How effective health insurance schemes are in tackling economic burden of healthcare in India

Mahapatro, Sandhya R.; Singh, Pushpendra; Singh, Yadawendra

doi:10.1016/j.cegh.2017.04.002

Cited by 18 publications

(27 citation statements)

References 23 publications

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“…Studies have shown the effectiveness of these schemes in reducing the burden of out of pocket expenditures (Nandi, Schneider & Dixit, 2017;Karan, Yip & Mahal, 2017;Madheswaran & Sahoo, 2014;Ghosh, 2014b;Ghosh & Gupta, 2017). However, the evidence on the adequacy of these schemes in reducing inequalities in healthcare use has not been analyzed sufficiently (Mahapatro et al, 2018). Besides reducing financial burdens, the primary role of financial protection schemes is to addresses expenditure inequalities and pave the way toward the acceptance of universal healthcare.…”

Section: Financial Protection Measures and Inequalities In Health Care mentioning

confidence: 99%

“…As to the second factor, the role of insurance in reducing the burden of out-of-pocket expenditure was highlighted in many studies (Selvaraj & Karan, 2012;Hooda, 2015;Madheswaran & Sahoo, 2014;Ghosh, 2014b;Ghosh & Gupta, 2017) and the findings were mixed. The impact of such interventions in reducing inequalities in healthcare utilization remains inconclusive and needs to be evaluated adequately (Mahapatro, Singh & Singh, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Inequality in Healthcare Utilization in India: Is Health Insurance a Way Out?

Mahapatro¹

2019

JPSS

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Both the rapidly changing demographics and the epidemiological profile pose major challenges to the health care system in India especially regarding the equitable provision of health care services. Over the past decade, the government has emphasized universal access to healthcare, however, access to healthcare is still inequitable. Studies so far have addressed health inequalities through health outcomes with limited emphasis in quantifying the contribution of the determinants and the role of insurance in tackling such inequalities. Using data from the National Sample Survey (2014-15), this study sought to measure the impact of socioeconomic factors on inequality in healthcare and whether financial protection had any bearing on those conditions. Inequalities were measured through the Concentration Index (CI) and the impact of socioeconomic factors was assessed by the decomposition method. The results suggest that utilisation of inpatient care was based on economic factors and favors the affluent. Impact of health insurance on healthcare utilization, as positive as that might be in principle, was not effective in tackling the economic inequalities. Assessing the performance of the health system by prioritizing the required adjustments, and doing so with an emphasis on ensuring the equity of financial protection measures is important for universal healthcare access.

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Section: Financial Protection Measures and Inequalities In Health Care mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Socioeconomic Inequality in Healthcare Utilization in India: Is Health Insurance a Way Out?

Mahapatro¹

2019

JPSS

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“…However, considerable differences in health insurance coverage exist within countries. On average, richer, educated, younger, and regularly employed populations have increasing rates of coverage, while coverage remains low among poorer, less educated and older populations [13][14][15][16][17][18]. Contextual factors associated with population levels beyond the household may also contribute to a lack of coverage.…”

Section: Introductionmentioning

confidence: 99%

Multilevel population and socioeconomic variation in health insurance coverage in India

Khan

Perkins

Kim

et al. 2021

Tropical Med Int Health

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Objectives: This study explores population-level variation in different types of health insurance coverage in India. We aimed to estimate the extent to which contextual factors at community, district, and state levels may contribute to place-based inequalities in coverage after accounting for household-level socioeconomic factors. Methods:We used data from the 2015-2016 National Family Health Survey in India, which provides the most recent and comprehensive information available on reports of different types of household health insurance coverage. We used multilevel regression models to estimate the relative contribution of different population levels to variation in coverage by national, state, and private health insurance schemes.Results: Among 601,509 households in India, 29% reported having coverage in 2015-2016. Variation in each type of coverage existed between population levels before and after adjusting for differences in the distribution of household socioeconomic and demographic factors. For example, the state level accounted for 36% of variation in national scheme coverage and 41% of variation in state scheme coverage after adjusting for household characteristics. In contrast, the community level was the largest contextual source of variation in private insurance coverage (accounting for 24%). Each type of coverage was associated with higher socioeconomic status and urban location. Conclusions: Contextual factors at community, district, and state levels contribute to variation in household health insurance coverage even after accounting for socioeconomic and demographic factors. Opportunities exist to reduce disparities in coverage by focusing on drivers of place-based differences at multiple population levels. Future research should assess whether new insurance schemes exacerbate or reduce place-based disparities in coverage.

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“…The findings suggest the dominance of private providers in the insurance market. The larger dependence on private health care despite high OOPE perhaps could be the results of poor functioning of public health system (Mahapatro, Singh & Singh, 2018).…”

Section: Financial Coveragementioning

confidence: 99%

Health Insurance Inequity in Selected Asia Countries

M.R¹,

Khaled

Aidalina³

2019

IJPHCS

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Background: Health insurance is the primary mechanism that enables people to obtain health care services. There are three major types of health insurance involves private health insurance, social health insurance and community-based health insurance. Aims: This systematic review aims to identify the implication on equity after implementation of health insurance focusing on selected Asian countries. The review is based on the three dimensions of universal health coverage (UHC): population coverage, and service coverage and financial coverage. Materials and methods: A systematic search for articles was conducted form 4 search engines, Scopus, Science Direct, Proquest, and Google scholar. A total of 13 articles were selected after screenings and equity implications were concluded in three UHC dimensions based on equity index reported or equity improvement observed in time series studied. Result and discussion: All the three health insurance has different implication on equity between countries or within country. In terms of population coverage, SHI in Thailand showed an equitable coverage. Philippine also reported to have equitable population coverage in terms of geographical while in Vietnam, CBHI showed inequitable population coverage. The financial coverage has showed an inequity of CBHI in India, China, and Thailand. The inequity was also observed for SHI in Philippine, Vietnam and Philippines. More apparent is inequity in PHI for Malaysia and Philippines. The only equitable financial coverage reported was Thailand for its SHI. The final aspect is on service delivery coverage with equity has been observed in CBHI in China and SHI in Vietnam and Thailand. Conclusion: Social health insurance schemes can be further improved in addressing equity in all UHC aspects. CBHI of which showed some equitable measures for certain population subgroups, such as the poor, and formal workers can collectively be the way to go for SHI.

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How effective health insurance schemes are in tackling economic burden of healthcare in India

Cited by 18 publications

References 23 publications

Socioeconomic Inequality in Healthcare Utilization in India: Is Health Insurance a Way Out?

Socioeconomic Inequality in Healthcare Utilization in India: Is Health Insurance a Way Out?

Multilevel population and socioeconomic variation in health insurance coverage in India

Health Insurance Inequity in Selected Asia Countries

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