The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure

In 2008, India launched Rashtriya Swasthya Bima Yojana (RSBY), a government subsidized health insurance scheme for the poor that covers secondary hospital care for Below Poverty Line (BPL) households. Designed to improve access to healthcare and re...

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Main Authors: Johnson, Douglas, Krishnaswamy, Karuna
Format: Working Paper
Language:English
en_US
Published: World Bank, Washington, DC 2015
Subjects:
Online Access:http://documents.worldbank.org/curated/en/2015/08/24144032/impact-rsby-hospital-utilization-out-of-pocket-health-expenditure
http://hdl.handle.net/10986/22820
id okr-10986-22820
recordtype oai_dc
spelling okr-10986-228202021-04-23T14:04:10Z The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure Johnson, Douglas Krishnaswamy, Karuna ACCESS TO HOSPITAL BEDS COMMUNITY HEALTH COST OF HEALTH CARE CRIME CRIMES DIAGNOSTIC TESTS DISTRICTS DRUGS ECONOMIC REVIEW ENROLLEES EXPENDITURES FAMILY PLANNING FINANCIAL RISK FINANCIAL RISK PROTECTION HEALTH CARE HEALTH CARE PROVISION HEALTH CARE SYSTEMS HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH MARKET HEALTH OUTCOMES HEALTH POLICY HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEMS HEALTHCARE HEALTHCARE EXPENDITURE HOSPITAL ADMISSION HOSPITAL CARE HOSPITAL UTILIZATION HOSPITALIZATION HOSPITALS HOUSEHOLD EXPENDITURE HOUSEHOLDS INCOME INCOME HOUSEHOLDS INFORMAL SECTOR INPATIENT CARE INSURANCE COMPANIES INTERVENTION LABOR MARKET LOW INCOME MEDICAL EXPENDITURE MEDICAL EXPENSES MEDICAL INSURANCE MEDICAL SERVICES MORTALITY OUTPATIENT CARE PATIENT PATIENTS POLICY RESEARCH PRIMARY CARE PRIMARY HEALTH CARE PRIMARY HEALTH CARE SERVICES PRIVATE SECTOR PRIVATE SPENDING PROBABILITY PUBLIC HEALTH PUBLIC HEALTH SPENDING PUBLIC HEALTH SYSTEM RURAL AREAS SOCIAL HEALTH INSURANCE SOCIAL SCIENCE SOCIAL SECURITY SOCIAL SECURITY HEALTH INSURANCE URBAN AREA URBAN AREAS USE OF HEALTH SERVICES VILLAGES VISITS In 2008, India launched Rashtriya Swasthya Bima Yojana (RSBY), a government subsidized health insurance scheme for the poor that covers secondary hospital care for Below Poverty Line (BPL) households. Designed to improve access to healthcare and reduce the financial burden of healthcare expenses, RSBY currently covers 32 million households. The authors exploit the phased rollout of RSBY to estimate the impact of the scheme in its early days on hospitalization rates and out-of-pocket health expenditure using a difference-in-differences approach with matching. We use secondary data from the National Sample Survey Organization conducted in 2009-10. We find that the scheme has led to a small decrease in out-of-pocket household outpatient expenditure and consequently total medical expenditure. The authors also find limited evidence of increase in the number of households that have had a hospitalization case though there are regional variations in the nature of impact. It is unclear whether the improved access to inpatient care is reducing outpatient expenses through decreased need for outpatient care or because some people or hospitals are colluding to convert outpatient treatment to inpatient to avail of the scheme. The authors suggest that additional evidence with a more recent data set allowing for more time for RSBY to display effects is needed to strengthen these early findings. 2015-11-03T18:55:22Z 2015-11-03T18:55:22Z 2012-12 Working Paper http://documents.worldbank.org/curated/en/2015/08/24144032/impact-rsby-hospital-utilization-out-of-pocket-health-expenditure http://hdl.handle.net/10986/22820 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research South Asia India
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic ACCESS TO HOSPITAL
BEDS
COMMUNITY HEALTH
COST OF HEALTH CARE
CRIME
CRIMES
DIAGNOSTIC TESTS
DISTRICTS
DRUGS
ECONOMIC REVIEW
ENROLLEES
EXPENDITURES
FAMILY PLANNING
FINANCIAL RISK
FINANCIAL RISK PROTECTION
HEALTH CARE
HEALTH CARE PROVISION
HEALTH CARE SYSTEMS
HEALTH ECONOMICS
HEALTH EXPENDITURE
HEALTH EXPENDITURES
HEALTH FINANCING
HEALTH INSURANCE
HEALTH INSURANCE PROGRAM
HEALTH INSURANCE SCHEME
HEALTH INSURANCE SCHEMES
HEALTH MARKET
HEALTH OUTCOMES
HEALTH POLICY
HEALTH SERVICES
HEALTH STATUS
HEALTH SYSTEM
HEALTH SYSTEMS
HEALTHCARE
HEALTHCARE EXPENDITURE
HOSPITAL ADMISSION
HOSPITAL CARE
HOSPITAL UTILIZATION
HOSPITALIZATION
HOSPITALS
HOUSEHOLD EXPENDITURE
HOUSEHOLDS
INCOME
INCOME HOUSEHOLDS
INFORMAL SECTOR
INPATIENT CARE
INSURANCE COMPANIES
INTERVENTION
LABOR MARKET
LOW INCOME
MEDICAL EXPENDITURE
MEDICAL EXPENSES
MEDICAL INSURANCE
MEDICAL SERVICES
MORTALITY
OUTPATIENT CARE
PATIENT
PATIENTS
POLICY RESEARCH
PRIMARY CARE
PRIMARY HEALTH CARE
PRIMARY HEALTH CARE SERVICES
PRIVATE SECTOR
PRIVATE SPENDING
PROBABILITY
PUBLIC HEALTH
PUBLIC HEALTH SPENDING
PUBLIC HEALTH SYSTEM
RURAL AREAS
SOCIAL HEALTH INSURANCE
SOCIAL SCIENCE
SOCIAL SECURITY
SOCIAL SECURITY HEALTH INSURANCE
URBAN AREA
URBAN AREAS
USE OF HEALTH SERVICES
VILLAGES
VISITS
spellingShingle ACCESS TO HOSPITAL
BEDS
COMMUNITY HEALTH
COST OF HEALTH CARE
CRIME
CRIMES
DIAGNOSTIC TESTS
DISTRICTS
DRUGS
ECONOMIC REVIEW
ENROLLEES
EXPENDITURES
FAMILY PLANNING
FINANCIAL RISK
FINANCIAL RISK PROTECTION
HEALTH CARE
HEALTH CARE PROVISION
HEALTH CARE SYSTEMS
HEALTH ECONOMICS
HEALTH EXPENDITURE
HEALTH EXPENDITURES
HEALTH FINANCING
HEALTH INSURANCE
HEALTH INSURANCE PROGRAM
HEALTH INSURANCE SCHEME
HEALTH INSURANCE SCHEMES
HEALTH MARKET
HEALTH OUTCOMES
HEALTH POLICY
HEALTH SERVICES
HEALTH STATUS
HEALTH SYSTEM
HEALTH SYSTEMS
HEALTHCARE
HEALTHCARE EXPENDITURE
HOSPITAL ADMISSION
HOSPITAL CARE
HOSPITAL UTILIZATION
HOSPITALIZATION
HOSPITALS
HOUSEHOLD EXPENDITURE
HOUSEHOLDS
INCOME
INCOME HOUSEHOLDS
INFORMAL SECTOR
INPATIENT CARE
INSURANCE COMPANIES
INTERVENTION
LABOR MARKET
LOW INCOME
MEDICAL EXPENDITURE
MEDICAL EXPENSES
MEDICAL INSURANCE
MEDICAL SERVICES
MORTALITY
OUTPATIENT CARE
PATIENT
PATIENTS
POLICY RESEARCH
PRIMARY CARE
PRIMARY HEALTH CARE
PRIMARY HEALTH CARE SERVICES
PRIVATE SECTOR
PRIVATE SPENDING
PROBABILITY
PUBLIC HEALTH
PUBLIC HEALTH SPENDING
PUBLIC HEALTH SYSTEM
RURAL AREAS
SOCIAL HEALTH INSURANCE
SOCIAL SCIENCE
SOCIAL SECURITY
SOCIAL SECURITY HEALTH INSURANCE
URBAN AREA
URBAN AREAS
USE OF HEALTH SERVICES
VILLAGES
VISITS
Johnson, Douglas
Krishnaswamy, Karuna
The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure
geographic_facet South Asia
India
description In 2008, India launched Rashtriya Swasthya Bima Yojana (RSBY), a government subsidized health insurance scheme for the poor that covers secondary hospital care for Below Poverty Line (BPL) households. Designed to improve access to healthcare and reduce the financial burden of healthcare expenses, RSBY currently covers 32 million households. The authors exploit the phased rollout of RSBY to estimate the impact of the scheme in its early days on hospitalization rates and out-of-pocket health expenditure using a difference-in-differences approach with matching. We use secondary data from the National Sample Survey Organization conducted in 2009-10. We find that the scheme has led to a small decrease in out-of-pocket household outpatient expenditure and consequently total medical expenditure. The authors also find limited evidence of increase in the number of households that have had a hospitalization case though there are regional variations in the nature of impact. It is unclear whether the improved access to inpatient care is reducing outpatient expenses through decreased need for outpatient care or because some people or hospitals are colluding to convert outpatient treatment to inpatient to avail of the scheme. The authors suggest that additional evidence with a more recent data set allowing for more time for RSBY to display effects is needed to strengthen these early findings.
format Working Paper
author Johnson, Douglas
Krishnaswamy, Karuna
author_facet Johnson, Douglas
Krishnaswamy, Karuna
author_sort Johnson, Douglas
title The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure
title_short The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure
title_full The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure
title_fullStr The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure
title_full_unstemmed The Impact of RSBY on Hospital Utilization and Out-of-Pocket Health Expenditure
title_sort impact of rsby on hospital utilization and out-of-pocket health expenditure
publisher World Bank, Washington, DC
publishDate 2015
url http://documents.worldbank.org/curated/en/2015/08/24144032/impact-rsby-hospital-utilization-out-of-pocket-health-expenditure
http://hdl.handle.net/10986/22820
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