‘Ayushman Bharat’ Program and Universal Health Coverage in India

Lahariya, Chandrakant

doi:10.1007/s13312-018-1341-1

Cited by 176 publications

(132 citation statements)

References 15 publications

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“…The draft of India`s National Health Policy [32] states that 63 million people have been pushed into poverty due to out-of-pocket expenditure on healthcare. As India progresses towards Universal Health Coverage, the financial burden posed by comorbidity among diabetes patients needs to be considered in greater detail.…”

Section: Resultsmentioning

confidence: 99%

Healthcare utilisation and out-of-pocket expenditure of type 2 diabetes patients with and without comorbidity: A study in primary care in Bhubaneswar, India.

Pati

Swain

Akker

et al. 2020

Preprint

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Background Globally, non-communicable diseases (NCD) necessitate increased healthcare expenditure. One NCD in particular, diabetes mellitus, is often associated with multiple, co-existing chronic conditions. In low- and middle-income countries where healthcare expenditure is mostly borne out of pocket, diabetes management may pose a significant economic burden. Methods A cross-sectional study was conducted in 17 urban primary healthcare facilities of Bhubaneswar to assess the healthcare utilisation and out-of-pocket expenditure among type 2 diabetes patients attending these facilities. Healthcare utilisation was determined by the number of visits to healthcare facilities in the last six months, and out-of-pocket expenditure was assessed by outpatient consultation fees, medicines, travels to health care facilities and diagnostic tests. Total out-of-pocket expenditure was defined as the sum of these costs. Results The median number of visits in 6 months for diabetes patients with any comorbidity was 4 and 5 for diabetes patients with more than 4 comorbidities. Among comorbidities, depression, stroke, auditory impairment and acid peptic disease were associated with higher healthcare utilisation. The total out-of-pocket expense was 2.3 times higher among diabetes patients with any comorbid condition compared to patients with diabetes only. The total median expenditure was higher for diabetes patients having stroke, heart diseases, kidney diseases and cancer compared to other comorbid conditions. The association of comorbidity in diabetes patients with health care utilization and out-of-pocket expenditure is statistically significant after adjustment for sociodemographic characteristics and diabetes duration. Conclusion Considerable expenditure is incurred by diabetes patients attending primary healthcare facilities for the management of diabetes and other chronic conditions. This is particularly painful for patients below the poverty line and with limited insurance cover. There is a need to increase the coverage of insurance schemes to address the chronic conditions management expenditure of outpatients.

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Section: Resultsmentioning

confidence: 99%

Healthcare utilisation and out-of-pocket expenditure of type 2 diabetes patients with and without comorbidity: A study in primary care in Bhubaneswar, India.

Pati

Swain

Akker

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The draft of India`s National Health Policy [33] states that 63 million people have been pushed into poverty due to out-of-pocket expenditure on healthcare. As India progresses towards Universal Health Coverage, the nancial burden posed by comorbidity among diabetes patients needs to be considered in greater detail.…”

Section: Resultsmentioning

confidence: 99%

Healthcare utilisation and out-of-pocket expenditure of type 2 diabetes patients with and without comorbidity: A study in primary care in Bhubaneswar, India.

Pati

Swain

Akker

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: Globally, non-communicable diseases (NCD) demand a higher healthcare expenditure. Amongst the NCDs, diabetes mellitus, is often associated with multiple, co-existing chronic conditions. In low- and middle-income countries where most of the healthcare expenditure is borne out of pocket, diabetes management may pose a significant financial stress.Methods: A cross-sectional study was conducted in 17 urban primary healthcare facilities of Bhubaneswar to assess the healthcare utilisation and out-of-pocket expenditure among type 2 diabetes patients attending these facilities. Healthcare utilisation was determined by the number of visits to healthcare facilities in the last six months, and out-of-pocket expenditure was assessed by outpatient consultation fees, medicines, travels to health care facilities and diagnostic tests. Total out-of-pocket expenditure was defined as the sum of these costs.Results: The median number of visits in 6 months for diabetes patients with any comorbidity was 4 and 5 for diabetes patients with more than 4 comorbidities. Among the comorbid conditions, depression, stroke, auditory impairment and acid peptic disease were associated with higher healthcare utilisation. The total out-of-pocket expense was 2.3 times higher among diabetes patients with any comorbid condition compared to patients with diabetes only. The total median expenditure was higher for diabetes patients having stroke, heart diseases, kidney diseases and cancer compared to other comorbid conditions. The association of comorbidity in diabetes patients with health care utilization and out-of-pocket expenditure is statistically significant after adjustment for sociodemographic characteristics and diabetes duration.Conclusion: Considerable expenditure is incurred by diabetes patients attending primary healthcare facilities for the management of diabetes and other chronic conditions. This is a significant burden for diabetes patients below the poverty line and with limited or no insurance cover. There is a need to increase the coverage of insurance schemes to address the chronic conditions management expenditure of outpatients.

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“…Unless taken care of, this may ultimately lead to wrong inferences being drawn from the analysis that may impact the business strategy (Brodie et al, ). For mass health insurance schemes, the success of the scheme is linked to the procurement of high‐quality technology platforms (Dabak et al, ; Lahariya, ). Large health insurance programmes have been plagued with technology procurement issues (Kastanioti, Kontodimopoulos, Stasinopoulos, Kapetaneas, & Polyzos, ) making this an important part of the technology policy.…”

Section: Discussion Of Results and Implications For Social Inclusionmentioning

confidence: 99%

“…Unless taken care of, this may ultimately lead to wrong inferences being drawn from the analysis that may impact the business strategy (Brodie et al, 2000). For mass health insurance schemes, the success of the scheme is linked to the procurement of high-quality technology platforms (Dabak et al, 2018;Lahariya, 2018…”

Section: Factor 3-technology Utilizationmentioning

confidence: 99%

Democratizing health insurance services; accelerating social inclusion through technology policy of health insurance firms

2019

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Technology plays an important role in reducing inequalities in health care delivery and enhancing quality of life. Health insurance firms require a potent technology policy to understand social determinants of health insurance that can lead to more innovative approaches to social inclusivity initiatives. This paper explicates critical factors of technology policy of health insurance firms that can contribute to better social inclusion and move towards universal health care. Through structured survey questionnaire, data were collected from 125 senior health insurance executives from India for identifying factors important for technology policy. A technology policy scale comprising six distinct factors is developed for health insurance firms using exploratory factor analysis. The factors are “organizational technology strategy,” “technology value drivers,” “technology utilization,” “firm agility in technology,” “firm technology capabilities,” and “customer focus through technology.” The factors identified in this study can be utilized and integrated with enabling technologies such as machine learning, internet of things, big data analytics, and digital phenotyping for creation of electronic health records that are critical for risk management of health insurance firms. This would help to promote healthy lifestyles and disease prevention strategies to strengthen universal health care for society. This paper looks at the factors that are essential in framing a technology policy for the health insurance sector. It provides reasons on how the factors contribute in the evolving health insurance field and can increase the rate of social inclusion for health care. And, finally, it helps in distinguishing how technology requirements and utilization in health insurance is different from other businesses.

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‘Ayushman Bharat’ Program and Universal Health Coverage in India

Cited by 176 publications

References 15 publications

Healthcare utilisation and out-of-pocket expenditure of type 2 diabetes patients with and without comorbidity: A study in primary care in Bhubaneswar, India.

Healthcare utilisation and out-of-pocket expenditure of type 2 diabetes patients with and without comorbidity: A study in primary care in Bhubaneswar, India.

Healthcare utilisation and out-of-pocket expenditure of type 2 diabetes patients with and without comorbidity: A study in primary care in Bhubaneswar, India.

Democratizing health insurance services; accelerating social inclusion through technology policy of health insurance firms

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