Revisiting equity in healthcare spending through capability-approach

Assessing the effectiveness of health-insurance schemes in reducing Oope and CHE in India

Datos Bibliográficos

ID6150807
AutoresRinshu Dwivedi (0000-0001-5912-2764, Indian Institute of Information Technology Allahabad), Jalandhar Pradhan (0000-0001-5998-0363, National Institute of Technology Rourkela)
Año2020
Volumen14
Número2
Páginas117-132
Fecha de publicación2020-12-09
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaInternational Journal of Human Rights in Healthcare (JOURNAL)
Identificadores de la revistaISSN: 2056-4902 • E-ISSN: 2056-4910
EditorialEmerald Publishing Limited (PUBLISHER • GB)
DOI10.1108/ijhrh-08-2020-0070
OpenAlexW3113049256
IdiomaEN
Citas recibidas1
Referencias citadas32

Purpose 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/approach Data 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. Findings A 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/implications Being a study based on secondary data sources, its applicability may vary as per the other social indicators. Practical implications Extending 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 implications Extending 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/value This research brings a theoretical and conceptual analysis for improving the health-insurance coverage among the community as a public health strategy

Actuarial science · Business · Economic growth · Economics · Environmental health · Equity (law · Health care · Health equity · Population · Reimbursement · Global Health Care Issues · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine