Illness Mapping: A Time and Cost Effective Method to Estimate Healthcare Data Needed to Establish Community-Based Health Insurance

BMC Medical Research Methodology 2012, 12:153 doi:10.1186/1471-2288-12-153 Published: 9 October 2012

16 Pages Posted: 9 Oct 2012

See all articles by Erika Binnendijk

Erika Binnendijk

Erasmus University Rotterdam (EUR)

Meenakshi Gautham

affiliation not provided to SSRN

Ruth Koren

Tel Aviv University - Professor Sackler Faculty of Medicine

David M. Dror

Micro Insurance Academy (MIA)

Date Written: October 8, 2012

Abstract

Background: Most healthcare spending in developing countries is private out-of-pocket. One explanation for low penetration of health insurance is that poorer individuals doubt their ability to enforce insurance contracts. Community-based health insurance schemes (CBHI) are a solution, but launching CBHI requires obtaining accurate local data on morbidity, healthcare utilization and other details to inform package design and pricing. We developed the "Illness Mapping" method (IM) for data collection (faster and cheaper than household surveys).

Methods: IM is a modification of two non-interactive consensus group methods (Delphi and Nominal Group Technique) to operate as interactive methods. We elicited estimates from "Experts" in the target community on morbidity and healthcare utilization. Interaction between facilitator and experts became essential to bridge literacy constraints and to reach consensus.

The study was conducted in Gaya District, Bihar (India) during April-June 2010. The intervention included the IM and a household survey (HHS). IM included 18 women's and 17 men's groups. The HHS was conducted in 50 villages with1,000 randomly selected households (6,656 individuals).

Results: We found good agreement between the two methods on overall prevalence of illness (IM: 25.9% /-3.6; HHS: 31.4%) and on prevalence of acute (IM: 76.9%; HHS: 69.2%) and chronic illnesses (IM: 20.1%; HHS: 16.6%). We also found good agreement on incidence of deliveries (IM: 3.9% /-0.4; HHS: 3.9%), and on hospital deliveries (IM: 61.0%. /- 5.4; HHS: 51.4%). For hospitalizations, we obtained a lower estimate from the IM (1.1%) than from the HHS (2.6%). The IM required less time and less person-power than a household survey, which translate into reduced costs. Conclusions

We have shown that our Illness Mapping method can be carried out at lower financial and human cost for sourcing essential local data, at acceptably accurate levels. In view of the good fit of results obtained, we assume that the method could work elsewhere as well.

Suggested Citation

Binnendijk, Erika and Gautham, Meenakshi and Koren, Ruth and Dror, David M., Illness Mapping: A Time and Cost Effective Method to Estimate Healthcare Data Needed to Establish Community-Based Health Insurance (October 8, 2012). BMC Medical Research Methodology 2012, 12:153 doi:10.1186/1471-2288-12-153 Published: 9 October 2012 , Available at SSRN: https://ssrn.com/abstract=2158992

Erika Binnendijk

Erasmus University Rotterdam (EUR) ( email )

Burgemeester Oudlaan 50
3000 DR Rotterdam, Zuid-Holland 3062PA
Netherlands

Meenakshi Gautham

affiliation not provided to SSRN ( email )

Ruth Koren

Tel Aviv University - Professor Sackler Faculty of Medicine ( email )

Ramat Aviv
Tel-Aviv, 6997801
Israel

David M. Dror (Contact Author)

Micro Insurance Academy (MIA) ( email )

New Delhi, NCR
India
+41 78 790 6789 (Phone)

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