Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved]
Background: There are various medical insurance options available in India. However, unlike many other countries, dental insurance plans are rare. The aim of this study was to assess the utilization of various government and private health insurance schemes by patients admitted for dental surgical p...
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2023-11-01
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| Series: | F1000Research |
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| Online Access: | https://f1000research.com/articles/12-959/v2 |
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| author | Ashwini Kumar Ramprasad Vasthare Nishu Singla Ritesh Singla Bhargav Bhat Prajna P Nayak |
| author_facet | Ashwini Kumar Ramprasad Vasthare Nishu Singla Ritesh Singla Bhargav Bhat Prajna P Nayak |
| author_sort | Ashwini Kumar |
| collection | DOAJ |
| description | Background: There are various medical insurance options available in India. However, unlike many other countries, dental insurance plans are rare. The aim of this study was to assess the utilization of various government and private health insurance schemes by patients admitted for dental surgical procedures at a tertiary care hospital in coastal Karnataka, India. Methods: A study was conducted retrospectively to gather data on the socio-demographics, bill details, insurance, and benefits claimed by patients admitted to the Department of Oral and Maxillofacial Surgery at a tertiary care hospital from May 2016 to September 2022. Results: Out of 1750 patients, only 856 (48.9%) patients had availed of insurance, 395 patients (22.6%) utilized government health insurance policies, and 461 patients (26.3%) availed of private health insurance plans. Among Government schemes, primarily Ayushman Bharat-Arogya Karnataka was used by 262 (30.6%) patients, followed by Employees’ State Insurance Scheme by 110 (12.9%) patients. Among private schemes, 212 (24.8%) patients used the policies purchased by them, 19 (2.2%) patients’ medical expenses were paid by their employers, 105 (12.3%) patients utilized Manipal Arogya Suraksha and 124 (14.5%) patients used Medicare provided by the hospital. Bivariate linear regression confirmed that the total bill amount, out-of-pocket expenditure by the patient, and insurance amount reimbursed to the hospital were significantly associated with the type of insurance (government vs. private). The study noticed a gradual rise in insured patients every year. Conclusion: Greater utilization of health insurance should be encouraged because the cost of dental treatment has always hindered the use of oral health services worldwide. This study highlights that the benefit available to the patients were mainly through general health insurance schemes, not specifically dental health insurance. Insurance schemes covering dental must be promoted more aggressively in the media, highlighting their available benefits, merits, and demerits. |
| first_indexed | 2024-04-24T13:13:50Z |
| format | Article |
| id | doaj.art-582417760aba4b31880a414f9cdaef8c |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-04-24T13:13:50Z |
| publishDate | 2023-11-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-582417760aba4b31880a414f9cdaef8c2024-04-05T00:00:02ZengF1000 Research LtdF1000Research2046-14022023-11-0112155963Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved]Ashwini Kumar0Ramprasad Vasthare1https://orcid.org/0000-0002-0181-7069Nishu Singla2https://orcid.org/0000-0002-9007-8092Ritesh Singla3https://orcid.org/0000-0002-1215-5988Bhargav Bhat4Prajna P Nayak5Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaDepartment of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaBackground: There are various medical insurance options available in India. However, unlike many other countries, dental insurance plans are rare. The aim of this study was to assess the utilization of various government and private health insurance schemes by patients admitted for dental surgical procedures at a tertiary care hospital in coastal Karnataka, India. Methods: A study was conducted retrospectively to gather data on the socio-demographics, bill details, insurance, and benefits claimed by patients admitted to the Department of Oral and Maxillofacial Surgery at a tertiary care hospital from May 2016 to September 2022. Results: Out of 1750 patients, only 856 (48.9%) patients had availed of insurance, 395 patients (22.6%) utilized government health insurance policies, and 461 patients (26.3%) availed of private health insurance plans. Among Government schemes, primarily Ayushman Bharat-Arogya Karnataka was used by 262 (30.6%) patients, followed by Employees’ State Insurance Scheme by 110 (12.9%) patients. Among private schemes, 212 (24.8%) patients used the policies purchased by them, 19 (2.2%) patients’ medical expenses were paid by their employers, 105 (12.3%) patients utilized Manipal Arogya Suraksha and 124 (14.5%) patients used Medicare provided by the hospital. Bivariate linear regression confirmed that the total bill amount, out-of-pocket expenditure by the patient, and insurance amount reimbursed to the hospital were significantly associated with the type of insurance (government vs. private). The study noticed a gradual rise in insured patients every year. Conclusion: Greater utilization of health insurance should be encouraged because the cost of dental treatment has always hindered the use of oral health services worldwide. This study highlights that the benefit available to the patients were mainly through general health insurance schemes, not specifically dental health insurance. Insurance schemes covering dental must be promoted more aggressively in the media, highlighting their available benefits, merits, and demerits.https://f1000research.com/articles/12-959/v2Health Insurance Dental insurance Oral surgical procedures Insurance schemeseng |
| spellingShingle | Ashwini Kumar Ramprasad Vasthare Nishu Singla Ritesh Singla Bhargav Bhat Prajna P Nayak Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved] F1000Research Health Insurance Dental insurance Oral surgical procedures Insurance schemes eng |
| title | Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved] |
| title_full | Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved] |
| title_fullStr | Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved] |
| title_full_unstemmed | Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved] |
| title_short | Utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in Coastal Karnataka: a retrospective study [version 2; peer review: 2 approved] |
| title_sort | utilization of health insurance by patients admitted for dental surgical procedures at a tertiary care hospital in coastal karnataka a retrospective study version 2 peer review 2 approved |
| topic | Health Insurance Dental insurance Oral surgical procedures Insurance schemes eng |
| url | https://f1000research.com/articles/12-959/v2 |
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