Evaluating the Perceived Benefits and Effectiveness of a Government Health Insurance Scheme for Chronic Kidney Disease Patients: A Study in Nellore, Andhra Pradesh

Background Chronic kidney disease (CKD) is prevalent in India, particularly among underprivileged populations. Government initiatives such as the Dr. YSR Aarogyasri Health Insurance Scheme aim to provide affordable healthcare to economically impoverished individuals with kidney diseases. This study assessed participants' perceptions of the scheme's benefits, effectiveness, and challenges. Methods A cross-sectional study was conducted in Nellore, Andhra Pradesh, involving 100 CKD patients. Data was collected using a structured questionnaire assessing socio-demographic factors, insurance scheme's awareness, perceived benefits, and effectiveness. Multivariable logistic regression analysis was employed to identify factors influencing participants' perceptions. Results Participants aged over 40 years were more likely to perceive the Dr. YSR Aarogyasri Health Insurance Scheme positively (crude odds ratio {COR}: 9.2; 95% CI: 2.6-31.7). Males (adjusted odds ration {aOR} 1.5; 95% CI: 1.1-2.1), married individuals (aOR 1.3; 95% CI: 0.8-1.7), and those with higher education (aOR 1.9; 95% CI: 1.1-3.2) reported greater scheme effectiveness. However, 32% of CKD patients lacked awareness of the scheme's enrolment process, 29% believed that the eligibility criteria were too strict, and 17% of insured patients reported gaps in coverage for specific services, treatments, and medications, reducing the scheme's appeal to diseased patients. Discussion Older males and those with diabetes, who require extensive care, perceive the scheme as beneficial. However, gaps in awareness and coverage remain barriers to its full effectiveness. Conclusion While the Dr. YSR Aarogyasri Health Insurance Scheme provides critical financial relief for CKD patients, enhancing its outreach and expanding coverage could improve its impact. These findings can guide policy improvements to optimize the scheme's effectiveness and accessibility.