Coping with Out-of-Pocket Health Expenditure in India: Evidence from NSS 71st Round
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The present paper seeks to examine the incidence and socio-economic inequality in the utilisation of different sources of finance to cope up with out-of-pocket (OOP) health expenditure in rural and urban India. By employing National Sample Survey Organisation (NSSO), 71st Round (2014) data, the authors found that among inpatient cases, about 60 and 50% households in rural and urban areas respectively rely upon distress sources such as borrowings, contributions from friends and relatives and sale of assets to finance OOP health expenditure. Socio-economically deprived sections in rural areas have a higher likelihood of using distress financing than in urban areas. Greater dependency on debt and sale of assets emphasises the need for a comprehensive health financing system in the country.
KeywordsCoping Inequality Source of finance Rural Urban
Compliance with Ethical Standards
The study used the data set that is available online in public domain; hence, there was no need to seek ethical consent to publish this study.
Conflict of Interest
The authors declare that they have no conflict of interest.
Availability of Data and Materials
This paper is based on anonymized survey data collected by the National Sample Survey organisation (NSSO), a department of the Ministry of Statistics and Programme Implementation, Government of India. Data is available in the public domain. The data is already available in publicly available repositories to individuals both at the national and international level through http://www.mospi.gov.in/.
- Bajpai, V. (2014). The challenges confronting public hospitals in India, their origins, and possible solutions. Advances in Public Health, 2014.Google Scholar
- Berman, P., Ahuja, R., & Bhandari, L. (2010). The impoverishing effect of healthcare payments in India: new methodology and findings. Economic and Political Weekly, 65–71.Google Scholar
- Bonfrer, I., & Gustafsson-Wright, E. (2016). Health shocks, coping strategies and foregone healthcare among agricultural households in Kenya. Global Public Health, 1–22.Google Scholar
- Daivadanam, M., Thankappan, K., Sarma, P., & Harikrishnan, S. (2012). Catastrophic health expenditure & coping strategies associated with acute coronary syndrome in Kerala, India. The Indian journal of medical research, 136(4), 585–592.Google Scholar
- Dhanaraj, S. (2014). Health shocks and coping strategies. In WIDER Working Paper 2014/003 (pp. 1–28): World Institute for Development Economics Research, United Nations University.Google Scholar
- Dilip, T., & Duggal, R. (2002). Incidence of non-fatal health outcomes and debt in urban India: CEHAT.Google Scholar
- Ghosh, S. (2010). Catastrophic payments and impoverishment due to out-of-pocket health spending: the effects of recent health sector reforms in India.Google Scholar
- Gupta, I. (2009). Out-of-pocket expenditures and poverty: estimates from NSS 61st Round. Draft paper. Institute of Economic Growth, New Delhi.Google Scholar
- IRDA (2016). Annual Report 2015-16. Hyderabad: Insurance Regulatory and Development Authority of India (IRDAI).Google Scholar
- Jayakrishnan, T., Jeeja, M., Kuniyil, V., & Paramasivam, S. (2016). Increasing out-of-pocket health care expenditure in India-due to supply or demand. Pharmacoeconomics, 1(105), 2.Google Scholar
- Kakwani Nanak, C. (1980). Income inequality and poverty: methods of estimation and policy applications: Oxford University Press.Google Scholar
- Mondal, S., Lucas, H., Peters, D., & Kanjilal, B. (2014). Catastrophic out-of-pocket payment for healthcare and implications for household coping strategies: evidence from West Bengal, India. Economics Bulletin, 34(2), 1303–1316.Google Scholar
- NHA. (2016). National Health Accounts 2014-15. New Delhi: Ministry of Health and Family Welfare, Govt. of India.Google Scholar
- NSSO. (2004). Health, morbidity and condition of aged, NSSO 60th Round (January-June 2004). New Delhi: Ministry of Statistics and Programme Implementaion, Government of India.Google Scholar
- NSSO. (2014). Key Indicators of Social Consumption in India: Health, 71st Round (January-June 2014). New Delhi: Ministry of Statistics and Programme Implementation, Government of India.Google Scholar
- Registrar General, I. (2011). Census of India 2011: provisional population totals-India data sheet. Office of the Registrar General Census Commissioner, India. Indian Census Bureau.Google Scholar
- WHO (2000). The world health report 2000: health systems: improving performance: World Health Organization.Google Scholar
- WHO (2007). The world health report 2007: a safer future: global public health security in the 21st century.Google Scholar