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


  • Aradhna Aggarwal


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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  • Aradhna Aggarwal, 2010. "Impact evaluation of India's ‘Yeshasvini’ community‐based health insurance programme," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 5-35, September.
  • Handle: RePEc:wly:hlthec:v:19:y:2010:i:s1:p:5-35

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    1. repec:eee:jhecon:v:55:y:2017:i:c:p:14-29 is not listed on IDEAS
    2. Sukumar Vellakkal, 2013. "Determinants of Enrolment in Voluntary Health Insurance: Evidences from a Mixed Method Study, Kerala, India," International Journal of Financial Research, International Journal of Financial Research, Sciedu Press, vol. 4(2), pages 99-107, April.
    3. 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.
    4. 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.
    5. 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.
    6. S. Savitha & K. Kiran, 2015. "Effectiveness of micro health insurance on financial protection: Evidence from India," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 53-71, March.
    7. Squire, Lyn & Jones, Andrew M & Thomas, Ranjeeta, 2010. "Evaluating Innovative Health Programs: Lessons for Health Policy," MPRA Paper 29205, University Library of Munich, Germany.
    8. repec:eee:wdevel:v:102:y:2018:i:c:p:1-17 is not listed on IDEAS
    9. Sahoo, Amit Kumar & Madheswaran, S., 2014. "Out of pocket (OOP) financial risk protection: The role of health insurence," Working Papers 330, Institute for Social and Economic Change, Bangalore.
    10. 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.
    11. 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.
    12. Shimeles Abebe & Andinet Woldemichael, 2015. "Working Paper 225 - Measuring the Impact of Micro-Health Insurance on Healthcare Utilization: A Bayesian Potential Outcomes Approach," Working Paper Series 2166, African Development Bank.
    13. Azam, Mehtabul, 2018. "Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India," World Development, Elsevier, vol. 102(C), pages 1-17.
    14. Barnes, Kayleigh & Mukherji, Arnab & Mullen, Patrick & Sood, Neeraj, 2017. "Financial risk protection from social health insurance," Journal of Health Economics, Elsevier, vol. 55(C), pages 14-29.
    15. 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.
    16. repec:eee:socmed:v:181:y:2017:i:c:p:83-92 is not listed on IDEAS


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