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Pattern of Health Insurance Coverage and Reimbursement among Elderly and Non-Elderly in India

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Handbook of Aging, Health and Public Policy

Abstract

Using data from the 75th round of the National Sample Survey, 2018, this chapter examines the extent of health insurance coverage and reimbursement among the elderly and the non-elderly in India. Descriptive statistics, logistic, and Tobit regression models were used. Results indicate that less than one-fifth of the population was insured by any kind of health insurance. Among those insured, only 27% of the elderly and 18% of the non-elderly received any form of reimbursement after hospitalization. Reimbursement accounted for only about one-fifth of the total medical expenditure among the elderly. Coverage and reimbursement showed a strong economic and education gradient. Households with up to five members had higher coverage and reimbursement. Asymmetric information, restriction on covering higher household size, and poor governance are the major factors in low health insurance coverage and low reimbursement in India.

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References

  • Abegunde, D. O., Mathers, C. D., Adam, T., Ortegon, M., & Strong, K. (2007). The burden and costs of chronic diseases in low-income and middle-income countries. The Lancet, 370(9603), 1929–1938.

    Article  Google Scholar 

  • Ahamed, F., Haldar, P., Kant, S., Malhotra, S., & Kaur, R. (2016). Challenges and opportunities for private and public health care insurance system in India. Community & Family Medicine, 2(02), 15.

    Google Scholar 

  • Ahlin, T., Nichter, M., & Pillai, G. (2016). Health insurance in India: What do we know and why is ethnographic research needed. Anthropology & Medicine, 23(1), 102–124.

    Article  Google Scholar 

  • Beard, H. P. J. R., & Bloom, D. E. (2015). Towards a comprehensive public health response to population ageing. Lancet (London, England), 385(9968), 658.

    Article  Google Scholar 

  • Brinda, E. M., Attermann, J., Gerdtham, U. G., & Enemark, U. (2016). Socio-economic inequalities in health and health service use among older adults in India: Results from the WHO Study on Global AGEing and adult health survey. Public Health, 141, 32–41.

    Article  Google Scholar 

  • Chatterjee, P. (2018). India launches Ayushman Bharat’s secondary care component. The Lancet, 392(10152), 997.

    Article  Google Scholar 

  • Ebrahim, S., Pearce, N., Smeeth, L., Casas, J. P., Jaffar, S., & Piot, P. (2013). Tackling non-communicable diseases in low-and middle-income countries: Is the evidence from high-income countries all we need? PLoS Medicine, 10(1), e1001377.

    Article  Google Scholar 

  • Keshri, V. R., & Ghosh, S. (2019). Health insurance for universal health coverage in India: A critical analysis based on coverage, distribution and predictors from national family health survey–4 data.

    Google Scholar 

  • Kunna, R., San Sebastian, M., & Williams, J. S. (2017). Measurement and decomposition of socio-economic inequality in single and multimorbidity in older adults in China and Ghana: Results from the WHO study on global Ageing and adult health (SAGE). International Journal for Equity in Health, 16(1), 79.

    Article  Google Scholar 

  • Mavalankar, D., & Bhat, R. (2000). Health insurance in India: Opportunities, challenges and concerns (pp. 1–16). Indian Institute of Management.

    Google Scholar 

  • Ministry of Statistics and Programme Implementation. (2015). NSSO 71st round (January–June 2014): Key indicators of social consumption in India health. Government of India.

    Google Scholar 

  • Mohanty, S. K., Kim, R., Khan, P. K., & Subramanian, S. V. (2018). Geographic variation in household and catastrophic health spending in India: Assessing the relative importance of villages, districts, and states, 2011–2012. The Milbank Quarterly, 96(1), 167–206.

    Article  Google Scholar 

  • Mukhopadhyay, S., Cullati, S., Sieber, S., Chakraborty, A., & Burton-Jeangros, C. (2020). Self-reported morbidity and self-rated health among the elderly in India: Revisiting the puzzles. Journal of Population Ageing, 1–36. https://link.springer.com/article/10.1007/s12062-020-09301-7.

  • National Sample Survey Organisation. (2019). Key indicators of social consumption in India: Health, 2017–18 (NSS report no. KI (75/25.0)). Ministry of Statistics and Program Implementation, Government of India.

    Google Scholar 

  • Registrar General of India. (2019). Population projections for India and States 2011–2036, report of The Technical Group on Population Projections, New Delhi, India https://nhm.gov.in/New_Updates_2018/Report_Population_Projection_2019.pdf. Accessed 24 Nov 2020.

  • Schoenberg, N. E., Kim, H., Edwards, W., & Fleming, S. T. (2007). Burden of common multiple-morbidity constellations on out-of-pocket medical expenditures among older adults. The Gerontologist, 47(4), 423–437.

    Article  Google Scholar 

  • Shahrawat, R., & Rao, K. D. (2012). Insured yet vulnerable: Out-of-pocket payments and India’s poor. Health Policy and Planning, 27(3), 213–221.

    Article  Google Scholar 

  • Sorenson, C., Drummond, M., & Khan, B. B. (2013). Medical technology as a key driver of rising health expenditure: Disentangling the relationship. Clinico Economics and Outcomes Research: CEOR, 5, 223.

    Article  Google Scholar 

  • United Nations. (2019). World population ageing 2019 highlights. World population ageing.

    Book  Google Scholar 

  • Xu, K., Evans, D. B., Kawabata, K., Zeramdini, R., Klavus, J., & Murray, C. J. (2003). Household catastrophic health expenditure: A multicountry analysis. The Lancet, 362(9378), 111–117.

    Article  Google Scholar 

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Khan, P.K., Sen, S., Mohanty, S.K. (2022). Pattern of Health Insurance Coverage and Reimbursement among Elderly and Non-Elderly in India. In: Handbook of Aging, Health and Public Policy. Springer, Singapore. https://doi.org/10.1007/978-981-16-1914-4_27-1

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  • DOI: https://doi.org/10.1007/978-981-16-1914-4_27-1

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  • Print ISBN: 978-981-16-1914-4

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