Indian women are more likely to have a hysterectomy when state-provided health insurance programs reimburse private hospital reimbursement arrangements, and young Indian women are more likely to have a hysterectomy. Become.
Researcher at the Indian Institute of Technology Delhi used data from the National Family Health Survey to show a positive association between hysterectomy rates and access to cashless state health insurance, especially in Andhra Pradesh and Telangana.
Andhra Pradesh (AP) State Government Rajiv Aalogyasri health insurance scheme (simply Arroghasri) was launched in 2007 to provide generous cashless coverage to tertiary care providers. 19.2 million households below the poverty linepays hospitals higher premiums than other comparable insurance programs.
Following media reports of a sharp rise in hysterectomy rates in private hospitals, the AP government introduced strict controls in 2010 requiring detailed pre-operative reports before performing hysterectomies on women under the age of 35. and in 2011 restricted the procedure to public hospitals only.
According to research, women Arroghasri Health insurance (which reimburses both public and private hospitals) is 2.8% more likely to have a hysterectomy than women outside the program, and private hospitals are 2.8% more likely to have a hysterectomy than public hospitals. was also found to be significantly higher than
This group was more likely to have a hysterectomy before age 40 and more likely to have a hysterectomy between 2008 and 2011.
cause? Physicians in private hospitals in India are usually compensated on a per-service fee basis rather than the fixed fees typical of public hospitals that receive fixed fees.
This may be due to cashless public health insurance programs, which typically do not involve payments by women who are eligible for surgery.
Private hospitals performed more unnecessary hysterectomies than public hospitals because of the newly available government-funded health insurance scheme payments and incentive structures.
A hysterectomy (surgically removing the uterus) Second most frequent medical procedure In women, it is next to caesarean section and is generally performed only later in a woman’s reproductive life. Second line treatment For life-threatening gynecological diseases.
However, an analysis of India’s 2015-2016 National Family Health Survey of approximately 700,000 women aged 15 to 49 found that between 2012 and 2016, the number of hysterectomies in India increased. The rate was found to increase from 1.7 to 3.2 per 100 women ever operated on. I am married.Although this prevalence is relatively low, the average age to undergo a hysterectomy in India is much lower compared to some high-income countries. This trend is a public health concern, especially among young women. serious adverse health effects It may continue like Side effects after surgery.
In India, the contribution of non-communicable diseases (NCDs) to the total disease burden is 30% to 55% in the last 30 years. NCDs, unlike communicable diseases, are expensive to treat and, without insurance, drive a household into poverty. As the burden of disease shifts to NCDs in developing countries, public funding for tertiary care has increased significantly.
Many Indian states Recently Introduced Insurance Program Covers tertiary care treatment for economically weaker sections. These programs have the potential to reverse the negative impact of devastating out-of-pocket health care costs on household savings and income.
The downside is that public funding in the form of cashless insurance programs, often with no co-payment or cost-sharing, can increase demand for avoidable surgical procedures such as those observed with hysterectomies. It is a matter of nature.
It is also difficult for financial authorities to observe and verify the behavior of financial institutions. hospital When patient health.
Some surgeries covered by public health insurance are likely to see increased demand. These include caesarean section, appendectomy, cholecystectomy, tonsillectomy, and hysterectomy.
A common way to deal with the problem of unnecessary proceedings is to share the costs in the form of co-payments or deductibles.
U.S. Medicaid copays to cover health care costs for low-income individuals range from $1 to $15 (which is 0.1% to 1.4% of the monthly subsistence level or poverty line per U.S. adult). %). However, higher cost sharing may reduce medical use and treatment discontinuation.
of RAND health insurance experiment A study conducted between 1974 and 1982 showed that cost sharing reduced both ‘inappropriate or unnecessary’ and ‘adequate or necessary’ care.
In the absence of cost sharing, intensively scrutinizing claims filed for medical procedures that are likely to be induced would increase profits from public health insurance programs and reduce the financial burden of unnecessary treatment. can be mitigated.
Sicil Devnath He is currently working in the field of health economics at the Indian Institute of Technology, Delhi.
Surab B. Paul He is currently at the Indian Institute of Technology, Delhi, where he studies issues such as caste and labor migration, access to education, conditions in the women’s labor market, and interactions between science and technology policy and the macroeconomy.
Komal Saleen A PhD Candidate from the Indian Institute of Technology, Delhi, her research focuses on gender and health economics.
The authors have no conflicts of interest to declare and the research was not supported by external funding.
Originally published in creative commons To 360 information™.
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