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Impact evaluation of India's ‘Yeshasvini’ community‐based health insurance programme

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  • Aradhna Aggarwal

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. Copyright (C) 2010 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1605
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 19 (2010)
Issue (Month): S1 (September)
Pages: 5-35

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Handle: RePEc:wly:hlthec:v:19:y:2010:i:s1:p:5-35

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

Related research

Keywords: community‐based health insurance ; propensity score matching methods ; impact evaluation ; Yeshasvini health‐care programme ; cooperative sector ; Karnataka ; India ;

References

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  7. Charles Michalopoulos & Howard S. Bloom & Carolyn J. Hill, 2004. "Can Propensity-Score Methods Match the Findings from a Random Assignment Evaluation of Mandatory Welfare-to-Work Programs?," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 156-179, February.
  8. Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
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  15. Dror, David M. & Soriano, Elmer S. & Lorenzo, Marilyn E. & Sarol, Jesus Jr. & Azcuna, Rosebelle S. & Koren, Ruth, 2005. "Field based evidence of enhanced healthcare utilization among persons insured by micro health insurance units in Philippines," Health Policy, Elsevier, vol. 73(3), pages 263-271, September.
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Citations

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Cited by:
  1. Mebratie, A.D. & Sparrow, R.A. & Alemu, G. & Bedi, A.S., 2013. "Community-Based Health Insurance Schemes," ISS Working Papers - General Series 568, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
  2. Acharya, Arnab & Vellakkal, Sukumar & Taylor Fiona & Masset Edoardo & Satija, Ambika & Burke, Margaret & Ebrahim, Shah, 2013. "The impact of health insurance schemes for the informal sector in low- and middle-income countries : a systematic review," Policy Research Working Paper Series 6324, The World Bank.
  3. Squire, Lyn & Jones, Andrew M & Thomas, Ranjeeta, 2010. "Evaluating Innovative Health Programs: Lessons for Health Policy," MPRA Paper 29205, University Library of Munich, Germany.
  4. Victoria Fan & Anup Karan & Ajay Mahal, 2012. "State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India," Working Papers id:5032, eSocialSciences.
  5. Dutta, Mousumi & Husain, Zakir, 2012. "Use of hospital services and socio-economic status in urban India: Does health insurance ensure equitable outcomes?," MPRA Paper 40055, University Library of Munich, Germany.
  6. Victoria Fan, Anup Karan, and Anjay Mahal, 2012. "State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India - Working Paper 298," Working Papers 298, Center for Global Development.
  7. Thomas, Ranjeeta & Jones, Andrew M & Squire, Lyn, 2010. "Methods for Evaluating Innovative Health Programs (EIHP): A Multi-Country Study," MPRA Paper 29402, University Library of Munich, Germany.

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