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State health insurance and out-of-pocket health expenditures in Andhra Pradesh, India

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  • Victoria Fan

    ()

  • Anup Karan
  • Ajay Mahal

Abstract

In 2007 the state of Andhra Pradesh in southern India began rolling out Aarogyasri health insurance to reduce catastrophic health expenditures in households ‘below the poverty line’. We exploit variation in program roll-out over time and districts to evaluate the impacts of the scheme using difference-in-differences. Our results suggest that within the first nine months of implementation Phase I of Aarogyasri significantly reduced out-of-pocket inpatient expenditures and, to a lesser extent, outpatient expenditures. These results are robust to checks using quantile regression and matching methods. No clear effects on catastrophic health expenditures or medical impoverishment are seen. Aarogyasri is not benefiting scheduled caste and scheduled tribe households as much as the rest of the population. Copyright Springer Science+Business Media New York 2012

Suggested Citation

  • Victoria Fan & Anup Karan & Ajay Mahal, 2012. "State health insurance and out-of-pocket health expenditures in Andhra Pradesh, India," International Journal of Health Economics and Management, Springer, vol. 12(3), pages 189-215, September.
  • Handle: RePEc:kap:ijhcfe:v:12:y:2012:i:3:p:189-215
    DOI: 10.1007/s10754-012-9110-5
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    References listed on IDEAS

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    Cited by:

    1. repec:spr:jsecdv:v:19:y:2017:i:1:d:10.1007_s40847-017-0040-4 is not listed on IDEAS
    2. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press, vol. 32(1), pages 147-189.
    3. Azam, Mehtabul, 2018. "Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India," World Development, Elsevier, vol. 102(C), pages 1-17.
    4. Dhanaraj, Sowmya, 2014. "Health shocks and coping strategies: State health insurance scheme of Andhra Pradesh, India," WIDER Working Paper Series 003, World Institute for Development Economic Research (UNU-WIDER).
    5. Bergkvist, Sofi & Wagstaff, Adam & Katyal, Anuradha & Singh, Prabal V. & Samarth, Amit & Rao, Mala, 2014. "What a difference a state makes : health reform in Andhra Pradesh," Policy Research Working Paper Series 6883, The World Bank.
    6. repec:eee:socmed:v:181:y:2017:i:c:p:83-92 is not listed on IDEAS

    More about this item

    Keywords

    Health insurance; Health expenditure; Tertiary care; Poverty; India; I18; I38; G22;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies

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