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. 2011 Jan;133(1):40-9.

Community health insurance schemes & patient satisfaction--evidence from India

N Devadasan  1 , Bart Criel, Wim Van Damme, Pierre Lefevre, S Manoharan, Patrick Van der Stuyft
Affiliations

Community health insurance schemes & patient satisfaction--evidence from India

N Devadasan et al. Indian J Med Res. 2011 Jan.

Abstract

Background & objectives: 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.

Interpretation & 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.

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Figures

Fig. 1
Fig. 1
The ACCORD-ASHWINI-AMS community health insurance scheme in 2004. ACCORD, Actions for Community Organisation, Rehabilitation and Development; ASHWINI, Association for Health Welfare in the Nilgiris; AMS, Adivasi Munnetra Sangam.
Fig. 2
Fig. 2
The KKVS community health scheme in 2005. KKVS, Kadamalai Kalanjiam Vattara Sangam.
Fig. 3
Fig. 3
A schematic representation of the sampling method used at ACCORD, Gudalur. SE, socio-economic.
Fig. 4
Fig. 4
Interview schedules at ACCORD for the 568 households.
See this image and copyright information in PMC

Comment in

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