Background: The economic costs associated with morbidity pose a great financial risk on the population. Household's over-dependence on out-of-pocket (OOP) health expenditure and their inability to cope up with the economic costs associated with illness often push them into poverty. The current paper aims to measure the economic burden and resultant impoverishment associated with OOP health expenditure for a diverse set of ailments in India.Methods: Cross-sectional data from National Sample Survey Organization (NSSO) 71st Round on “Key Indicators of Social Consumption: Health” has been employed in the study. Indices, namely the payment headcount, payment gap, concentration index, poverty headcount and poverty gap, are defined and computed. The measurement of catastrophic burden of OOP health expenditure is done at 10% threshold level.Results: Results of the study reveal that collectively non-communicable diseases (NCDs) have higher economic and catastrophic burden, individually infections rather than NCDs such as Cardio Vascular Diseases and cancers have a higher catastrophic burden and resultant impoverishment in India. Ailments such as gastro-intestinal, respiratory, musco-skeletal, obstetrics, and injuries also have a substantial economic burden on population and push them below the poverty line. Results also show that despite the pro-poor concentration of infections, their economic burden is more concentrated among the wealthier consumption groups.Conclusion: The study concludes that universal health coverage through adequate provision of pooled resources for health care and community-based health insurance is critical to reduce the economic burden and impoverishment related to OOP health expenditure. Measures should also be instituted to insulate people from economic burden on morbidity, especially the NCDs.
In the absence of a universal health insurance mechanism, the increasing burden of out‐of‐pocket (OOP) health expenditure has become a growing concern in India. To cope with the cost of illness, people use either their savings and income, or they have to rely upon distress means of finance such as depletion of household assets, borrowings from banks and moneylenders, and contributions from family and friends. This paper analyses the changes that have taken place in the incidence and covariates of distress financing in India by using data from National Sample Survey Organisation for the years 2004 and 2014. Results indicate that during this period the incidence of distress sources as a means to finance OOP health expenditure has hovered around 50%. Further, the results reveal a significant socioeconomic gradient in the incidence of distress financing. Socioeconomic and health‐related covariates significantly impact the likelihood of distress financing as a means to cope with OOP health expenditure. The results indicate the need for government action to formulate a comprehensive plan through an increase in public spending on health care that will improve the quantity and quality of the public health‐care system and enhance the scope of health insurance in India.
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