Relying on Whom? Correlates of Out of Pocket Health Expenditure among the Rural Elderly in Odisha, India

Pradhan, Jalandhar; Dwivedi, Rinshu; Banjare, Pallavi

doi:10.1007/s12126-017-9293-7

Cited by 12 publications

(10 citation statements)

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“…Furthermore, the households with higher number of elderly members and households with higher number of children and elderly had also incurred higher OOPE. 31 The results also indicate notable differentials in OOPE among the households who have used traditional modes of cooking. Being the negative environmental behavioural factor, traditional modes of cooking such as fuel, wood, charcoal and cow dung cakes have severe repercussions for the health of the population.…”

Section: Discussionmentioning

confidence: 86%

“…29,30 In addition, Indian health care system is one among the highly privatized health care systems in the world. 31 Therefore, identifying the high-risk population for OOPE is important for better policy formulation. 32,33 Available literature reveals that there are dearth of studies which combine theoretical and empirical insights on health expenditure and focus on the predicting factors of high OOPE and affordability of health care services.…”

Section: Introductionmentioning

confidence: 99%

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Does affordability matter? Examining the trends and patterns in health care expenditure in India

Dwivedi

Pradhan

2020

Health Serv Manage Res

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Background Absence of better financing mechanism results in higher out of pocket expenditure and catastrophe, which leads to impoverishment and poverty especially among low- and middle-income countries like India. This paper examines the major characteristics associated with the higher out of pocket expenditure and provides an insight from Andersen’s behavioural model that how predisposing, enabling and need factors influence the level and pattern of out of pocket expenditure in India. Methods Data has been extracted from three rounds of nationally representative consumer expenditure surveys, i.e. 1993–1994, 2004–2005 and 2011–2012 conducted by the Government of India. States were categorized based on regional classification, and adult equivalent scale was used to adjust the household size. Multiple Generalized-Linear-Regression-Model was employed to explore the relative effect of various socio-economic covariates on the level of out of pocket expenditure. Results The gap has widened between advantaged and disadvantaged segment of the population along with noticeable regional disparities among Indian states. Generalized-Linear-Regression-Model indicates that the most influential predisposing and enabling factor determining the level of out of pocket expenditure were age composition, religion, social-group, household type, residence, economic status, sources of cooking and lighting arrangements among the households. Conclusions Present study suggests the need for strengthening the affordability mechanism of the households to cope with the excessive burden of health care payments. Furthermore, special consideration is required to accommodate the needs of the elderly, rural, backward states and impoverishment segment of population to reduce the unjust burden of out of pocket expenditure in India.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Does affordability matter? Examining the trends and patterns in health care expenditure in India

Dwivedi

Pradhan

2020

Health Serv Manage Res

Self Cite

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“…Although an equitable financial system can protect households from suffering from a CHE,11 12 it is unable to provide all required health services for free. The out-of-pocket expenditure (OOPE) thus remains a source of CHE and poverty 13. Out-of-pocket expenditure means the direct payment of money that may or may not be later reimbursed from a third-party source.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic determinants of out-of-pocket pharmaceutical expenditure among middle-aged and elderly adults based on the China Health and Retirement Longitudinal Survey

Yang

Chen

et al. 2019

BMJ Open

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ObjectiveOut-of-pocket pharmaceutical expenditure (OOPPE) is a considerable burden for middle-aged and elderly adults due to their high prevalence of diseases, insufficient income and absence of medical insurance in China. The objective of this study was to assess the determinants of OOPPE among Chinese middle-aged and elderly adults.MethodsThis is a cross-sectional study based on the China Health and Retirement Longitudinal Survey conducted in 2015. The Andersen behavioural health model was used to select the factors. Binary multivariable logistic and generalised linear regressions were both applied to examine the determinants of OOPPE.ResultsOf the respondents, 15.28%, 5.20% and 51.35% reported an OOPPE for outpatient services, inpatient services and self-medication, respectively. The OOPPE for outpatient services, inpatient services and self-medication was US$6.66, US$17.93 and US$15.32, respectively. Increased age significantly influenced the likelihood of OOPPE, and older people (aged >65 years) had lower OOPPE for outpatient services. Having health insurance significantly reduced the likelihood of OOPPE for outpatient and inpatient services but increased OOPPE for self-medication. In general, compared with the low-income group, higher income groups had a significantly lower likelihood of having an OOPPE, and when they did the amounts were less. Generally, middle-aged and elderly people with poor self-reported health status, limitation of daily activities, and critical or chronic diseases had a significantly higher likelihood of having an OOPPE and at a significantly higher amount.ConclusionPolicy-making efforts should focus on reducing self-medication OOPPE and alleviating its associated socioeconomic determinants to ease the economic burden of diseases among middle-aged and elderly adults in China.

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“…Elderly females spend less money compared to elderly males [5], [8], [12], [13], [15], [16]. The amount of money spent on health care by elderly females was lower than elderly males.…”

Section: Discussionmentioning

confidence: 99%

Who Spends More on Health Expenditures among Elderly? Men or Women?

Tama

Ulfa

Hapsari

2020

KSS

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Women face various health problems during their lives. This has an impact on health costs that must be paid. Gender bias tends to place women in subordinate positions, so they have limited power in making a decision. This study aimed to examine whether gender is a factor impacting health expenditures among the elderly. A cross-sectional study based on the Indonesian Family Life Survey (IFLS) wave 5 included all elderly who accessed self-medication and health services in health facilities during the past 12 months (n=6773). Data regarding outpatient, inpatient, and self-medication costs was obtained from section RJ, RN, and PS from book 3B IFLS wave 5. The health costs that come out of the personal pocket resulted from the total cost of treatment that paid for self-medication, outpatient, and inpatient. Independent T-Test was performed to analyze the difference in health expenditure between elderly males and females. This study found that the average health expenditure was higher among elderly males (IDR 471,011; SD 7,103,932.7) than females (IDR 296,969.9; SD 2,552,816.4), but it was not statistically significant (p=0.195). Based on the type of health expenditure, there was no significant difference in self-medication spending between elderly males and females, as well as in outpatient and inpatient expenditures (p>0.05). Nevertheless, elderly males tended to spend more money on self-medication, outpatient, and inpatient services than females. It concluded that health expenditures between elderly males and females were almost the same. Gender equality in health care was addressed to establish universal health coverage. Keywords: gender, health expenditure, IFLS, elderly, out-of-pocket

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Relying on Whom? Correlates of Out of Pocket Health Expenditure among the Rural Elderly in Odisha, India

Cited by 12 publications

References 37 publications

Does affordability matter? Examining the trends and patterns in health care expenditure in India

Does affordability matter? Examining the trends and patterns in health care expenditure in India

Socioeconomic determinants of out-of-pocket pharmaceutical expenditure among middle-aged and elderly adults based on the China Health and Retirement Longitudinal Survey

Who Spends More on Health Expenditures among Elderly? Men or Women?

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