Research Study (Statistical Evaluation) on Health Care Plan Scheme

ABSTRACT: BACKGROUND OF WORK Telangana’s state government has devised a new healthcare plan called as Employee and Journalist Health Scheme, (EJHS) for its employees, journalists, retirees, and their dependent family members. They can use the Network Hospitals’ cashless hospitalization services (NWH) Employees working and retired Journalist Health Scheme is intended to provide cashless treatment to all State Government employees including the State Government pensioners, along with their dependent family members through a network of impaneled hospitals of Aarogyasri Health Care Trust in lieu of the present reimbursement system with additional benefits including Dental Insurance coverage which do not require hospitalization and can be treated under regular OutPatient (OP)basis. BACKGROUND Despite large investment in central and state-sponsored schemes for Dental Treatments, out of pocket expenditure (OOPE) and catastrophic health spendings (CHS)remains high over time, across states and socioeconomic groups OOP spending is an inefficient way of financing health care. It can have a negative impact on equity and can increase the risk of liable groups slipping into poverty. The primary objective of the EJHS schemes is to ascertain the provision of high-quality healthcare services to its beneficiaries completely cashless in the impaneled hospitals. We believe that information on the level of beneficiary satisfaction under the schemes can be considered an indicator of whether the schemes are in fact meeting their objectives or not and where interventions are necessary. In this study, we will analyze the overall satisfaction of beneficiaries and factors amplifying the out-of-pocket expenditure with the secondary data collected from the EJHS organization using random sampling method, beneficiaries selected both from Government and Empanelled Hospitals. Questionnaire data covering sociodemographic background, socio-economic status, dental care utilization, marginal time cost estimates, fees spent, traveling cost for the dental care will be collected. Study the overall satisfaction of beneficiaries based on self-reported patient satisfaction and measure the comprehensiveness of the schemes for the reduction of the financial burden of healthcare expenditure. OBJECTIVES • To study the extent and dissemination of OOP payments • The elements that trigger cash on hand payments • This study helps to examine issues relating to the terms and references for the empanelment of service providers • To assess beneficiary satisfaction regarding the treatment procedures • The feasibility of suggestions to reform the schemes. SCOPE OF WORK • The scope of the study is to evaluate the negative effect of out-of-pocket expenses by the beneficiaries of EJHS • To promote better quality services to the beneficiaries by enhancing better healthcare delivery and for a long term, sustainable public-private partnership • To study the reason for the dissatisfaction of the private impaneled service providers regarding the tariffs of the scheme compared to market rate