IJCM_228A: Awareness & possession of health insurance scheme and its impact on health care utilization amongst people seeking services in tertiary care hospitals of coastal Karnataka: A cross-sectional study

Abstract

Background: Healthcare is a fundamental human right, and various insurance schemes in India strive to make healthcare inexpensive and accessible to everyone. The government’s Ayushman Bharat and PMJAY programmes aim to guarantee universal health coverage and financial risk protection for households within the country. According to the NITI Ayog, more than 40 crore people lack health insurance coverage in the country. This lack of awareness limits access to healthcare services, especially for the marginalized population. The focus of this study is to assess the impact of availing health insurance on healthcare utilization. Objective: To assess the level of awareness and proportion of patients who are availing health insurance scheme and its impact on healthcare utilisation. Methodology: This cross-sectional study was carried out at teaching hospitals affiliated with Kasturba Medical College, Mangalore. The sample size was estimated to be 118, which included the adult patients admitted to the wards of respective hospitals who gave informed consent. The study participants received an internally verified questionnaire with four sections in Kannada and English. Results: Out of 118 participants, 89% are literate, and two-thirds are holders of BPL card. 84% of study participants are aware of a certain health insurance scheme, among which 90% being aware of the services offered and 82% considering it may be a worthwhile investment. 60% of total respondents possessed any kind of insurance scheme, with three quarters of them utilizing government schemes. Among the insurance holders, 82% receive full reimbursement for their medical condition and 58.5% agree that owning health insurance enables them greater access to health-care services. Paying medical expenses out of pocket drives uninsured people to reconsider obtaining an insurance. Conclusion: Public awareness and financial assistance programs should be tailored with culturally competent communication and simplified enrolment processes to enhance the coverage of health insurance services.