title: Does Health Insurance Premium Exemption Policy for Older People Increase Access to Health Care? Evidence from Ghana.
abstract: Aging in Sub-Saharan Africa causes major challenges for policy makers in social protection. Our study focuses on Ghana, one of the few Sub-Saharan African countries that passed a National Policy on Aging in 2010. Ghana is also one of the first Sub-Saharan African countries that launched a National Health Insurance Scheme (NHIS; NHIS Act 650, 2003) with the aim to improve access to quality health care for all citizens, and as such can be considered as a means of poverty reduction. Our study assesses whether premium exemption policy under the NHIS that grants non-payments of annual health insurance premiums for older people increases access to health care. We assessed differences in enrollment coverage among four different age groups (18-49, 50-59, 60-69, and 70+). We found higher enrollment for the 70+ and 60-69 age groups. The likelihood of enrollment was 2.7 and 1.7 times higher for the 70+ and 60-69 age groups, respectively. Our results suggest the NHIS exemption policy increases insurance coverage of the aged and their utilization of health care services.
authors.affiliation: a PhD Candidate, VU Amsterdam , Amsterdam , The Netherlands.|b the Amsterdam Institute for Global Health and Development , Amsterdam , The Netherlands.|c University of Ghana , Accra , Ghana.
authors.forename: Stephen Kwasi Opuku
authors.initials: SK
authors.lastname: Duku
authors.affiliation: a PhD Candidate, VU Amsterdam , Amsterdam , The Netherlands.
authors.forename: Caroline Elisabeth
authors.initials: CE
authors.lastname: van Dullemen
authors.affiliation: b the Amsterdam Institute for Global Health and Development , Amsterdam , The Netherlands.|c University of Ghana , Accra , Ghana.|d Post-Doctoral Researcher, Population Research Centre , University of Groningen , Groningen.
authors.forename: Christine
authors.initials: C
authors.lastname: Fenenga
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005869:Ghana; D006291:Health Policy / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data; D011203:Poverty; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Ghana; aging population; determinants of enrollment; health insurance; health policy