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Background <p>Government health insurance schemes are vital for improving healthcare access and reducing out-of-pocket expenditure, particularly socioeconomically vulnerable populations. Assessing awareness and utilization among patients attending Primary Health Centers (PHCs) is essential to identify existing gaps and to strengthen the implementation of these schemes.</p> Objectives <p>To assess awareness and utilization of government health insurance schemes among patients attending a Primary Health Centre (PHC) and to identify barriers to utilization.</p> Methods <p>A cross-sectional study was conducted at a PHC in Tenali Mandal, Andhra Pradesh, from November 2025 to January 2026. A total of 200 participants aged ≥ 18 years were included using convenience sampling. Data were collected using a pre-tested semi-structured questionnaire. Chi-square test was applied for associations.</p> Results <p>Awareness of at least one scheme was observed in 64% (95% CI: 57.2%–70.4%) participants. Among them, 56.3% were enrolled, but only 37.5% (95% CI: 30.8%–44.6%) had utilized benefits. Awareness was significantly associated with education (<i>p</i> = 0.005) and socioeconomic status (<i>p</i> = 0.008). Major barriers included lack of procedural knowledge (53.1%), complexity (42.2%), and documentation issues (35.9%).</p> Conclusion <p>In this single PHC-based study, awareness was moderate but utilization was low. Findings highlight the need for improved awareness and simplified procedures; however, results may not be generalizable beyond the study setting.</p>

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Awareness and utilization of government health insurance schemes among patients attending a primary health centre in Tenali Mandal, Andhra Pradesh

  • 期刊论文

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  • 发表日期：

    2026年8月5日

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  • Devaki Talluri,
  • Sathya Maithreyi Tadiboina,
  • Sathya Jagathi Tadiboina

摘要

Background

Government health insurance schemes are vital for improving healthcare access and reducing out-of-pocket expenditure, particularly socioeconomically vulnerable populations. Assessing awareness and utilization among patients attending Primary Health Centers (PHCs) is essential to identify existing gaps and to strengthen the implementation of these schemes.

Objectives

To assess awareness and utilization of government health insurance schemes among patients attending a Primary Health Centre (PHC) and to identify barriers to utilization.

Methods

A cross-sectional study was conducted at a PHC in Tenali Mandal, Andhra Pradesh, from November 2025 to January 2026. A total of 200 participants aged ≥ 18 years were included using convenience sampling. Data were collected using a pre-tested semi-structured questionnaire. Chi-square test was applied for associations.

Results

Awareness of at least one scheme was observed in 64% (95% CI: 57.2%–70.4%) participants. Among them, 56.3% were enrolled, but only 37.5% (95% CI: 30.8%–44.6%) had utilized benefits. Awareness was significantly associated with education (p = 0.005) and socioeconomic status (p = 0.008). Major barriers included lack of procedural knowledge (53.1%), complexity (42.2%), and documentation issues (35.9%).

Conclusion

In this single PHC-based study, awareness was moderate but utilization was low. Findings highlight the need for improved awareness and simplified procedures; however, results may not be generalizable beyond the study setting.