Perceptions and experiences of healthcare providers and beneficiaries on the National health insurance scheme of Rashtriya Swasthya Bima Yojana (RSBY) in a Taluk of South Indian State of Karnataka

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Clinical Epidemiology and Global Health


Background: Rashtriya Swasthya Bima Yojana (RSBY) was launched by the government of India on 1st April 2008 to provide BPL families of unorganized work sectors with access, choice, and, financial-risk protection for inpatient healthcare. The objective of the present study is to recognize the pros and cons by understanding the current process of RSBY implementation in Udupi Taluk of Karnataka State. Material and methods: Qualitative research method was followed. An in-depth interview was the main tool of data collection from beneficiaries and service providers. The collected information was analyzed in a thematic manner. Results: Factors that inhibit service utilization from beneficiaries’ perspective were rejection from the hospitals, lack of awareness, and availability of fewer services. Acceptance by the hospital is one of the main factors that is encouraging the service utilization. From providers’ perspective satisfaction of certain bona fides through the scheme was driving the service delivery. Negative aspects include No reimbursement and No proper guidelines from State Government. Conclusion: Delay and uncertainty in the payment of claims by the insurance companies is the major reason informed by the hospitals for not providing treatment to the card holders. For people to gain back the confidence in the government schemes like RSBY, these concerns like delay in reimbursements, lack of awareness, fewer services, etc. reported would have to be addressed as the progress towards universal health coverage is hindered by negative perceptions impacting the trust in the RSBY. There is an urgent need to address this issue for RSBY to maintain its credibility.

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