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Disease-Specific Out-of-Pocket Payments, Catastrophic Health Expenditure and Impoverishment Effects in India: An Analysis of National Health Survey Data

Author

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  • Jeetendra Yadav

    (ICMR-National Institute of Medical Statistics)

  • Geetha R. Menon

    (ICMR-National Institute of Medical Statistics)

  • Denny John

    (Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham)

Abstract

Background In India, more than two-thirds of the total health expenditure is incurred through out-of-pocket expenditure (OOPE) by households. Morbidity events thus impose excessive financial risk on households. The Sustainable Development Goals Target 3.8 specifies financial risk protection for achieving universal health coverage (UHC) in developing countries. This study aimed to estimate the impact of OOPE on catastrophic health expenditure (CHE) and impoverishment effects by types of morbidity in India. Methods Data came from the 75th round of the National Sample Survey (NSS) on the theme ‘Social consumption in India: Health’, which was conducted during the period from July 2017 to June 2018. For the present study, 56,722 households for hospitalisation, 29,580 households for outpatient department (OPD) care and 6285 households for both (OPD care and hospitalisation) were analysed. Indices, namely health care burden, CHE, poverty head count ratio and poverty gap ratio using standard definitions were analysed. Results Households with members who underwent treatment for cancers, cardiovascular diseases, psychiatric conditions, injuries, musculoskeletal and genitourinary conditions spent a relatively high amount of their income on health care. Overall, 41.4% of the households spent > 10% of the total household consumption expenditure (HCE) and 24.6% of households spent > 20% of HCE for hospitalisation. A total of 20.4% and 10.0% of households faced CHE for hospitalisation based on the average per capita and average two capita consumption expenditure, respectively. Health care burden, CHE and impoverishment was higher in households who sought treatment in private health facilities than in public health facilities. Conclusion Our study suggests that there is an urgent need for political players and policymakers to design health system financing policies and strict implementation that will provide financial risk protection to households in India.

Suggested Citation

  • Jeetendra Yadav & Geetha R. Menon & Denny John, 2021. "Disease-Specific Out-of-Pocket Payments, Catastrophic Health Expenditure and Impoverishment Effects in India: An Analysis of National Health Survey Data," Applied Health Economics and Health Policy, Springer, vol. 19(5), pages 769-782, September.
    • Handle: RePEc:spr:aphecp:v:19:y:2021:i:5:d:10.1007_s40258-021-00641-9
    DOI: 10.1007/s40258-021-00641-9
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    References listed on IDEAS

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    1. Sophie Mitra & Patricia A. Findley & Usha Sambamoorthi, 2008. "Healthcare Expenditures of Living with a Disability: Total Expenditures, Out of Pocket Expenses and Burden, 1996-2004," Fordham Economics Discussion Paper Series dp2008-18, Fordham University, Department of Economics.
    2. Kaushalendra Kumar & Ashish Singh & Santosh Kumar & Faujdar Ram & Abhishek Singh & Usha Ram & Joel Negin & Paul R Kowal, 2015. "Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-19, August.
    3. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan‐Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184, November.
    4. Sebastian Levine, 2012. "Exploring Differences in National and International Poverty Estimates: Is Uganda on Track to Halve Poverty by 2015?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 107(2), pages 331-349, June.
    5. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    6. Sanjay K. Mohanty & Anshul Kastor, 2017. "Out-of-pocket expenditure and catastrophic health spending on maternal care in public and private health centres in India: a comparative study of pre and post national health mission period," Health Economics Review, Springer, vol. 7(1), pages 1-15, December.
    7. Sunil Rajpal & Abhishek Kumar & William Joe, 2018. "Economic burden of cancer in India: Evidence from cross-sectional nationally representative household survey, 2014," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
    8. Awad Mataria & Firas Raad & Mohammad Abu-Zaineh & Cam Donaldson, 2010. "Catastrophic healthcare payments and impoverishment in the occupied Palestinian territory," Applied Health Economics and Health Policy, Springer, vol. 8(6), pages 393-405, November.
    9. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
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    Cited by:

    1. Rohit Kumar & Aditya Duggirala, 2021. "Health Insurance as a Healthcare Financing Mechanism in India: Key Strategic Insights and a Business Model Perspective," Vikalpa: The Journal for Decision Makers, , vol. 46(2), pages 112-128, June.
    2. Nafis Faizi & Yasir Alvi, 2021. "Comment on: “Disease-Specific Out-of-Pocket Payments, Catastrophic Health Expenditure and Impoverishment Effects in India: An Analysis of National Health Survey Data”," Applied Health Economics and Health Policy, Springer, vol. 19(5), pages 783-784, September.

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