Coping with Out-of-Pocket Health Expenditure in India: Evidence from NSS 71st Round

  • Shivendra Sangar
  • Varun Dutt
  • Ramna ThakurEmail author


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.


Coping 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


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of Humanities and Social SciencesIndian Institute of TechnologyMandiIndia

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