Philip Neena Elezebeth, Kannan Srinivasan, Sarma Sankara P
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Asia Pac J Public Health. 2016 Jan;28(1 Suppl):77S-85S. doi: 10.1177/1010539515602306. Epub 2015 Aug 27.
We aimed to compare the sociodemographics, health care utilization pattern, and out-of-pocket (OOP) expenses of 149 insured and 147 uninsured below-poverty-line households insured under the Comprehensive Health Insurance Scheme, Kerala, through a comparative cross-sectional study. Family size more than 4 (odds ratio [OR] = 2.34; 95% confidence interval [CI] = 1.13-4.82), family member with chronic disease (OR = 2.05; 95% CI = 1.18-3.57), high socioeconomic status (OR = 2.95; 95% CI = 1.74-5.03), and an employed household head (OR = 2.69; 95% CI = 1.44-5.02) were significantly associated with insured households. Insured households had higher inpatient service utilization (OR = 1.57; 95% CI = 1.05-2.34). Only 40% of inpatient service utilization among the insured was covered by insurance. The mean OOP expenses for inpatient services among insured (INR 448.95) was higher than among uninsured households (INR 159.93); P = .003. These findings show that urgent attention of the government is required to redesign and closely monitor the scheme.
我们旨在通过一项比较性横断面研究，比较喀拉拉邦综合健康保险计划下149户参保和147户未参保的贫困线以下家庭的社会人口统计学特征、医疗保健利用模式和自付费用。家庭规模超过4人（比值比[OR]=2.34；95%置信区间[CI]=1.13-4.82）、有慢性病家庭成员（OR=2.05；95%CI=1.18-3.57）、社会经济地位高（OR=2.95；95%CI=1.74-5.03）以及户主就业（OR=2.69；95%CI=1.44-5.02）与参保家庭显著相关。参保家庭的住院服务利用率更高（OR=1.57；95%CI=1.05-2.34）。参保者中只有40%的住院服务利用率由保险覆盖。参保者住院服务的平均自付费用（448.95印度卢比）高于未参保家庭（159.93印度卢比）；P=0.003。这些发现表明，政府需要紧急关注重新设计并密切监测该计划。
