AN EFFECTIVENESS SCAN OF THE PUBLIC HEALTH INSURANCE PROGRAM OF KHYBER PAKHTUNKHWA

Abstract

This study target Health Insurance Program by government of KP, its budget allocation and utilization, level of awareness, and patient demographic profiles. The study also covers disease coverage and the minimum and maximum cost of the diseases. The study's population is the three major Medical Teaching Institutions (MTIs) of Peshawar. Sample of the study comprises 9,000 patients selected using purposive sampling approach from 2018 to 2020. The findings show that a lower average budget utilization ratio accounts for a lower level of public awareness. The study found that males dominate females by 55% in availing the Sehat Sahulat facility. The cardiac issue is the most common disease treated by the program. These findings are expected to assist policymakers in developing strategies for utilizing the program's resources. MTIs and insurance firms' managers may emphasize diseases cured and higher budget utilization ratios. Furthermore, policymakers may address less-covered areas and patient characteristics through awareness seminars to ensure the program's effectiveness. Finally, the study adds to the current literature by including imperial evidence from Khyber Pakhtunkhwa; Pakistan in the program. Future studies may address comparative analysis of the said program with the other insurance coverage programs.