Health Insurance: Awareness, Utilization, and its Determinants among the Urban Poor in Delhi, India

Kusuma, Yadlapalli S.; Pal, Manisha; Babu, B.V.

doi:10.2991/j.jegh.2018.09.004

Cited by 46 publications

(46 citation statements)

References 23 publications

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“…Unfortunately, there is little awareness and complete ignorance towards such schemes among the majority population (poor and middle class) of Pakistan. Consequently, this reduces the community's' willingness to spend on CBHIS (8,9). This underscores the need for governmental policymakers and other researchers to key into the findings of the present study and create more community awareness, stakeholder sensitization and eventually stimulates commencement of CBHIS as per demand in the country (10).…”

Section: Introductionmentioning

confidence: 78%

Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

Akhtar¹,

Fatima²,

Tayyaba³

et al. 2020

Ethiop J Health Sci

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BACKGROUND: Healthcare costs and poverty are significant barriers to achieving universal access to healthcare. Thus, Community-Based Health Insurance Schemes (CBHIS) are regarded as an influential instrument for providing access to healthcare. For this purpose, this study was carried out in order to assess the community’s Willingness to Pay (WTP) for CBHIS and its determinants among the residents of Lahore City.METHODS: A cross-sectional study was adopted during the period of May 2018 to August 2018 to conduct a standardized questionnaire survey among targeted population of Lahore. A total of 250 households from lower, middle and upper-middle-class areas were approached randomly from which 200 participated in the survey, rendering a response rate of 90.9%. Sample size was determined by using single population proportion formula assuming 5% margin of error and 95% Confidence Interval (CI). Moreover, multiple regression analysis, Pearson’s correlation and t-test were employed to determine relationships between different variables affecting WTP.RESULTS: Sixty-four percent of the respondents were willing to pay for CBHIS. Among the remaining thirty-six% of unwilling the community, income level (p< 0.05, CI=0.34 to 1.11) and education level (p< 0.05, CI=0.52-1.37) were significant predictors of WTP. Moreover, strong positive relation (p<0.05) between people’s awareness and WTP for CBHIS was witnessed. The findings further suggested that the larger population of the willing community was not willing to pay more than 5000 Rs annually.CONCLUSION: Henceawareness level of the community regarding the benefits of CBHIS is a major hindrance. The key policy priority is to increase the community’s awareness regarding the benefits of CBHIS and to increase willingness to pay rate among public.

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Section: Introductionmentioning

confidence: 78%

Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

Akhtar¹,

Fatima²,

Tayyaba³

et al. 2020

Ethiop J Health Sci

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“…[ 17 ] In our study, 80.8% were covered under some form of health insurance scheme with a majority, 97.9%, being enrolled to RSBY, which is greater than other parts of India. [ 18 19 ] Studies show that major factors contributing to poor coverage were found to be lack of awareness and political will. [ 17 20 ] It was found that only 5.8% were totally unaware of any health insurance schemes in this study population.…”

Section: Discussionmentioning

confidence: 99%

Health insurance coverage and its impact on out-of-pocket expenditures at a public sector hospital in Kerala, India

Harish

Suresh

Rameesa

et al. 2020

J Family Med Prim Care

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Background: Health insurance coverage ensures protection from catastrophic health-care expenditure, especially to the underprivileged sections of society. Health insurance schemes such as Ayushman Bharat are coming up in addition to the existing schemes such as Rashtriya Swasthya Bima Yojana in India. The objectives are to find the health insurance coverage and its impact on out-of-pocket (OOP) expenditure for public sector tertiary health-care hospitalization. Methods: A cross-sectional study was conducted at a tertiary care hospital in Kerala. Insurance coverage was assessed among patients seeking inpatient care in various medical and surgical departments. OOP expenses incurred for those receiving and not receiving insurance coverage were compared. In addition, factors influencing enrolment and availing of insurance schemes were determined. Results: The coverage of health insurance was found to be 74%. Awareness campaigns and activities of local self-government (LSG) departments were the important reasons for enrolment and availing, respectively. Significantly lower OOP expenditures occurred in insured persons with regard to expenses incurred for treatment procedures ( P = 0.019), investigations ( P = 0.004), and medicines ( P = 0.001). Among the enrolled patients, 45% expressed dissatisfaction regarding available services. Conclusion: A quarter of patients still remain out of insurance coverage. All patients are incurring OOP expenditures, though the insured patients have significantly lower OOP expenses. The role of primary care providers and LSG is pivotal in creating awareness and ensuring enrolment. Availing services depend on the availability of resources at the respective institution. Improvements in enrolment and use of health insurance should ultimately result in improved patient satisfaction.

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“…For these remote localities, it may be cost-effective to go to a nearby facility and pay out of pocket. Distance to the empanelled healthcare facility was found to be significant to utilization in several other global studies (Iqbal et al, 2017;Kusuma, Pal, & Babu, 2018).…”

Section: Discussionmentioning

confidence: 81%

“…All this fall under the 'awareness creation' umbrella that was not strongly and frequently linked with the scheme from the start. Employees State Insurance Corporation health camps at Bengaluru, India, suggest that repeated interaction with the community work to establish trust and develop understanding of the benefits of the scheme (Kusuma, Pal, & Babu, 2018;Nagaraja et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Availability Does Not Mean Utilisation: Analysis of a Large Micro Health Insurance Programme in Pakistan

Cheema¹,

Zaidi²,

Najmi³

et al. 2020

GJHS

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In recent years, several Micro Health Insurance (MHI) schemes have been initiated in low- and middle-income countries (LMIC) to meet the universal health coverage targets. Evidence on the utilization of these MHI schemes is scarce. Field experiences and lesson learning is crucial to effectively increase access to health care and offer protection against catastrophic health expenditure to the poorest population through the MHI schemes. This paper analyzes community utilization and factors affecting utilization of an MHI provided to the poorest rural households in eight districts of Sindh province of Pakistan. This initiative is part of a larger pro-poor European Union (EU) funded Sindh Union Council and Community Economic Strengthening Support (SUCCESS) Programme implemented by the Rural Support Programs (RSPs). The analysis draws on insurance utilization records and an internal assessment report by the RSPs Network (RSPN). The analysis provides qualitative experiences of the community, empanelled health care providers, the insurance agency and frontline management staff. Our analysis revealed that the overall utilization was very low (0.42%) and the highest number of cases treated at the hospital were of women utilizing obstetric and gynaecology related care. The scheme was noted to prevent catastrophic health expenditure in households that were able to successfully utilize the scheme. Key factors affecting utilization were identified to be around i) awareness creation, ii) distance to empanelled hospitals, and iii) access issues at the health facility level. We aim to add to the knowledge base around MHI for policy makers to design and implement more informed initiatives in the future.

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Health Insurance: Awareness, Utilization, and its Determinants among the Urban Poor in Delhi, India

Cited by 46 publications

References 23 publications

Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

Health insurance coverage and its impact on out-of-pocket expenditures at a public sector hospital in Kerala, India

Availability Does Not Mean Utilisation: Analysis of a Large Micro Health Insurance Programme in Pakistan

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