Measuring the burden of accidental injuries in India: a cross-sectional analysis of the National Sample Survey (2017–18)

Abstract

Globally, injuries are the leading cause of premature deaths and disability and account for nearly 9 per cent of total deaths worldwide. Like other countries, India also faces a very high burden of injuries, with the second most common cause of death and disability. Annually, 0.15 million people lose their lives due to accidental injuries/road traffic accidents in India, which is 11 per cent of the accident-related death worldwide. This study aims to analyse the socio-economic and demographic differentials in the magnitude of economic burden and coping strategies associated with accidental injuries in India. The study used the nationally representative cross-sectional data on the ‘Key Indicators of Social Consumption in India: Health, (2017–18)’ of the National Sample Survey Organisation (NSSO). Simple descriptive statistics have been used to measure the incidence and intensity of accidental injuries. The economic burden is estimated through out-of-pocket (OOP) health expenditure on accidental injuries and the use of different sources of finance to cope with the same. In addition, the logistic regression analysis has been used to analyse the association between socio-economic covariates and the likelihood of suffering from accidental injuries in India. The findings reveal that, unlike outpatient care, the high incidence in inpatient care reveals that hospitalisation is inevitable in most cases after accidental injuries. Among various socio-economic variables, the incidence of accidental cases is higher among individuals residing in urban areas, males, educated persons, and economically better-off sections of society. Also, the mean monthly OOP expenditure on the accidental injuries-affected population has been estimated at INR 2672 .46 (US$ 41.06) and INR 3041.64 (US$ 47.09) in inpatient and outpatient care, respectively. Almost the same sections and the individuals who received insurance spend more OOP expenditure on accidental injuries. However, OOP expenditure as a share of total consumption expenditure (TCE) is significantly high among their counterparts, such as rural inhabitants, illiterates, scheduled castes, the very poor and those who do not have any kind of health insurance coverage. In addition to savings/income, individuals depend more on the distress sources such as borrowings and selling of household assets to meet their OOP health expenditure in India. In conclusion, the high incidence of accidental injuries threatens people more than some of the other ailments in India. A strict motor vehicle act, administrative and political determination, awareness campaigns through various media platforms, diverse road lane systems and traffic norms can help reduce accidental fatalities in the country. Reducing the economic burden of accidental injuries requires increasing public spending on healthcare services as a percentage share of the country’s GDP. Furthermore, comprehensive universal health insurance coverage for all, including each component of healthcare expenditure, is the need of the hour.

Economic Burden of Accidents and Injuries in India: What Does 75th Round of National Sample Survey Imply?

“…(2018) estimated the annual OOPE of RTA/accidental injuries in 2014 using the national statistics as Rs 26,132/and Rs 27,731/respectively. [ 11 12 ]…”

State-wise Economic Burden of Road Traffic Accidents in India

“…The study conducted by Ram et al also noted a significant interstate variation in traffic accidents, both in terms of prevalence and associated OOPEs in India. (Ram and Thakur 2022) Interestingly, the highest expenditure is observed in States with lower prevalence, such as Uttar Pradesh and Jharkhand, while the lowest amount is found in the state of Goa. (Ram and Thakur 2022) The higher indirect costs show the strain on both the affected individuals/households and the broader economy, emphasizing the need for preventive measures and interventions to reduce the overall economic burden of RTAs.…”

“…2019) along with the substantial regional disparities in the burden they pose, RTAs impose a substantial financial burden on the healthcare system. (Balakrishnan and Karuppanagounder 2020, Ram and Thakur 2022) This is attributable to the high cost of medical care, long-term care for the injured, and lost productivity. (Pal et al .…”