Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018

Objectives With about one-third of the population living below the poverty line, Jordan faces major healthcare, social and national development issues. Low insurance coverage among the poor and high out-of-pocket expenditure worsens the financial insecurity especially for the marginalised population...

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Main Authors: Ruoxi Wang, Shangfeng Tang, Bishwajit Ghose, Meilian Liu, Zhaoxin Luo, Donghua Zhou, Lu Ji, Huilin Zhang
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/3/e038945.full
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author Ruoxi Wang
Shangfeng Tang
Bishwajit Ghose
Meilian Liu
Zhaoxin Luo
Donghua Zhou
Lu Ji
Huilin Zhang
author_facet Ruoxi Wang
Shangfeng Tang
Bishwajit Ghose
Meilian Liu
Zhaoxin Luo
Donghua Zhou
Lu Ji
Huilin Zhang
author_sort Ruoxi Wang
collection DOAJ
description Objectives With about one-third of the population living below the poverty line, Jordan faces major healthcare, social and national development issues. Low insurance coverage among the poor and high out-of-pocket expenditure worsens the financial insecurity especially for the marginalised population. The Government of Jordan aims to achieve universal coverage of health insurance—a bold plan that requires research evidence for successful implementation. In this study, we aimed to assess the proportion of the population covered by any health insurance, and the determinants owing a health insurance.Design A population-based prospective cohort study.Setting Jordan.Methods Data for this study were derived from the Jordan Population and Family Health Survey, which was implemented by the Department of Statistics from early October 2017 to January 2018. Sample characteristics were described as percentages with 95% CIs. Binary logistic regression models were used to estimate OR of health insurance ownership. Parsimonious model was employed to assess the sex and geographical differences.Results Data revealed that in 2017–2018, 73.13% of the 12 992 men and women had health insurance. There was no indication of age of sex difference in health insurance ownership; however, marital status and socioeconomic factors such as wealth and education as well as internet access and geographical location appeared to be the important predictors of non-use of health insurance. The associations differed by sex and urbanicity for certain variables. Addressing these inequities may help achieve universal coverage in health insurance ownership in the population.Conclusions More than one-quarter of the population in Jordan were not insured. Efforts to decrease disparities in insurance coverage should focus on minimising socioeconomic and geographical disparities to promote equity in terms of healthcare services.
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spelling doaj-art-7e4aa06230f049999f2e97bbb0da8f522024-11-20T10:50:09ZengBMJ Publishing GroupBMJ Open2044-60552021-03-0111310.1136/bmjopen-2020-038945Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018Ruoxi Wang0Shangfeng Tang1Bishwajit Ghose2Meilian Liu3Zhaoxin Luo4Donghua Zhou5Lu Ji6Huilin Zhang7Blood Components Department, Chengdu Blood Center, Health and Family Planning Commission of Sichuan Province, Chengdu, ChinaSchool of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaInstitute of Nutrition and Food Science, University of Dhaka, Dhaka, BangladeshSchool of Business, Guilin University of Electronic Technology, Guilin, ChinaSchool of Business, Guilin University of Electronic Technology, Guilin, ChinaSchool of Physical Education, Research Center of Sports and Health, Wuhan Business University, Wuhan, ChinaSchool of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaSchool of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaObjectives With about one-third of the population living below the poverty line, Jordan faces major healthcare, social and national development issues. Low insurance coverage among the poor and high out-of-pocket expenditure worsens the financial insecurity especially for the marginalised population. The Government of Jordan aims to achieve universal coverage of health insurance—a bold plan that requires research evidence for successful implementation. In this study, we aimed to assess the proportion of the population covered by any health insurance, and the determinants owing a health insurance.Design A population-based prospective cohort study.Setting Jordan.Methods Data for this study were derived from the Jordan Population and Family Health Survey, which was implemented by the Department of Statistics from early October 2017 to January 2018. Sample characteristics were described as percentages with 95% CIs. Binary logistic regression models were used to estimate OR of health insurance ownership. Parsimonious model was employed to assess the sex and geographical differences.Results Data revealed that in 2017–2018, 73.13% of the 12 992 men and women had health insurance. There was no indication of age of sex difference in health insurance ownership; however, marital status and socioeconomic factors such as wealth and education as well as internet access and geographical location appeared to be the important predictors of non-use of health insurance. The associations differed by sex and urbanicity for certain variables. Addressing these inequities may help achieve universal coverage in health insurance ownership in the population.Conclusions More than one-quarter of the population in Jordan were not insured. Efforts to decrease disparities in insurance coverage should focus on minimising socioeconomic and geographical disparities to promote equity in terms of healthcare services.https://bmjopen.bmj.com/content/11/3/e038945.full
spellingShingle Ruoxi Wang
Shangfeng Tang
Bishwajit Ghose
Meilian Liu
Zhaoxin Luo
Donghua Zhou
Lu Ji
Huilin Zhang
Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018
BMJ Open
title Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018
title_full Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018
title_fullStr Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018
title_full_unstemmed Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018
title_short Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017–2018
title_sort determinants of health insurance ownership in jordan a cross sectional study of population and family health survey 2017 2018
url https://bmjopen.bmj.com/content/11/3/e038945.full
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