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.
Using data from the National Family Health Survey, researchers at the Indian Institute of Technology Delhi found a positive association between hysterectomy rates and access to cashless state health insurance, especially in Andhra Pradesh and Telangana. showed that there is
Andhra Pradesh (AP) State Government Rajiv Aalogyasri health insurance scheme (simply Arroghasri) was launched in 2007, providing generous cashless coverage for tertiary care to 19.2 million households below the poverty line and paying higher premiums to hospitals 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.
Hysterectomy (surgical removal of the uterus) is the second most frequent medical procedure in women after caesarean section and is generally a life-threatening secondary procedure only late in a woman’s reproductive life. It is given only as a second line treatment. Gynecological disease.
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, hysterectomy in India 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 of having a hysterectomy in India is much lower compared to some high-income countries. Such a trend is of public health concern, especially among young women, as serious adverse health effects can follow as side effects after surgery.
In India, the share of non-communicable diseases (NCDs) in the total disease burden has increased from 30% to 55% over the last 30 years. NCDs, unlike communicable diseases, are expensive to treat and can drive families into poverty without insurance. As the burden of disease shifts to his NCDs in developing countries, public funding for tertiary care has increased significantly.
Many states in India have recently introduced insurance programs to cover tertiary health care in economically vulnerable areas. 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 monitor and verify hospital behavior and 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 U.S. poverty line per adult). %). However, higher cost sharing may reduce medical use and treatment discontinuation.
A RAND health insurance experiment conducted from 1974 to 1982 showed that cost sharing reduced both “inadequate or unnecessary” and “appropriate 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™.
read also | | Substance abuse, a silent pandemic
