October 01, 2015
The Question
What existing evidence exists regarding the impact of Rashtriya Swasthya Bima Yojana (RSBY)—a government-run health insurance program for the poor in India? How reliable is the existing evidence and what biases and limitations are present in the studies? Can we effectively assess the program with the available evidence?
What we found
We found that amongst the studies that currently exist, information is incomplete or lacking on evaluation of the program. Existing studies are observational, and it is difficult to arrive at causal conclusions based on such data. Some studies have conflicting reports, such as on the correlation between insurance use and out-of-pocket health expenditures. A few randomized design health insurance studies have begun in India, with the potential to assess RSBY. These could be useful, though there are also inherent limitations in such studies as well.
We argue that RSBY still needs to be rigorously evaluated for its impacts. The future of the program can’t depend on just a few studies that disagree with each other and don’t use a randomized controlled design.
