Effectiveness of Various Health Insurances in Tackling Health Problems of the 21st Century: A Systematic Review

Abstract

Objective:

To investigate the relationship between health insurance and health quality using systematic method.

Background:

Health insurance can be said has strong relation in achieving Goal 3 of Sustainable Development Goals (SDGs), “Ensure healthy lives and promote well-being for all at all ages”. One of the key factor in reaching ‘healthy lives’ is the access to medical care. Health insurance has been implemented across many countries in order to facilitate access for good quality medical care. Some studies indicated that health insurance have positive effect to improve health quality of patient. Another study indicated there is inverted effect between ownership of health insurance and health quality. The link between health insurance and its ability to tackle health problems therefore should be thoroughly investigated.

Methods:

Systematic review was conducted using keywords “Insurance, Health”[Mesh] AND “Health Care Quality, Access, and Evaluation”[Mesh] on Pubmed. Afterwards, titles are screened for relevancy and duplication. Contents then were then screened for inclusion criteria, which include studies with publication age less than five years, observational studies, and studies which look upon effects of health insurance on its users’ health, and exclusion criteria, which include inaccessible articles, articles written in foreign languages, and irrelevant articles. A total of 6 suitable studies were included in the final review and were subjected to STROBE analysis.

Key Findings:

Increased usage of proper health insurance is related to an increase in overall health outcomes of various diseases, including type 1 Diabetes Mellitus (7% decrease of hyperglycemia on patients with more expensive insurance), acuity of thoracic aortic operations (underinsured patients were at greatest risk of getting acute nonelective operation; OR: 2.67), gastritis (insurance coverage reduce prevalence of H. pylori), cardiac arrest (102/100.000 to 85/100.000 incidence after insurance expansion), albuminuria (higher mortality for individuals without private insurance), and peritonitis (better prognosis for individuals with better insurance). These conditions could be explained by increase in health awareness and accessibility of medication by patients with quality health insurance. This finding could become a basis for governments to highly consider quality insurances as means to improve the health of the nation.