ArticleGlobal health action2018
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.
Article in Global health action, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Equity in the allocation of professional public health human resources and its improvement path in China.BMC health services research · 2026Article
- Does health insurance coverage improve cardiometabolic risk factor levels? Quasi-experimental evidence from India.Global health action · 2025Article
- Administrative perspectives on the implementation and sustainability of state-supported health insurance schemes in Nigeria: a descriptive qualitative study.BMC public health · 2025Article
- What stops private hospitals from engaging with publicly funded health insurance schemes? A mixed-methods study on PMJAY/MJPJAY in Maharashtra, India.BMC health services research · 2025Article
- Impact of Government-Funded Health Insurance on Out-of-Pocket Expenditure and Quality of Hospital-Based Care in Indian States of Madhya Pradesh and Maharashtra.Applied health economics and health policy · 2024Article
- Assessing inequalities in publicly funded health insurance scheme coverage and out-of-pocket expenditure for hospitalization: findings from a household survey in Kerala.International journal for equity in health · 2023Article
- Evolution of Government-funded health insurance for universal health coverage in India.The Lancet regional health. Southeast Asia · 2023Review
- Implementing a health labour market analysis to address health workforce gaps in a rural region of India.Human resources for health · 2022Article
- Article
- Delivering Essential Surgical Care for Lower-limb Musculoskeletal disorders in the Low-Resource Setting.World journal of surgery · 2021Article
- Empanelment of health care facilities under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) in India.PloS one · 2021Article
- 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
- Ayushman Bharat National Health Protection Scheme: an Ethical Analysis.Asian bioethics review · 2019Article
- Does the Distribution of Empanelled Hospitals have an Impact on the Utilization of Services under State Insurance Scheme?Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
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3 authors.
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Abstract
backgroundCountries are increasingly adopting health insurance schemes for achieving Universal Health Coverage. India's state-funded health insurance scheme covers hospital care provided by 'empanelled' private and public hospitals.
objectiveThis paper assesses geographical equity in availability of hospital services under the universal health insurance scheme in Chhattisgarh state.
methodsThe study makes use of district data from the insurance scheme and government surveys. Selected socio-economic indicators are combined to form a composite vulnerability index, which is used to rank and group the state's 27 districts into tertiles, named as highest, middle and lowest vulnerability districts (HVDs, MVDs, LVDs). Indicators of hospital service availability under the scheme - insurance coverage, number of empanelled private/public hospitals, numbers and amounts of claims - are compared across districts and tertiles. Two measures of inequality, difference and ratio, are used to compare availability between tertiles.
resultsThe study finds that there is a geographical pattern to vulnerability in Chhattisgarh state. Vulnerability increases with distance from the state's centre towards the periphery. The highest vulnerability districts have the highest insurance coverage, but the lowest availability of empanelled hospitals (3.4 hospitals per 100,000 enrolled in HVDs, vs 8.2/100,000 enrolled in LVDs). While public sector hospitals are distributed equally, the distribution of private hospitals across tertiles is highly unequal, with higher availability in LVDs. The number of claims (per 100,000 enrolled) in the HVDs is 3.5-times less than that in the LVDs. The claim amounts show a similar pattern.
conclusionsAlthough insurance coverage is higher in the more vulnerable districts, availability of hospital services is inversely proportional to vulnerability and, therefore, the need for these services. Equitable enrolment in health insurance schemes does not automatically translate into equitable access to healthcare, which is also dependent on availability and specific dynamics of service provision under the scheme.
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