Journal article
Sex differences in utilization of hospital care in a state-sponsored health insurance program providing access to free services in south India
- Abstract:
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Background
Universal healthcare coverage provides health care and financial protection to all citizens and might help to facilitate gender equity in care. We assessed the utilization of hospital care services among women and men in a large underprivileged population with access to free hospital care in India.
Methods
The Rajiv Aarogyasri Community Health Insurance Scheme, a state-sponsored scheme, provided access to free hospital care for poor households across undivided Andhra Pradesh. Claims data for hospitalizations between 2008 and 2012 were analysed to determine the number of individuals, hospitalizations, bed-days, and hospital expenditure for sex-specific and sex-neutral conditions, by sex, disease category, and age-group.
Results
A total of 961,442 individuals (43% women), 1,223,723 hospitalizations (48% women), 7.7 million bed-days (47% women), and hospital expenditure of 579.3 million USD (42% women) were recorded. Sex-specific conditions accounted for 27% of hospitalizations, 12% of bed-days and 15% of costs for women, compared with 5%, 4% and 4% in men. Women had a lower share of hospitalizations (42%), bed-days (45%) and costs (39%) for sex-neutral conditions, than men. These findings were observed across 14 of 18 disease categories and across all age-groups, but especially for older and younger women.
Interpretation
In this large underprivileged population in India with access to free hospital care, utilization of hospital care differed for women and men. For sex-neutral conditions, women accessed a smaller proportion of care than men, suggesting that coverage of hospital care alone is not sufficient to guarantee gender equity in access to healthcare.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.2MB, Terms of use)
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- Publisher copy:
- 10.1136/bmjgh-2018-000859
Authors
- Publisher:
- BMJ Publishing Group
- Journal:
- BMJ Global Health More from this journal
- Volume:
- 3
- Pages:
- e000859
- Publication date:
- 2018-06-29
- Acceptance date:
- 2018-05-29
- DOI:
- EISSN:
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2059-7908
- Keywords:
- Pubs id:
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pubs:854208
- UUID:
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uuid:6e253eae-34be-444b-a211-7ccd1f37d1c9
- Local pid:
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pubs:854208
- Source identifiers:
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854208
- Deposit date:
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2018-05-30
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Terms of use
- Copyright holder:
- Peters et al
- Copyright date:
- 2018
- Notes:
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© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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