ABSTRACT. Payment of user-fees for healthcare has negative consequences including catastrophic expenditures and reduction in utilization of healthcare services. Conversely, health insurance provides a means to protect against the financial risk associated with healthcare. This paper primarily investigates the effect of out-of-pocket payments (OPP) on the utilization of health services and the likelihood of exposure to catastrophic expenditure. Data was obtained from a household survey conducted in the Ga South Municipality. In all, 117 households consisting of 530 individuals were interviewed. In 55% of the households surveyed, at least one member had a valid health insurance policy against 45% with no insurance. Our finding from the multivariate regression shows that enrolment in health insurance has a negative and significant effect on out-of-pocket payment. Other significant predictors of OPP were utilization and household per capita expenditure. Surprisingly, insurance status did not have a significant impact on utilization, as there was no significant difference between the insured and uninsured. However, per capita expenditure had a significant effect on utilization. Moreover, OPP and per capita expenditure had a significant effect on catastrophic expenditure. The paper concludes that health insurance is important in reducing out-of-pocket payments for healthcare but does not influence utilization of health services and exposure to catastrophic spending. pp. 42–65
JEL codes: I11; I13; I14

Keywords: out-of-pocket-payments; catastrophic expenditures; healthcare utilization; insurance status; Ga South Municipality; Ghana

How to cite: Aidam, Patricia W., Edward Nketiah-Amponsah, and Richard Kutame (2016), “The Effect of Health Insurance on Out-of-Pocket Payments, Catastrophic Expenditures and Healthcare Utilization in Ghana: Case of Ga South Municipality,” Journal of Self-Governance and Management Economics 4(3): 42–65.

Received 8 September 2015 • Received in revised form 4 December 2015
Accepted 5 December 2015 • Available online 25 January 2016

doi:10.22381/JSME4320163