Indian Journal of Economics and Development

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Extent of Use of the Government Sponsored Health Insurance Schemes: Evidence from Rural Odisha


Affiliations
1 Department of Analytical and Applied Economics, Utkal University, Vani Vihar, Bhubaneswar-751004, Odisha, India
 

Objectives: The National Health Insurance Scheme of India, i.e., Rashtriya Swasthya Bima Yojana, and the Odisha State health insurance scheme, i.e., Biju Krushak Kalayan Yojanaaim to provide financial protection to target population against catastrophic health expenditure by reducing out-of-pocket spending and improve access to quality healthcare. The study estimates healthcare expenditure of beneficiaries, the extent of use of the scheme and to point out obstacles that the beneficiaries face.

Methodology: The study was based on both secondary and primary data. Multi-stage random sampling method is used to select 200 beneficiaries of both the scheme. Data were collected through direct personal interviews by using structured schedules. Descriptive statistics are used to substantiate the objectives. Qualitative data were also analysed briefly to supplement quantitative analysis.

Results: The average amount of expenditure on Medicine, Diagnostic and Food and accommodation incurred by beneficiaries for their treatment were quiet high. The overall spending on medicine in proportion of total healthcare payment was 60.01%.47.5% beneficiaries spend from own pocket for their treatment. Only 5.7% beneficiaries fully access the facilities of the scheme. The average claimed amount and received amount was only `6246 and `3632.70 respectively. Only 58.15% of the claimed amount was only realized. The obstacles faced by the beneficiaries in the reimbursement of the claimed amount are bureaucratic official procedures, mismatch of the fingerprint of beneficiaries, failure of networking of installed software, more amounts of money deducted than released amount and exploitation involved in the delivery of facilities.

Conclusions: This paper contributes to the current debate on financial protection provided by the health insurance scheme which is burning issue in the healthcare sector. The finding of the study may help the policymaker to create awareness among insured, the behaviour of healthcare providers may be turned friendly, immediate attention may be provided by help desk counters to the beneficiaries, the sum assured amount may be increased and the detailed receipt of hospital expenditure may be supplied to the insured at the time of discharge.


Keywords

Rashtriya Swasthya Bima Yojana, Biju Krushak Kalayan Yojana, Health Insurance, Out of Pocket Payment, Odisha.
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  • Universal Health Coverage, why health insurance scheme poor people are living the poor behind. https://www.oxfam.org/sites/www.oxfam.org/files/bp176-universal-health-coverage-091013-en_.pdf. Date accessed: 09/10/2013.

  • S. Ghosh. Catastrophic payment and Impoverishment to out of pocket health spending. Economics Political Weekly. 2011; 46(47), 63-70.

  • Out of pocket health care payments on chronic conditions impoverish urban poor in Bangalor. https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/1471-2458-12-990. Date accessed: 2012.

  • S. Nandi, R. Dasgupta, K. Kanugol, N. Madhurima, G. Muruganl. Challenges in attaining universal health coverage: empirical findings from Rashtriya Swashthya Bima Yojana in Chhattisgarh. Public Health Policy. 2012; 6(5).

  • T. Seshadri, M. Trivedi, D. Sexena, W. Soors, B. Criel, N. Devadasanl. Impact of RSBY on enrolled households: lessons from Gujarat. BMC Proceeding. 2012; 6(5), 1-2.

  • P. Patel, J. Shah, M. Agarwak, G. Kedia. A cross sectional study: post utilization survey of RSBY beneficiaries in civil hospital, Ahmadabad. International Journal of Medical Science and Public Health. 2013; 2(4), 1109-1111.

  • R. Dasgupta, S. Nandi, K. Kanugo, M. Nundy, G. Murugan, R. Neog. What the doctor said: a critical examination of design issues of the RSBY through provider’s perspectives in Chhattisgarh. Social Change. 2013; 43(2), 227-243.

  • N. Devadasan, T. Seshadri, M. Trivedi, C. Bart. Promoting universal financial protection: evidence from the Rashtriya Swasthaya Bima Yojana (RSBY) in Gujarat, India. Health Research Policy and Systems. 2013; 11(29), 1-8.

  • N. Jain. 56 million steps towards universal coverage: RSBY health insurance for the poor in India. German Development Cooperation. 2010; 1-12.

  • H. Gill, A. Shahi. Rashtriya Swasthya Bima Yojana in India- implementation and impact. Zenith International Journal of Multidisciplinary Research. 2012; 2(5), 155-173.

  • H. Thakur. Study of Awareness, Enrolment, and Utilization of Rashtriya Swasthya Bima Yojana (National Health Insurance Scheme) in Maharashtra, India. Frontiers in Public Health. 2016; 3(282), 1-13.

  • R.K. Sinha. A critical assessment of Indian national health insurance scheme–Rashtriya Swasthya Bima Yojana (RSBY). European Academic Research. 2013; 1, 2299-2325.

  • A. Aiyer, V. Sharma, K. Narayanan, N. Jain, P. Bhat, S. Mahendiran. Rashtriya Swasthya Bima Yojana (A Study in Karnataka). Centre for Budget and Policy Studies (CBPS), Bangalore, India. 2013.


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  • Extent of Use of the Government Sponsored Health Insurance Schemes: Evidence from Rural Odisha

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Authors

Babita Panda
Department of Analytical and Applied Economics, Utkal University, Vani Vihar, Bhubaneswar-751004, Odisha, India
Himanshu Sekhar Rout
Department of Analytical and Applied Economics, Utkal University, Vani Vihar, Bhubaneswar-751004, Odisha, India

Abstract


Objectives: The National Health Insurance Scheme of India, i.e., Rashtriya Swasthya Bima Yojana, and the Odisha State health insurance scheme, i.e., Biju Krushak Kalayan Yojanaaim to provide financial protection to target population against catastrophic health expenditure by reducing out-of-pocket spending and improve access to quality healthcare. The study estimates healthcare expenditure of beneficiaries, the extent of use of the scheme and to point out obstacles that the beneficiaries face.

Methodology: The study was based on both secondary and primary data. Multi-stage random sampling method is used to select 200 beneficiaries of both the scheme. Data were collected through direct personal interviews by using structured schedules. Descriptive statistics are used to substantiate the objectives. Qualitative data were also analysed briefly to supplement quantitative analysis.

Results: The average amount of expenditure on Medicine, Diagnostic and Food and accommodation incurred by beneficiaries for their treatment were quiet high. The overall spending on medicine in proportion of total healthcare payment was 60.01%.47.5% beneficiaries spend from own pocket for their treatment. Only 5.7% beneficiaries fully access the facilities of the scheme. The average claimed amount and received amount was only `6246 and `3632.70 respectively. Only 58.15% of the claimed amount was only realized. The obstacles faced by the beneficiaries in the reimbursement of the claimed amount are bureaucratic official procedures, mismatch of the fingerprint of beneficiaries, failure of networking of installed software, more amounts of money deducted than released amount and exploitation involved in the delivery of facilities.

Conclusions: This paper contributes to the current debate on financial protection provided by the health insurance scheme which is burning issue in the healthcare sector. The finding of the study may help the policymaker to create awareness among insured, the behaviour of healthcare providers may be turned friendly, immediate attention may be provided by help desk counters to the beneficiaries, the sum assured amount may be increased and the detailed receipt of hospital expenditure may be supplied to the insured at the time of discharge.


Keywords


Rashtriya Swasthya Bima Yojana, Biju Krushak Kalayan Yojana, Health Insurance, Out of Pocket Payment, Odisha.

References