RESUMO
Background: Health insurance schemes launched by governments have been inadequate to provide health coverage to the vulnerable elderly population. This research aimed to study the prevalence, preference, and pattern of health insurance coverage among the study participants and barriers to its accessibility. Methods: It was a facility-based Sequential explanatory mixed-method study where patients above 60yrs attending the non-communicable disease OPD were recruited by systematic random sampling and enquired using a semi-structured questionnaire for the prevalence, preference, and pattern of health insurance. Focussed Group discussions (FGD) were later conducted to explore the barriers faced by participants in accessing health insurance. Results: Health Insurance coverage among the study participants was 74.5%. Of the participants who had any type of health insurance, 86.7% had public health insurance. About three fourth (73.8%) of those who had health insurance were covered under the CMCHIS. Mean health insurance coverage provided was significantly higher by private health insurance (INR170897.4) as compared to both the LIC and CMCHIS (p<0.01) while premium charged was significantly higher for LIC (INR 10003.3/yr.) as compared to others (p<0.01). Institutional issues, lack of awareness, and economic dependence on children were considered as barriers to the accessibility of health insurance among elderly. Conclusions: A dedicated universal Health Insurance Programme with higher monetary coverage and low premium involving all elderly populations may provide necessary financial risk protection and reduce out-of-pocket health expenditure.
RESUMO
The effect of ethanolic extract of Aristolochia indica was studied on experimentally induced nepharolithatic and urolithuasis in rats. Oxalate urolithiasis was produced by the addition of 0.75% ethylene glycol in the diet for a period for 30 days. Ethylene glycol treatment resulted in a significant increase in the levels of calcium and oxalate. Treatment of ethanolic extract of Aristolochia indica 100mg/kg body weight for 30 days revealed a dose –related effect in the reduction of lithogenic substances, following glycolic acid induced urolithiasis. Simultaneous oral treatment with at a dose of ethanolic extract of Aristolochia indica 100mg/kg for 30 days significantly reversed the ethylene glycol induced nepharolithiasis and urolithiasis. Presumably by preventing the urinary supersaturation of lithogenic substances. Especially of oxalate and calcium. These observation indicate that ethanolic extract of Aristolochia indica can play an important role in the prevention of disorders associated with kidney stone formation.