The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review.

摘要: Background Expanding public health insurance seeks to attain several desirable objectives, including increasing access healthcare services, reducing the risk of catastrophic expenditures, and improving outcomes. The extent which these objectives are met in a real-world policy context remains an empirical question research interest recent years. Methods We reviewed systematically studies published from July 2010 September 2016 using Medline, Embase, Econlit, CINAHL Plus via EBSCO, Web Science grey literature databases. No language restrictions were applied. Our focus was on both randomised observational studies, particularly those explicitly attempts tackle selection bias estimating treatment effect insurance. main outcomes are: (1) utilisation (2) financial protection for target population, (3) changes status. Findings 8755 abstracts 118 full-text articles assessed. Sixty-eight inclusion criteria six reflecting substantial increase quantity quality output compared time period before 2010. Overall, schemes low- middle-income countries (LMICs) have been found improve care as measured by increased facilities (32 out 40 studies). There also appeared be favourable (26 46 studies), although indicated otherwise. is moderate evidence that insured (9 12 Interpretation Increased coverage generally appears facilities, status, findings not totally consistent. Understanding drivers differences reforms critical inform future implementations publicly funded achieve broader goal universal coverage.