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Cost of hospitalisation for non‐communicable diseases in India: are we pro‐poor?
Author(s) -
Tripathy J. P.,
Prasad B. M.,
Shewade H. D.,
Kumar A. M. V.,
Zachariah R.,
Chadha S.,
Tonsing J.,
Harries A. D.
Publication year - 2016
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12732
Subject(s) - medicine , public sector , environmental health , public expenditure , public health , consumption (sociology) , private sector , health care , economic growth , economics , nursing , social science , economy , public finance , sociology , macroeconomics
Objectives To estimate out‐of‐pocket ( OOP ) expenditure due to hospitalisation from NCD s and its impact on households in India. Methods The study analysed nationwide representative data collected by the National Sample Survey Organisation in 2014 that reported health service utilisation and healthcare‐related OOP expenditure by income quintiles and by type of health facility (public or private). The recall period for inpatient hospitalisation expenditure was 365 days. Consumption expenditure was collected for a recall period of 1 month. OOP expenditure amounting to >10% of annual consumption expenditure was termed as catastrophic. Weighted analysis was performed. Results The median expenditure per episode of hospitalisation due to NCD s was USD 149 – this was ~3 times higher among the richest quintile compared to poorest quintile. There was a significantly higher prevalence of catastrophic expenditure among the poorest quintile, more so for cancers (85%), psychiatric and neurological disorders (63%) and injuries (63%). Mean private‐sector OOP hospitalisation expenditure was nearly five times higher than that in the public sector. Medicines accounted for 40% and 27% of public‐ and private‐sector OOP hospitalisation expenditure, respectively. Conclusion Strengthening of public health facilities is required at community level for the prevention, control and management of NCD s. Promotion of generic medicines, better availability of essential drugs and possible subsidisation for the poorest quintile will be measures to consider to reduce OOP expenditure in public‐sector facilities.