Epidemiology: Open Access

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How Does Health Insurance Affect Healthcare Spending in India over the Decade: A Two Part Model Approach

Apyayee Sil, Sourav Dey, Mithun Mog

Healthcare financing (in public and private both ends) is a challenging priority in India where low public healthcare expenditure causing unaffordable cost of treatment. Introduction of health insurance is considered as a major invension in healthcare. The main focal point of the study is to visualize the changes in the insurance coverage and healthcare spending pattern and to assess the relationship between health insurance and healthcare cost emphasizing Out Of Pocket Expenditure (OOPE) on healthcare in India. We use 60th round (2004-2005) and 71st round (2014- 2015) data of National Sample Survey Organization covering 65,932 and 73,868 households respectively. Bivariate analysis and two part model has been adopted for the analysis. It has been found that the insurance coverage has shown an excellent advancement between 2004-2005 and 2014-2015 with a higher enhancement among females. Insured persons are more likely to take treatment than that of uninsured for both for inpatient and outpatient cases and also insurance coverage is more influencing the treatment seeking behaviour in rural than urban area. It is to be noted that the insurance is helping people to curtail the OOPE on treatment for both inpatient and outpatient cases but in most cases insured persons pays more for treatments than for uninsured (though it is not uniform on all the factors). The health insurance significantly determines the health-seeking behaviour and out of pocket cost paid for healthcare for all the patient.