Evaluation of a Health Insurance Scheme in a Multi-Specialty Tertiary Level Teaching Hospital of North India

Due to costlier and unaffordable health care, Government has been introducing various measures time to time. Similarly, a newer health insurance scheme was introduced for Below-Poverty-Line population, called Rashtriya Swasthya Bima Yojana. A descriptive study was conducted in a multispecialty tertiary level institute of North India to understand the awareness level and utilization of the scheme and Out of pocket expenditure borne by the beneficiaries and impact of financial burden and quality of care provided by institute. 53 (42.7%) respondents got awareness about scheme through media while 39 (31.4%) through political gatherings. Satisfaction level was more than 75% with respect to clinicians' clinical and behavioural characteristics, while satisfaction was 70.0% with nursing cooperative care and sympathetic nature. The hospital had spent about 4.85 lakhs for treatment against the total incentives of Rs 5.72 lakhs. None of beneficiary made any expenditure from Out of Pocket. These findings are an eye opener to know where the patients stand with regard to their knowledge and awareness about insurance schemes. As catastrophic health expenditures are a major cause of impoverishment and protection can be further enhanced if government design changes as incorporated by RSBY or make the premium affordable, especially for the poorer sections.