Exploring the health insurance dynamics during the COVID-19 pandemic in Delhi NCR, India

During the COVID-19 pandemic, many people faced financial insecurity due to a surge in medical expenses and out-of-pocket expenditure. This study aims to evaluate the awareness, attitude, and utilization of health insurance among COVID-19 survivors in Delhi-NCR, India. The findings will help policymakers in formulating strategies to boost health insurance adoption and strengthen healthcare resilience for future pandemics. A cross-sectional study was undertaken among 300 COVID-19 survivors hospitalized in Delhi, NCR region. Enrolment occurred through two stage sampling technique from January 2023 to January 2024. A simple random sampling technique was used to select blocks/sectors in the Delhi NCR region and then a systematic sampling method was applied to identify participants for data collection. Data analysis was conducted using the SPSS-26 version. The relationship between various aspects of health insurance and selected socio-demographic variables was assessed using the chi-square test of association. Additionally, binomial logistic regression was also done. 86.6% of participants were aware of health insurance, with 65.3% enrolled in the insurance policy. Non-enrolment reasons included lack of knowledge (36.5%), disinterest in investing in health insurance (32.6%), and financial constraints (27.8%). 52.5% of participants utilized insurance and 36.8% incurred out-of-pocket expenses. A statistically significant association was found between age, education, employment sector, income, and type of hospital with various aspects of health insurance. The study emphasizes the need to strengthen awareness initiatives, especially for lower-income, less-educated, and older populations, who are more likely to underutilize health insurance.