Impact evaluation of India's ‘Yeshasvini’ community‐based health insurance programme
AbstractUsing 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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Bibliographic InfoArticle provided by John Wiley & Sons, Ltd. in its journal Health Economics.
Volume (Year): 19 (2010)
Issue (Month): S1 (September)
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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749
community‐based health insurance ; propensity score matching methods ; impact evaluation ; Yeshasvini health‐care programme ; cooperative sector ; Karnataka ; India ;
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- Michael Lechner, 2002.
"Some practical issues in the evaluation of heterogeneous labour market programmes by matching methods,"
Journal of the Royal Statistical Society Series A,
Royal Statistical Society, vol. 165(1), pages 59-82.
- Michael Lechner, 2005. "Some practical issues in the evaluation of heterogeneous labour market programmes by matching methods," Labor and Demography 0505006, EconWPA.
- James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
- Dehejia, Rajeev, 2005. "Practical propensity score matching: a reply to Smith and Todd," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 355-364.
- Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr.
- Wagstaff, Adam, 2008. "Measuring financial protection in health," Policy Research Working Paper Series 4554, The World Bank.
- Caliendo, Marco & Kopeinig, Sabine, 2005.
"Some Practical Guidance for the Implementation of Propensity Score Matching,"
IZA Discussion Papers
1588, Institute for the Study of Labor (IZA).
- Marco Caliendo & Sabine Kopeinig, 2008. "Some Practical Guidance For The Implementation Of Propensity Score Matching," Journal of Economic Surveys, Wiley Blackwell, vol. 22(1), pages 31-72, 02.
- Marco Caliendo & Sabine Kopeinig, 2005. "Some Practical Guidance for the Implementation of Propensity Score Matching," Discussion Papers of DIW Berlin 485, DIW Berlin, German Institute for Economic Research.
- Syed Abdul Hammid & Jennifer Roberts & Paul Mosley, 2010.
"Can Micro Health Insurance Reduce Poverty? Evidence from Bangladesh,"
2010001, The University of Sheffield, Department of Economics, revised Jan 2010.
- Syed Abdul Hamid & Jennifer Roberts & Paul Mosley, 2011. "Can Micro Health Insurance Reduce Poverty? Evidence From Bangladesh," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 78(1), pages 57-82, 03.
- A. Smith, Jeffrey & E. Todd, Petra, 2005.
"Does matching overcome LaLonde's critique of nonexperimental estimators?,"
Journal of Econometrics,
Elsevier, vol. 125(1-2), pages 305-353.
- Jeffrey Smith & Petra Todd, 2003. "Does Matching Overcome Lalonde's Critique of Nonexperimental Estimators?," University of Western Ontario, CIBC Centre for Human Capital and Productivity Working Papers 20035, University of Western Ontario, CIBC Centre for Human Capital and Productivity.
- James Heckman & Hidehiko Ichimura & Jeffrey Smith & Petra Todd, 1998.
"Characterizing Selection Bias Using Experimental Data,"
NBER Working Papers
6699, National Bureau of Economic Research, Inc.
- James Heckman & Hidehiko Ichimura & Jeffrey Smith & Petra Todd, 1998. "Characterizing Selection Bias Using Experimental Data," Econometrica, Econometric Society, vol. 66(5), pages 1017-1098, September.
- Heckman, James J & Ichimura, Hidehiko & Todd, Petra E, 1997. "Matching as an Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," Review of Economic Studies, Wiley Blackwell, vol. 64(4), pages 605-54, October.
- Dror, David Mark & Koren, Ruth & Steinberg, David Mark, 2006. "The impact of filipino micro health-insurance units on income-related equality of access to healthcare," Health Policy, Elsevier, vol. 77(3), pages 304-317, August.
- Sianesi, Barbara, 2001. "An evaluation of the active labour market programmes in Sweden," Working Paper Series 2001:5, IFAU - Institute for Evaluation of Labour Market and Education Policy.
- Alberto Abadie & Guido W. Imbens, 2002. "Simple and Bias-Corrected Matching Estimators for Average Treatment Effects," NBER Technical Working Papers 0283, National Bureau of Economic Research, Inc.
- Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009.
"Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme,"
Journal of Health Economics,
Elsevier, vol. 28(1), pages 1-19, January.
- 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.
- 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.
- Besley, Timothy, 1989. "The Demand for Health Care and Health Insurance," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 21-33, Spring.
- 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.
- 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.
- 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.
- Squire, Lyn & Jones, Andrew M & Thomas, Ranjeeta, 2010. "Evaluating Innovative Health Programs: Lessons for Health Policy," MPRA Paper 29205, University Library of Munich, Germany.
- 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.
- Victoria Fan & Anup Karan & Ajay Mahal, 2012.
"State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India,"
- Victoria Fan & Anup Karan & Ajay Mahal, 2012. "State health insurance and out-of-pocket health expenditures in Andhra Pradesh, India," International Journal of Health Care Finance and Economics, Springer, vol. 12(3), pages 189-215, September.
- 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.
- 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.
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