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Burden of out-of-pocket health expenditure and its impoverishment impact in India

Evidence from National Sample Survey

Bibliographic Data

ID12911159
AuthorsShivendra Sangar (Indian Institute of Technology Mandi), Dutt (0000-0002-2151-8314, Indian Institute of Technology Mandi), Ramna Thakur (0000-0002-7253-1033, Indian Institute of Technology Mandi, corresponding author)
Year2019
Volume15
Issue1
Pages60-77
Publication date2019-04-13
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Asian Public Policy (JOURNAL)
Journal identifiersISSN: 1751-6242 • E-ISSN: 1751-6234
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/17516234.2019.1601065
OpenAlexW2938541072
LanguageEN
Citations received5
References cited22

In low- and middle-income countries like India, financing of health-care expenditure is predominantly characterized by out-of-pocket (OOP) spending. Given this context, the current study examined the economic burden of OOP health expenditure and resultant impoverishment in India. The study employed nationally representative survey on ‘Health and Morbidity’ conducted by National Sample Survey Organization (NSSO) in 2014 in India. Standard catastrophic, inequality and impoverishment measures were used to analyse the burden and impact of OOP health expenditure. Findings revealed that although the overall incidence and intensity of OOP health expenditure was concentrated among the richer consumption groups, in-depth study of the same in terms of inpatient and outpatient care showed that the incidence of outpatient care was highly concentrated towards the poorer consumption groups. Study also revealed that around 8% of the population fell below the poverty line due to OOP health expenditure in which outpatient care was the main contributing factor (5.8%). Among different socio-economic covariates, rural population, Muslims, Scheduled Castes and casual/agriculture labour were most affected and had higher impoverishment impact. Our findings suggest that there is a need to revisit the approach towards health-care financing in India.Abbreviations: OOP: Out-of-pocket; MPCE: Monthly per capita consumption expenditure; SCs: Scheduled Castes; STs: Scheduled Tribes; OBCs: Other Backward Castes; TCE: Total consumption expenditure; PFHI: Publicly financed health insurance; RSBY: Rashtriya Swasthya Bima Yojana; CMCHIS: Chief Minister’s Comprehensive Health Insurance Scheme; UHC: Universal health coverage

Business · Casual · Consumption (sociology · Context (archaeology · Economic growth · Economics · Environmental health · Geography · Health care · Per capita · Political science · Population · Poverty · Socioeconomics · Sociology · Survey sampling · Global Health and Epidemiology · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine

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Unique citing works5
Citations per year1
Citation span2021 - 2026 (6)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 5

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