Does spending matters? Re-looking into various covariates associated with Out of Pocket Expenditure (OOPE) and catastrophic spending on accidental injury from NSSO 71st round data

Abstract

BackgroundAccidental Injury is a traumatic event which not only influences physical, psychological, and social wellbeing of the households but also exerts extensive financial burden on them. Despite the devastating economic burden of injuries, in India, there is limited data available on injury epidemiology. This paper aims to, first, examine the socio-economic differentials in Out of Pocket Expenditure (OOPE) on accidental injury; second, to look into the level of Catastrophic Health Expenditure (CHE) at different threshold levels; and last, to explore the adjusted effect of various socio-economic covariates on the level of CHE.MethodsData was extracted from the key indicators of social consumption in India: Health, National Sample Survey Organisation (NSSO), conducted by the Government of India during January–June-2014. Logistic regression analysis was employed to analyse the various covariates of OOPE and CHE associated to accidental injury.FindingsBinary Logistic analysis has demonstrated a significant association between socioeconomic status of the households and the level of OOPE and CHE on accidental injury care. People who used private health services incurred 16 times higher odds of CHE than those who availed public facilities. The result shows that if the person is covered via any type of insurance, the odd of CHE was lower by about 28% than the uninsured. Longer duration of stay and death due to accidental injury was positively associated with higher level of OOPE. Economic status, nature of healthcare facility availed and regional affiliation significantly influence the level of OOPE and CHE.ConclusionDespite numerous efforts by the Central and State governments to reduce the financial burden of healthcare, large number of households are still paying a significant amount from their own pockets. There are huge differentials in cost for the treatment among public and private healthcare providers for accidental injury. It is expected that the findings would provide insights into the prevailing magnitude of accidental injuries in India, the profile of the population affected, and the level of OOPE among households.

Minimum data set (MDS) based trauma registry, is the data adequate? An evidence-based study from Odisha, India

“…This study indicates that majority of the reported cases were among the males. Literature also supports the present findings,[29] where it was observed that males were more prone to accidental injury as compared to females. It is also mentioned that males are more vulnerable and are more often the victims of injuries in comparison to females.…”

“…[28] India is no exception, where the burden of trauma is increasing due to the lack of adequate documentation and unavailability of medical records, which makes the scenario more complicated. [2930]…”

Improvement of the reduction in catastrophic health expenditure in China’s public health insurance

“…Xie(2018) [ 18 ], Si(2017) [ 19 ], Liu(2017) [ 20 ], Gu(2017) [ 21 ], Yang(2016) [ 22 ], Qin(2017) [ 23 ], Mao(2017) [ 24 ] demonstrated financing inequity on health expenditure for different group in China and concluded Chinese government needed to invest more fund to expand further Social Health Insurance Programs for low-income household especially in rural area to avoid CHE. The research of Sahu (2017) [ 25 ], Gwatidzo(2017) [ 26 ], Pandey(2017) [ 27 ], Pradhan(2017) [ 28 ], Nandi(2017) [ 29 ] showed Out-of-pocket expenditure (OOPE) was an obstacle in the path of getting universal health coverage in India and the proportion of households experiencing catastrophic health expenditure in India had increased in past years. Mohanty (2017) [ 30 ] suggested increasing government spending on health and increasing households' access to health insurance could reduce catastrophic health spending and multidimensional poverty based on 9247 households sample size in Myanmar, Nepal and India.…”

The Basic vs. Ability-to-Pay Approach: Evidence From China's Critical Illness Insurance on Whether Different Measurements of Catastrophic Health Expenditure Matter

“…The ATP approach commonly adopts 25% (25) or 40% (30,31) as the threshold value. Besides, a range of thresholds, typically extending from 10 to 40%, are used to compare the difference in CHE between the basic approach (32,33) and the ATP approach (34)(35)(36)(37). Scholars also compare the performances of these two approaches at different thresholds (8,(38)(39)(40).…”

“…Scholars also compare the performances of these two approaches at different thresholds ( 8 , 38 – 40 ). The existing literature shows that the incidence and intensity of CHE and the poverty impact decrease when the threshold rises ( 32 , 34 , 36 ). Some papers arrive at the conclusion that the incidence of CHE in the basic approach at the 10 % threshold is higher than that in the ATP approach at the 40% threshold ( 24 , 38 ).…”