Exploring the health insurance dynamics during the COVID-19 pandemic in Delhi NCR, India

Abstract

Introduction: During the COVID-19 pandemic, many people faced financial insecurity due to a surge in medical expenses and out-of-pocket expenditure. This study aims to evaluate the awareness, attitude, and utilization of health insurance among COVID-19 survivors in Delhi-NCR, India. The findings will help policymakers in formulating strategies to boost health insurance adoption and strengthen healthcare resilience for future pandemics. Methods: A cross-sectional study was undertaken among 300 COVID-19 survivors hospitalized in Delhi, NCR region. Enrolment occurred through two stage sampling technique from January 2023 to January 2024. A simple random sampling technique was used to select blocks/sectors in the Delhi NCR region and then a systematic sampling method was applied to identify participants for data collection. Data analysis was conducted using the SPSS-26 version. The relationship between various aspects of health insurance and selected socio-demographic variables was assessed using the chi-square test of association. Additionally, binomial logistic regression was also done. Results: 86.6% of participants were aware of health insurance, with 65.3% enrolled in the insurance policy. Non-enrolment reasons included lack of knowledge (36.5%), disinterest in investing in health insurance (32.6%), and financial constraints (27.8%). 52.5% of participants utilized insurance and 36.8% incurred out-of-pocket expenses. A statistically significant association was found between age, education, employment sector, income, and type of hospital with various aspects of health insurance. Conclusion: The study emphasizes the need to strengthen awareness initiatives, especially for lower-income, less-educated, and older populations, who are more likely to underutilize health insurance.