Key words :
Hospital based health insurance, discount card, subscription, acceptability, utilization rate, cost benefit analysis

Key Messages :

*    The scheme has encouraged the card users to use the hospital facility more often.
*    About 75% of the card holders used the facility for 4 to 10 times in a year.
*    In patient received considerable cash discount on their hospital bills.

ABSTRACT
A cross sectional study was conducted to find out the factors influencing the acceptability, utilization pattern and cost benefit analysis of a hospital based health insurance card issued by a tertiary care hospital in Mangalore. It is a discount scheme with an objective of providing health care at a discounted cost to the lower economy group and regular patients. A questionnaire survey was conducted to study the determinants. The sample size was 400,of which 200 were card users (test) and 200 were non card users (controls). The various determinants studied for finding out the acceptability and utilization rate of the scheme were ‘age, gender, monthly income, and educational status showed no significant relation with the acceptability of the card,while occupation and hospital service utilization showed statistical significance. Overall 35% of card subscribers were agriculturists and labourers’ whereas the remaining of them did service either in Government or private sector. In card utilization, 46% of the subscribers used the facility more than 10 times,28.5% - used it 7 to 10 times. 22.5% used it for 4 to 6 times and 3.5% used it 1 to 3 times in past 2 years. The cost benefit analysis was calculated on the total bill amount for the in-patients with the card (test sample) during the study period. It was found that the card subscribers had a 33% reduction on their medical bill. The study concludes that occupation and hospital service utilization shows significant relation to card subscription. The utilization rate of the scheme is as high as 75%. The findings indicate that the overall performance of the scheme is very good.