utilization in the National Health Insurance System: National panel study in the Republic of Korea. BMC Health Services Research, 16(1), 503. https://doi.org/10.1186/s12913-016- 1746-2.DOI ↗Google Scholar ↗
  31. Terza, J. V., Basu, A., & Rathouz, P. J. (2008). Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling. Journal of Health Economics, 27(3), 531–543. https://doi.org/10.1016/j.jhealeco.2007.09.009.DOI ↗Google Scholar ↗
  32. Ujunwa, F., Onwujekwe, O., & Chinawa, J. (2014). Health services utilization and costs of the insured and uninsured under the formal sector social health insurance scheme in Enugu metropolis South East Nigeria. Nigerian Journal of Clinical Practice, 17(3), 331. https://doi.org/10.4103/1119-3077.130235.DOI ↗Google Scholar ↗
  33. Wang, Y., Jiang, Y., Li, Y., Wang, X., Ma, C., & Ma, S. (2013). Health Insurance Utilization and Its Impact: Observations from the Middle-Aged and Elderly in China. PLoS ONE, 8(12), e80978. https://doi.org/10.1371/journal.pone.0080978.DOI ↗Google Scholar ↗
  34. Wellay, T., Gebreslassie, M., Mesele, M., Gebretinsae, H., Ayele, B., Tewelde, A., & Zewedie, Y. (2018). Demand for health care service and associated factors among patients in the community of Tsegedie District, Northern Ethiopia. BMC Health Services Research, 18(1), 697. https://doi.org/10.1186/s12913-018-3490-2.DOI ↗Google Scholar ↗
  35. World Health Organization. (2010). The world health report: Health systems financing: the path to universal coverage. Rapport Sur La Santé Dans Le Monde : Le Financement Des Systèmes de Santé : Le Chemin Vers Une Couverture Universelle.Google Scholar ↗
  36. https://iris.who.int/handle/10665/44371.Google Scholar ↗
  37. Yilmaz Gunduz, A. (2018). The Importance of Healthy Human Life on Economic Development. Social Sciences, 7(2), 63. https://doi.org/10.11648/j.ss.20180702.12.DOI ↗Google Scholar ↗
Author details
Omary P.S.
Department of Labour Studies-Institute of Social Work (ISW-Kijitonyama Campus)
✉ Corresponding Author
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Mugula, V.J.
Faculty of Social Science –Department of Economics: Mzumbe University –Morogoro Campus, Tanzania
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Kubetta N.E.
Faculty of Leadership and management Sciences – Department of Economics: Mwalimu Nyerere Memorial Academy University-Karume Campus, Zanzibar
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