Health care utilization and out of pocket expenditure in a rural area of Kerala: a cross sectional study

Abstract

Background: Out-of-pocket expenditure in health has substantial negative side effects. They may lead to impoverishment. The knowledge of pattern of health care utilization and out of pocket expenditure is imperative for policy making in health care. Objectives of this study were to study utilization pattern of health care services of the population in a rural area of Thrissur district and study of the self-reported chronic morbidity profile and out of pocket expenditure for chronic diseases among the population.Methods: A community based cross sectional study was conducted in Tholur panchayath area of Thrissur district of Kerala. The calculated sample size was 552 households. House hold was considered as primary sampling units. All family members of the house hold were included in the study. Cluster sampling method was adopted. Data was collected using a pre tested semi-structured questionnaire.Results: A total of 809 individuals from 583 households were found to have chronic diseases. Among them, 54.8% were utilizing private health facility for their treatment. Majority (86%) were following modern medicine system for treatment. Health insurance was availed by 26.6 % of the study participants. Most common reported morbidity was combination of hypertension, diabetes mellitus, and hypercholesterolemia. The total median out of pocket expenditure for chronic diseases was found to be 5000 Indian Rupees. It was found that 41.6% of the total income of study participants was spent for health care of chronic diseases which indicate catastrophic health expenditure.Conclusions: The burden of chronic disease is high and the private hospitals are approached more by the study population for treatment rather than government hospitals. Health insurance coverage is low, and social assistance availed for treatment is marginal. These factors lead to high out of pocket expenditure amounting to catastrophic health expenditure.

Out-of-pocket expenditure on non-communicable diseases during Covid-19. A cross-sectional study from a semi-urban area of Kannur, Kerala

“…In a similar study conducted at Thrissur, Kerala, to find out the health care utilization and OOPE, it was found that, median cost of total direct expenses for health was ₹5000 whereas median indirect cost was ₹500. 16 In the current study, among the service utilizers, the median direct medical cost of NCD care was ₹400.0 (120–2360.0) and the median direct non-medical cost was ₹720.0 (300.0–1200.0). Also, the median total medical cost was ₹1200.0.0 (200.0–3990.0).…”

A study on health care utilization and out of pocket expenditure in rural central India: A cross-sectional study

“…These factors result in high OOP expenses, reaching the level of catastrophic health expenditures. 9 Thuong et al (2020) Household Living Standard Surveys in Vietnam is a Southeast Asian. To investigate the effect of these health insurance initiatives on the utilization of healthcare facilities and out-of-pocket health expenditures (OOP).…”

“…Notably, health insurance coverage remains at a low level, and the utilization of social assistance for treatment is minimal. 9 This study will be conducted because in-patient and out-patient care are associated with the highest out-of-pocket expenditure and less information about healthcare utilization patterns. Only 20 percent of households in Maharashtra have any kind of health insurance that covers at least one member of the household.…”

“…8 In India, health-related public expenditure is managed by three tiers of the government: the Central Government, the State Government, and the local bodies. 9 Although government businesses and insurance providers are major healthcare funding agencies, each family and individual covers each of the healthcare expenses that can be incurred through OOP payments, insurance premiums, or government taxes. 4 In India, Gross Domestic Product (GDP) spends only 5% on health and 80% of this takes the form of OOPE in rural areas.…”

Sex differences in disease burden, utilization, and expenditure on Primary Health Care Services: Findings from a baseline study in Kerala, India

“…This is consistent with the ndings of National Sample Survey (NSS) 75th round 9 and similar studies in the state. 36,38,44,45 Results from a study examining gender differentials in health care utilization in India found that both sexes preferred private hospitals over public hospitals for OP and IP care, and also that males travelled greater distance to reach hospital than women. 46 However nearly 15% of both males and females reported not taking any type of treatment for an ailment -a matter of concern for both sexeswhich is consistent with similar studies in India.…”