Out-of-pocket expenditure on healthcare amongst households of an urban village in Delhi
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20233101Keywords:
Out-of-pocket expenditure, OOPE, Urban village, Catastrophic expenditure, Urban poorAbstract
Background: Poor urban households residing in an unplanned overcrowded settlement, are at a higher risk of morbidities and healthcare expenditure which can be impoverishing. Effective assessment of healthcare expenditure of households living in an urban village is needed to mitigate and protect the vulnerable households from catastrophic health expenditure. The objective of the study was to find out the mean out-of-pocket expenditure on healthcare, and catastrophic health expenditure amongst households of an urban village of Delhi.
Methods: This 18-month duration cross-sectional study was carried out in an urban village of Delhi, Aliganj amongst households residing for the last one year. A sample size of 188 was statistically calculated, and households were selected using systematic random sampling. A pre-designed, pre-tested, semi-structured and interviewer administered questionnaire was used in Hindi to elicit and record information. Data was recorded and coded in MS Excel, and analysis was done using licensed SPSS v.26. Tables was generated, and cross-tables were used to assess statistical association with Chi-square or Fischer Exact tests, as required. Multivariate logistic regression was applied to the variables found having a statistically significant association on cross-tables (p<0.05).
Results: The mean out-of-pocket expenditure borne by a household was INR 20,125.5 (SD± 50,772.3), with a median expenditure of INR 1800. Eighty percent of OOPE was incurred as direct expenditure and 56% was spent in private health facilities.
Conclusions: The households of an urban village of Aliganj, Delhi, have high out-of-pocket expenditure (60.6%), and catastrophic health expenditure (22.9%).
References
Tracking universal health coverage: 2017 global monitoring report. Available at: https://www/who.int. Accessed on 20 February 2023.
National Health Accounts Estimates for India (2019-20). Available at: https://pib.gov.in/PressReleaseI framePage.aspx?PRID=1919582. Accessed on 20 February 2023.
Pandey A, Ploubidis GB, Clarke L, Dandona L. Trends in catastrophic health expenditure in india: 1993 to 2014. Bull World Health Organ. 2018;96(1):18-28.
Mohanty SK, Kim R, Khan PK, Subramanian SV. Geographic Variation in Household and Catastrophic Health Spending in India: Assessing the Relative Importance of Villages, Districts, and States, 2011-2012. Milbank Q. 2018;96(1):167-206.
Balan B, Elazan S, Morillas MSA. Disease Load in Aliganj, an Urban Village in New Delhi A Search for Directions in Risk Reduction through Urban Planning. Knowl Comm Child India. 2012;04:1-46.
Tiwari P, Datta A. Out of Pocket Ex-penditure on Health Care among the Households of Urban Area in Dakshina Kannada. Nat J Community Med. 2018;9(7): 529-33.
Key indicators of social consumption in India: Health. Available at: https://ideas.repec.org/. Accessed on 20 February 2023.
National health accounts estimates for India (2014-15). Available at: https://pib.gov.in/Press ReleaseIframe Page.aspx?PRID=1919582. Accessed on 20 February 2023.
Vasudevan U, Akkilagunta S, Kar SS. Household out-of-pocket expenditure on health care - A cross-sectional study among urban and rural households, Puducherry. J Family Med Prim Care. 2019;8(7):2278-82.
10.Sharma A, Singh AK, Singh LM, Rana SK, Mehboob S, Sharma V, et al. Out-of-pocket Expenditure on Healthcare among the Urban Poor in India. Urban Poor Healthcare Access. 2020;49:32-9.
Dalui A, Banerjee S, Roy R. Determinants of out-of-pocket and catastrophic health expenditure in rural population: A community-based study in a block of Purba Barddhaman, West Bengal. Indian J Public Health. 2020;64(3):223-8.
Loganathan K, Deshmukh PR, Raut A V. Socio-demographic determinants of out-of-pocket health expenditure in a rural area of Wardha district of Maharashtra, India. Indian J Med Res. 2017;146(5): 654.
Key Indicators of Social Consumption in India. Available at: https://ideas.repec.org/. Accessed on 20 February 2023.
Prinja S, Kaur G, Gupta R, Rana SK, Aggarwal AK. Out-of-pocket expenditure for health care: District level estimates for Haryana state in India. Int J Health Plann Manage. 2018;34(1):277-93.
Mohanty SK, Dwivedi LK. Addressing data and methodological limitations in estimating catastrophic health spending and impoverishment in India, 2004-18. Int J Equity Health. 2021;20(1):85.
Hadaye RS, Thampi JG. Catastrophic health-care expenditure and willingness to pay for health insurance in a metropolitan city: A cross-sectional study. Indian J Community Med. 2018;43(4):307.
Kastor A, Mohanty SK. Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing? PLoS One. 2018;13(5):e106.
Singh T, Bhatnagar N, Singh G, Kaur M, Kaur S, Thaware P, et al. Health-care utilization and expenditure patterns in the rural areas of Punjab, India. J Family Med Prim Care. 2018;7(1):39.
Kusuma YS, Babu B V. The costs of seeking healthcare: Illness, treatment seeking and out of pocket expenditures among the urban poor in Delhi, India. Health Soc Care Community. 2019;27(6):1401-20.