Analyzing Out of Pocket Health Expenses: An Assessment based on Cross Section Study in Assam
DOI:
https://doi.org/10.47203/IJCH.2019.v31i02.008Keywords:
Health Expenditures; Logistic Models; Health Care Costs; Delivery of Health Care; Health Facilities; Surveys and Questionnaires; IndiaAbstract
Background: Increasing out of pocket health expenses is one of the major debates among the policy makers during the recent years. Out of pocket (OOP) health expenses above the catastrophic level leads to impoverishment of the rural poor. Aims & Objectives: To analyzes the impact of inpatient care in escalating OOP expenses and identifies the factors associated with catastrophic health expenditure in Assam, India. Material & Methods: The study is based on the household survey conducted during 2014 - 15 in Nagaon and Nalbari districts of Assam. The factors associated with catastrophic health expenditure are estimated using binary logistic regression model. Results: The households are afflicted with a larger burden of healthcare expenditure mainly in case of inpatient care. Due to severe shortage of medical personnel and equipment, residents are compelled to visit private health facilities. Huge costs are borne by the households due to outsourcing of services from government to private sector. Conclusions: Provision of protection from financial risk for health hazards and improvement of quality of health care in government hospitals is imperative to improve the existing situation.
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Baru, R., Acharya, A., Acharya, S., Kumar, S. A., and Nagaraja, K. Inequities in Access to Health Care Services in India:Caste, Class and Religion. Economic and Political Weekly, 2010, 45 (38); 49-58.
National Health Systems Resource Centre. New Delhi: Ministry of Health and Family Welfare, Government of India; 2016. National Health Accounts Estimates for India (2013-14).
Government of India, National Health Accounts, Ministry of Health and Family Welfare, New Delhi, 2017; p 11 and 46.
The Hindu. Out of pocket spend makes up 62 % of health care costs. December, 2017 file:///D:/%E2%80%98Out%20of%20pocket%20spend%20makes%20up%2062%25%20of%20health%20care%20costs%E2%80%99%20-%20The%20Hindu.html.
Pandey A. Ploubidis G.B., Clarke L. and Dandona L. Trends in catastrophic health expenditure in India: 1993 to 2014. Bulletin of World Health Organization. 2018.
Nandi S., Schneider H. and Dixit P. Hospital Utilization and Out of Pocket expenditure in Public and Private Sectors under the Universal Government Health Insurance Schemes in Chhattisgarh State, India: Lessons for Universal Health Coverage. | https://doi.org/10.1371/journal.pone.0187904. Plos One; 2017; 1-18
Selvaraj, S. and Karan, A.K., Deepening Health Insecurity in India: Evidence from National Sample Surveys since 1980, Economic and Political Weekly. 2009; 44 (40); 55-60.
Jayakrishnan T., MC. Jeeja. & Paramasivam S. Increasing out of pocket Health Expenditure in India-due to Supply or Demand? Pharmacoeconomics. 2016; 1 (1); 1-6.
Sharma D, Prinja S, Aggarwal AK, Bahuguna P, Sharma A, Rana SK. Out-of-pocket expenditure for hospitalization in Haryana State of India: Extent, determinants & financial risk protection. Indian J Med Res. 2017 Dec;146(6):759-767. doi: 10.4103/ijmr.IJMR_2003_15. PubMed PMID: 29664035; PubMed Central PMCID: PMC5926348.[PubMed].
Chakravarthi I., Roy B., Mukhopadhyay I. and Barria S. Investing in Health, Healthcare Industry in India. Economic and Political Weekly. 2017; 52 (45); 50-56.
Joe W., Rudra S., Mishra U.S. and Ramanathan M. Social Choice and Political Economy of Health-Reflections on the National Health Policy, Economic and Political Weekly. 2017. 2018; 53 (28); 83-91.
Government of India, National Rural Health Mission document, Ministry of Health and Family Welfare, New Delhi, 2005.
Government of Assam, Assam Human Development Report 2014; 2016.
Ram, F. and Shekhar, C. Ranking and Mapping of Districts Based on Socio-economic and Demographic Indicators. International Institute of Population Sciences. Ministry of Health and Family Welfare, Government of India (2006).
Wagstaff A, van Doorslaer E. Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ. 2003 Nov;12(11):921-34. doi: 10.1002/hec.776. PubMed PMID: 14601155.[PubMed].
Berki, S.E. A look at Catastrophic Medical Expenses and the Poor. Health Affairs (Millwood). vol. 5, 1986; 138-145.
Xu, K. Evans, D, Kawabata, K, Zeramdini, R. and Murray, C. Household Catastrophic Health Expenditure: a Multicountry Analysis. The Lancet. 2003; 362; 111–17.
Bose M. and Dutta A. Inequity in Hospitalization Care: a study on Utilization of Healthcare Services in West Bengal, India. International Journal of Health Policy and Management. 2015; 4 (1); 29-38.
Chowdhury C., Gupta I., Trivedi M and Prinja S. Inequity and burden of out-of-pocket spending: District Level Evidences from India. Indian Journal of Medical Research, 2018; Vol.148, No.2: 180-189.
Loganathan K. Deshmukh P.R. & Raut A.V. Socio-demographic determinants of out-of pocket health expenditure in a rural area of Wardha district of Maharashtra, India. Indian Journal of Medical Research. 2017; 146 (5); 654-661.
Ghosh S. Health Sector Reforms and Changes in Prevalence of Untreated Morbidity, Choice of Healthcare Providers among the poor and Rural Population in India. Int. J Health Policy Management; 2014; 2 (3); 125-130.
Sundararaman T., Muraleedharan V R. Falling Sick, Paying Price, NSS 71st Round on Morbidity and Costs of Healthcare, Economic and Political Weekly, 2015; 12(33), 17-20.
Mukherjee, S, Chaudhuri, A. and Barik, A. New Health Policy and Chronic Disease: Analysis of Data and Evidence. Economic and Political Weekly. 2015; 12 (37); 21-24.
Mohanty K.S. Kim R. Khan P.K. & Subramanian S. V. Geographic Variation in Household and Catastrophic Health Spending in India: Assessing the Relative Importance of Villages, Districts, and States, 2011-2012, The Milbank Quarterly. 2018; 96 (1); 167-206.
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