title: Impact evaluation of India's 'Yeshasvini' community-based health insurance programme.
abstract: Using propensity score matching techniques, the study evaluates the impact of India's Yeshasvini community-based health insurance programme on health-care utilisation, financial protection, treatment outcomes and economic well-being. The programme offers free out-patient diagnosis and lab tests at discounted rates when ill, but, more importantly, it covers highly catastrophic and less discretionary in-patient surgical procedures. For its impact evaluation, 4109 randomly selected households in villages in rural Karnataka, an Indian state, were interviewed using a structured questionnaire. A comprehensive set of indicators was developed and the quality of matching was tested. Generally, the programme is found to have increased utilisation of health-care services, reduced out-of-pocket spending, and ensured better health and economic outcomes. More specifically, however, these effects vary across socio-economic groups and medical episodes. The programme operates by bringing the direct price of health-care down but the extent to which this effectively occurs across medical episodes is an empirical issue. Further, the effects are more pronounced for the better-off households. The article demonstrates that community insurance presents a workable model for providing high-end services in resource-poor settings through an emphasis on accountability and local management.
authors.affiliation: Department of Business Economics, South Campus, University of Delhi, Delhi-110021, India. aradhna.aggarwal@gmail.com
authors.forename: Aradhna
authors.initials: A
authors.lastname: Aggarwal
mesh_terms: D003153:Community Health Services / Q000706:statistics & numerical data*; D019058:Community Networks; D003695:Delivery of Health Care; D004059:Diffusion of Innovation; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics; D006304:Health Status; D006801:Humans; D007194:India; D007348:Insurance, Health / Q000191:economics*; D057216:Propensity Score; D012424:Rural Population; D012923:Social Class