Impact Evaluation of India’s Yeshasvini Community Health insurance Programme

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Abstrakt

Using propensity score matching techniques, the study evaluates the impact of India's Yeshasvini community-based health insurance programme on health-care utilisation, financial protection, treatment outcomes and economic well-being. The programme offers free out-patient diagnosis and lab tests at discounted rates when ill, but, more importantly, it covers highly catastrophic and less discretionary in-patient surgical procedures. For its impact evaluation, 4109 randomly selected households in villages in rural Karnataka, an Indian state, were interviewed using a structured questionnaire. A comprehensive set of indicators was developed and the quality of matching was tested. Generally, the programme is found to have increased utilisation of health-care services, reduced out-of-pocket spending, and ensured better health and economic outcomes. More specifically, however, these effects vary across socio-economic groups and medical episodes. The programme operates by bringing the direct price of health-care down but the extent to which this effectively occurs across medical episodes is an empirical issue. Further, the effects are more pronounced for the better-off households. The article demonstrates that community insurance presents a workable model for providing high-end services in resource-poor settings through an emphasis on accountability and local management.
OriginalsprogEngelsk
TidsskriftHealth Economics
Vol/bind19
Udgave nummerS1
Sider (fra-til)5-35
Antal sider30
ISSN1057-9230
DOI
StatusUdgivet - sep. 2010
Udgivet eksterntJa

Emneord

  • Community-based health Insurance
  • Propensity Score Matching Methods
  • Impact Evaluation
  • Yeshasvini Health-Care Programme
  • Cooperative Sector
  • Karataka
  • India

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