Achieving Equity in Health through Community-based Health Insurance: India's Experience with a Large CBHI Programme
基于印度Yeshasvini项目的入户调查数据,分析社区健康保险在参保、续保和利用方面的公平性,发现虽存在不平等但利用环节较参保环节更公平,并指出CBHI不能替代政府卫生基础设施。
Abstract This article analyses equity in enrolment, renewal of enrolment, and utilisation of community-based health insurance with special reference to the Yeshasvini health care programme. The analysis employs a primary survey conducted in rural Karnataka using a random sample of 4109 households. The study identifies quantifiable variables covering various dimensions of vulnerability and assesses their relationship with enrolment, renewal of enrolment, and utilisation using logistic regression techniques. The results demonstrate that inequities do exist even though they are less pronounced in utilisation than in enrolments and renewals. While community-based health insurance (CBHI) may be used as a mechanism to reach the disadvantaged population, they can not be considered as substitute for government-created health infrastructure.