Impact Evaluation of India’s Yeshasvini Community Health insurance Programme

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.
Original languageEnglish
JournalHealth Economics
Volume19
Issue numberS1
Pages (from-to)5-35
Number of pages30
ISSN1057-9230
DOIs
Publication statusPublished - Sep 2010
Externally publishedYes

Cite this

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title = "Impact Evaluation of India’s Yeshasvini Community Health insurance Programme",
abstract = "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.",
keywords = "Community-based health Insurance, Propensity Score Matching Methods, Impact Evaluation, Yeshasvini Health-Care Programme, Cooperative Sector, Karataka, India",
author = "Aradhna Aggarwal",
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doi = "10.1002/hec.1605",
language = "English",
volume = "19",
pages = "5--35",
journal = "Health Economics",
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Impact Evaluation of India’s Yeshasvini Community Health insurance Programme. / Aggarwal, Aradhna.

In: Health Economics, Vol. 19, No. S1, 09.2010, p. 5-35.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Impact Evaluation of India’s Yeshasvini Community Health insurance Programme

AU - Aggarwal, Aradhna

PY - 2010/9

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AB - 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.

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KW - Propensity Score Matching Methods

KW - Impact Evaluation

KW - Yeshasvini Health-Care Programme

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KW - Karataka

KW - India

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