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Catastrophic health expenditure among households with differently abled children and adolescents in Puducherry, India

A mixed-method study

Bibliographic Data

ID22076707
AuthorsSona Priyanka Auroprem (Jawaharlal Institute of Post Graduate Medical Education and Research), Sitanshu Sekhar Kar (0000-0001-7122-523X, Jawaharlal Institute of Post Graduate Medical Education and Research), Loganathan Devaraj (0000-0003-3400-0722, Jawaharlal Institute of Post Graduate Medical Education and Research), Mahalakshmy Thulasingam (0000-0001-8326-2855, Jawaharlal Institute of Post Graduate Medical Education and Research, corresponding author)
Year2025
Volume13
Pages1647871-1647871
Publication date2025-09-22
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1647871
PMID41059184
OpenAlexW4414425292
LanguageEN
References cited14

Introduction: Households with disabled members are at greater risk of catastrophic health expenditure (CHE) due to their continual medical visits and treatments, the consequences of which force them into vicious cycles of impoverishment and distress financing. Additionally, they face various challenges in accessing healthcare, which compromises Universal Health Coverage (UHC). A significant gap exists in the cost of health expenditure for differently abled children in India. Methods: A mixed-methods study was conducted among 192 households, comprising 96 with differently abled children and 96 without. Quantitative data on health expenditures, insurance coverage, and utilization of disability benefits were collected through structured interviews. Catastrophic health expenditure was defined using the 40% of Capacity to Pay (CTP) threshold. Additionally, 10 IDIs were conducted among households with differently abled children to explore barriers and facilitators to healthcare access. Results: Approximately 44.8% of the households experienced CHE at the 40% of CTP threshold. The most common type of disability reported was mental disability. Approximately 50% of the households did not have any insurance coverage, and only 44.8% were availing disability benefits for their child. As many as 77.1% of households experienced financial distress. A significant compensating variation was found. Barriers to health seeking included high medical expenses, poor accessibility, limited availability of specialized care, and lack of continuity in care. Facilitators such as good access to information, availability of healthcare facilities, and social support were also identified. Various recommendations to improve health-seeking were provided by parents. Conclusion: This study found a higher prevalence of CHE, distress financing, and numerous challenges for health-seeking among households with differently abled children, highlighting the need for prompt measures to address these issues

Cross-sectional study · Distress · Mental health · Population · Psychological distress · Public health · Global Maternal and Child Health · Health Systems, Economic Evaluations, Quality of Life · Healthcare Systems and Reforms

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