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Table 4 Association between Health insurance and health status/outcomes amongst people with disabilities in LMICs

From: Access to health insurance amongst people with disabilities and its association with healthcare use, health status and financial protection in low- and middle-income countries: a systematic review

Studies

Country

Health insurance

Type of disability (measurement)

Outcome measure

Results

Association (insured vs uninsured)

Risk of bias

Fan (2023) [91]

China

Long term care insurance,

Public

All types (ADL—> 1 limitation)

1. Self-rated life satisfaction

2. Self-reported health

3. Unmet LTC needs

Coefficient (PSM DiD)

1. 0.2121 (0.0671) P < 0.01

2. 0.1389 (0.0707) P < 0.05

3. -0.1071 (0.0502) P < 0.05

1. Positive

2. Positive

3. Positive

Low

Guan (2019) [97]

China

Any health insurance, public

Vision impairment (clinical diagnosis, moderate VI or worse in both eyes; VA < 6/18)

Quality of life (The Time Trade-Off [TTO] evaluation technique)

Quality of Life (mean)

No insurance: 0.64

New Cooperative Medical Scheme: 0.63

Urban Resident Basic Medical Insurance: 0.81

Urban Employee Basic Medical Insurance: 0.63

Government Medical Insurance: 0.66

Commercial Medical Insurance: 0.49

P: 0.003

NA

High

Mohammed (2019) [98]

Sudan

Any health insurance

Physical – Cerebral Palsy (clinical diagnosis – medical record)

Quality of Life (4 domains: physical, schooling, social, emotional; low response 0, high response 1)

Mean difference of QoL (insured vs uninsured)

B: 7.910; P = 0.018

Positive

High

Tien (2021) [99]

Vietnam

Any health insurance

Physical – complete cervical spinal cord injury (clinical diagnosis – medical record)

1. Health-related Quality of Life (HRQoL) (EuroQoL-5D-5L)

2. ADL (Katz Index)

3. IADL

Insured vs uninsured aCoef (95%CI)

1. -0.11 (-0.21—-0.006) P < 0.05

2. -1.63 (-2.83—-0.43) P < 0.01

3. 0.91 (-0.07 – 1.90)

1. Negative

2. Negative

3. Null

High

  1. Abbreviation: PSM Propensity Score Matching, DiD Difference-in-Difference, QoL Quality of Life
  2. Positive: Among people with disabilities, the insured had better health status than the uninsured. Mixed results of positive and null are categorized as positive
  3. Negative: Among people with disabilities, the insured had worse health status than the uninsured. Mixed results of negative and null are categorized as negative
  4. Null: There is no difference in health status between the insured and uninsured people with disabilities
  5. Mixed: When a study has more than one result showing positive and negative associations
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International Journal for Equity in Health

ISSN: 1475-9276

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