Status and factors affecting the enrollement of health insurance scheme in local residents at selected ward in Pokhara Metropolitian city

Abstract

Introduction: Health Insurance is an indisputable instrument for healthcare funding. It has been utilized by most developed nations in its different structures to subsidize healthcare. It is just of late being applied by poorer developing countries to attend to the obvious issue of deficient healthcare availability which has over the years been financed from public. Methods: A cross sectional study was conducted to assess the status and factors associated of enrollment in health insurance scheme from adults of selected ward of Pokhara Metropolitian city. Probability sampling involving cluster and systematic randomization strategy was adopted in this study. Permission was obtained from Institutional Review Committee, Gandaki Medical College and verbal informed consent was taken from respondents prior to data collection. Results: About 51.2% were enrolled in health insurance scheme, among those only 73.57% had utilized scheme. 28% of participant were non-enrollment due to not aware about the scheme. 21.9% were High payment of premium cost. Enrollment status was statistically significant with chronic illness and face financial trouble.Conclusions: About 52.1% of families had enrolled in health insurance scheme. Among enrollment 73.57% were utilization the scheme. Health personal/ Friends/ family members and insurance service providers played an important role in dissemination of information. Multiple factors were found to be associated with the enrollement of the health insurance scheme which includes presence of chronic illness, face financial problem and mode of Enrollement.