ArticleHealth economics review2018
Analysis of multi drug resistant tuberculosis (MDR-TB) financial protection policy: MDR-TB health insurance schemes, in Chhattisgarh state, India.
Article in Health economics review, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Assessing intervention effects on healthcare-related financial protection in low- and middle-income countries: a rapid evidence review.Health policy and planning · 2026Review
- Psychosocial challenges of drug-resistant tuberculosis: A qualitative study in Deoghar, Eastern India.The Indian journal of medical research · 2026Review
- What affects the performance of hospital financing interventions in low and lower-middle income countries from the program design and implementation perspective? A scoping review.Health policy and planning · 2025Article
- The influence of provider payment mechanisms on TB service provider behavior in Indonesia: insights from National Health Insurance data and provider perspectives.Frontiers in public health · 2025Article
- Social protection as a right of people affected by tuberculosis: a scoping review and conceptual framework.Infectious diseases of poverty · 2023Article
- A Dual Perspective of Psycho-Social Barriers and Challenges Experienced by Drug-Resistant TB Patients and Their Caregivers through the Course of Diagnosis and Treatment: Findings from a Qualitative Study in Bengaluru and Hyderabad Districts of South India.Antibiotics (Basel, Switzerland) · 2022Article
- Using an equity-based framework for evaluating publicly funded health insurance programmes as an instrument of UHC in Chhattisgarh State, India.Health research policy and systems · 2020Article
- Association of Tuberculosis With Household Catastrophic Expenditure in South India.JAMA network open · 2020Article
- Survival analysis of time to cure on multi-drug resistance tuberculosis patients in Amhara region, Ethiopia.BMC public health · 2019Article
- Assessing geographical inequity in availability of hospital services under the state-funded universal health insurance scheme in Chhattisgarh state, India, using a composite vulnerability index.Global health action · 2018Article
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7 authors.
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Abstract
introductionThere are significant financial barriers to access treatment for multi drug resistant tuberculosis (MDR-TB) in India. To address these challenges, Chhattisgarh state in India has established a MDR-TB financial protection policy by creating MDR-TB benefit packages as part of the universal health insurance scheme that the state has rolled out in their effort towards attaining Universal Health Coverage for all its residents. In these schemes the state purchases health insurance against set packages of services from third party health insurance agencies on behalf of all its residents. Provider payment reform by strategic purchasing through output based payments (lump sum fee is reimbursed as per the MDR-TB benefit package rates) to the providers - both public and private health facilities empanelled under the insurance scheme was the key intervention.
aimTo understand the implementation gap between policy and practice of the benefit packages with respect to equity in utilization of package claims by the poor patients in public and private sector.
methodsData from primary health insurance claims from January 2013 to December 2015, were analysed using an extension of 'Kingdon's multiple streams for policy implementation framework' to explain the implementation gap between policy and practice of the MDR-TB benefit packages.
resultsThe total number of claims for MDR-TB benefit packages increased over the study period mainly from poor patients treated in public facilities, particularly for the pre-treatment evaluation and hospital stay packages. Variations and inequities in utilizing the packages were observed between poor and non-poor beneficiaries in public and private sector. Private providers participation in the new MDR-TB financial protection mechanism through the universal health insurance scheme was observed to be much lower than might be expected given their share of healthcare provision overall in India.
conclusionOur findings suggest that there may be an implementation gap due to weak coupling between the problem and the policy streams, reflecting weak coordination between state nodal agency and the state TB department. There is a pressing need to build strong institutional capacity of the public and private sector for improving service delivery to MDR-TB patients through this new health insurance mechanism.
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