Helping Communities Manage risks from the ground up.
WOTRO Research Project
Research
Project Title:WOTRO Research Project: Development of a New Cost & Time Effective Methodology to Upscale Demand for Health Insurance
PROJECT CATEGORY:Research
OBJECTIVE:
Development of a new cost and time effective methodology to upscale the reach and demand of microinsurance through a mathematical model.
BACKGROUND:
MIA, in its role in facilitating the launch of micro health insurance schemes by local NGOs, assists in the critical process of tailoring insurance packages and premium options to the needs of specific communities. The data necessary for elaborating context-specific microinsurance packages, particularly for the calculation of sustainable premiums, is usually collected through comprehensive household surveys (including information on location-relevant incidence of illness, utilisation of healthcare services and cost of healthcare, etc.). This process requires a significant investment in funds and time. In order to tackle the high costs of the fieldwork, MIA is developing an efficient alternative method.
PROJECT CONCEPT:
The goal of the WOTRO project is to estimate local healthcare utilisation and costs for any location in India based on harvested data that would be adjusted through a mathematical model. The model will use input data collected from national sources (e.g. National Sample Survey Organization – NSSO), complemented by information about the local situation obtained from Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs).
PARTNERS:
The project will be conducted in collaboration with Erasmus University Rotterdam (The Netherlands) and the Indian Institute of Health Management Research, Jaipur (India).
FUNDING:
This research project is funded by a grant from WOTRO (science for Global Development) division of the Netherlands Organisation for Scientific Research (NWO) to MIA Chairman Prof. David Dror.
DURATION:2008-2012
COUNTRY:India
LOCATION:
- Wave 1: Andhra Pradesh - Warangal and Karimnagar districts,
- Wave II: Orissa - Kalahandi, Khorda and Malkangiri districts;
- Wave III: Uttar Pradesh, Gaya
CONTACT:Prof. David Dror, MIA Chairman, davidror@socialre.org
PROGRESS:
Baseline household (HH) surveys were conducted in three states (Andhra Pradesh - June 2008; Orissa - June 2009; and Bihar - May 2010). With this information, estimates for premiums of different benefits that could be covered under an insurance programme for each of the specific locations were calculated (e.g. outpatient consultations, medicines, hospitalisation, and maternal care). With the use of a simulations exercise called CHAT (Choosing Health-plans All Together) a customised benefit package was developed for each setting.
The goal of this project is to develop an alternative new methodology to obtain actuarial estimates at lower cost and more quickly than the classical HH survey. Therefore data was also collected through alternative sources like Focus Group Discussions (FGDs), Key Informant Interviews (KIIs) at the same time and in the same locations as the HH survey. In the third wave in Bihar, an alternative illness mapping method was developed to collect data on incidence and prevalence of morbidities, hospitalisation and maternity.
Through multivariate analysis and mathematical modelling of the HH survey data, data from National Statistics, and a comparison with alternative sources, the team is trying to elaborate a mathematical model that can adjust data obtained through the alternative sources to a quantified whole which can be used to perform actuarial estimations. In collaboration with modelling expert, Dr. Eric Gerelle, the team has identified and compared possible socio-demographic and morbidity-related key variables. So far it has been found that the distributions of total HH expenditures and HH health expenditures were lognormal and the median and variance of health expenditure data were strongly correlated. It was also observed that there is a linear relationship between the median HH health expenditures (from HH surveys) and the state-level morbidity data (from the National Sample Survey – NSS – India). Comparison with NSS data at the state level across India showed similar correlations between health expenditure and morbidity. Using state-specific data from NSS India from previous years the team is now checking whether relationships between parameters and other constant phenomena hold over time and across states.
