Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Demographic Correlates of Catastrophic Health Expenditure: An Assessment from Indian Household Survey Data


Affiliations
1 Fellow-II, NIPFP, 18/2, Satsang Vihar Marg, Special Institutional Area, New Delhi 110067, India
2 Ph.D, NIPFP, 18/2, Satsang Vihar Marg, Special Institutional Area, New Delhi 110067, India
     

   Subscribe/Renew Journal


This study finds out the importance of socio-economic, demographic and health-care-related factors in determining catastrophic health expenditure (CHE) of a household and how they influence its health care expenditure. Rising out-of-pocket (OOP) expenses for health financing in developing countries with different methodologies to assess the associated factors with CHE has been documented. This study contributes to the existing literature from the methodological viewpoint. In the two-step approach, at the first step, the probability of a household incurring CHE has been estimated and in the second the importance of the determinants of health expenditure is examined. An analysis is done to find out whether the situation varies across the quintiles. The database is the 71st round of social consumption of health survey conducted by the NSSO during January-June 2014. Health expenditure in household budgets is the highest among the poorest quintile. Treating a non-communicable disease and opting for private facilities are expensive. Relaxing the budget constraint by financing the healthcare from sources like contributions from friends/relatives and sale of assets lead to high spending on healthcare. The study recommends health expenditure protection schemes for the vulnerable groups, etc.
Subscription Login to verify subscription
User
Notifications
Font Size

  • Berki, S.E. (1986), A Look at Catastrophic Medical Expenses and the Poor, Health Affairs, 5(4): 138-145.
  • Berman, P., R. Ahuja and L. Bhandari (2010), The Impoverishing Effect of Healthcare Payments in India: New Methodology and Findings, Economic and Political Weekly, 45(14): 65-71.
  • Bonu, S., I. Bhushan and Peters H. David (2007), Incidence, Intensity, and Correlates of Catastrophic Out-Of-Pocket Health Payments in India, ERD Working Paper No 102, Asian Development Bank.
  • Correa-Burrows, P. (2012), Out-of-pocket Health Care Spending by the Chronically ill in Chile, Procedia Economics and Finance, 1: 88-97.
  • Cutler, D.M. (1995), The Cost and financing of Health Care, The American Economic Review, 85(2): 32-37.
  • Di Matteo, L. (2003), The Income Elasticity of Health Care Spending, The European Journal of Health Economics, 4(1): 20-29.
  • Ecob, R. and G.D. Smith (1999), Income and Health: What is the Nature of the Relationship?, Social Science and Medicine, 48(5): 693-705.
  • Flores, G., J. Krishnakumar, O. O'Donnell and E. Van Doorslaer (2008), Coping with Health‐care Costs: Implications for the Measurement of Catastrophic Expenditures and Poverty, Health Economics, 17(12): 1393-1412.
  • Garg, C.C. and A.K. Karan (2009), Reducing Out-of-Pocket Expenditures to Reduce Poverty: A Disaggregated Analysis at Rural-urban and State Level in India, Health Policy and Planning, 24(2): 116-128.
  • Ghosh, S. (2011), Catastrophic Payments and Impoverishment Due to Out-of-Pocket Health Spending, Economic and Political Weekly, 46(47): 63-70.
  • Government of India (2013-14), NHA Repot 2013-14, Ministry of Health and Family Welfare, Government of India.
  • Grossman, M. (1972), On the Concept of Health Capital and the Demand for Health, Journal of Political Economy, 80(2): 223-255.
  • Hjortsberg, C. (2003), Why Do the Sick not Utilise Health Care? The case of Zambia, Health Economics, 12(9): 755-770.
  • Hooda, S.K. (2017), Out-of-Pocket Payments for Healthcare in India: Who have affected the Most and Why? Journal of Health Management, 19(1): 1-15.
  • Hsu, J., G. Flores, D. Evans, A. Mills and K. Hanson (2018), Measuring Financial Protection against Catastrophic Health Expenditures: Methodological Challenges for Global Monitoring, International Journal for Equity in Health, 17(1): 69.
  • Hwang, W., W. Weller, H. Ireys and G. Anderson (2001), Out-of-Pocket Medical Spending for Care of Chronic Conditions, Health Affairs, 20(6): 267-278.
  • Kimani, D.N., M.G. Mugo and U.M. Kioko (2016), Catastrophic Health Expenditures and Impoverishment in Kenya. European Scientific Journal, 12(15): 434-452.
  • Ladusingh, L. and A. Pandey (2013), Health Expenditure and Impoverishment in India, Journal of Health Management, 15(1): 57-74.
  • Lee, L.F. (1983), Generalized Econometric Models with selectivity, Econometrica: Journal of the Econometric Society, 51(2): 507-512.
  • Manning, W.G. and M.S. Marquis (1996), Health Insurance: The Trade off between Risk Pooling and Moral Hazard, Journal of Health Economics, 15(5): 609-639.
  • McIntyre, D., M. Thiede, G. Dahlgren and M. Whitehead (2006), What are the Economic Consequences for Households of Illness and of Paying for Health Care in low-and MiddleIncome Country Contexts?, Social Science and Medicine, 62(4): 858-865.
  • Pal, R. (2012), Measuring Incidence of Catastrophic Out-of-pocket Health Expenditure: With Application to India, International Journal of Health Care Finance and Economics, 2(1): 63-85.
  • Pandey, A., G.A. Kumar, R. Dandona and L. Dandona (2018), Variations in Catastrophic Health Expenditure across the States of India: 2004 to 2014, PloS one, 13(10), https://doi.org/10.1371/journal.pone.0205510
  • Puteh, S.E.W. and Y. Almualm (2017), Catastrophic Health Expenditure among Developing Countries, Health Syst Policy Res, 4(1), doi:10.21767/2254-9137.100069
  • Raban, M.Z., R. Dandona and L. Dandona (2013), Variations in Catastrophic Health Expenditure Estimates from Household Surveys in India, Bulletin of the World Health Organization, 91(10): 726-735.
  • Rajpal, S. and W. Joe (2018), Measuring Catastrophic Healthcare Expenditure, Economic and Political Weekly, 53(32): 23.
  • Ravi, S., R. Ahluwalia and S. Bergkvist (2016), Health and Morbidity in India (2004-2014), Brookings, India Research Paper No. 092016
  • Rous, J.J. and D.R. Hotchkiss (2003), Estimation of the Determinants of Household Health Care Expenditures in Nepal with Controls for Endogenous Illness and Provider Choice, Health Economics, 12(6): 431-451.
  • Rubin, R.M. and K. Koelln (1993), Determinants of Household Out-of-Pocket Health Expenditures, Social Science Quarterly, 74(4): 721-735, or Endogenous Illness and Provider Choice, Health Economics, 12(6): 431-451.
  • Russell, S. (2005), Illuminating Cases: Understanding the Economic Burden of Illness through Case Study Household Research, Health Policy and Planning, 20(5): 277-289.
  • Saikia, N. (2019), Gender Disparities in Health Care Expenditures and Financing Strategies (HCFS) for Inpatient Care in India, SSM-Population Health, 9: 100372.
  • Saksena, P., K. Xu and V. Durairaj (2010), The Drivers of Catastrophic Expenditure: Outpatient Services, Hospitalization or medicines? World Health Report (2010), Background paper, 21. Geneva: World Health Organization.
  • Sauerborn, R. A. Adams and M. Hien (1996), Household Strategies to Cope with the Economic Costs of Illness, Social Science and Medicine, 43(3): 291-301.
  • Selvaraj, S. and A.K. Karan (2009), Deepening Health Insecurity in India: Evidence from National Sample Surveys since 1980s, Economic and Political Weekly, 44(40): 55-60.
  • Selvaraj, S., H.H. Farooqui and A. Karan (2018), Quantifying the Financial Burden of Households’ Out-of-Pocket Payments on Medicines in India: A Repeated Cross-Sectional Analysis of National Sample Survey data, 1994–2014, BMJ Open, 8(5): p.e018020.
  • Shahrawat, R. and K.D. Rao (2012), Insured Yet Vulnerable: Out-of-Pocket Payments and India’s Poor, Health Policy and Planning, 27(3): 213-221.
  • Van Doorslaer, E., O. O'Donnell, R.P. Rannan-Eliya, A. Somanathan, S.R. Adhikari, C.C. Garg, D.
  • Harbianto, A.N. Herrin, M.N. Huq, S. Ibragimova and A. Karan (2006), Effect of Payments for Health Care on Poverty Estimates in 11 Countries in Asia: An Analysis of Household Survey Data, The Lancet, 368(9544): 1357-1364.
  • ---------- (2007), Catastrophic Payments for Health Care in Asia, Health Economics, 16(11): 1159-1184.
  • Wagstaff, A. (2008), Measuring Financial Protection in Health, The World Bank.
  • Wagstaff, A. and E.V. Doorslaer (2003), Catastrophe and Impoverishment in Paying for Health Hare: With Applications to Vietnam 1993–1998, Health Economics, 12(11): 921-933.
  • Wagstaff, A. and M. Lindelow (2008), Can Insurance Increase Financial Risk? The Curious Case of Health Insurance in China, Journal of Health Economics, 27(4): 990-1005.
  • Wagstaff, A., E. Van Doorslaer and P. Paci (1989), Equity in the Finance and Delivery of Health Care: Some Tentative Cross-Country Comparisons, Oxford Review of Economic Policy, 5(1): 89-112.

Abstract Views: 396

PDF Views: 0




  • Demographic Correlates of Catastrophic Health Expenditure: An Assessment from Indian Household Survey Data

Abstract Views: 396  |  PDF Views: 0

Authors

Jay Dev Dubey
Fellow-II, NIPFP, 18/2, Satsang Vihar Marg, Special Institutional Area, New Delhi 110067, India
Bidisha Mondal
Ph.D, NIPFP, 18/2, Satsang Vihar Marg, Special Institutional Area, New Delhi 110067, India

Abstract


This study finds out the importance of socio-economic, demographic and health-care-related factors in determining catastrophic health expenditure (CHE) of a household and how they influence its health care expenditure. Rising out-of-pocket (OOP) expenses for health financing in developing countries with different methodologies to assess the associated factors with CHE has been documented. This study contributes to the existing literature from the methodological viewpoint. In the two-step approach, at the first step, the probability of a household incurring CHE has been estimated and in the second the importance of the determinants of health expenditure is examined. An analysis is done to find out whether the situation varies across the quintiles. The database is the 71st round of social consumption of health survey conducted by the NSSO during January-June 2014. Health expenditure in household budgets is the highest among the poorest quintile. Treating a non-communicable disease and opting for private facilities are expensive. Relaxing the budget constraint by financing the healthcare from sources like contributions from friends/relatives and sale of assets lead to high spending on healthcare. The study recommends health expenditure protection schemes for the vulnerable groups, etc.

References





DOI: https://doi.org/10.21648/arthavij%2F2020%2Fv62%2Fi4%2F204645