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State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India - Working Paper 298

  • Victoria Fan, Anup Karan, and Anjay Mahal

In 2007, the state of Andhra Pradesh in southern India began rolling out the 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 year 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.

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Paper provided by Center for Global Development in its series Working Papers with number 298.

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Length: 53 pages
Date of creation: Jun 2012
Date of revision:
Handle: RePEc:cgd:wpaper:298
Contact details of provider: Web page: http://www.cgdev.org

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  1. 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.
  2. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
  3. Alessandro Tarozzi, 2004. "Calculating Comparable Statistics from Incomparable Surveys, with an Application to Poverty in India," Econometric Society 2004 North American Winter Meetings 280, Econometric Society.
  4. Dror, David Mark & Koren, Ruth & Ost, Alexander & Binnendijk, Erika & Vellakkal, Sukumar & Danis, Marion, 2007. "Health insurance benefit packages prioritized by low-income clients in India: Three criteria to estimate effectiveness of choice," Social Science & Medicine, Elsevier, vol. 64(4), pages 884-896, February.
  5. Daniel Ho & Kosuke Imai & Gary King & Elizabeth A. Stuart, . "MatchIt: Nonparametric Preprocessing for Parametric Causal Inference," Journal of Statistical Software, American Statistical Association, vol. 42(i08).
  6. Kijima, Yoko, 2006. "Caste and Tribe Inequality: Evidence from India, 1983-1999," Economic Development and Cultural Change, University of Chicago Press, vol. 54(2), pages 369-404, January.
  7. Das Gupta, Monica & Desikachari, B.R. & Somanathan, T.V. & Padmanaban, P., 2009. "How to improve public health systems : lessons from Tamil Nadu," Policy Research Working Paper Series 5073, The World Bank.
  8. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412.
  9. Kosuke Imai & Gary King & Elizabeth A. Stuart, 2008. "Misunderstandings between experimentalists and observationalists about causal inference," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(2), pages 481-502.
  10. Angus Deaton & Valerie Kozel, 2005. "Data and Dogma: The Great Indian Poverty Debate," World Bank Research Observer, World Bank Group, vol. 20(2), pages 177-199.
  11. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low-income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857.
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