Determinants of Health Insurance Choice and Ownership in India-Evidence from National Sample Survey Data
Keywords:
Health insurance, Hospitalization, India, Multinomial logit, Outof-pocket health expenditure
Abstract
Out-of-pocket expenditure (OOPE) accounts for approximately 39% of total health expenditure in India and is on the rise. This is a matter of concern as high OOPE has impoverishing effects on the economy. Insurance serves as a cushion in the event of health-related distress and also helps consumers access the required quantity and better quality of care. Demand for insurance is a choice between risk and return that is contingent upon several socio-economic and demographic factors. The paper aims to identify the factors that influence the choice and ownership of health insurance in India. A multinomial logit model has been estimated using data on hospitalization published by the National Sample Survey Organisation, India (NSSO), 2014-15. Findings reveal that the presence of chronic ailments plays a significant role in the demand for health insurance. Other factors that not only shape demand but also influence the type of insurance chosen include education and income levels, household size and age of the individual. Government efforts have been crucial in reducing OOPE in India; however, better results can be expected with target-based innovative insurance products that offer greater coverage and transparency.
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2. Bourne, P. A., & Kerr-Campbell, M. D. (2010). Determinants of health insurance ownership in Jamaica: A public health concern. Asian Journal of Business Management, 2(1), 11–18.
3. Capatina, A., & Kang, K. (2024). The effect of marital status and health conditions on the demand for health insurance. Journal of Consumer Affairs, 58(1), 143–165. Chakraborty, G., & Shankar, P. (2010). Pulse of the nation: Understanding Indian consumers' perception of health insurance. IIM Lucknow & Max Bupa.
4. Chatterjee, S., Das, S., & Singh, A. K. (2022). Awareness of health insurance: A study among rural and urban households in India. Journal of Family Medicine and Primary Care, 11(5), 1836–1842.
5. Finn, Catherine M., and Patrisio N. Owando. (2006). "Shepherding the poor: The Health Extension Programme in Ethiopia." The Lancet 368, no. 9546: 1519–21.
6. Ghosh, S. (2013). Willingness to pay for health insurance in a developing economy: A study of West Bengal, India. Indian Journal of Public Health, 57(3), 163–168.
7. Gumber, A., Kulkarni, V., & Dhak, A. K. (2000). The uninsured in India: A study on the determinants of demand for health insurance. National Council of Applied Economic Research.
8. Harmon, C., & Nolan, B. (2006). Health insurance and health services use in Ireland. The Economic and Social Review, 37(1), 49–70.
9. Jütting, J. P. (2004). Do community-based health insurance schemes improve poor people's access to health care? Evidence from rural Senegal. World Development, 32(2), 273–288.
10. Kimani, D. N., Muriithi, M. K., & Okeyo, I. M. (2014). Determinants of health insurance ownership among women in Kenya. International Journal of Financial Research, 5(4), 113–121.
11. Kiplagat, E. T., Musiega, D., & Nondi, R. (2013). Determinants of choice of health insurance in Eldoret, Kenya. European Scientific Journal, 9(13), 263–274.
12. Kirigia, J. M., Sambo, L. G., Nganda, B., Mwikisa, C. N., & Kainyu, I. (2005). Determinants of health insurance ownership among South African women. BMC Health Services Research, 5(1), 17.
13. Kumar, P. (2019). Awareness and perception of health insurance in India. International Journal of Research in Commerce & Management, 10(2), 1–4.
14. Modi, A., & Dubey, A. K. (2019). Barriers to health insurance penetration in India: A review of challenges and opportunities. Journal of Health Management, 21(4), 512–524.
15. Muketha, D. M. (2016). Determinants of uptake of health insurance schemes in Meru County, Kenya [Master's thesis, University of Nairobi]. University of Nairobi Research Archive.
16. National Sample Survey Office. (2015). Key indicators of social consumption in India: Health (NSS 71st Round, Report No. 574). Ministry of Statistics and Programme Implementation, Government of India.
17. Nketiah, E. (2009). Demand for health insurance among formal sector employees in Ghana [Master's thesis, Kwame Nkrumah University of Science and Technology]. KNUST Online Repository.
18. Owando, P. (2006). Factors influencing the demand for health insurance in the formal sector in Kenya [Master's thesis, University of Nairobi]. University of Nairobi Research Archive.
19. Pandey, A., Ploubidis, G. B., & Chandola, T. (2019). Determinants of health insurance coverage in India: A study of the 2014-16 National Family Health Survey. PLoS ONE, 14(11), e0224165.
20. Pandve, H. T., & Parulkar, P. B. (2013). Awareness and perception about health insurance in an urban community of India. International Journal of Health & Allied Sciences, 2(1), 48–51.
21. Propper, C. (1989). An econometric analysis of the demand for private health insurance in England and Wales. Applied Economics, 21(6), 777–792.
22. Reshmi, B., Sreekumaran, N. K., & Raju, K. (2008). A study on the awareness of health insurance in a rural population of Kerala. Indian Journal of Public Health, 52(2), 92–93.
23. Reshmi, B., Unnikrishnan, B., & Mithra, P. (2010). Awareness of health insurance in a South Indian population. National Journal of Community Medicine, 1(2), 118–120.
24. Reshmi, B., Sreekumar, K., & Sreemoy, G. (2012). Awareness and perception of health insurance among the people of rural Kerala. Journal of Medical and Allied Sciences, 2(1), 18–21.
25. Ruchita, G., & Bawa, S. K. (2011). Health insurance for the poor in India: A review of challenges and opportunities. International Journal of Social Inquiry, 4(1), 101–123.
26. Samuel, A., Edward, N., Owoo, N. S. (2018): Gender perspective on life insurance demand in Ghana. International Journal of Social Economics; 45 (12): 1631–1646.
27. Shukla, S. (2018). Determinants of willingness to pay for health insurance: A study of rural Uttar Pradesh, India. International Journal of Health Policy and Management, 7(12), 1109–1117.
28. Xiao, J. J. (2018). Marital status and health insurance coverage: A household finance perspective. Journal of Financial Counseling and Planning, 29(1), 58–71.
29. Zhou, M., Zhao, S. & Zhao, Z.(2021). Gender differences in health insurance coverage in China. International Journal for Equity in Health 20, 52.
Published
2025-09-26
How to Cite
Sanyal, M. (2025). Determinants of Health Insurance Choice and Ownership in India-Evidence from National Sample Survey Data. European Scientific Journal, ESJ, 45, 600. Retrieved from https://eujournal.org/index.php/esj/article/view/20077
Section
ESI Preprints
Copyright (c) 2025 Mauli Sanyal
This work is licensed under a Creative Commons Attribution 4.0 International License.
