The Impact of SEWA's Medical Insurance Fund on Hospital Utilization and Expenditure : A Household Survey

This paper assesses the impact of the Self-Employed Women's Association's (SEWA's) Medical Insurance Fund, Gujarat, in terms of inclusion of the poor, hospital utilization, and expenditure. Age-matched insured and uninsured women were compared using survey data (2000). The authors found that wealth was not a determinant of membership in the Fund; i.e., the poor were not excluded. Of 28 hospitalizations among Fund members over one year, only five were reimbursed. Membership in SEWA was not significantly associated with increased frequency of hospitalization, but there was a significant association with lower costs of hospitalization, net of reimbursement. Unlike many other CBHI schemes, the Fund has overcome barriers that exclude the poorest. This is due in part to nesting of the Fund within a larger development organization. Utilization of the Fund, and thus impact on hospital utilization and expenditure, was minimal. This may relate to a lack of awareness of benefits among Fund members, or costs and difficulties associated with submitting an insurance claim.

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Bibliographic Details
Main Author: Ranson, M. Kent
Format: Working Paper biblioteca
Language:English
en_US
Published: World Bank, Washington, DC 2001-09
Subjects:ADDICTION, ADVERSE SELECTION, COMMUNITIES, COMMUNITY DEVELOPMENT, COMMUNITY PARTICIPATION, CONSUMPTION EXPENDITURES, DEBT, DIABETES, DISTRICTS, DOCTORS, ECONOMIC DEVELOPMENT, FAMILY PLANNING, GENDER, GNP, HEALTH CARE, HEALTH CARE FINANCING, HEALTH CARE UTILIZATION, HEALTH EXPENDITURES, HEALTH FINANCING, HEALTH INSURANCE, HEALTH POLICY, HEALTH SECTOR, HEALTH SERVICES, HOSPITAL CARE, HOSPITAL COSTS, HOSPITAL UTILIZATION, HOSPITALIZATION, HOSPITALS, HOUSEHOLDS, HUMAN DEVELOPMENT, HYGIENE, HYPERTENSION, INCOME, INCOME LEVELS, INFORMAL SECTOR, INPATIENT CARE, ISOLATION, LIFE INSURANCE, LOW INCOME, LOW-INCOME COUNTRIES, MACROECONOMICS, MEDICAL INSURANCE, MORAL HAZARD, NONPROFIT HOSPITALS, NUTRITION, POLICY MAKERS, POVERTY ALLEVIATION, PREGNANCY, PROBABILITY, PUBLIC GOODS, PUBLIC SECTOR, RESOURCE ALLOCATION, RISK MANAGEMENT, SCHOOL HEALTH, SHELTER, TAXATION, VILLAGES, WAGES,
Online Access:http://documents.worldbank.org/curated/en/2001/09/3584288/impact-sewas-medical-insurance-fund-hospital-utilization-expenditure-household-survey
http://hdl.handle.net/10986/13788
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