Abstract

Background: Acceptance and satisfaction of retired beneficiaries towards a healthcare insurance scheme may be an important indicator towards the overall architecture of any healthcare scheme. Hence, a study was conducted to assess the acceptability of retired beneficiaries regarding facility to avail outpatient services at any other hospital, to be reimbursed at CGHS rates.

Methodology: A cross-sectional study was conducted in the OPD and Pharmacy of the institute. The data was collected using a structured questionnaire developed to capture the details regarding patient’s details and their satisfaction regarding the services provided.

Results: Out of the 426 participants, 69.95% (n=298) were male. About 53.5% participants were willing to avail OPD services outside the institute, 58.2% stated that they were aware about the CGHS provisions and 64.1% (n=273) were not willing to bear the additional expenses incurred on OPD services at other hospitals. The waiting time during various steps of visit to the Out-patient department ranged from one hour to 8 hours. The mean rating of the OPD services according to the participants was 7.04.

Conclusion: Since most participants were not willing to bear any out of pocket expense for their consultation at other hospitals, an attempt may be made to device a cashless model for the treatment of retired beneficiaries outside the institute. The quality of services provided, trained manpower and the availability of services under one roof may be one of the factors that many beneficiaries still want to visit for outpatient consultations despite the long distances.

Keywords: Employee Health, Contributory Health Scheme, Health Insurance, patient satisfaction, outpatient services