Basant Adhikari

Mahidol University, Nepal

Abstract Title:

Effects of Health Insurance on Economic Burden and Health Service Utilization among People with Noncommunicable Diseases in Low- and Middle-income Countries: A Systematic Review

Biography:

Basant Adhikari is a public health professional working with the Ministry of Health and Population, Nepal. He is actively involved in national and international public health networks, including the Nepal Public Health Association (NEPHA) and the World Federation of Public Health Associations (WFPHA). He is currently pursuing a PhD in Public Health at Mahidol University, Thailand. His academic and professional interests include health policy and systems research, global health, and evidence-informed public health practice. His work focuses on generating and translating research evidence to support health system strengthening and improve population health outcomes.

Research Interests:

Background: Noncommunicable diseases (NCDs) are leading causes of mortality and impose significant financial burdens on households. Health insurance is intended to mitigate these economic burdens and increase health service utilization among people with NCDs. This study aims to investigate the impacts of health insurance on protecting people with NCDs from economic burden and their health service utilization in Low-and middle-income countries (LMICs). Method: A systematic search of the relevant articles was conducted in the PubMed, Scopus, and Embase databases in accordance with the PRISMA guidelines. The search strategy was based on keywords representing the population (non-communicable diseases), exposure (health insurance), and outcomes (economic burden and health service utilization). Data were synthesized according to NCD type and reported outcomes. Results: Of the 3,992 articles screened, 15 met the inclusion criteria. Socioeconomic status was the most common determinant of NCD-related economic burden, alongside health service utilization, multiple morbidities, employment status, family size, and education. Health insurance was strongly associated with increased service utilization, whereas multiple morbidities, socioeconomic status, physician access, and education also influenced care use. The impact of insurance on financial burden was mixed; 7 out of 10 studies found no significant relief, while all reported increased service utilization among the insured.
Conclusion: Health insurance was associated with increased health service utilization among people with NCDs, but its protective effect against economic burden remained inconclusive. Increased utilization was frequently linked to higher healthcare payments due to limited benefit coverage. Strengthening insurance design and assessing utilization pathways are essential to improve financial protection.