This paper seeks to quantify and compare for insured and uninsured groups first horizontal inequity in utilisation of medical care based on indirect standardization and second, impoverishment through out-of-pocket health payments following the minimum standard approach. The indirect standardization method serves to compare the actual distribution of use with the distribution that would be expected given the distribution of need for the two groups. The minimum standard approach examines to what extent out-of-pocket health spending contribute to increased poverty. The analysis uses a cross-sectional household survey collected in Rwanda in 2000. The results indicate that out-of-pocket health spending has a similar small impact on uninsured and insured households' socio-economic situation; however for the uninsured this is at the price of horizontal inequity in utilisation of care and significantly lower visit rates compared to insurance members.
Schneider, P.; Hanson, K. The impact of micro health insurance on Rwandan health centre costs. Health Policy and Planning 22 (1) 40-48. [DOI: 10.1093/heapol/czl030]