健康小额保险 M-FUND 对泰国外来务工人员及其家属使用医疗服务的影响:病例对照研究

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Migration and Health Pub Date : 2024-01-01 DOI:10.1016/j.jmh.2024.100236
Andrea König , Jarntrah Sappayabanphot , Li Liang , Steffen Fleßa , Volker Winkler
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引用次数: 0

摘要

背景尽管泰国推出了多项移民医疗政策,但移民在获得医疗服务方面仍面临各种障碍。在某种程度上,医疗小额保险可以减少这些障碍。M-FUND是由Dreamlopments社会企业和基金会为泰国移民工人设立的一项低成本、非营利性的健康保障计划,旨在支持移民可持续地获得优质医疗服务。方法在三个月的时间里,我们在泰国德省对 408 名基金成员和 452 名年龄、性别和地点相匹配的非成员对照组进行了定量面对面访谈。我们使用逻辑回归法比较了会员和非会员使用医疗服务的情况,并控制了一些社会人口变量和与移民相关的变量,如在泰国的年数、法律地位等。研究结果 M-FUND会员更有可能使用门诊服务(调整后的几率比:1-74,95 %置信区间:1-24-2-44)、住院服务(2-96,1.11-7-92)和急诊服务(1-89,0-78-4-56),尽管后者在统计上并不显著。与非会员相比,会员更有可能不购买非处方药(1-67,1-22-2-27)。会员还更有可能在就诊期间使用任何额外的特定服务(2-31,1-49-3-58),包括任何类型的成像方法(2-62,1-29-5-29)和血液化验(1-64,0-99-2-71)。M-FUND健康小额保险与泰国外来务工人员及其家属使用所有主要类型的医疗服务呈正相关。对于移民,尤其是弱势移民工人及其家属而言,M-FUND 似乎是减少医疗保健障碍的一个好方法。这项关于移民健康小额保险影响的研究为移民健康领域的政策和项目规划者提供了重要信息。然而,还需要对不同环境下的移民和其他服务不足社区的医疗小额保险计划以及性别对医疗服务利用率的影响进行更多的研究。
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The impact of the health microinsurance M-FUND on the utilization of health services among migrant workers and their dependents in Thailand: A case-control study

Background

Even though Thailand has launched multiple migrant health policies, migrants still face various barriers in accessing health care. To some extent, these barriers may be reduced by health microinsurance. The M-FUND is a low-cost, not-for-profit health protection scheme for migrant workers in Thailand, created by Dreamlopments Social Enterprise and Foundation to support sustainable access to quality healthcare services for migrants. We aimed to investigate the impact of the M-FUND on utilization of health services.

Methods

Over a period of three months, we conducted quantitative face-to-face interviews with 408 M-FUND members, and 452 age, sex and location matched non-member controls in Tak Province, Thailand. We compared utilization of health services between members and non-members using logistic regression controlling for a number of socio-demographic variables and variables related to migration such as years in Thailand, legal status, etc.

Findings

M-FUND members were more likely to have utilized outpatient services (adjusted odds ratio: 1·74, 95 % confidence interval: 1·24–2·44), inpatient services (2·96, 1.11–7·92), and emergency care (1·89, 0·78–4·56), although the latter was not statistically significant. Members were more likely not to have purchased medicines over-the-counter (1·67, 1·22–2·27) than non-members. Members were also more likely to have utilized any additional specific service during a consultation (2·31, 1·49–3·58) including any type of imaging method (2·62, 1·29–5·29) and blood tests (1·64, 0·99–2·71). There were some differences between men and women, but most were not statistically significant.

Interpretation

The M-FUND health microinsurance was positively associated with the utilization of all major types of health services among migrant workers and their dependents in Thailand. For migrants, particularly vulnerable migrant workers and their dependents, the M-FUND appears to be a good approach to reducing barriers to health care. This study of the impact of health microinsurance for migrants provides important information for policy and program planners in the field of migrant health. However, more research is needed on health microinsurance schemes for migrants in different settings and for other underserved communities as well as the sex-specific impact on health service utilization.

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来源期刊
Journal of Migration and Health
Journal of Migration and Health Social Sciences-Sociology and Political Science
CiteScore
5.70
自引率
8.70%
发文量
65
审稿时长
153 days
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