title: Community health insurance schemes & patient satisfaction--evidence from India.
abstract: OBJECTIVE
  Quality of care is an important determinant for utilizing health services. In India, the quality of care in most health services is poor. The government recognizes this and has been working on both supply and demand aspects. In particular, it is promoting community health insurance (CHI) schemes, so that patients can access quality services. This observational study was undertaken to measure the level of satisfaction among insured and uninsured patients in two CHI schemes in India.
  
  
  METHODS
  Patient satisfaction was measured, which is an outcome of good quality care. Two CHI schemes, Action for Community Organisation, Rehabilitation and Development (ACCORD) and Kadamalai Kalanjiam Vattara Sangam (KKVS), were chosen. Randomly selected, insured and uninsured households were interviewed. The household where a patient was admitted to a hospital was interviewed in depth about the health seeking behaviour, the cost of treatment and the satisfaction levels.
  
  
  RESULTS
  It was found that at both ACCORD and KKVS, there was no significant difference in the levels of satisfaction between the insured and uninsured patients. The main reasons for satisfaction were the availability of doctors and medicines and the recovery by the patient.
  
  
  CONCLUSIONS
  Our study showed that insured hospitalized patients did not have significantly higher levels of satisfaction compared to uninsured hospitalized patients. If CHI schemes want to improve the quality of care for their clients, so that they adhere to the scheme, the scheme managers need to negotiate actively for better quality of care with empanelled providers.
authors.affiliation: Institute of Public Health, Bangalore & Achutha Menon Centre for Health Science Studies, SCTIMST, Thiruvananthapuram, India. deva@iphindia.org
authors.forename: N
authors.initials: N
authors.lastname: Devadasan
authors.forename: Bart
authors.initials: B
authors.lastname: Criel
authors.forename: Wim
authors.initials: W
authors.lastname: Van Damme
authors.forename: Pierre
authors.initials: P
authors.lastname: Lefevre
authors.forename: S
authors.initials: S
authors.lastname: Manoharan
authors.forename: Patrick
authors.initials: P
authors.lastname: Van der Stuyft
mesh_terms: D000328:Adult; D003150:Community Health Workers; D005260:Female; D017048:Health Care Costs; D006297:Health Services Accessibility; D006760:Hospitalization; D006801:Humans; D007194:India; D007348:Insurance, Health / Q000191:economics* / Q000592:standards*; D008483:Medical Assistance / Q000191:economics; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients; D011787:Quality of Health Care; D055815:Young Adult