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Citation Information

Type Journal Article - Health
Title Determinants of self-rated private health insurance coverage in Jamaica
Author(s)
Volume 2
Issue 06
Publication (Day/Month/Year) 2010
Page numbers 541-550
URL http://file.scirp.org/Html/2125.html
Abstract
The purpose of the current study was to model
the health insurance coverage of Jamaicans;
and to identify the determinants, strength and
predictive power of the model in order to aid
clinicians and other health practitioners in un-
derstanding those who have health insurance
coverage. This study utilized secondary data
taken from the dataset of the Jamaica Survey of
Living Conditions which was collected between
July and October 2002. It was a nationally rep-
resentative stratified random sample survey of
25,018 respondents, with 50.7% females and
49.3% males. The data was collected by way of a
self-administered questionnaire. The non-re-
sponse rate for the survey was 29.7% with
20.5% not responding to particular questions,
9.0% not participating in the survey and another
0.2% being rejected due to data cleaning. The
current research extracted 16,118 people 15
years and older from the survey sample of
25,018 respondents in order to model the de-
terminants of private health insurance coverage
in Jamaica. Data were stored, retrieved and
analyzed using SPSS for Windows 15.0. A
p-value of less than 0.05 was used to establish
statistical significance. Descriptive analysis was
used to provide baseline information on the
sample, and cross-tabulations were used to
examine some non-metric variables. Logistic
regression was used to identify, determine and
establish those factors that influence private
health insurance coverage in Jamaica. This
study found that approximately 12% of Jamai-
cans had private health insurance coverage, of
which the least health insurance was owned by
rural residents (7.5%). Using logistic regression,
the findings revealed that twelve variables
emerged as statistically significant determinants
of health insurance coverage in this sample.
These variables are social standing (two weal-
thiest quintile: OR = 1.68, 95% CI = 1.23 – 2.30),
income (OR = 1.00, 95%CI = 1.00 – 1.00), durable
goods (OR = 1.16, 95% CI = 1.12 – 1.19), marital
status (married: OR = 1.97, 95% CI = 1.61 – 2.42),
area of residence (Peri-urban: OR = 1.45, 95% CI
= 1.199 – 1.75; urban: OR = 1.83, 95% CI = 1.40 –
2.40), education (secondary: OR = 1.57, 95% CI =
1.20 – 2.06; tertiary: OR = 9.03, 95% CI = 6.47 –
12.59), social support (OR = 0.64, 95% CI = 0.53
– 0.76), crowding (OR = 1.14, 95% CI = 1.02 –
1.28), psychological conditions (negative affec-
tive: OR = 0.97, 95% CI = 0.94 – 1.00; positive
affective: OR = 1.11, 95% CI = 1.06 – 1.16), num-
ber of males in household (OR = 0.85, 95% CI =
0.77 – 0.93), living arrangements (OR = 0.62,
95% CI = 0.41 – 0.92) and retirement benefits
(OR = 1.55, 95% CI = 1.03 – 2.35). This study
highlighted the need to address preventative
care for the wealthiest, rural residents and the
fact that social support is crucial to health care,
as well as the fact that medical care costs are
borne by the extended family and other social
groups in which the individual is (or was) a
member, which explains the low demand for
health insurance in Jamaica. Private health care
in Jamaica is substantially determined by af-
fordability and education rather than illness,
and it is a poor measure of the health care-
seeking behaviour of Jamaicans.

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