The Impact of health insurance on the healthcare utilization of children below the age of 18 years

Abstract

The Ghana National Health Insurance policy was established in August 2003 with an underlining objective of attaining a Universal Health Coverage. Low-income community who couldn’t afford instant or cash payment for health services were the primary target. Under this policy, children below age 18 years were excluded from paying premium conditioned on their parents’ enrollment. This study therefore evaluates the bearing of the health insurance policy on children’s healthcare usage. Household data from the Ghana Demographic Health Survey was exploited to identify children whose parent were insured under the scheme. In order to minimize the possible bias arising due to self-selection into the scheme, propensity score matching was applied. It was identified that about 57.4 percent of household heads with children under 18 years had health insurance. The main independent variable used was health insurance enrollment of the household head. Four basic healthcare utilization measures were evaluated. Variables based on whether or not a person had a general health examination, paid a visit to the clinic/hospital, spent at least a night at the hospital and whether a person went for medical prescription during the last 12 months before the survey. There was positive correlation between state of wealth and health insurance subscription. Rural-urban residency also had a positive correlation with insurance. The findings from analyzing each outcome variable indicated a statistically significant effect of health insurance on healthcare use, where a child who is insured utilizes at least one measure of healthcare. In conclusion, the health insurance does encourage people to take their children to visit a health facility to access healthcare. The authorities therefore need to put in extra efforts to encourage all persons to be insured under the health insurance system in order to have access to medical services which they would otherwise cannot afford out of pocket for their children. This will ensure growing access to health insurance which will empower Ghana to continue to advance the health outcomes of all citizens.