Introduction

This chapter looks at the impact of the Bwamanda insurance scheme on hospital use⁹ Hospital utilisation in Bwamanda is significantly higher among insured. In terms of system-efficiency, it is important to know whether the increased hospitalisation rates affect all hospital services homogeneously. They could also be related to health problems that absolutely require hospital-based inpatient care, or to hospitalisation for problems that could be cared for adequately at lower levels of the district health services system. In terms of equity it is important to know how the utilisation differentials are distributed over the various insured communities throughout the district. To a large extent such questions can be answered using data generated by the routine information system.

9 This chapter is based on the paper The Bwamanda hospital insurance scheme effective for whom? A study of its impact on hospital utilisation patterns (Criel et al 1999, in press)