Patterns and determinants of health care spending in denizens of urban slums from peri-industrial area of Hyderabad
Keywords:OOPE, Health care spending, Catastrophic healthcare expenses, Health insurance
Background: Dream of universal health coverage cannot be possible with huge burden of out of pocket expenditures, common in our community. Here attempt was made to find out the pattern of expenditure towards health in the people residing around the field practice area of concerned medical college.
Methods: Community based cross sectional survey with predesigned and pretested questionnaire, with stratified random sampling, total of 257 study participants were included in study, which was initiated after ethical clearance and with informed oral consent.
Results: With majority in lower socio economic class, 33.85% of population was found to be beneficiaries of one of the other Health insurance, provided through social security measures. On an average, families were spending Rs. 770.08 (±956.24) for monthly health related expenses. This high variation in was observed due to difference in the constitutional structure of families. Outpatient expenses had least burden on families (154.26 (±99.90)) followed by in patient expenses, which included day care for various minor elements. More than 60% reported catastrophic Health expenses, resulting in variety of financial issues in family.
Conclusions: Huge burden of OOPE exists in the study area and at the same time, health care expenditure resulting in catastrophic expenses is high. The need of society to provide healthcare at subsidised rates including medicines is emphasised, which to be considered while implementing any policy decision.
Anderson I, Axelson H, Tan BK. The other crisis: The economics and financing of maternal, newborn and child health in Asia. Health Policy Plan. 2011;26:288‑97.
Sharma S, Smith S, Sonneveldt E, Pine M, Dayarantna V, Sanders R. Formal and informal fees for maternal health care services in five countries: Policies, practices, and perspectives. Policy Project Washington DC: Policy Working Paper Series No. 16. 2005.
Dhawan A. 2015 health care outlook India. Available at: https://www2.deloitte.com/content/ dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-lshc-2015-health-care-outlook-india.pdf. Accessed on 22 September 2017.
Fazaeli AA, Ghaderi H, Salehi M, Fazaeli AR. Health care expenditure and GDP in oil exporting countries: evidence from OPEC data, 1995-2012. Glob J Health Sci. 2015;8(2):93-8.
Mohanty SK, Agarval NK, Mohapatra B. Multidimensional poverty and catastrophic health spending in the mountainous regions of Myanmar, Nepal and India. Int J Equity Health. 2017;16:21.
Acharya L, Rau RN, Udupa N, Rajan MS, Vijayanarayana K. Asessment of Cost of Illness for diabetic patients in southern Indian tertiary care hoaspital. J Pharm Bioallied Sci. 2016;8(4):314-20.
Sneha LM, Sai J, Ashwini S, Ramaswami S, Rajan M, Scott J. Financial Burdeon Faced by Families due to Out of Pocket Expenses During the treatment of their cancer Children: An Indian Perspectives. Indian J Med Oaediatric Oncol. 2017;38(1):4-9.
Garg CC, Karan AK. Reducing out-of-pocket expenditures to reduce poverty: a disaggregated analysis at rural-urban and state level in India. Health Policy and Planning. 2009;24:116–28.
Ministry of Health and Family Welfare (MOHFW) National Health Accounts India 2004–05, 2009 New Delhi Ministry of Health and Family Welfare, Government of India. Available at: http://mohfw.nic.in/NHA%202004-05%20Final%20 Report.pdf. Accessed on 22 August 2017.
Mahal A, Singh J, Afridi F, Lamba V, Gumber A, Selvaraju V. Who benefits from public health spending in India? Results of a Benefit Incidence Analysis for India New Delhi: National Council Applied Economic Res. 2001.
Peters DH, Yazbeck AS, Sharma RR. Better health system for India’s poor: findings, analysis and options. Human Development Network, Health, Nutrition and Population series. Washington DC: The World Bank. 2002.
Peters DH, Rao SK, Fryatt R. Lumping and splitting: the health policy agenda in India. Health Policy and Planning. 2003;18:249–60.
NCMH. 2005. Report of the national commission on macro economics and health. New Delhi: Ministry of Health and Family Welfare, Government of India.
Government of India. 2005. National Health Accounts India (2001–2002). New Delhi: Ministry of Health and Family Welfare.
Roy K, Hill HD. Equity in out of pocket payments for hospital care: evidence from India. Health Policy. 2007;80:297–307.