Experimental Study to Assess Interventions Aimed at Improving the Equity Impact of Community-Based Health Insurance

Health Insurance Clinical Trial

Official title:

Experimental Study to Assess Interventions Aimed at Improving the Equity Impact of Community-Based Health Insurance

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00421629
• Other study ID #: PHHPBD25
• Secondary ID: GR067926MA
• Status: Completed
• Phase: N/A
• First received: January 10, 2007
• Last updated: January 11, 2007
• Start date: October 2003
• Est. completion date: April 2006

Study information

• Verified date: January 2007
• Source: London School of Hygiene and Tropical Medicine
• Contact: n/a
• Is FDA regulated: No
• Health authority: United Kingdom: Research Ethics Committee
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to assesses interventions aimed at improving the distributional impact of a community based health insurance scheme in rural India.

Description:

Community based health insurance is often cited as a means of improving access and financial protection in developing countries, but such schemes may not benefit the poorest. We evaluate alternative strategies for improving the uptake of benefits of a community based health insurance scheme by its poorest members.

Comparisons: Three groups are compared to standard insurance scheme members (Control). One group is provided with after-sale service and supportive supervision (AfterSS). A second group is provided with prospective reimbursement (PR). A third group is provided with these two interventions together (Both).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 688
• Est. completion date: April 2006
• Gender: Both
• Age group: 18 Years and older

Eligibility

Subdistrict Inclusion Criteria:

• 500 or more female (>=18 y of age) SEWA Insurance members in 2003

Subdistrict Exclusion Criteria:

• All members were mandatorily enrolled in the scheme by a donor agency

• Ahe sub-district had no general hospital of 25 beds or more

Individual Inclusion Criteria:

• All female and male members of SEWA Insurance for 2004 and 2005

Individual Exclusion Criteria:

• Those whose home could not be found based on given address data

Study Design

Allocation: Randomized, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Health Insurance

Intervention

Behavioral:
• After-sales service and supportive supervision (AfterSS)

• Prospective reimbursement (PR)

• Both (AfterSS and PR)

Locations

Country	Name	City	State
India	Self Employed Women's Association	Ahmedabad	Gujarat

Sponsors (2)

Lead Sponsor	Collaborator
London School of Hygiene and Tropical Medicine	Wellcome Trust

Country where clinical trial is conducted

India, 

References & Publications (5)

Morris SS, Ranson MK, Sinha T, Mills AJ. Measuring improved targeting of health interventions to the poor in the context of a community-randomised trial in rural India. Contemp Clin Trials. 2007 Jul;28(4):382-90. Epub 2006 Oct 14. — View Citation

Ranson MK, Sinha T, Chatterjee M, Acharya A, Bhavsar A, Morris SS, Mills AJ. Making health insurance work for the poor: learning from the Self-Employed Women's Association's (SEWA) community-based health insurance scheme in India. Soc Sci Med. 2006 Feb;62(3):707-20. Epub 2005 Jul 28. — View Citation

Ranson MK, Sinha T, Gandhi F, Jayswal R, Mills AJ. Helping members of a community-based health insurance scheme access quality inpatient care through development of a preferred provider system in rural Gujarat. Natl Med J India. 2006 Sep-Oct;19(5):274-82. — View Citation

Ranson MK, Sinha T, Morris SS, Mills AJ. CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India. Can J Public Health. 2006 Jan-Feb;97(1):72-5. — View Citation

Sinha T, Ranson MK, Chatterjee M, Acharya A, Mills AJ. Barriers to accessing benefits in a community-based insurance scheme: lessons learnt from SEWA Insurance, Gujarat. Health Policy Plan. 2006 Mar;21(2):132-42. Epub 2005 Dec 22. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	socioeconomic status of claimants relative to the membership base in their subdistricts of residence
Secondary	enrolment rates in Vimo SEWA
Secondary	mean socioeconomic of the insured relative to the general rural population
Secondary	rate of insurance claim submission