Health insurance coverage and healthcare expenditure pattern in rural Mandya, Karnataka

Abstract

Background: Poverty and ill-health go hand in hand.In developing countries, high out of pocket payment, absence of risk pooling mechanism in health financing systems, and high level of poverty are said to result in catastrophic health expenditure.Health insurance (HI) is the need of the hour in the absence of Universal Health Coverage. Hence this study was undertaken to assess the health insurance coverage among people of rural field practice area of Mandya Institute of Medical Sciences, Mandya and to describe the health care expenditure pattern in the study population.Methods: Study design was based on community based cross sectional study. Study area was at rural field practice area of Mandya Institute of Medical Sciences, which comprises of 11 villages. Study population: Permanent residents of villages in the study area. Study period was on 4 months (August 2016–November 2016). Sample size: 264 households. Sampling method: Multistage sampling. Method of data collection: Personal interview of patients/head of the family of patients admitted to a hopital during study period using semi structured questionnaire.Results: 58.0% of the households in study area had some form of health insurance coverage. Among the covered households only 40.50% were having whole family coverage. Individual level HI coverage was 48.8%. Out of pocket (OOP) expenditure for inpatient care contributed to 83.81% of the health care expenditure.Conclusions: HI coverage is higher than national average. But health care expenditure is largely borne out of pocket.