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Revisiting equity in healthcare spending through capability-approach: assessing the effectiveness of health-insurance schemes in reducing OOPE and CHE in India

Revisiting equity in healthcare spending through capability-approach: assessing the effectiveness... This paper aims to draw theoretical insight from Sen’s capability-approach and attempts to examine the effectiveness of health-insurance-schemes in reducing out-of-pocket-expenditure (OOPE) and catastrophic-health-expenditure (CHE) in India.Design/methodology/approachData were extracted from the National-Sample-Survey-Organization, 71st round on Health-2014. Generalized-linear-regression-model was used to investigate the impact of social-protection-schemes on OOPE and CHE.FindingsA notable segment of the Indian population is still not covered under any health-insurance-schemes. The majority of the insured population was covered by publicly-financed-health-insurance-schemes (PFHIs), with a trivial-share of private-insurance. Households from 16–59 age-group, urban, literate, richest, southern-regions, using private-facilities and having ear and skin ailments have reported higher insurance coverage. Reimbursement was higher among elderly, literates, middle-class, central-regions, using private-facilities/insurance and for infections. Access to PFHIs significantly reduces the risk of OOPE and CHE. Unavailability of reimbursement exposes the population to a higher risk of CHE.Research limitations/implicationsBeing a study based on secondary data sources, its applicability may vary as per the other social indicators.Practical implicationsExtending insurance-coverage alone cannot answer the widespread inequalities in health care. Rather, an efficiently managed reimbursement-mechanism could condense OOPE and CHE by enhancing the capability of the population to confront the undue financial burden.Social implicationsExtending the health-insurance-coverage to the entire population requires a better understanding of the underlying-dynamics and health-care needs and must make health-care affordable by enhancing the overall capability.Originality/valueThis research brings a theoretical and conceptual analysis for improving the health-insurance coverage among the community as a public health strategy. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Human Rights in Healthcare Emerald Publishing

Revisiting equity in healthcare spending through capability-approach: assessing the effectiveness of health-insurance schemes in reducing OOPE and CHE in India

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References (51)

Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
2056-4902
eISSN
2056-4902
DOI
10.1108/ijhrh-08-2020-0070
Publisher site
See Article on Publisher Site

Abstract

This paper aims to draw theoretical insight from Sen’s capability-approach and attempts to examine the effectiveness of health-insurance-schemes in reducing out-of-pocket-expenditure (OOPE) and catastrophic-health-expenditure (CHE) in India.Design/methodology/approachData were extracted from the National-Sample-Survey-Organization, 71st round on Health-2014. Generalized-linear-regression-model was used to investigate the impact of social-protection-schemes on OOPE and CHE.FindingsA notable segment of the Indian population is still not covered under any health-insurance-schemes. The majority of the insured population was covered by publicly-financed-health-insurance-schemes (PFHIs), with a trivial-share of private-insurance. Households from 16–59 age-group, urban, literate, richest, southern-regions, using private-facilities and having ear and skin ailments have reported higher insurance coverage. Reimbursement was higher among elderly, literates, middle-class, central-regions, using private-facilities/insurance and for infections. Access to PFHIs significantly reduces the risk of OOPE and CHE. Unavailability of reimbursement exposes the population to a higher risk of CHE.Research limitations/implicationsBeing a study based on secondary data sources, its applicability may vary as per the other social indicators.Practical implicationsExtending insurance-coverage alone cannot answer the widespread inequalities in health care. Rather, an efficiently managed reimbursement-mechanism could condense OOPE and CHE by enhancing the capability of the population to confront the undue financial burden.Social implicationsExtending the health-insurance-coverage to the entire population requires a better understanding of the underlying-dynamics and health-care needs and must make health-care affordable by enhancing the overall capability.Originality/valueThis research brings a theoretical and conceptual analysis for improving the health-insurance coverage among the community as a public health strategy.

Journal

International Journal of Human Rights in Healthcare – Emerald Publishing

Published: Jun 4, 2021

Keywords: Health-insurance; Reimbursement; PFHIs; OOPE; CHE; Capability-approach; India

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