Effectiveness of A Health Microinsurance Scheme for Private Primary Care in Malaysia
- Conditions
- Health Care Quality, Access, and EvaluationInsurance, Health
- Interventions
- Other: HMI
- Registration Number
- NCT02696174
- Lead Sponsor
- Chulalongkorn University
- Brief Summary
This is the Phase 3 of a 3 phase study to determine the feasibility, acceptability and effectiveness of a health microinsurance scheme in improving health equity and clinical outcomes for private primary care (PPC) in Kuala Lumpur, Malaysia. This two-arm, pre-post, quasi-experimental trial consisted of utilizing a HMI scheme (experimental clinic) and normal OOP payments (control clinic) for 6 months. The HMI scheme enabled subscribed households to access a defined benefit package at a selected PPC for treatment and follow-up.
- Detailed Description
This will be a quasi-experimental study designed to determine the effectiveness of a community health microinsurance scheme (HMI) in private primary care clinics in Malaysia via a pre-post study of an experimental and control clinic. A proposed HMI scheme, whose price and benefit package have been defined through the earlier Phases 1 and 2, will be accessible to subscribed households at the experimental clinic, while the control clinic has subscribed patients paying as per normal practise, which is by Out-Of-Pocket payment. The HMI scheme enabled subscribers to visit the selected clinic chosen for any form of primary care diagnosis, treatment and follow-up. Both the clinics are located in the Jalan Ipoh area, a suburb of Kuala Lumpur, and have common sociodemographic characteristics. A pre-intervention questionnaire will aim to capture health seeking behaviour, delay in seeking medical care, monthly health expenditure and improvements in clinical outcome (assessed by clinical test results). After six months, a post-intervention questionnaire is administered again to the respondents which then allows assessment of the outcome variables.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 114
- Households were located in the study area
- Method of payment to clinic is by out-of-pocket
- This is household's regular choice of primary care provider.
- Patient has been seen in the clinic since at least the past two years i.e from before Jan 1, 2014
- Households had members who died in the year 2014.
- Households had members who were away from this place of residence for work/transferred for more than 1 month in 2014.
- Households had members who had regular follow-up in public facilities for chronic disease.
- Households with members who have switched methods of payment in the last year- (e.g newly bought insurance or retired and lost health benefits so paying OOP)
- Patients who refuse consent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Health Microinsurance Scheme HMI Households owning the HMI package, entitling them to visit and receive treatment from the selected primary care clinic
- Primary Outcome Measures
Name Time Method Health-seeking behavior Change from Baseline health seeking behavior at 6 months Delays in seeking healthcare (days)
Monthly health expenditure Change from Baseline Monthly Health Expenditure at 6 months How much has been spent for monthly health expenses (in Ringgit Malaysia)
- Secondary Outcome Measures
Name Time Method Clinical Outcome of Diabetes Mellitus Change from Baseline HbA1c at 6 months Measurement of HbA1c
Clinical Outcome of Hypertension Change from Baseline Resting Mean Blood Pressure at 6 months Resting mean blood pressure
Clinical outcome of dyslipidemia Change from Baseline serum cholesterol and LDL at 6 months Total serum cholesterol and LDL
Clinical outcome of bronchial Asthma Change from Baseline spirometry levels at 6 months Spirometry levels