Burden of out-of-pocket health expenditure and its impoverishment impact in India: evidence from National Sample Survey

Sangar, Shivendra; Dutt, Varun; Thakur, Ramna

doi:10.1080/17516234.2019.1601065

Cited by 18 publications

(16 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, we are not going into quantifying the impoverishment led by healthcare cost and its effects. A humongous volume of literature already exists on the issue of catastrophic health expenditure and impoverishments due to health payments (Garg & Karan, 2009;Pandey et al, 2018;Sangar et al, 2019Sangar et al, , 2022Shahrawat & Rao, 2011) for India. Instead, we are trying to analyse the underlying reasons that are contributing to high cost of healthcare in the private sector from the supply side statistics.…”

Section: Resultsmentioning

confidence: 99%

“…High out-of-pocket payment for medical treatment often leads to financial hardship and impoverishment in low- and middle-income countries (Aryeetey et al, 2016; Sangar et al, 2022; Van Doorslaer et al, 2006; Van Minh et al, 2013). Sustainable Development Goal3 designed by UNDP targets to achieve universal health coverage with access to good-quality essential healthcare services and financial risk protection.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is Profit Motive Infecting Indian Private Health Care Sector? An Analysis of Unincorporated Healthcare Providers

Datta

Chaudhuri

2022

Journal of Health Management

View full text Add to dashboard Cite

Indian healthcare system is dominated by private sector; its importance is growing with implementation of ‘Ayushman Bharat’, flagship programme of Indian government. Though 62% and 75% of inpatient and outpatient cases in India are treated in private sector, the information about the economy of private healthcare providers is very limited. To the author’s best knowledge, this is the first attempt to address the issue with empirical evidence for the private healthcare providers from a nationally representative survey data for India. Private healthcare sector is estimated to provide employment to 2.34 million persons annually and generate gross value added (GVA) of ₹473.3 billion. Treatment cost on an average is much high in private sector as compared to the public sector. But supply-side data show that average annual receipt per annum is six times higher than average operating cost per annum for unincorporated private healthcare providers in India, indicating underlying profit motive. Analysis of factor payments shows that 55% of GVA of unincorporated private hospitals is gross operating surplus (or profit), followed by emoluments paid to employees and workers (42%). These factors potentially cause over-charging in private sector. Context-specific and appropriate regulatory mechanisms are very much needed to ensure quality of services and control medical inflation.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Profit Motive Infecting Indian Private Health Care Sector? An Analysis of Unincorporated Healthcare Providers

Datta

Chaudhuri

2022

Journal of Health Management

View full text Add to dashboard Cite

show abstract

“…Additionally, to curtail the share of OOP expenditure on health care, an increase in the percentage of GDP on health care and universalisation of insurance coverage is the need of the hour ( 36 ). According to the budget estimates for the fiscal year 2018, around 1.3% of India's GDP has been spent on public health, whereas it is a minimum of 6–7% of GDP in most European countries.…”

Section: Discussionmentioning

confidence: 99%

“…This meager amount of public health spending and under-coverage of health insurance increases the household's dependence on out-of-pocket expenditure. The households' inability to cope with the economic burden of diseases pushes them into poverty ( 34 – 36 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Economic Burden of Continuing Challenge of Infectious Diseases in India: Analysis of Socio-Demographic Differentials

Ram

Thakur

2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

Unlike other low- and middle-income countries, infectious diseases are still predominant, and non-communicable diseases (NCDs) are emerging without replacing the burden of infectious diseases in India, where it is imposing a double burden of diseases on households in the country. This study aimed to analyse the socio-economic and demographic differentials in the magnitude of economic burden and coping strategies associated with health expenditure on infectious diseases in India. National Sample Survey Organization (NSSO) data on “Key Indicators of Social Consumption in India: Health, (2017–18)” have been employed in this study. The findings of the study revealed that more than 33% of the individuals are still suffering from infectious diseases out of the total ailing population in India. Based on the various socio-economic and demographic covariates, infectious diseases are highly prevalent among individuals with marginalized characteristics, such as individuals residing in rural areas, females, 0–14 age groups, Muslims, illiterates, scheduled tribes (STs), and scheduled castes (SCs), large family households, and economically poor people in the country. The per capita out-of-pocket (OOP) expenditure on infectious diseases is INR 7.28 and INR 29.38 in inpatient and outpatient care, respectively. Whereas, monthly per patient OOP expenditure on infectious diseases by infection-affected populations is INR 881.56 and INR 1,156.34 in inpatient and outpatient care in India. The study found that people residing in rural areas, SCs followed by other backward classes (OBCs), illiterates, poor, and very poor are more dependent on borrowings, sale of assets, and other distressed sources of financing. However, under National Health Policy 2017, many initiatives, such as “Ayushman Bharat,” PM-JAY, and National Digital Health Mission (NDHM) in 2021, have been launched by the government of India in the recent years. These initiatives are holistically launched for ensuring better health facilities, but it is early to make any prediction regarding its outcomes; hopefully, the time will define it over the passing of a few more years. Finally, the study proposed the need for proper implementations of policy initiatives, awareness against unhygienic conditions and contamination of illnesses, immunisations/vaccination campaigns, subsidized medical facilities, and the country's expansion of quality primary health-care facilities.

show abstract

“…Results reveal that in urban areas of India, the incidence of OOP health expenditure is concentrated towards poorer consumption groups, whereas in rural areas, it is pro-rich, especially at higher threshold levels (Sangar et al, 2019). Financially protecting households from high OOP payments can be achieved either by funding health services through taxes or risk pooling through an insurance mechanism (Shahrawat & Rao, 2012).…”

Section: Impact Of Health Expenditurementioning

confidence: 99%

Potential Impact of the Insurance on Catastrophic Health Expenditures Among the Urban Poor Population in India

Singh¹,

Siddhanta²,

Singh³

et al. 2022

Journal of Health Management

View full text Add to dashboard Cite

Background: Urban poor face a disproportionate burden of ill health and high out-of-pocket expenditure (OOPE), creating a severe unmet need for affordable and quality health care. This article highlights the impact of health insurance on OOPE and catastrophic healthcare expenditure among the urban poor of India. Methods: The study uses randomly collected household data from a baseline survey conducted in the states of Rajasthan and Uttar Pradesh. Separate Insurance impact models have been generated for the analysis. Results: Mean out-of-pocket health expenses is higher in the private health facility for the inpatient care but in case of outpatient care, the expenditure was more in public. Expenditure on medicine constitutes the largest part of the total OOPE. Insurance impact model shows that coverage on medicine alone can reduce medical impoverishment by 85% in the case of Outpatient Deparment (OPD) and 71% in the case of Inpatient Department (IPD). The urban poor preferred private facility for treatment in case of illness, albeit when it comes to delivery, they prefer public facility Conclusions: Study findings indicate overt reliance on private health care must be regulated, to reduce OOPE among the urban poor. Also, effective universal health insurance can go a long way in reducing the OOPE with availability of free medicines and diagnostics in the public health facilities.

show abstract

Burden of out-of-pocket health expenditure and its impoverishment impact in India: evidence from National Sample Survey

Cited by 18 publications

References 22 publications

Is Profit Motive Infecting Indian Private Health Care Sector? An Analysis of Unincorporated Healthcare Providers

Is Profit Motive Infecting Indian Private Health Care Sector? An Analysis of Unincorporated Healthcare Providers

Epidemiology and Economic Burden of Continuing Challenge of Infectious Diseases in India: Analysis of Socio-Demographic Differentials

Potential Impact of the Insurance on Catastrophic Health Expenditures Among the Urban Poor Population in India

Contact Info

Product

Resources

About