Types of health insurance and its utilization in a primary, secondary and tertiary care setting in coastal Karnataka

Abstract

Background: Health insurance as a tool to finance health care has very recently gained popularity in India. While health insurance has a long history, the upsurge in breadth of coverage can be explained by a serious effort by the Government to introduce health insurance for the poor in last four years. Objective of this study is to determine the types of health insurance prevalent in coastal Karnataka and to study its advantages in decreasing out of pocket expenditure.Methods: A cross sectional study was done among 450 patients by administering a validated questionnaire on health insurance with details, coverage amount, presence of APL or BPL card and utilization pattern with advantages to the patient from scheme.Results: Out of the 450 patients have been surveyed, 57% had availed health insurance. 35% of patients were benefited by sampoorna suraksha and 27.5% patients used KSHEMA health card. ESI and kadamba were least used. Unlimited slab was seen with aarogya bhagya and yashaswini schemes. 65% of APL category and only 35% of BPL had health insurance. 92.5% of the patients with health insurance surveyed used private hospitals for health assistance. In 25% of people, hospital visits increased due to health insurance. In 15% of patients the total expenditure on health has increased after obtaining health insurance.Conclusions: 57% of the patients had some form of health insurance. Sampoorna suraksha was the most commonly used scheme and health insurance was most commonly used for in patient care.

Health insurance: Uptake, perception and its determinants among health care seekers at a tertiary care hospital in Lucknow, India

“…9 Whereas, Baisil S et al in their study conducted in Karnataka, found a higher (57%) proportion of the participants were insured, which can be due to the different study settings and population with varied awareness and perception on health insurance. 4 In the present study,…”

“…10 In the present study, OPD consultations were covered under only one-third (36.2%) of the participants, similar to the findings of Baisil S et al showed that only 34.9 percent of patients used it for outpatient care. 4 We found that 8.6 percent of the participants used it once a year during the past financial year and 6.9 percent have used it twice, while Baisil S et al…”

“…showed that about one-fourth (28%) of the patients used it once a year and a less than one-fourth (22%) utilised it twice in a year. 4…”

“…3 Over 63 million people in India face financial stressyearly due to healthcare spending alone. 4 In 2008, India launched the Rashtriya Swasthya Bima Yojana (RSBY) for below-the-poverty-line familiesto reduce catastrophic healthcare expenditures arising from health status involving hospitalization. 5 With the launch of Ayushman Bharat, health insurance has come to the forefront of government health policy in India.…”

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

“…Health Insurance coverage in costal Karnataka was 57%. 3 Recently Karnataka government approved a universal health coverage scheme in a effort to increase the health insurance coverage. 4 Study conducted in neighboring district (Mysore) shows a health insurance coverage of 41%.…”