Comprehensive health insurance scheme and factors associated with health care utilization: A case study among insured households in Kerala

Background: to protect the people from high economic cost of illness and providing financial protection at the time of hospitalization, government of Kerala introduced a unique health insurance scheme  in 2008. This study is trying to explore the utilization among insured people and the problems regarding the utilization.
Objectives; to assess the role of CHIS and health care utilization among insured households in Kerala
Methods: Explanatory -Case study method. Both quantitative and qualitative methods used to track the objectives. A community based cross sectional survey conducted among 150 insured households supplemented with qualitative data obtained from in-depth interviews and key informants interviews.
Results: Majority of the respondents were females and 97.4% from BPL families. Main source of income of 40% households were from daily wages and don’t have any other formal insurance coverage. About 30.4% people utilized the service. People have positive attitude towards the scheme and wants to expand the coverage to out- patient’s care also. Many eligible members exempted because of coverage limit.
Conclusion: Poor people were benefited through the scheme but delay in settling of claims. Empanelled Government hospitals should expand the facilities and improve the quality to attract more people in to public health system.