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

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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Bibliographic Details
Main Authors:	Johnson, Douglas, Krishnaswamy, Karuna
Language:	English en_US
Published:	World Bank, Washington, DC 2015
Subjects:	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
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

Description
Summary:	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.

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

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