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...
Main Authors: | , |
---|---|
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 |
_version_ |
1764451882133094400 |