The Value of Health Insurance: A Field Experiment in India

Last registered on June 23, 2019
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Pre-Trial

Trial Information

General Information

Title
The Value of Health Insurance: A Field Experiment in India
RCT ID
AEARCTR-0001793
Initial registration date
December 16, 2016

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
December 16, 2016, 10:38 AM EST

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
June 23, 2019, 11:20 PM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Country
India
Region
South Asia

Primary Investigator

Name
Cynthia Kinnan
Affiliation
Tufts University
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Other Primary Investigator(s)

PI Name
Morgen Miller
PI Affiliation
University of Chicago
Contact Investigator
PI Name
Anup Malani
PI Affiliation
University of Chicago
Contact Investigator
PI Name
Kosuke Imai
PI Affiliation
Princeton University
PI Name
Gabriella Conti
PI Affiliation
University College London
PI Name
Alessandra Voena
PI Affiliation
University of Chicago

Additional Trial Information

Status
On going
Start date
2013-09-01
End date
2019-12-31
Keywords
Health, Welfare
Additional Keywords
RSBY, free health insurance, inpatient insurance, income transfer, wealth effects, health expenditure
JEL code(s)
Secondary IDs
Abstract
In this study, we use a randomized field experiment in Karnataka, India, to measure the effects of a free inpatient public health insurance plan, Rashtriya Swasthya Bima Yojana (RSBY), on health and poverty. We randomize approximately 12,000 households in the two districts of Mysore and Gulbarga into one of four treatment or control groups, which receive:

1) Free RSBY inpatient coverage (the treatment group)
2) Income transfer equal to the insurance premium for RSBY and the opportunity to buy RSBY at the same premium the government pays
3) The opportunity to buy RSBY at the same premium that the government pays
4) No treatment, except the survey compensation granted to all participants

Our goal is to quantify how the RSBY program benefits health and reduces poverty in the short and medium term.
External Link(s)
Expanding Indian public health insurance above the poverty line
India Health Insurance Experiments

Registration Citation

Citation
Conti, Gabriella et al. 2019. "The Value of Health Insurance: A Field Experiment in India." AEA RCT Registry. June 23. https://doi.org/10.1257/rct.1793-4.0
Former Citation
Conti, Gabriella et al. 2019. "The Value of Health Insurance: A Field Experiment in India." AEA RCT Registry. June 23. https://www.socialscienceregistry.org/trials/1793/history/48581
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
We randomize approximately 12,000 households in the two districts of Mysore and Gulbarga, India into one of four treatment or control groups, which receive:

1) Free RSBY inpatient coverage (the treatment group)
2) Income transfer equal to the insurance premium for RSBY and the opportunity to buy RSBY at the same premium the government pays
3) The opportunity to buy RSBY at the same premium that the government pays
4) No treatment, except the survey compensation granted to all participants

To be eligible, households must not live below the poverty line.

Please see the pre-analysis plan for a full description of all project-related details.
Intervention Start Date
2015-06-30
Intervention End Date
2019-08-31

Primary Outcomes

Primary Outcomes (end points)
inpatient treatment, cognitive capacity, employment status, income, health care utilization and expenditures (inpatient and outpatient), health status, nonmedical consumption, productive and nonproductive assets, borrowing and savings, knowledge of/attitude towards the health care system and facilities
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
A house listing exercise was conducted one month prior to enrollment to identify eligible households. Then, field staff randonly visited selected households to enroll them in the study. Randomization into treatment occurred after baseline data collection. Data is collected through baseline and at least two follow up surveys, as well as from data on RSBY health insurance claims forms. Data is being collected on cognitive capacity, employment status, income, health care utilization and expenditures (inpatient and outpatient), health status, nonmedical consumption, productive and nonproductive assets, borrowing and savings, and other investments, including education, through longitudinal household surveys, special surveys following serious health events, and insurance claims data. Special surveys will be administered to some households that have a health event during the study period.

The primary survey respondent is the female head of household. Male heads of the household will complete some of the modules and the youngest child in the household who is under 18 will also provide anthropometric measures.
Experimental Design Details
Randomization Method
Computer randomization
Randomization Unit
Household
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
12,030 households
Sample size: planned number of observations
57,744 individuals (children and adults)
Sample size (or number of clusters) by treatment arms
4,740 households treatment, 2,370 households control group one, 2,370 households control group two, 2,370 control group three, and 180 households control group four.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
The 12,030 household sample will allow us to estimate a 25% change in the utilization of outpatient care with 95% confidence and 80% power.
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Chicago Social and Behavioral Sciences Institutional Review Board
IRB Approval Date
2013-04-01
IRB Approval Number
IRB12-2085
IRB Name
Northwestern University Institutional Review Board
IRB Approval Date
2013-01-23
IRB Approval Number
STU00073184
Analysis Plan

Analysis Plan Documents

Pre-Analysis Plan for Endline Data in the India Health Insurance Experiment_Amended

MD5: a03227f5f03c21cb402c0782a0a68f34

SHA1: 1913e7fddaed1b5c43f737573fd91143075d7561

Uploaded At: June 23, 2019

Pre-Analysis Plan for Endline Data in the India Health Insurance Experiment

MD5: c5d7fcec769e81b982d85994a9a261e9

SHA1: a4c66e40a9c36600bbf2a38e9097c7c691040c0a

Uploaded At: March 14, 2019

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials