What a Difference a State Makes : Health Reform in Andhra Pradesh

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dc.creatorBergkvist, Sofi
dc.creatorWagstaff, Adam
dc.creatorKatyal, Anuradha
dc.creatorSingh, Prabal V.
dc.creatorSamarth, Amit
dc.creatorRao, Mala
dc.date2014-06-26T22:08:11Z
dc.date2014-06-26T22:08:11Z
dc.date2014-05
dc.date.accessioned2026-07-01T00:58:03Z
dc.descriptionIn the mid-2000s, India began rolling out large-scale, publicly-financed health insurance schemes mostly targeting the poor. This paper describes and analyzes Andhra Pradesh's Aarogyasri scheme, which covers against the costs of around 900 high-cost procedures delivered in secondary and tertiary hospitals. Using a new household survey, the authors find that 80 percent of families are eligible, equal to about 68 million people, and 85 percent of these families know they are covered; only one-quarter, however, know that the benefit package is limited. The study finds that, contrary to the rules of the program, patients incur quite large out-of-pocket payments during inpatient episodes thought to be covered by Aarogyasri. In the absence of data and program design features that would allow for a rigorous impact evaluation, a comparison is made between Andhra Pradesh and neighboring Maharashtra over an eight-year period spanning the scheme's introduction. During this period, Maharashtra did not introduce any at-scale health initiative that was not also introduced in Andhra Pradesh. Andhra Pradesh other health initiatives were considerably less ambitious and costly than Aarogyasri. The paper finds that Andhra Pradesh recorded faster growth than Maharashtra (even after adjusting for confounders) in inpatient admissions per capita (for all income groups) and in surgery admissions (among the poor only), slower growth in out-of-pocket payments for inpatient care (in total and per admission, but only among the better off), and slower growth in transport and outpatient out-of-pocket costs. The paper argues that these results are consistent with Aarogyasri having the intended effects, but also with minor health initiatives in Andhra Pradesh (especially the ambulance program) playing a role.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2014/05/19546767/difference-state-makes-health-reform-andhra-pradesh
dc.identifierhttps://hdl.handle.net/10986/18803
dc.identifierhttps://doi.org/10.1596/1813-9450-6883
dc.identifier.urihttp://hdl.handle.net/123456789/413630
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationPolicy Research Working Paper;No. 6883
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectAMBULANCE
dc.subjectAMBULANCE SERVICE
dc.subjectAMBULANCE SERVICES
dc.subjectANTENATAL CARE
dc.subjectBASIC HEALTH
dc.subjectBEDS
dc.subjectCANCER
dc.subjectCATASTROPHIC ILLNESSES
dc.subjectCHILD HEALTH
dc.subjectCOMMUNICABLE DISEASE
dc.subjectCOMMUNITY HEALTH
dc.subjectCONVALESCENCE
dc.subjectCOST OF TRANSPORT
dc.subjectDIAGNOSIS
dc.subjectDIAGNOSTIC TESTS
dc.subjectDISEASE MANAGEMENT
dc.subjectDOCTORS
dc.subjectDRAINAGE
dc.subjectDRINKING WATER
dc.subjectELECTRONIC PAYMENT
dc.subjectEMPLOYMENT
dc.subjectEXPENDITURES
dc.subjectEXPOSURE
dc.subjectFAMILIES
dc.subjectFARES
dc.subjectFEVER
dc.subjectFILARIASIS
dc.subjectFINANCIAL RISK
dc.subjectGASTROENTERITIS
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE CENTERS
dc.subjectHEALTH CARE EXPENDITURES
dc.subjectHEALTH CARE FINANCE
dc.subjectHEALTH CENTERS
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH INSTITUTIONS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH PROGRAMS
dc.subjectHEALTH REFORM
dc.subjectHEALTH SERVICES
dc.subjectHEALTH WORKERS
dc.subjectHEALTHCARE
dc.subjectHIV/AIDS
dc.subjectHOSPITAL ADMISSION
dc.subjectHOSPITAL ADMISSIONS
dc.subjectHOSPITAL ASSOCIATIONS
dc.subjectHOSPITAL CARE
dc.subjectHOSPITALIZATION
dc.subjectHOSPITALIZATIONS
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectILLNESS
dc.subjectINCIDENTAL COSTS
dc.subjectINCOME
dc.subjectINCOME DISTRIBUTION
dc.subjectINFECTIOUS DISEASES
dc.subjectINPATIENT ADMISSION
dc.subjectINPATIENT ADMISSIONS
dc.subjectINPATIENT CARE
dc.subjectINTERVENTION
dc.subjectKIDNEY FAILURE
dc.subjectLEPROSY
dc.subjectLIVER
dc.subjectMALARIA
dc.subjectMATERNAL AND CHILD HEALTH
dc.subjectMEDICAL TREATMENT
dc.subjectMEDICINE
dc.subjectMEDICINES
dc.subjectMOBILE HEALTH UNITS
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectNEUROSURGERY
dc.subjectOUTPATIENT CARE
dc.subjectPATIENT
dc.subjectPATIENTS
dc.subjectPETROLEUM GAS
dc.subjectPHYSICIAN
dc.subjectPREGNANT WOMEN
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE SERVICES
dc.subjectPROBABILITY
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HOSPITALS
dc.subjectPUBLIC PARTNERSHIP
dc.subjectSCREENING
dc.subjectSOCIAL EXCLUSION
dc.subjectSOCIAL RESEARCH
dc.subjectSURGERY
dc.subjectTAX
dc.subjectTB
dc.subjectTRANSPORT
dc.subjectTRANSPORT COSTS
dc.subjectTRANSPORT EXPENDITURES
dc.subjectTRANSPORT SUBSIDIES
dc.subjectTRANSPORTATION
dc.subjectTRANSPORTATION COSTS
dc.subjectTRANSPORTATION SUBSIDIES
dc.subjectTREATMENTS
dc.subjectTRUE
dc.subjectUNDERGROUND
dc.subjectUSE OF HEALTH CARE SERVICES
dc.subjectUSE OF HEALTH SERVICES
dc.subjectVISITS
dc.subjectWEALTH
dc.subjectWORKERS
dc.titleWhat a Difference a State Makes : Health Reform in Andhra Pradesh

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