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Rising Catastrophic Expenditure on Households Due to Tuberculosis

Is India Moving Away From the END-TB Goal

Bibliographic Data

ID22088419
AuthorsBanuru Muralidhara Prasad (corresponding author), Jaya Prasad Tripathy (0000-0002-2626-5977, All India Institute of Medical Sciences, Nagpur), V R Muraleedharan (0000-0002-6698-7958, Indian Institute of Technology Madras), Jamhoih Tonsing
Year2021
Volume9
Pages614466-614466
Publication date2021-02-15
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.614466
PMID33659233
OpenAlexW3132164567
LanguageEN
Citations received2
References cited17

Introduction: One of the targets of the END-TB strategy is to ensure zero catastrophic expenditure on households due to TB. The information about household catastrophic expenditure is limited in India and, therefore difficult to monitor. The objective is to estimate household and catastrophic expenditure for Tuberculosis using national sample survey data. Methods: For arriving at out-of-pocket expenditure due to tuberculosis and its impact on households the study analyzed four rounds of National Sample Survey data (52nd round-1995–1996, 60th round-2004–2005, 71st round-2014–15, and 75th round 2017–2018). The household interview survey data had a recall period of 365 days for inpatient/ hospitalization and 15 days for out-patient care expenditure. Expenditure amounting to >20% of annual household consumption expenditure was termed as catastrophic. Results: A 5-fold increase in median outpatient care cost in 75th round is observed compared to previous rounds and increase has been maximum while accessing public sector. The overall expense ratio of public v/s private is 1:3, 1:4, 1:5, and 1:5, respectively across four rounds for hospitalization. The prevalence of catastrophic expenditure due to hospitalization increased from 16.5% (52nd round) to 43% (71st round), followed by a decline to 18% in the recent 75th round. Conclusion: Despite free diagnostic and treatment services offered under the national program, households are exposed to catastrophic financial expenditure due to tuberculosis. We strongly advocate for risk protection mechanisms such as cash transfer or health insurance schemes targeting the patients of tuberculosis, especially among the poor

Economic growth · Economics · Environmental health · Health care · Population · Public expenditure · Public finance · Public health · Survey sampling · Tuberculosis · Demography · Global Health and Epidemiology · Global Health Care Issues · Healthcare Systems and Reforms · Medicine

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  • Financial burden for tuberculosis patients in low- and middle-income countries

    Tadayuki Tanimura, Ernesto Jaramillo et al.•European Respiratory Journal•2014

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    Open Access•Abhay S Nirgude, Ajay M V Kumar et al.•Global Health Action•2019

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Citations per year0.67
Citation span2023 - 2023 (1)
Highly citedNo

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