Health Insurance Penetration Research Articles

Factors affecting the incidence of health insurance penetration among elderly: Evidence from India

A thrust on insurance‐financed health systems may reduce Out‐of‐pocket health spending. But health insurance penetration among Indian elderly is abysmally low. In this context, the paper intends to examine the factors affecting demand for various types of insurances among Indian elderly. Data were drawn from 71st round (2014–15) “Key Consumption: Health” household survey data collected by National Sample Survey Organization (NSSO), Government of India. A total number of 27,245 older adults were selected for this study. In addition to basic descriptive statistics, we employ logistic regression models to conduct the econometric analysis. Socioeconomic, health‐related and contextual predictors are considered in this study. The results show that the probability of health insurance coverage among elderly significantly depends on income, education, disease types, caste, family size, and most importantly, social relationships. The underprivileged groups have higher likelihood to be covered by government‐funded insurance, while the older people with higher income and education, having spouses and less number of children, and residing in urban areas have a higher likelihood of purchasing private health insurance. The study identified the factors responsible for low demand for health insurance among elderly. The study suggests the expansion of private insurance network, especially, in the underserved rural areas, along with generating financial awareness among the elderly. The study also suggests an inclusive model of health insurance demand, which may be adopted by future empirical studies to find out the significant factors affecting health insurance demand.

1339P Crowd funding in cancer in India: A much needed financial therapy but needs checkpoints

Most cancer patients in India resort to Out of pocket expenditure (OOP), leading to loss of savings. Despite Government support, the low penetration of health insurance among other factors make long term cancer treatment unsustainable. Crowdfunding in its nascent stage is emerging as an option. The funds are raised after due diligence and verification and would be transferred to the hospital on the patient’s name. Despite the quick, attractive, direct payment method many questions remain unanswered.

A disappointing Budget -2022 so far as Health Insurance Protection is concerned especially during the critical period of covid influence

The expectations were soaring amongst the general public just before the 2022 budget with hopes in respect of reduced Income Tax rates or increased exemption limits etc. One of the biggest expectations was in respect of upward revision in Section 80 D limits which refers to health insurance premium paid and the same has not been revised for long time. Over the years, the health insurance premium has increased substantially and more so due to huge claims from Covid in last two years. But, much to shock of all Income Tax Payers, the, Section 80 D limits remains untouched. There are also other policies which comes under the broad category of Health Insurance that does not qualify for Income Tax exemption but merits serious consideration. Health Insurance policies are subject to GST of 18% which is certainly too high especially when the Government should have looked at initiating major step to boost the health insurance penetration and make feel people more secured. For an individual to manage one’s health risk properly, he/she need to have more than one type of health insurance policies for adequate amount with all applicable riders or add-on covers which matters and all dependents like spouse, children and parents being completely covered.

Factors Influencing the Purchase of Individual Health Insurance Policy in Urban India with Special Reference to Visakhapatnam City

Post insurance reforms of India witnessed new insurance products in the health sector which were not available before the reforms. The share of health care expenditure to GDP is very low in India compared to other developing nations. Due to the exponential increase in the health care segment, the demand for health insurance product increased. As the demand for health care services is increasing in India it becomes important to study the factors which induce the demand for health insurance. Due to the absence of proper health care system in India, private health care system emerges very strongly and cost per head in health care is increasing very fast. It has become very difficult for lower-middle and middle-class people to afford the cost of health care. This has improved the awareness level of having health insurance to protect them from any unforeseen health cost in near future. I assume and propose that rising cost of health insurance would help people to understand the importance of unforeseen risk in case of health cost and induce to purchase health insurance products. As the cost of health seems to be rising so far In India people are becoming more conscious of health insurance purchase. The change in lifestyle encourages people to take treatment at high-end hospitals. This factor and the rising inflation are making individuals purchase health insurance. The outcome of this study would help the insurers and financial policy makers formulate proper strategies to increase the penetration of health insurance.

Determinants of choice of health insurance: Empirical evidence from responses of Indian households.

Health insurance has been accepted as one of the channels that can serve the purpose of universalisation of health care and especially useful in the period of health crisis. This is the emerging and challenging sector in India. The present study explores the health insurance penetration in India using the latest two rounds of nationally representative datasets of the National Family Health Survey (2005-06 and 2015-16). This study identifies the covariates of households' participation and their choice for different health insurance schemes, using the average marginal effects of binary and multinomial logit regression models with conditional categories after checking their Kernel density function. The results suggest that health insurance in India is more skewed towards the households belonging to higher wealth quintile and in the front runner states. Age, occupation and education level are also positively associated with health insurance enrolment. The variable 'weighted information index', which is estimated through Principal Component Analysis, is a significant determinant of private health insurance and community-based health insurance, and this also caters to the richer households. The study also identifies several shortcomings of not accessing health insurance, their choices and suggests reforms with the goal of universalization of healthcare. The robustness check has been performed using 20 percent, 50 percent and 80 percent sub-sampling of the models.

Overseas Medical Treatment of Sri Lankan Medical Travellers

More and more Sri Lankans reach for overseas medical treatment with the raising standards of living in the country. However, it is largely an unexplored area. Economic burden of overseas medical treatment is largely an out-of-the-pocket expenditure. Considering the economic burden and low health insurance penetration among Sri Lankans, healthcare decision-makers should explore the clinical dynamics of this subset of patients to improve the services within the country. The study aimed to describe the clinical characteristics and cost of medical treatment by medical travellers for treatment overseas. A descriptive study was carried out by a team of experts analyzing the data of estimated overseas medical expenditure recorded at the President Fund, a body established to assist Sri Lankans who need financial assistance for the said purpose. The team studied the deidentified databases for 2018 and 2019. Of the 60 patients studied, liver transplant, treatment for scoliosis, and bone marrow transplant topped the list by the number of cases and the estimated cost for the procedure overseas. Advance cancer treatment, cardiac surgery, and brain and spinal cord surgery also contributed significantly to the burden. Highest estimated unit cost per procedure has been recorded by the liver and bone marrow transplant surgeries. In conclusion, the healthcare decision-makers should liaise with relevant professional bodies to establish liver and bone marrow transplant services, advance brain and spinal cord surgery including treatment of scoliosis, and advance cancer treatment and cardiac surgeries. Considering the lack of data sources on the economic burden of overseas medical treatment, authorities should act promptly to capture nationwide details of this important group of patients.

Reasons for discontinuing insulin and factors associated with insulin discontinuation in patients with type 2 diabetes mellitus: a real-world evidence study

BackgroundEvidence suggests that insulin therapy of patients with type 2 diabetes mellitus (T2DM) is frequently discontinued. However, the reasons for discontinuing insulin and factors associated with insulin discontinuation in this patient population are not well understood.MethodsWe conducted a retrospective cohort study of adults with T2DM prescribed insulin between 2010 and 2017 at Partners HealthCare. Reasons for discontinuing insulin and factors associated with insulin discontinuation were studied using electronic medical records (EMR) data. Natural language processing (NLP) was applied to identify reasons from unstructured clinical notes. Factors associated with insulin discontinuation were extracted from structured EMR data and evaluated using multivariable logistic regression.ResultsAmong 7009 study patients, 2957 (42.2%) discontinued insulin within 12 months after study entry. Most patients who discontinued insulin (2121 / 71.7%) had reasons for discontinuation documented. The most common reasons were improving blood glucose control (33.2%), achieved weight loss (18.5%) and initiation of non-insulin diabetes medications (16.7%). In multivariable analysis adjusted for demographics and comorbidities, patients were more likely to discontinue either basal or bolus insulin if they were on a basal-bolus regimen (OR 1.6, 95% CI 1.3 to 1.8; p < 0.001) or were being seen by an endocrinologist (OR 2.6; 95% CI 2.2 to 3.0; p < 0.001).ConclusionsIn this large real-world evidence study conducted in an area with a high penetration of health insurance, insulin discontinuation countenanced by healthcare providers was common. In most cases it was linked to achievement of glycemic control, achieved weight loss and initiation of other diabetes medications. Factors associated with and stated reasons for insulin discontinuation were different from those previously described for non-adherence to insulin therapy, identifying it as a distinct clinical phenomenon.

Prospects for growth and issues in marketing of health insurance in India

Health insurance market in India has become the fastest growing segment in non –life insurance sector in India. The health insurance business in India saw a 24% growth in FY 17 with a premium of INR 30,765 Cr and a market share of 24%. It has been the fastest growing market segment registering a CAGR of 23% for the past 10 years. Health insurance industry is in a nascent stage with 25% of population under its coverage. There exists a huge potential for growth and penetration of health insurance to a large population. Going forward there are both opportunities and obstacles in marketing and distribution of health insurance products in India. This paper attempts to uncover the prospects of successful marketing of such products from the standpoint of insurance marketers and look at issues of impeding the growth of health insurance market in India. Keywords: Challenges, Drivers, General insurance, Health insurance, Opportunities, India.

Attainment of the sustainable development goal of poverty eradication: A review, critique, and research agenda

Eliminating poverty by 2030 is the main target of Sustainable Development Goal 1(SDG1). India had an ambitious target of cutting down its poverty rate to 10.95% from 21.92%, by 2030. This review has the objective to consolidate the literature related to SDG1 in India, since 2015 and to identify futuristic research niches. This research focuses on the research questions of identifying the public policy initiatives in India for achieving SDG1 and the performance of various indicators of SDG1 in India. Forty‐one peer‐reviewed articles related to SDG1 in India are selected from the sources of Web of Science and consolidated the findings of these works of literature by using the indicators of NITI Aayog as the themes; described the empirical papers by highlighting the key variables and findings. This research had identified the health insurance penetration; slum rehabilitation and rejuvenation of Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) are the futuristic areas for research. This paper contributes to the existing body of knowledge and recommends the key areas to be focused on achieving SDG1 in India. This review can help readers in understanding better methods of poverty eradication. High spirits are recommended from the implementing authorities to meet the objectives of indicators of poverty, better housing, health insurance penetration to households, and for the generation of employment and consumption by the scheme of MGNREGA. Moreover, a realistic picture of poverty eradication in India may be possible by using more indicators covering all the targets of SDG1.

Catastrophic Health Expenditure of Middle class in India Due to Covid-19

The COVID-19 pandemic is far more than a health crisis: it is affecting societies and economies at their core. While the impact of the pandemic will vary from country to country, it will most likely increase poverty and inequalities at a global scale. Assessing the impacts of the COVID-19 crisis on societies, economies and vulnerable groups is fundamental to inform and tailor the responses of the government to recover from the crisis. With the rising cost of medical care, in such a pandemic like covid-19, health insurance has become a necessity, but many of the middle class and the lower middle class people are still not able to afford it. A wider penetration of health insurance can help in improving the scenario, but affordable health insurance plans will have to be promoted.

Claim Settlement: The Moment of Truth in Health Insurance

A customer centric claim settlement system goes a long way in mitigating the anxiety of patients. At the time of buying Health Insurance, a customer is assured that the Health Insurance Company (HIC) will take care of the medical expenses, in case of his hospitalization. But when such an eventuality happens, many times HICs go back on their words based on procedural non-compliance or because of some conditions written in fine prints. Therefore, how HICs respond to the financial needs of the patients during the claim settlement is the real Moment of Truth. Failure on the part of the HICs in honoring their commitment leads to high Out of Pocket (OOP) Expenses and acute financial hardship to the patients. This article is important primarily because a customer always has an apprehension about the claim settlement. Hurdles one faces during claim settlement is a big contributor to the low customer satisfaction (LCS) which in turn contributes to poor Health Insurance penetration. On the other hand, false, ineligible and inflated claims adversely affect the business model of HICs. The article also highlights why the Incurred Claim Ratio (ICR) in Health Insurance is very high in India and why this has become a roadblock towards expansion of Health Insurance Market (HIM).

The Winner in the Battle of Health Insurance Penetration: India or china

Both India and China are very old civilizations with societies which are run and driven by the aura of culture and traditions of their ancestors. This has resulted in a silent competition between both the countries in varied aspects. Therefore, many comparisons have been made between India and China to draw conclusions on how well both the countries, with identical societal norms, are doing.

Risk‐Coping Measures against Health Shocks during the Process of Penetration of Health Insurance in Vietnam

Does the recent introduction of public health insurance influence households' risk‐coping measures in developing countries? This study investigates risk‐coping measures for health shocks using a Living Standard Measurement Survey in Vietnam where universal health coverage is aimed to be achieved. The estimated results suggest that precautionary savings are the main form of assets in poor households. Health insurance seems to be used by people in poor health, which indicates that the problem of adverse selection exits. Importantly, get well gifts in the form of money play a significant role in helping households cope with health shocks. A traditional informal insurance system still exists in close Vietnamese communities.

An Audit of Indian Health Insurance Claims for Mental Illness from Pooled Insurance Information Bureau's Macroindicator Data.

Introduction:Information on the social and voluntary insurance coverage of mental illness in India is scarce. We attempted to address this lacuna, utilizing a secondary macrodata approach for 3 years. Mental illness per se is not covered by most of existing Indian health insurance policies.Materials and Methods:Publicly available de-identified claim macrodata for all health (nonlife) insurance for Indian financial year from 2011–2012 to 2013–2014 were collected. The age group, gender, amount of claims, proportion of claims, and details of number of days of hospitalization were collected and analyzed. Descriptive statistics, Chi-square test, and Wilcoxon tests were used appropriately. P ≤ 0.05 was considered statistically significant.Results:In 2011–2012, there were 2864 claims from the registered 2,591,781 members citing mental illness (0.11%) which decreased to 0.03% in 2012–2013 and marginally rose to 0.07% of all claims. The total amount of claims paid for mental illness was Rs. 51.7 millions in 2011–2012, Rs. 97.2 million in 2012–2013, and Rs. 150 million in 2013–2014. Statistically significant difference emerged in terms of age group, gender, amount and proportion of claim, and number of days of hospitalization.Conclusion:The penetration of health insurance is low and claim for mental illness remains low. The difference in patterns of age, gender, amount of claims, and number of days for mental illness provides detailed relevant information to formulate future policies.

Reprocessing and reuse of urological armamentarium: How correct are we!

Healthcare is expensive for a large proportion of the population in spite of high per capita income and good health insurance penetration. In an effort to reduce cost of the procedure, reprocessing of devices was started in the late 1970s. Reprocessing practice includes various measures such as proper cleaning, disinfection, and sterilization procedures. As reprocessing is aimed at reducing cost, there is a potential risk of compromising patient safety due to cross contamination after inadequate sterilization. There is also risk of performance alteration of urological reprocessed devices during sterilization/disinfection processing. Therefore, there is a need for formulating proper guidelines to decide methods of reprocessing for various urological equipment. There is also need to discuss the problematic areas that urologists face and to find their solutions. A PubMed search was made in September 2016, using key words “reprocessing of medical devices,” “Single Use Devices,” “methods of reprocessing of devices in clinical practice,” “use of formalin chamber,” “urological disposable sterilization,” etc., After excluding duplicates, all English articles were reviewed by title and abstract. Full texts of selected articles were obtained, and these articles were cross-referenced to find any other related articles. All the articles were reviewed. A product can be reused if it can be economically reprocessed with validated protocols with preservation of its function. There is no reason to discard it after one use. This practice is useful for controlling economics of a urological case and to reduce the financial burden. Current Food and Drug Administration guidelines are stringent. The contamination described to test the sterilization process in the suggested guidelines actually does never exist in clinical practice. Therefore, new guidelines considering the clinical practice scenario are desirable.

Occupational Differences in the Awareness and Perception of Health Insurance of Workers Employed in Urban Informal Sector of Punjab

Health insurance could play a vital role to improve the health status in a country. But penetration of health insurance is very low in India. Therefore, present study endeavours to examine the awareness of health insurance, sources of awareness and determinants of awareness among workers employed in urban informal sector of Punjab. For the analysis three group of informal sector workers (construction workers, vendors and shopkeepers) have been identified from the three urban districts of Punjab, namely, Amritsar, Jalandhar and Ludhiana. The analysis was made with the help of descriptive statistics and multivariate probit regression. The analysis shows a significant difference in the awareness of health insurance across the occupational groups. The multivariate probit regression shows that age, education, religion, type of family, occupation, income, BPL card, experience of outpatient care, inpatient care and awareness of the insurance were the significant determinants of awareness of health insurance. In order to increase the penetration of health insurance the government, policy makers and the marketers of health insurance should make people aware about the potential benefits of health insurance policies. It is recommended to understand the awareness and perceptions of the people towards health and develop a package that is accessible, available, affordable and acceptable among informal sector of the society.

Determinants of Health Insurance Penetration in India: An Empirical Analysis

Insufficient participation of the government in the provision of health care services to the people puts tremendous pressure on households financing their health care expenditure from private sources. Health insurance can be seen as an effective measure to circumvent this problem. However, penetration of health insurance in India is very low. This article seeks to explore the effect of household assets, access to media demographic and caste profile of households in explaining the use of health insurance in India using data from the National Family Health Survey-III. Results suggest that richer households have a higher probability of enrolling into health insurance and access to media exerts a positive significant impact on health insurance enrolment. Particularly vulnerable are those from the scheduled tribe background in both rural and urban region and the Muslim community residing in urban area. Non-profit insurance scheme such as community-based health insurance (CBHI) has limited success in drawing people from the poorest economic status into their safety nets. Considerable regional disparity exists in terms of health insurance enrolment pattern. Odds of enrolling in private health insurance and public health insurance in comparison to no insurance are significantly higher for urban region. The opposite result holds for CBHI scheme.

Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states.

With some of the richest economies in the world, the Gulf Cooperation Council (GCC) is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC’s abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states.

Employee Engagement in Corporate Dental Clinics: An Incredible Challenge

The Indian healthcare sector is expected to reach US$ 100 billion by 2015 from the current US$ 65 billion, growing at around 20 per cent a year, according to rating agency Fitch. Some of the major factors driving the growth in the sector include increasing population, growing lifestyle related health issues, cheaper costs for treatment, thrust in medical tourism, improving health insurance penetration, increasing disposable income, government initiatives and focus on Public Private Partnership (PPP) models Companies - the corporate dental clinics announced their presence with a view to providing comprehensive dental care by specialized professionals. With further expansion of the group Companies diversified into the fields of Contemporary Dental Education, Research and Dental Project Consultancy services and tie up with New York University College of Dentistry. This report gives comprehensive details of challenges ahead of Top Management to maintain ownership of employees as since 2008; healthcare industry particularly in Dentistry; particularly in Maharashtra started adopting new dimensions with new world class treatments and technologies. The Risk ahead of Top Management of Companies has been that their staffs are attracted by other giant Single person private practitioners at large and how it is tackled by Companies Top Management. This paper focuses on current situation in Corporate Dental Clinics and the role top management commitments for the corporate sustainability.

Health Care Management in India

Objectives: The objective of this research is to study the developments in Indian health care sector and will torch upon the rising demand of health care sector in India. The study will evolve the concept of globalization, development of information technology, medical tourism, role of urbanization, growth of health care insurance sector, affordability of health care in India and the role played by major private health care firms in India. Study design: Descriptive design. Methods: Data used here is secondary data, and collection of data is done from different health care surveys in India, health care websites, journals, newspapers, health magazines and conferences. Results: Rising demand of health care in India. India is one among the leading developing countries in health care as the demand of this sector is expected to reach US$ 100 billion by 2015 from the current US$ 65 billion, growing at around 20 per cent a year, according to rating agency Fitch, and the major factors driving the growth in the sector include increasing population, growing lifestyle related health issues, cheaper costs for treatment, thrust in medical tourism, improving health insurance penetration, increasing disposable income, government initiatives and focus on Public–Private Partnership (PPP) models. Conclusion: With rising health care demand in India, private sector hospitals and health care firms started to come with the concept of Corporate Social Responsibility (CSR) by giving subsidized rates and rural coverage concepts in India, so that the poor people can afford for the necessary treatment, as 32.7 per cent of the total Indian people fall below the international poverty line of US$ 1.25 per day (PPP) while 68.7 per cent live on less than US$ 2 per day ( http://www.wikipedia.org ). Oxford Poverty and Human Development Initiative (OPHI) stated in 2010, that eight Indian states have more poor people than 26 poorest African nations combined which totals to more than 410 million poor in the poorest African countries.