A study to assess feedback of patients who received benefit of Rajeev Gandhi Jeevandayi Arogya Yojana during first year of phase I in a private tertiary care network hospital in Maharashtra
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20182184Keywords:
Health insurance, Social security, Government schemeAbstract
Background:Rajeev Gandhi Jeevandayi Arogya Yojana (RGJAY) is a government initiated cashless Health Insurance Scheme. The scheme’s objective is to improve health care access through an identified network of health care providers. MGM Medical College is one of the network hospitals in Raigad District of Maharashtra, India. This study is aimed at assessing feedback of patients who received benefit of this scheme.
Methods:A total of 884 pre-authorizations were approved during the study period. As a 10 percent random sample, feedback letters received were analyzed for 91 patients. The responses obtained were in local language. Telephonic validations were done wherever needed. Response categories were standardized and coded. Analysis was done using Epi-info software.
Results:Complete improvement in ailment was felt by 76 (83.5%) respondents while 12 (13.2%) mentioned partial improvement. Though all patients felt that scheme should continue, 37 (40.7%) said they had faced issues related to scheme. If free treatment would not have been received under the scheme, a majority of patients (56%) felt they would have succumbed to their illness while 32 (35.2%) patient had thought of selling their assets or taking loan for covering treatment expenses. Only 5 (5.5%) patients said they would have gone to Government or Charitable hospital in absence of the scheme.
Conclusions:The scheme acts as an important social security measure as many poor patients would not have sought medical treatment in absence of this scheme. However there is a scope for improvement to reduce the hurdles for better scheme utilization.
References
Resolution WHA64.9. Sustainable health financing structures and universal coverage. In Sixty-fourth World Health Assembly, Geneva, 24th March 2011. Geneva: World Health Organization; 2011.
Report of the National Commission on Macroeconomics and Health. New Delhi: Ministry of Health & Family Welfare, Government of India; 2005: 192.
Eleventh Five Year Plan (2007–2012) Social Sector Volume II. New Delhi: Government of India Planning Commission; 2008.
Faster, Sustainable and more Inclusive Growth An approach to the Twelfth Five Year Plan. New Delhi: Government of India Planning Commission; October 2011.
Rao M, Katyal A, Singh PV, Samarth A, Bergkvist S, Kancharla M, et al. Changes in addressing inequalities in access to hospital care in Andhra Pradesh and Maharashtra states of India: a difference-in-differences study using repeated cross-sectional surveys. BMJ Open. 2014;4:2.
Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY). Operational guidelines; 2013.
Available at: www.mahaarogya.gov.in/projectand schemes/Jeevandaiaarogya/default.htm. Accessed on 3 March 2018.
Rao M, Ramachandra SS, Bandyopadhyay S, Chandran A, Shidhaye R, Tamisettynarayana S, et al. Addressing healthcare needs of people living below the poverty line: a rapid assessment of the Andhra Pradesh health insurance scheme. Natl Med J India 2011;24(6):335-41.
Rao M, Kadam S, Sathyanarayana TN, Shidhaye R, Shukla R, Ramachandra SS, et al. A rapid evaluation of the Rajiv Aarogyasri community health insurance scheme in Andhra Pradesh, India. BMC Proceedings. 2012;6(1):4.
Devadasan N1, Criel B, Van Damme W, Manoharan S, Sarma PS, Van der Stuyft P. Community health insurance in Gudalur, India, increases access to hospital care. Health Policy Plan. 2010;25:145-54.
Reddy KS, Selvaraj S, Rao KD, Chokshi M, Kumar P. A critical assessment of the existing health insurance models in India. A Report Submitted to Planning Commission of India, Government of India. Public Health Foundation of India Report, 2011.