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.

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Abstract

Objectives: This study intends to find out the status of access to formal financial services (here it is banking services) in Kendrapara and Sunderagarh districts of Odisha in India.

Methods/Statistical Analysis: We applied the purposive random sampling and multistage random sampling methods for selecting the districts and villages respectively. A total of 400 households are chosen proportionately from the four selected villages. Both primary and secondary data are used in the study. Primary data are collected through direct personal interviews of heads of the households using structured interview schedules. Descriptive statistical tools such as averages, percentages and graphs are used for analyzing the data.

Findings: The provision of banking infrastructure in the sample districts is not adequate particularly in the sample panchayats of Sunderagarh district. A poor geographical penetration of bank branches and ATMs are found in this district in comparison to Kendrapara district. 94.8% of respondents in both the districts have access to banking services with 97% in Kendrapara and 89.5% in Sunderagarh district. The primary reasons for opening bank account are receiving govt. benefit transfers and receiving payments for work under National Rural Employment Guarantee Scheme (NREGS). A majority of respondents are found to have opened their account during the financial inclusion drive i.e. in the year 2005 and onwards. Income level and literacy of the respondents are found to be the major determinants of access to bank account. The financial awareness in both the district is very poor which obstructs the households from accessing the associated facilities of a bank account such as debit card, credit card, loan account, cheque facility and overdraft facility. The primary reasons for not having a bank account are lack of regular and sufficient income and lack of financial awareness.

Application/Improvement: The study explores the accessibility and its determinants at grass ischolar_mains level by studying the village households it will be helpful for policy makers for designing appropriate schemes and programmes for improving accessibility and utilization of banking services particularly in the rural and tribal areas.

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