Kumar Nishant, Tiwari Vijay Kumar, Kumar Kuldeep, Nair Kesavan Sreekantan, Raj Sherin, Nandan Deoki
Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.
Department of Planning and Evaluation, National Institute of Health and Family Welfare, New Delhi, India.
Int J Health Plann Manage. 2015 Oct-Dec;30(4):366-81. doi: 10.1002/hpm.2244. Epub 2014 Mar 27.
In view of high out-of-pocket costs and low spending even for basic healthcare for the poor employed in the unorganized sector, policy makers in India have turned their attention to developing a financing mechanism for social health insurance with the desire to provide quality care to the poor and economically disadvantaged.
This study aims to assess and determine the disease profile, treatment expenditure and willingness to pay for health insurance among rickshaw pullers in Delhi.
The study was conducted among 500 rickshaw pullers from five zones of the Municipal Corporation of Delhi, taking a sample of 100 from each zone.
The average cost of treatment was Rs.505 for outpatient and Rs. 3200 for inpatient care. To finance the treatment expenditure, 27.5% of the respondents spent from their household savings, and 43% had to borrow funds. Any "spell of sickness" and "total expenditure on acute illness" were significantly (p < 0.01) associated with the willingness to pay for health insurance. Overall, the majority (83%) of participants were willing to pay for health insurance.
The study provides the evidence for the need for urgent policy development by introducing a social health insurance package including wage losses for the vulnerable groups such as rickshaw pullers in the unorganized sector in India, which significantly contribute to pollution free and cheap transportation of community, tourists and commercial goods as well.
鉴于印度非正规部门就业的贫困人口自付费用高昂，即使是基本医疗保健支出也很低，印度政策制定者已将注意力转向发展社会医疗保险融资机制，希望为贫困和经济弱势群体提供优质医疗服务。
本研究旨在评估和确定德里人力车夫的疾病谱、治疗费用以及购买健康保险的意愿。
该研究在德里市政公司五个区域的500名人力车夫中进行，每个区域抽取100个样本。
门诊治疗的平均费用为505卢比，住院治疗为3200卢比。为支付治疗费用，27.5%的受访者动用了家庭储蓄，43%的人不得不借款。任何“疾病发作”和“急性疾病总支出”与购买健康保险的意愿均存在显著（p < 0.01）关联。总体而言，大多数（83%）参与者愿意购买健康保险。
该研究为印度迫切需要制定政策提供了证据，即推出一项社会医疗保险计划，其中包括为非正规部门的弱势群体（如人力车夫）提供工资损失补偿，这些人力车夫也为社区、游客和商品的无污染且低成本运输做出了重要贡献。
