{"id":"https://openalex.org/W7225835433","doi":"https://doi.org/10.21203/rs.3.rs-10420547/v1","title":"Public funded health insurance and its role in catering to Catastrophic Health Expenditure: A Reflexive Thematic Analysis from Karnataka, India","display_name":"Public funded health insurance and its role in catering to Catastrophic Health Expenditure: A Reflexive Thematic Analysis from Karnataka, India","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225835433","doi":"https://doi.org/10.21203/rs.3.rs-10420547/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-10420547/v1","doi":"https://doi.org/10.21203/rs.3.rs-10420547/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10420547/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.21203/rs.3.rs-10420547/v1","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5116491559","display_name":"Liya Joseph","orcid":"https://orcid.org/0009-0001-2123-9366","observed_orcids":["https://orcid.org/0009-0001-2123-9366"]},"institutions":[{"id":"https://openalex.org/I48018076","display_name":"Christ University","ror":"https://ror.org/022tv9y30","country_code":"IN","type":"education","lineage":["https://openalex.org/I48018076"]}],"countries":["IN"],"is_corresponding":true,"raw_author_name":"Liya Joseph","raw_affiliation_strings":["Christ University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Christ University","institution_ids":["https://openalex.org/I48018076"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5116491559"],"corresponding_institution_ids":["https://openalex.org/I48018076"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12708","display_name":"Economic and Financial Impacts of Cancer","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C74196892","wikidata":"https://www.wikidata.org/wiki/Q7781188","display_name":"Thematic analysis","level":3,"score":0.724399983882904},{"id":"https://openalex.org/C13200473","wikidata":"https://www.wikidata.org/wiki/Q2747831","display_name":"Reflexivity","level":2,"score":0.6553999781608582},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6148999929428101},{"id":"https://openalex.org/C100363876","wikidata":"https://www.wikidata.org/wiki/Q690661","display_name":"Nonprobability sampling","level":3,"score":0.5189999938011169},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.4900999963283539},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.4675999879837036},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.412200003862381},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.4047999978065491},{"id":"https://openalex.org/C83864248","wikidata":"https://www.wikidata.org/wiki/Q177323","display_name":"Developing country","level":2,"score":0.4034999907016754},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.39469999074935913},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.38920000195503235},{"id":"https://openalex.org/C113470044","wikidata":"https://www.wikidata.org/wiki/Q6056506","display_name":"Interpretative phenomenological analysis","level":3,"score":0.3587000072002411},{"id":"https://openalex.org/C198531522","wikidata":"https://www.wikidata.org/wiki/Q485146","display_name":"Sample (material)","level":2,"score":0.33169999718666077},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.3287000060081482},{"id":"https://openalex.org/C198327121","wikidata":"https://www.wikidata.org/wiki/Q7410163","display_name":"Sampling frame","level":3,"score":0.3100999891757965},{"id":"https://openalex.org/C45555294","wikidata":"https://www.wikidata.org/wiki/Q28113351","display_name":"Inequality","level":2,"score":0.3100000023841858},{"id":"https://openalex.org/C120527767","wikidata":"https://www.wikidata.org/wiki/Q3196867","display_name":"Debt","level":2,"score":0.2969000041484833},{"id":"https://openalex.org/C78491826","wikidata":"https://www.wikidata.org/wiki/Q3045352","display_name":"Social determinants of health","level":3,"score":0.29589998722076416},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.2935999929904938},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.2883000075817108},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.2840999960899353},{"id":"https://openalex.org/C87156501","wikidata":"https://www.wikidata.org/wiki/Q7268708","display_name":"Qualitative property","level":2,"score":0.28040000796318054},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.27480000257492065},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.27129998803138733},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.2603999972343445},{"id":"https://openalex.org/C2986740045","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health services","level":3,"score":0.2563000023365021},{"id":"https://openalex.org/C2983635472","wikidata":"https://www.wikidata.org/wiki/Q334911","display_name":"Health insurance","level":3,"score":0.25060001015663147}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-10420547/v1","doi":"https://doi.org/10.21203/rs.3.rs-10420547/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10420547/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-10420547/v1","doi":"https://doi.org/10.21203/rs.3.rs-10420547/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10420547/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":14,"referenced_works":["https://openalex.org/W2338991735","https://openalex.org/W3036063864","https://openalex.org/W4292219955","https://openalex.org/W4296276351","https://openalex.org/W4318594640","https://openalex.org/W4377139337","https://openalex.org/W4386227275","https://openalex.org/W4391041723","https://openalex.org/W4391465797","https://openalex.org/W4395012717","https://openalex.org/W4403338007","https://openalex.org/W4404981512","https://openalex.org/W4416787782","https://openalex.org/W7117151197"],"related_works":[],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"The":[2,42,230],"negative":[3],"impact":[4],"of":[5,11,44,93,110,150,166,202,219,238,316],"structural":[6,46],"inequalities":[7],"on":[8,61,140],"the":[9,49,73,77,86,90,111,115,127,141,203,220,235,260,285,314],"citizens":[10],"developing":[12,34],"countries'":[13],"ability":[14],"to":[15,29,71,287,299,312],"utilise":[16],"available":[17],"services":[18,28],"is":[19],"further":[20,97],"deteriorated":[21],"by":[22,76,89,136,265,291],"healthcare":[23,40,64],"systems":[24],"that":[25,191,280],"provide":[26],"insufficient":[27],"meet":[30],"population":[31],"needs.":[32],"Many":[33],"countries":[35],"face":[36],"severe":[37],"limitations":[38],"in":[39,84,179,200],"infrastructure.":[41],"combination":[43],"these":[45,289],"disadvantages":[47],"and":[48,106,138,184,212,248,273,296,308],"need":[50],"for":[51,54,157,173],"sustainable":[52],"solutions":[53],"improving":[55],"health":[56,207,228,241,252,282],"outcomes":[57],"creates":[58],"additional":[59],"pressures":[60],"already":[62],"fragile":[63],"systems.":[65],"Aim":[66],"This":[67,95,119,144,277],"qualitative":[68],"study":[69,96,120,145,159,278],"aims":[70],"explore":[72],"role":[74],"played":[75],"Ayushman":[78],"Bharat":[79],"Arogya":[80],"Karnataka":[81],"Scheme":[82],"(AB-Ark)":[83],"addressing":[85],"CHE,":[87],"faced":[88],"BPL":[91,153],"families":[92],"Bengaluru.":[94,168],"expands":[98],"into":[99,114,225],"understanding":[100],"claim":[101],"utilization,":[102],"service":[103],"provider":[104],"behaviour":[105],"overall":[107],"lived":[108],"experience":[109],"households,":[112],"enrolled":[113],"AB-Ark":[116,204],"scheme.":[117,205,229],"Methods":[118],"devises":[121],"an":[122],"Interpretative":[123],"Phenomenological":[124],"Approach":[125],"as":[126],"overarching":[128],"umbrella,":[129],"while":[130],"following":[131],"a":[132,147,194],"reflexive":[133],"thematic":[134],"analysis":[135],"Braun":[137],"Clark":[139],"interview":[142],"transcripts.":[143],"had":[146],"sample":[148],"size":[149],"eight.":[151],"Eight":[152],"households":[154,192],"were":[155,171,177],"selected":[156],"this":[158,226,317],"through":[160],"purposive":[161],"sampling":[162],"across":[163],"various":[164],"parts":[165],"Urban":[167],"Semi-structured":[169],"interviews":[170],"conducted":[172],"data":[174],"collection.":[175],"Interviews":[176],"collected":[178],"Kannada,":[180],"Tamil,":[181],"Malayalam,":[182],"Hindi":[183],"English.":[185],"Results":[186],"It":[187],"has":[188,284],"been":[189,217],"observed":[190],"have":[193,216,232],"reactive":[195],"enrollment":[196,224],"pattern":[197],"than":[198],"preventive":[199],"case":[201],"Unfortunate":[206],"contingences,":[208],"long-term":[209],"treatment":[210,269],"needs,":[211],"pilling":[213],"medical":[214,271],"debt":[215],"one":[218],"major":[221],"factors":[222],"causing":[223],"public-funded":[227],"results":[231],"also":[233],"shown":[234],"multiple":[236],"sides":[237],"accessing":[239],"public":[240,281],"care":[242],"systems,":[243],"within":[244],"its":[245],"existing":[246],"barriers":[247],"challenges.":[249],"Conclusion":[250],"Catastrophic":[251],"expenditure":[253],"extends":[254],"beyond":[255],"high":[256],"out-of-pocket":[257],"spending,":[258],"encompassing":[259],"cumulative":[261],"financial":[262,293],"vulnerability":[263],"created":[264],"chronic":[266],"illness,":[267],"costly":[268],"episodes,":[270],"debt,":[272],"depleted":[274],"household":[275],"resources.":[276],"demonstrates":[279],"insurance":[283],"potential":[286],"interrupt":[288],"pathways":[290],"providing":[292],"risk":[294],"protection":[295],"enabling":[297],"access":[298],"essential":[300],"healthcare.":[301],"However,":[302],"persistent":[303],"hidden":[304],"costs,":[305],"administrative":[306],"barriers,":[307],"procedural":[309],"inefficiencies":[310],"continue":[311],"limit":[313],"extent":[315],"protection.":[318]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}
