Original Research Article http://doi.org/10.18231/j.jchm.2019.019 The Journal of Community Health Management, July-September, 2019;6(3):82-85 82 Health insurance coverage and health care expenditure pattern in urban Mysuru, Karnataka, India Preetha Susan George 1* , Narayana Murthy M R 2 , Praveen Kulkarni 3 1 Post Graduate Student, 2 Professor and Head, 3 Associate Professor, Dept. of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India *Corresponding Author: Preetha Susan George Email: drsusanbejoy@gmail.com Abstract Introduction: The increasing out of pocket (OOP) expenditure due to increasing chronic diseases and inaccessibility to quality health care system, is a major threat to the income earning capacity of both rural and urban people. India is one among the countries with high OOPE with 89.2%. Health insurance (HI) is a method to finance health care. So with this background, this study intends to know about health insurance coverage and health care expenditure in Urban Mysuru. Materials and Methods: Community based cross sectional study was done in Bannimantap area, Mysuru city. Households were selected through systematic random sampling method and data was collected using pretested semi-structured questionnaire by interview method until the calculated sample size was attained. Health insurance coverage pattern and health care expenditure were collected from head of the family. Details regarding hospitalization in previous 1 year duration were collected. A sample size of 320 was calculated based on 24% prevalence (NFHS 1V). Data was analysed using SPSS-24. Descriptive statistics like percentage, mean and standard deviation were applied. Inferential statistical tests like chi-square test were applied for association. Results: Out of the 320 households, 130 (41%) were aware of health insurance and 190 (59%) were not aware of health insurance. Among the 130 (41%) households who were aware of health insurance, only 77 households (28%) had health insurance, maximum being government health schemes. Conclusions: The coverage and awareness regarding HI is less. Keywords: Health care expenditure, OOPE, Health insurance, Mysuru city. Introduction The health indices of a country is determined with reference to the ways with which its health care gets financed. In India more than 80 percentage of health care expenditure is borne by individuals, in the form of out-of-pocket which gradually pushing them in to a vicious circle of poverty. 1 Protecting the families from the financial consequences of paying for health services out of their pocket reduces the risk of them being pushed into poverty. 2 Poverty and ill-health go hand in hand. In developing countries, high out of pocket payment, absence of risk pooling mechanism in health financing systems, and high level of poverty are said to result in catastrophic health expenditure. In such situations, health insurance (HI) is the need of the hour. 2 As per NFHS IV data, households covered by health insurance was 23.4% in urban area. 3 The public health expenditure in India (total of centre and state governments) has remained constant at approximately 1.3% of the GDP between 2008 and 2015, and increased marginally to 1.4% in 2016-17 which is less than the world average of 6%. The National Health Policy, 2017 proposes to increase this to 2.5% of GDP by 2025. The highest percentage of out of pocket health expenditure (52%) is made towards medicines. 4 In order to address the issues related to health care finance, Government of India launched Ayushman Bharat in 2018, which provides cashless health insurance cover up to Rs. 5 lakh per family per year, to vulnerable 10 crore families. 9 Since there is paucity of published literature regarding health insurance coverage and health care expenditure in urban Mysuru, this study was undertaken in the urban field practice area of JSS Medical College, Mysuru, to assess health insurance coverage and health care expenditure. Materials and Methods A Community based cross sectional study was done in the urban field practice area of JSS Medical College, Mysuru. The study was done over a period of two months (Sept- Oct). Based on the health insurance coverage rate of 23% (as per NFHS IV data), a sample size of 320 households were calculated with 80% power, 95% confidence level and 5% α error. Data was collected using systematic random sampling method. All the houses in that area were line listed initially and a sampling interval of 34 was obtained. First house was selected randomly and every 34 th house were selected from then till the sample size was attained. All households who were permanent residents and who gave informed consent were included in the study. Data was collected using pre-tested semi structured questionnaire from adult responsible respondent. Details were collected regarding various socio demographic variables, awareness regarding health insurance and the pattern of expenditure on health care over the past 1 year. Data was entered in Microsoft excel 2010 worksheet. Descriptive statistical measures like percentages was used. Inferential Statistics were applied as needed using SPSS Version 22 software. Inferential statistical test like Chi-square test was applied to find out the association and was expressed statistically significant at p-value less than 0.05.