Experimental Study to Assess Interventions Aimed at Improving the Equity Impact of Community-Based Health Insurance

Study Overview
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Brief Summary
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The purpose of this study is to assesses interventions aimed at improving the distributional impact of a community based health insurance scheme in rural India.

Detailed Description
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Community based health insurance is often cited as a means of improving access and financial protection in developing countries, but such schemes may not benefit the poorest. We evaluate alternative strategies for improving the uptake of benefits of a community based health insurance scheme by its poorest members. Comparisons: Three groups are compared to standard insurance scheme members (Control). One group is provided with after-sale service and supportive supervision (AfterSS). A second group is provided with prospective reimbursement (PR). A third group is provided with these two interventions together (Both).

Official Title
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Experimental Study to Assess Interventions Aimed at Improving the Equity Impact of Community-Based Health Insurance

Conditions
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Health Insurance

Intervention / Treatment
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* Behavioral: After-sales service and supportive supervision (AfterSS)
* Behavioral: Prospective reimbursement (PR)
* Behavioral: Both (AfterSS and PR)


Participation Criteria
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Eligibility Criteria
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Subdistrict Inclusion Criteria: 500 or more female (>=18 y of age) SEWA Insurance members in 2003 Subdistrict Exclusion Criteria: All members were mandatorily enrolled in the scheme by a donor agency Ahe sub-district had no general hospital of 25 beds or more Individual Inclusion Criteria: All female and male members of SEWA Insurance for 2004 and 2005 Individual Exclusion Criteria: Those whose home could not be found based on given address data

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: After-sales service and supportive supervision (AfterSS)|nan|
|Behavioral: Prospective reimbursement (PR)|nan|
|Behavioral: Both (AfterSS and PR)|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| socioeconomic status of claimants relative to the membership base in their subdistricts of residence |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| enrolment rates in Vimo SEWA |  |  | 
| mean socioeconomic of the insured relative to the general rural population |  |  | 
| rate of insurance claim submission |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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health insurance, hospitalization insurance, community based health insurance, health care access, developing countries, randomized controlled trials