Understanding CBHI Hospitalization Patterns: A Comparison of Insured and Uninsured Women in Gujarat India

This case study compares the morbidity, outpatient treatment-seeking, and hospitalization patterns of VimoSEWA-insured women with uninsured women. VimoSEWA is an inpatient community-based health insurance (CBHI) scheme operating particularly for low-income people in Gujarat, India. The study is based on data obtained from a cross-sectional survey of 1,934 insured and uninsured women. A multivariable logistic regression was used on the data to identify predictors of insurance coverage and the association of insurance with hospitalization. The study finds that age, marital status, and occupation of adult women were associated with insurance status. While the length of stay was similar amongst insured and uninsured women, the choice of hospital differed between them. It also finds that despite similar reported morbidity patterns and initial treatment-seeking behavior, VimoSEWA members were more likely to be hospitalized. The study covers the following sections in detail:

• Background of CBHI schemes in India with a focus on the VimoSEWA scheme;
• Discussion on study objectives and the methodology used;
• Analysis of the results and a discussion on the findings with a focus on insurance coverage and treatment seeking, common illnesses, hospitalization rates among insured and uninsured, and odds of undergoing hysterectomy;
• Limitations of the study and concluding remarks.