To quantify the impact of community-based health insurance (CBI) on utilization
of health care services in rural Burkina Faso.
Methods: Propensity scorematching was used tominimise the observed baseline differences
in the characteristics of insured and uninsured groups such that the observed difference in
healthcare utilisation could generally be attributed to the CBI.
Results: Compared with those who were not enrolled in the CBI, the overall increase in
outpatient visits given illness in the insured group was about 40% higher, while the differential
effect on utilization of inpatient care between insured and non-insured groups was
insignificant. Not only were the very poor less likely to enroll in CBI, but even once insured,
they were less likely to utilize health services compared to their wealthier counterparts.
Conclusions: The overall effect of CBI on health care utilization is significant and positive but
the benefit of CBI is not equally enjoyed by all socioeconomic groups. The policy implications
are: (a) there is a need to subsidize the premium to favor the enrolment of the very poor;
and (b) various measures need to be placed in order to maximize the population’s capacity
to enjoy the benefits of insurance once insured