Background
Health insurance is considered as a mechanism to accelerate the progress towards universal health coverage and ensure financial risk protection for households throughout the country. There is a growing body of evidence reporting that the health insurance coverage can significantly improve the access and utilization of healthcare services. Hence, we attempted to determine the impact of health insurance on the utilization of healthcare services during COVID‐19 pandemic.
Methods
A community‐based cross‐sectional study was conducted in rural Tamil Nadu. The primary data collection was conducted during November 2021. We employed a multi‐stage stratified random sampling technique. Propensity score matching analysis was performed using radius matching method at 0.05 calliper to estimate the following parameters: average treatment effect (ATE), average treatment effect on treated (ATT), and average treatment effect on untreated (ATU).
Results
In total, 2390 participants were included. Almost two‐third belonged to 18–45 years with almost equal distribution of males and females. Only 13.6% were covered by health insurance. Healthcare utilization was significantly higher among participants with health insurance (55.2%) compared to participants without coverage (42.5%). The ATT values in intervention and control group were 0.55 and 0.46 (p < 0.001). Similarly, the ATU values in intervention and control group were 0.42 and 0.51. The ATE value was 0.08.
Conclusion
Our study shows that the health insurance coverage had significant impact on utilization of healthcare services during COVID‐19 pandemic. Further longitudinal research exploring the effect of different forms of health insurance for improving access and utilization of healthcare services can be undertaken.
Tissue engineering and regenerative medicine (TERM) have paved a way for treating musculoskeletal diseases in a minimally invasive manner. The regenerative medicine cocktail involves the usage of mesenchymal stem/stromal cells (MSCs), either uncultured or culture-expanded cells along with growth factors, cytokines, exosomes, and secretomes to provide a better regenerative milieu in degenerative diseases. The successful regeneration of cartilage depends on the selection of the appropriate source of MSCs, the quality, quantity, and frequency of MSCs to be injected, and the selection of the patient at an appropriate stage of the disease. However, confirmation on the most favorable source of MSCs remains uncertain to clinicians. The lack of knowledge in the current cellular treatment is uncertain in terms of how beneficial MSCs are in the long-term or short-term (resolution of pain) and improved quality of life. Whether MSCs treatments have any superiority, exists due to sources of MSCs utilized in their potential to objectively regenerate the cartilage at the target area. Many questions on source and condition remain unanswered. Hence, in this review, we discuss the lineage differentiation potentials of various sources of MSCs used in the management of knee osteoarthritis and emphasize the role of tissue engineering in cartilage regeneration.
Background:The Ministry of Health and Family Welfare has introduced the "National Patient Safety Implementation Framework" to ensure the patient safety at different levels of healthcare delivery system. However, there is limited effort made in evaluating the implementation status of this framework. Hence, we have performed the process evaluation of National Patient Safety Implementation Framework across the public healthcare facilities in Tamil Nadu.Methods: This was a facility-level survey conducted by research assistants who visited 18 public health facilities across 6 districts of Tamil Nadu, India, for the purpose of documenting the presence of structural support systems and strategies to promote patient safety. We developed a tool for data collection based on the framework. It comprised a total of 100 indicators under the following domains and subdomains:
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