T able 5. Open in new tab Impact of...

	Intervention group	Control group	Direct effect of health card^a	Overall effect of SSN^b	Indirect effect^c (percentage share of overall effect) p
All outpatient visits
Quintile 1 (poor)	0.0993	0.0869	0.0123*	14.2	0.0023*	0.0039	0.0056	(58.93)
Quintile 5 (rich)	0.1510	0.1451	0.0059	4.0	0.0002	0.0075**	0.0108**	98.15
Male	0.1158	0.1069	0.0089*	8.3	0.0009*	0.0037***	0.0053***	83.02
Female	0.1270	0.1157	0.0113*	9.8	0.0012*	0.0040***	0.0058***	79.31
Urban	0.1392	0.1281	0.0110*	8.6	0.0008*	0.0045	0.0064	(87.50)
Rural	0.1149	0.1061	0.0088*	8.3	0.0011*	0.0060**	0.0086**	87.21
All	0.1215	0.1113	0.0101*	9.1	0.0011*	0.0039***	0.0055***	80.00
Outpatient public
Quintile 1 (poor)	0.0729	0.0542	0.0187*	34.6	0.0035*	0.0035	0.0049	(28.57)
Quintile 5 (rich)	0.0841	0.0590	0.0251*	42.5	0.0009*	0.0094*	0.0134*	93.28
Male	0.0734	0.0537	0.0197*	36.8	0.0021*	0.0026***	0.0037***	43.24
Female	0.0871	0.0622	0.0249*	40.1	0.0027*	0.0040**	0.0057**	52.63
Urban	0.0869	0.0628	0.0241*	38.3	0.0017*	0.0016	0.0023	(26.09)
Rural	0.0779	0.0565	0.0214*	38.0	0.0027*	0.0053*	0.0076***	64.47
All	0.0804	0.0580	0.0224*	38.6	0.0024*	0.0033**	0.0047**	48.94
Outpatient private
Quintile 1 (poor)	0.0305	0.0371	−0.0066*	–17.7	−0.0012*	0.0020	0.0028
Quintile 5 (rich)	0.0803	0.0983	−0.0179*	–18.2	−0.0007*	−0.0016	−0.0023
Male	0.0501	0.0601	−0.0100*	–16.6	−0.0010*	0.0012	0.0017
Female	0.0477	0.0606	−0.0129*	–21.3	−0.0014*	0.0005	0.0008
Urban	0.0613	0.0726	−0.0113*	–15.5	−0.0008*	0.0031	0.0045
Rural	0.0442	0.0565	−0.0123*	–21.7	−0.0016*	0.0013	0.0019
All	0.0489	0.0604	−0.0115*	–19.0	−0.0012*	0.0009	0.0013

Intervention group

Control group

Direct effect of health card^a

Overall effect of SSN^b

Indirect effect^c (percentage share of overall effect) p

Difference (β̂)

Change (%)

Direct effect (p̂β̂)

Coefficient (γ̂)

Overall effect (γ̂

SSN

)

All outpatient visits

Quintile 1 (poor)

0.0993

0.0869

0.0123*

14.2

0.0023*

0.0039

0.0056

(58.93)

Quintile 5 (rich)

0.1510

0.1451

0.0059

4.0

0.0002

0.0075**

0.0108**

98.15

Male

0.1158

0.1069

0.0089*

8.3

0.0009*

0.0037***

0.0053***

83.02

Female

0.1270

0.1157

0.0113*

9.8

0.0012*

0.0040***

0.0058***

79.31

Urban

0.1392

0.1281

0.0110*

8.6

0.0008*

0.0045

0.0064

(87.50)

Rural

0.1149

0.1061

0.0088*

8.3

0.0011*

0.0060**

0.0086**

87.21

All

0.1215

0.1113

0.0101*

9.1

0.0011*

0.0039***

0.0055***

80.00

Outpatient public

Quintile 1 (poor)

0.0729

0.0542

0.0187*

34.6

0.0035*

0.0035

0.0049

(28.57)

Quintile 5 (rich)

0.0841

0.0590

0.0251*

42.5

0.0009*

0.0094*

0.0134*

93.28

Male

0.0734

0.0537

0.0197*

36.8

0.0021*

0.0026***

0.0037***

43.24

Female

0.0871

0.0622

0.0249*

40.1

0.0027*

0.0040**

0.0057**

52.63

Urban

0.0869

0.0628

0.0241*

38.3

0.0017*

0.0016

0.0023

(26.09)

Rural

0.0779

0.0565

0.0214*

38.0

0.0027*

0.0053*

0.0076***

64.47

All

0.0804

0.0580

0.0224*

38.6

0.0024*

0.0033**

0.0047**

48.94

Outpatient private

Quintile 1 (poor)

0.0305

0.0371

−0.0066*

–17.7

−0.0012*

0.0020

0.0028

Quintile 5 (rich)

0.0803

0.0983

−0.0179*

–18.2

−0.0007*

−0.0016

−0.0023

Male

0.0501

0.0601

−0.0100*

–16.6

−0.0010*

0.0012

0.0017

Female

0.0477

0.0606

−0.0129*

–21.3

−0.0014*

0.0005

0.0008

Urban

0.0613

0.0726

−0.0113*

–15.5

−0.0008*

0.0031

0.0045

Rural

0.0442

0.0565

−0.0123*

–21.7

−0.0016*

0.0013

0.0019

All

0.0489

0.0604

−0.0115*

–19.0

−0.0012*

0.0009

0.0013

	Intervention group	Control group	Direct effect of health card^a	Overall effect of SSN^b	Indirect effect^c (percentage share of overall effect) p
All outpatient visits
Quintile 1 (poor)	0.0993	0.0869	0.0123*	14.2	0.0023*	0.0039	0.0056	(58.93)
Quintile 5 (rich)	0.1510	0.1451	0.0059	4.0	0.0002	0.0075**	0.0108**	98.15
Male	0.1158	0.1069	0.0089*	8.3	0.0009*	0.0037***	0.0053***	83.02
Female	0.1270	0.1157	0.0113*	9.8	0.0012*	0.0040***	0.0058***	79.31
Urban	0.1392	0.1281	0.0110*	8.6	0.0008*	0.0045	0.0064	(87.50)
Rural	0.1149	0.1061	0.0088*	8.3	0.0011*	0.0060**	0.0086**	87.21
All	0.1215	0.1113	0.0101*	9.1	0.0011*	0.0039***	0.0055***	80.00
Outpatient public
Quintile 1 (poor)	0.0729	0.0542	0.0187*	34.6	0.0035*	0.0035	0.0049	(28.57)
Quintile 5 (rich)	0.0841	0.0590	0.0251*	42.5	0.0009*	0.0094*	0.0134*	93.28
Male	0.0734	0.0537	0.0197*	36.8	0.0021*	0.0026***	0.0037***	43.24
Female	0.0871	0.0622	0.0249*	40.1	0.0027*	0.0040**	0.0057**	52.63
Urban	0.0869	0.0628	0.0241*	38.3	0.0017*	0.0016	0.0023	(26.09)
Rural	0.0779	0.0565	0.0214*	38.0	0.0027*	0.0053*	0.0076***	64.47
All	0.0804	0.0580	0.0224*	38.6	0.0024*	0.0033**	0.0047**	48.94
Outpatient private
Quintile 1 (poor)	0.0305	0.0371	−0.0066*	–17.7	−0.0012*	0.0020	0.0028
Quintile 5 (rich)	0.0803	0.0983	−0.0179*	–18.2	−0.0007*	−0.0016	−0.0023
Male	0.0501	0.0601	−0.0100*	–16.6	−0.0010*	0.0012	0.0017
Female	0.0477	0.0606	−0.0129*	–21.3	−0.0014*	0.0005	0.0008
Urban	0.0613	0.0726	−0.0113*	–15.5	−0.0008*	0.0031	0.0045
Rural	0.0442	0.0565	−0.0123*	–21.7	−0.0016*	0.0013	0.0019
All	0.0489	0.0604	−0.0115*	–19.0	−0.0012*	0.0009	0.0013

Table 5.

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Impact of Health Card Ownership and Overall Effect of SSN Interventions on Use of Outpatient Services (one month reference period)

	Intervention group	Control group	Direct effect of health card^a			Overall effect of SSN^b		Indirect effect^c (percentage share of overall effect) p
	Intervention group	Control group	Difference (β̂)	Change (%)	Direct effect (p̂β̂)	Coefficient (γ̂)	Overall effect (γ̂ SSN )	Indirect effect^c (percentage share of overall effect) p
All outpatient visits
Quintile 1 (poor)	0.0993	0.0869	0.0123*	14.2	0.0023*	0.0039	0.0056	(58.93)
Quintile 5 (rich)	0.1510	0.1451	0.0059	4.0	0.0002	0.0075**	0.0108**	98.15
Male	0.1158	0.1069	0.0089*	8.3	0.0009*	0.0037***	0.0053***	83.02
Female	0.1270	0.1157	0.0113*	9.8	0.0012*	0.0040***	0.0058***	79.31
Urban	0.1392	0.1281	0.0110*	8.6	0.0008*	0.0045	0.0064	(87.50)
Rural	0.1149	0.1061	0.0088*	8.3	0.0011*	0.0060**	0.0086**	87.21
All	0.1215	0.1113	0.0101*	9.1	0.0011*	0.0039***	0.0055***	80.00
Outpatient public
Quintile 1 (poor)	0.0729	0.0542	0.0187*	34.6	0.0035*	0.0035	0.0049	(28.57)
Quintile 5 (rich)	0.0841	0.0590	0.0251*	42.5	0.0009*	0.0094*	0.0134*	93.28
Male	0.0734	0.0537	0.0197*	36.8	0.0021*	0.0026***	0.0037***	43.24
Female	0.0871	0.0622	0.0249*	40.1	0.0027*	0.0040**	0.0057**	52.63
Urban	0.0869	0.0628	0.0241*	38.3	0.0017*	0.0016	0.0023	(26.09)
Rural	0.0779	0.0565	0.0214*	38.0	0.0027*	0.0053*	0.0076***	64.47
All	0.0804	0.0580	0.0224*	38.6	0.0024*	0.0033**	0.0047**	48.94
Outpatient private
Quintile 1 (poor)	0.0305	0.0371	−0.0066*	–17.7	−0.0012*	0.0020	0.0028
Quintile 5 (rich)	0.0803	0.0983	−0.0179*	–18.2	−0.0007*	−0.0016	−0.0023
Male	0.0501	0.0601	−0.0100*	–16.6	−0.0010*	0.0012	0.0017
Female	0.0477	0.0606	−0.0129*	–21.3	−0.0014*	0.0005	0.0008
Urban	0.0613	0.0726	−0.0113*	–15.5	−0.0008*	0.0031	0.0045
Rural	0.0442	0.0565	−0.0123*	–21.7	−0.0016*	0.0013	0.0019
All	0.0489	0.0604	−0.0115*	–19.0	−0.0012*	0.0009	0.0013

	Intervention group	Control group	Direct effect of health card^a			Overall effect of SSN^b		Indirect effect^c (percentage share of overall effect) p
	Intervention group	Control group	Difference (β̂)	Change (%)	Direct effect (p̂β̂)	Coefficient (γ̂)	Overall effect (γ̂ SSN )	Indirect effect^c (percentage share of overall effect) p
All outpatient visits
Quintile 1 (poor)	0.0993	0.0869	0.0123*	14.2	0.0023*	0.0039	0.0056	(58.93)
Quintile 5 (rich)	0.1510	0.1451	0.0059	4.0	0.0002	0.0075**	0.0108**	98.15
Male	0.1158	0.1069	0.0089*	8.3	0.0009*	0.0037***	0.0053***	83.02
Female	0.1270	0.1157	0.0113*	9.8	0.0012*	0.0040***	0.0058***	79.31
Urban	0.1392	0.1281	0.0110*	8.6	0.0008*	0.0045	0.0064	(87.50)
Rural	0.1149	0.1061	0.0088*	8.3	0.0011*	0.0060**	0.0086**	87.21
All	0.1215	0.1113	0.0101*	9.1	0.0011*	0.0039***	0.0055***	80.00
Outpatient public
Quintile 1 (poor)	0.0729	0.0542	0.0187*	34.6	0.0035*	0.0035	0.0049	(28.57)
Quintile 5 (rich)	0.0841	0.0590	0.0251*	42.5	0.0009*	0.0094*	0.0134*	93.28
Male	0.0734	0.0537	0.0197*	36.8	0.0021*	0.0026***	0.0037***	43.24
Female	0.0871	0.0622	0.0249*	40.1	0.0027*	0.0040**	0.0057**	52.63
Urban	0.0869	0.0628	0.0241*	38.3	0.0017*	0.0016	0.0023	(26.09)
Rural	0.0779	0.0565	0.0214*	38.0	0.0027*	0.0053*	0.0076***	64.47
All	0.0804	0.0580	0.0224*	38.6	0.0024*	0.0033**	0.0047**	48.94
Outpatient private
Quintile 1 (poor)	0.0305	0.0371	−0.0066*	–17.7	−0.0012*	0.0020	0.0028
Quintile 5 (rich)	0.0803	0.0983	−0.0179*	–18.2	−0.0007*	−0.0016	−0.0023
Male	0.0501	0.0601	−0.0100*	–16.6	−0.0010*	0.0012	0.0017
Female	0.0477	0.0606	−0.0129*	–21.3	−0.0014*	0.0005	0.0008
Urban	0.0613	0.0726	−0.0113*	–15.5	−0.0008*	0.0031	0.0045
Rural	0.0442	0.0565	−0.0123*	–21.7	−0.0016*	0.0013	0.0019
All	0.0489	0.0604	−0.0115*	–19.0	−0.0012*	0.0009	0.0013

*Significant at the 1 percent level; **significant at the 5 percent level; ***significant at the 10 percent level.

Note: Detailed estimation results are available in the supplemental appendix (tables S.7, S.9–S.11).

^aNumber of observations: 76,903 individuals in treatment group, 73,986 in control group. Bootstrapped standard errors with 500 replications.

^bNumber of observations: 293 districts.

^cNumbers in parentheses are indirect effect estimates that are based on imprecise estimates of the total effect.

Source: Authors' analysis based on data described in text.

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