Effects of the Indian National Health Insurance Scheme (PM-JAY) on Hospitalizations, Out-of-pocket Expenditures and Catastrophic Expenditures

• Published in: Health systems and reform 2023-12, Vol.9 (1), p.2227430-2227430
• Main Authors: Parmar, Divya, Strupat, Christoph, Srivastava, Swati, Brenner, Stephan, Parisi, Diletta, Ziegler, Susanne, Neogi, Rupak, Walsh, Caitlin, De Allegri, Manuela
• Format: Article
• Language: English
• Subjects: Health insurance; hospitalization; India; out-of-pocket expenditure; universal health coverage
• ISSN: 2328-8604; 2328-8620
• DOI: 10.1080/23288604.2023.2227430

India launched one of the world's largest health insurance programs, the Pradhan Mantri Jan Arogya Yojana (PM-JAY), targeting more than 500 million economically and socially disadvantaged Indians. PM-JAY is publicly funded and covers hospitalization costs in public and private facilities. We examine how PM-JAY has affected hospitalizations and out-of-pocket expenditures (OOPE), and given the high use of private health care in India, we compare these outcomes across public and private facilities. We conducted a household survey to collect data on socioeconomic and demographic information, health status and hospitalizations for more than 57,000 PM-JAY eligible individuals in six Indian states. Using multivariate regression models, we estimated whether PM-JAY was associated with any changes in hospitalizations, OOPE and catastrophic health expenditures (CHE) and whether these differed across public and private facilities. We found that PM-JAY was not associated with an increase in hospitalizations, but it increased the probability of visiting a private facility by 4.6% points (p