Effect of Micro Health Insurance on Access and Utilization of Health Services in Karnataka

Background: Lack of sustainable and affordable health financing mechanisms in India has exposed the poor in informal sector to iatrogenic poverty. Hardship financing of health services has negative financial consequences on the future income of these households. This can be mitigated through micro health insurance (MHI) because it aims to remove financial barriers to access and utilize health services. Objectives: Recognizing the dearth of studies on impact of MHI schemes in India, we carried out an in-depth study on Sampoorna Suraksha Programme (SSP) in Karnataka to assess the effect on access and utilization of healthcare services. Methods: We designed a descriptive cross sectional household survey that collected data from 1146 households to evaluate the impact using logistic regression analysis. Results: Insured individuals were more likely to access and utilize inpatient services compared to uninsured individuals. Moral hazard measured as length of stay in the hospital was absent. Horizontal equity in utilization based on gender and income was observed. Insured used private providers than public hospitals or self-medicine. The results of the study support the positive impact of MHI on access and utilization of health services. Conclusion: The findings of the study enhance our understanding of the positive role of MHI in the promotion of better health behavior of the poor people who usually forego treatment during illness. This would reinforce policymakers to advocate MHI to mitigate iatrogenic poverty in India, the land of villages.