This week, I drafted a questionnaire and current
inpatients who were insured by a scheme were interviewed at the Narayana
Cardiac Center. I was up on the 6th floor in the general ward.
There, patient’s beds lie next to each other, much like an emergency room.
Patients have the option of upgrading their rooms to shared double rooms,
private rooms, and even executive and deluxe style rooms. However, this comes
at a cost that many scheme-paying patients simply cannot afford. The
questionnaire I drafted had information regarding age, gender, occupation, role
in family, patient income and expenditures, family income and expenditures,
level of completed education, community support, duration of illness, and
existing burdens.
One of my biggest roadblocks included the
questionnaires themselves. My research head decided that the best place to pull
participants was from within the hospital itself. I interviewed current
inpatient using a translator as my aide. This proved to be difficult as some of
the participants became unwilling to provide information about their financial
status partway through an interview. I think it’s possible that they feared aid
being rescinded if they happened to make more income than they were supposed
to. Another roadblock was finding eligible candidates for my study. Many
cardiac patients were typically older, nominal heads. The nominal head was
typically a retired grandparent who garnered respect from the rest of the
family, but was not oftentimes involved in big decision-making discussions.
They didn’t often have a comprehensive view of what the family finances looked
like. Many patients had adult children (who were likely functional heads)
accompanying them during their inpatient visit. My translator avoided all
contact with any patients who had accompanying adult children nearby because he
told me that they would cause trouble for me and ask too many questions. He
insisted that they would be more trouble than they were worth. I worked with
what I could and conducted my interviews with what was available to me.
I preferred
to conduct my interviews with the functional head of household over the nominal
head because they tended to have the most information about the welfare of the
family. Nine cardiac patients were sampled and the families had and average of
4.6 children each. I was surprised to see that the completed level of education
for participants was so broad. They ranged from 3rd standard to a
B.S. C. Family monthly income was also very broad with a range of 2000 rupees
to 50,000 rupees a month.
Every participant claimed to have expenditure costs
that were greater than their level of income. Despite the fact that private
money lenders and self-help groups exist, patients insisted that these were not
options that were available to them or options that they would consider. When
money became a problem, they sold the land and jewelry they had and depended on
their joint family members and adult children to aid them in their times of
need. Family cohesiveness truly appears to be one of the most important values
that upheld in the subcontinent.
I found that all patients reported that had they
lacked an insurance scheme to ease at least some of the financial burden, they
would either not be seeking treatment at a renowned institution such as
Narayana Healthcare Hospital or pursue alternative methods of treatment such a
managing their healthcare problems with medicines instead of more permanent and
ideal treatments such as surgery.
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