SOCIAL INSURANCE POLICY FORMATION ON FINANCIAL PROTECTION AND HEALTH SERVICE UTILIZATION:A STUDY OF COMMUNITY BASED HEALTH INSURANCE (CBHI) IN SAVANNAKHET PROVINCE, LAO P.D.R.

Abstract

This study aims to analyze the performance of the CBHI scheme in term of improving accessibility and financial protection of using health services in Savannakhet province, Laos. In addition, the study also aims to find out the reason of high dropout rate in the recent years. The cross-sectional study design was applied in this research. The interview process includes 252 households, which equally divided into insured and uninsured households. Logistic regression models were used to predict and compare the probability of hospitalization and financial catastrophe between insured and uninsured households. In addition, Focus Group Discussion (FGD) and in-depth interview were used to analyze the reason of high CBHI dropout rate from households and key informants respectively. The findings show that the insurance status does not significantly improve accessibility and financial protection. The quality of health care services provided by the CBHI contracted hospital was the most important reason for relatively high-income households to quit the scheme, whereas the unaffordable premium was the important factor for the poor households to dropout from the CBHI scheme. The policy recommendation related to health care facilities and CBHI scheme were proposed with the willingness to improve the quality of the CBHI in general.