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      Does Health Insurance Eligibility Improve Child Health: Evidence From the National Health Insurance Scheme (NHIS) in Nigeria

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      1 , 2 , 3 ,
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      Cureus
      Cureus
      health insurance eligibility, nigeria, difference in difference, child health, national health insurance reform

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          Abstract

          Favorable child health outcomes are important for sustainable growth and development, especially for developing economies. However, Nigeria has some of the worst health indicators. The problem seems to be inadequate access to affordable healthcare, especially for children. To improve policies aimed at improving access to affordable healthcare for children in Nigeria through health insurance, it is important to measure the extent to which health insurance affects child health. This study examines the effects of health insurance on child health and healthcare utilization in Nigeria using the implementation and expansion of the National Health Insurance Scheme (NHIS) to introduce the exogenous variation in health insurance eligibility, a natural experiment that fits a difference-in-difference model. The findings suggest that health insurance increases birth weight. It also increases the probability that children receive polio and diphtheria vaccines. The findings suggest that the NHIS in Nigeria is effective in improving the health outcomes of children. Policies strengthening the take-up of the NHIS should be encouraged across all sectors and socio-economic groups in the economy.

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          Social Conditions As Fundamental Causes of Disease

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            The common structure of statistical models of truncation, sample selection and limited dependent variables and a simple estimator for such models

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              The relation between health insurance coverage and clinical outcomes among women with breast cancer.

              Women without private health insurance are less likely than privately insured women to be screened for breast cancer, and their treatment may differ after cancer is diagnosed. In this study we addressed two related questions: Do uninsured patients and those covered by Medicaid have more advanced breast cancer than privately insured patients when the disease is initially diagnosed? And, for each stage of disease, do uninsured patients and patients covered by Medicaid die sooner after breast cancer is diagnosed than privately insured patients? We studied 4675 women, 35 to 64 years of age, in whom invasive breast cancer was diagnosed from 1985 through 1987, by linking New Jersey State Cancer Registry records to hospital-discharge data. We compared the stage of disease and stage-specific survival among women with private insurance, no insurance, and Medicaid coverage through June 1992. We also estimated the adjusted risk of death for these groups, using proportional-hazards regression analysis to control for age, race, marital status, household income, coexisting diagnoses, and disease stage. Uninsured patients and those covered by Medicaid presented with more advanced disease than did privately insured patients (P < 0.001 and P = 0.01, respectively). Survival was worse for uninsured patients and those with Medicaid coverage than for privately insured patients with local disease (P < 0.001 for both comparisons) and regional disease (P < 0.001 for both comparisons), but not distant metastases. The adjusted risk of death was 49 percent higher (95 percent confidence interval, 20 to 84 percent) for uninsured patients and 40 percent higher (95 percent confidence interval, 4 to 89 percent) for Medicaid patients than for privately insured patients during the 54 to 89 months after diagnosis. The more frequent adverse outcomes of breast cancer among women without private health insurance suggest that such women would benefit from improved access to screening and optimal therapy.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                1 September 2022
                September 2022
                : 14
                : 9
                : e28660
                Affiliations
                [1 ] Health Economics, The World Bank Group, Washington DC, USA
                [2 ] Micro-Economics, University of Pittsburgh, Bradford, Pittsburgh, USA
                [3 ] Neuro-Oncology, New York Institute of Technology, Old Westbury, USA
                Author notes
                Article
                10.7759/cureus.28660
                9526239
                36196291
                8c2c6f07-ccd2-4cfb-b15d-09a602b0f0ce
                Copyright © 2022, Ekhator-Mobayode et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 1 September 2022
                Categories
                Medical Education
                Pediatrics
                Health Policy

                health insurance eligibility,nigeria,difference in difference,child health,national health insurance reform

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