Healthcare Delivery and Stakeholder’s Satisfaction Under Social Health Insurance Schemes in India: An Evaluation of Central Government Health Scheme (CGHS) and Exservicemen Contributory Health Scheme (ECHS)

53 Pages Posted: 1 May 2012

See all articles by Sukumar Vellakkal

Sukumar Vellakkal

Public Health foundation of India (PHFI)

Shikha Juyal

affiliation not provided to SSRN

Ali Mehdi

affiliation not provided to SSRN

Date Written: May 1, 2012

Abstract

This study attempted to evaluate the working of the Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS) by assessing patient satisfaction as well as the issues and concerns of empaneled private healthcare providers.

The study is based on a primary survey of 1,204 CGHS and 640 ECHS principal beneficiaries, 100 empaneled private healthcare providers and 100 officials of the schemes across 12 Indian cities.

We have found that patients are reasonably well satisfied with the healthcare services of both empaneled private healthcare providers and the dispensaries-polyclinics but are relatively more satisfied with the former than the latter. We also found that beneficiaries are willing to pay more for better quality services. Though the schemes provide comprehensive healthcare services, the beneficiaries incur some out-of pocket health expenditure while seeking healthcare. Furthermore, beneficiaries are not in favor of the recent proposal to replace the schemes with health insurance for several reasons. The empaneled private healthcare providers are dissatisfied with the terms and conditions of empanelment, especially the low tariffs for their services as compared to prevailing market rates and the delays in reimbursements from the schemes.

We suggest that appropriate efforts be undertaken to enhance the quality of healthcare service provided in the dispensaries-polyclinics of the CGHS and ECHS as well as to address the issues and concerns of empaneled private healthcare providers to ensure better healthcare delivery and for a long-term, sustainable public-private partnership.

Keywords: CGHS, ECHS, patient satisfaction, willingness to pay, empanelled private

JEL Classification: H30, H51, H53, I19, I13

Suggested Citation

Vellakkal, Sukumar and Juyal, Shikha and Mehdi, Ali, Healthcare Delivery and Stakeholder’s Satisfaction Under Social Health Insurance Schemes in India: An Evaluation of Central Government Health Scheme (CGHS) and Exservicemen Contributory Health Scheme (ECHS) (May 1, 2012). Available at SSRN: https://ssrn.com/abstract=2049307 or http://dx.doi.org/10.2139/ssrn.2049307

Sukumar Vellakkal (Contact Author)

Public Health foundation of India (PHFI) ( email )

4 Institutional Area
Vasant Kunj
New Delhi, Delhi 110070
India

HOME PAGE: http://www.phfi.org

Shikha Juyal

affiliation not provided to SSRN

Ali Mehdi

affiliation not provided to SSRN ( email )

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