Effect of health insurance coverage on health care utilisation in Zambia

Abstract

Limited access to healthcare, particularly among low-income populations, hinders health outcomes in Zambia. Despite the existence of health insurance schemes, coverage remains low. This study investigates the impact of different types of health insurance on healthcare utilization in Zambia. Utilizing data from the 2014 Zambia Household Health Expenditure and Utilization Survey, we employed propensity score matching and endogenous treatment effect models to estimate the effects of health insurance coverage on healthcare utilization. We disaggregated coverage into overall, public, and private insurance, and measured utilization through outpatient visits and admissions. Our findings reveal that overall and private health insurance coverage significantly increase healthcare utilization across all measures. However, public health insurance coverage did not show a statistically significant impact at conventional levels. In conclusion, this study highlights the low prevalence of health insurance coverage in Zambia and its positive association with healthcare utilization, particularly for overall and private schemes. This emphasizes the potential of expanding health insurance coverage, notably through the newly implemented National Health Insurance Scheme, to improve healthcare access and utilization in Zambia.