scholarly journals Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India

2016 ◽  
Author(s):  
Mehtabul Azam
2018 ◽  
Vol 3 (1) ◽  
pp. e000582 ◽  
Author(s):  
Neeraj Sood ◽  
Zachary Wagner

Life-saving technology used to treat catastrophic illnesses such as heart disease and cancer is often out of reach for the poor. As life expectancy increases in poor countries and the burden from chronic illnesses continues to rise, so will the unmet need for expensive tertiary care. Understanding how best to increase access to and reduce the financial burden of expensive tertiary care is a crucial task for the global health community in the coming decades. In 2010, Karnataka, a state in India, rolled out the Vajpayee Arogyashree scheme (VAS), a social health insurance scheme focused on increasing access to tertiary care for households below the poverty line. VAS was rolled out in a way that allowed for robust evaluation of its causal effects and several studies have examined various impacts of the scheme on poor households. In this analysis article, we summarise the key findings and assess how these findings can be used to inform other social health insurance schemes. First, the evidence suggests that VAS led to a substantial reduction in mortality driven by increased tertiary care utilisation as well as use of better quality facilities and earlier diagnosis. Second, VAS significantly reduced the financial burden of receiving tertiary care. Third, these benefits of social health insurance were achieved at a reasonable cost to society and taxpayers. Several unique features of VAS led to its success at improving health and financial well-being including effective outreach via health camps, targeting expensive conditions with high disease burden, easy enrolment process, cashless treatment, bundled payment for hospital services, participation of both public and private hospitals and prior authorisation to improve appropriateness of care.


2021 ◽  
pp. 811-815
Author(s):  
Tamara Popic ◽  
Guergana Stolarov-Demuth

The Southern Eastern Europe regional outlook presents a comparative assessment of the historical development of the healthcare system, health politics, and selected health-related indicators for Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Kosovo, Montenegro, North Macedonia, Romania, and Serbia. Despite variations in their healthcare systems during communism, since 1989 the countries of the region have all undertaken efforts to introduce or consolidate social health insurance and combine it with a mix of public and private provision. In most of the countries at least half of healthcare financing originates from compulsory contributory health insurance, but in many of them, out-of-pocket payments constitute an extremely large share. Given this financial burden, satisfaction in the region is very low. Health outcomes are unsatisfactory, with low average life expectancy, very high infant mortality, and relatively high levels of health inequality. Unmet need is high, especially in Romania, mainly due to costs. Since at least 2004, healthcare has tended to be a moderately salient issue in Southern Eastern Europe. The key healthcare issues in the region have been incomplete or ineffective social health insurance coverage, privatization, insufficient financing, and high out-of-pocket payments, especially for pharmaceuticals and private services.


2020 ◽  
Vol 3 (1) ◽  
pp. 42-48
Author(s):  
Punam Karanjit ◽  
Prajita Mali ◽  
Rakshya Khadka ◽  
Lisasha Poudel

Introduction:  For the reduction of financial burden and to achieve universal health care, Government of Nepal launched a security program called as Social Health Insurance Program. This study aimed to find the factors associated with the utilization of the social health insurance scheme. Methods: Descriptive cross-sectional study was conducted in the Bhaktapur Municipality ward no 2. 422 households were chosen using systematic random sampling. Questionnaires were used to measure the factors affecting the utilization. The collected data was entered in Epidata and analyzed in SPSS version 16. The data were presented in the frequency and percentage. Bivariate analysis was done to identify factors utilizing social health insurance. Factors having p value less than 0.05 was taken as significantly associated. Multivariate analysis was done to examine the association between the outcome variables. Results: Almost half of the general population (42.4 %) were utilizing social health insurance scheme and reason for not utilizing includes lack of confidence in the scheme and the services of the scheme, followed by high premium cost. Age (p=0.044), occupation (p= 0.049), wealth quintiles (p=<0.001) were found to be significantly associated with utilization of social health insurance. Logistic regression analysis showed that the odds of enrollment among very rich population group were lower than the medium (AOR 0.550, 95% CI 0.305-0.993) and rich population (AOR 0.557, 95% CI 0.316-0.981). Conclusions: Multiple factors were found to be associated with the utilization of the health insurance scheme which includes age of the household head, occupation of the household head, economic status, availability of the drugs and charge paid during their visit in the health care services, behavior showed by the health care provider, confidence in the scheme, satisfaction in the services that have been providing and source of the information.


2019 ◽  
Vol 31 (7) ◽  
pp. 584-593
Author(s):  
Sumudu Karunaratna ◽  
Thushara Ranasinghe ◽  
Nadeeka Chandraratne ◽  
Amala De Silva

Agrahara is a mandatory social health insurance scheme providing coverage mostly for inpatient care for the public sector employees in Sri Lanka. For the 20 years of its’ existence there is no clear evidence on its’ effectiveness in reducing the financial burden due to ill health. We conducted a cross-sectional study among public sector employees (n = 500) in one district. Utilizing outpatient care was associated with a higher incidence of catastrophic health expenditure (29.4%) than utilizing inpatient care (7.2%). The poorest income quintile was at higher odds of facing catastrophic health expenditure than the richest. The social health insurance scheme with its lower utilization rate (38%) had only been able to protect 25% of households from catastrophe. Thus, alternative options to reduce out-of-pocket expenditure of outpatient care are needed. To improve the utilization rates of the social health insurance scheme, a wider benefit package, a cost-efficient delivery of government inpatient care, and improving awareness of the social health insurance policy are suggested.


2007 ◽  
Vol 16 (3) ◽  
pp. 243-256 ◽  
Author(s):  
Marcus Tamm ◽  
Harald Tauchmann ◽  
Jürgen Wasem ◽  
Stefan Greß

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