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Background: Universal Health Coverage refers to health care system that provides health care and financial protection to all the citizen. Rashtriya Swasthya Bima Yojna as National Health Insurance Scheme initiated in Chhattisgarh State in 2009 for below poverty line families. Second scheme is Mukhyamantri Swasthya Bima Yojna initiated in 2012, which covers non below poverty line families. Objectives: To assess socio demographic factors among women residing in slum of Rajnandgaon, to find their universal health insurance coverage under RSBY/ MSBY and to assess the extent of concerned treatment under RSBY/MSBY. Methods: It was a community based cross sectional study, conducted in the urban slum area of Rajnandgaon amongst 188 women above 18 years of age who were hospitalized 6 months prior to the study using snow ball technique as a sampling method. They were interviewed using semi structured questionnaires by the investigator with the help of anganwadi worker. Result: 77.65% respondents/study subjects were enrolled under the universal health insurance (RSBY card/ MSBY card). Subjects belonging to Lower socio-economic status and having BPL card were enrolled under scheme more than upper socio-economic group. Out of 146 smart card holders, a mere 1.36% subjects incurred catastrophic OOPE. Out of 42 respondents not having smart card, 40.47% subjects incurred catastrophic OOPE Conclusion: The RSBY card reduced the inpatient OOPE. RSBY card prevented catastrophic OOP in most of the respondent. RSBY has made health services accessible to all sections of community at minimal cost.
Background: Universal Health Coverage refers to health care system that provides health care and financial protection to all the citizen. Rashtriya Swasthya Bima Yojna as National Health Insurance Scheme initiated in Chhattisgarh State in 2009 for below poverty line families. Second scheme is Mukhyamantri Swasthya Bima Yojna initiated in 2012, which covers non below poverty line families. Objectives: To assess socio demographic factors among women residing in slum of Rajnandgaon, to find their universal health insurance coverage under RSBY/ MSBY and to assess the extent of concerned treatment under RSBY/MSBY. Methods: It was a community based cross sectional study, conducted in the urban slum area of Rajnandgaon amongst 188 women above 18 years of age who were hospitalized 6 months prior to the study using snow ball technique as a sampling method. They were interviewed using semi structured questionnaires by the investigator with the help of anganwadi worker. Result: 77.65% respondents/study subjects were enrolled under the universal health insurance (RSBY card/ MSBY card). Subjects belonging to Lower socio-economic status and having BPL card were enrolled under scheme more than upper socio-economic group. Out of 146 smart card holders, a mere 1.36% subjects incurred catastrophic OOPE. Out of 42 respondents not having smart card, 40.47% subjects incurred catastrophic OOPE Conclusion: The RSBY card reduced the inpatient OOPE. RSBY card prevented catastrophic OOP in most of the respondent. RSBY has made health services accessible to all sections of community at minimal cost.
Introduction: Cardiovascular diseases are a major public health issue and the leading cause of mortality globally. The global economic burden of out-of-pocket expenditure (OOPE) for cardiovascular surgeries and procedures is substantial, with average costs being significantly higher than other treatments. This imposes a heavy economic burden. Government insurance schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aim to enhance affordability and access to cardiac care. Methodology: This retrospective study analyzed OOPE incurred for top cardiac surgeries under AB-PMJAY, private insurance, and uninsured patients at a tertiary care teaching hospital in Karnataka. Data of 1021 patients undergoing common cardiac procedures from January to July 2023 were analyzed using descriptive statistics (mean, median) and the Shapiro-Wilk test for normality. The study aims to evaluate financial risk protection offered by AB-PMJAY compared to private plans and inform effective policy-making in reducing the OOPE burden for surgeries in India. Results: The study analyzed OOPE across 1021 patients undergoing any of four surgeries at a tertiary care teaching hospital in Karnataka. AB-PMJAY patients incurred zero OOPE across all surgeries. Uninsured patients faced the highest median OOPE, ranging from ₹1,15,292 (1390.57 USD) to ₹1,72,490 (2080.45 USD) depending on surgery type. Despite the presence of private insurance, the median out-of-pocket expenditure ranged from ₹1,689 (20.38 USD) to ₹68,788 (829.67 USD). Significant variations in OOPE were observed within different payment groups. Private insurance in comparison with AB-PMJAY had limitations like co-payments, deductibles, and limited coverage resulting in higher OOPE for patients. Discussion: The results illustrate the efficacy of AB-PMJAY in reducing the financial burden and improving the affordability of cardiac procedures compared to private insurance. This emphasizes the significance of programmmes funded by the government in reducing the OOPE burden and ensuring equitable healthcare access. The comprehensive and particular estimates of OOPE for different surgical procedures, categorized by payment methods provide valuable information to guide the development of policies that aim to reduce OOPE and progress toward universal health coverage in India.
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