Introduction: Out-of-Pocket (OOP) spending is a prominent health care payment mechanism in India and other developing countries. However, it is more common amongst the lower income group of people especially in the rural areas. And due to this type of payments mechanisms (OOP) many households incur catastrophic payments and possibility of falling into poverty trap is high. To avoid such an impoverishment situation, some households forgo the needed health care when get health shocks. This study analyses the various issues related to treatment forgone and its major determinants.
Data and Methods: The empirical analysis is based on the primary survey conducted in the last quarter of 2015 in rural Chirang districts of Assam (India). It is based on the data collected on OOP payments, income of the households, and treatment forgone due to lack of money or unbearable cost for the last one year preceding the survey date. The analysis is descriptive as well as based on binary logistic regression model.
Results/Application: It has been found that the households with lower income groups are more likely to forgo treatment than the higher income groups. The treatment forgone by the households whose annual income is up to ₹75,000 is higher relative to the income group greater than ₹2,00,000 (OR=15.96, p< 0.001), and the households in the income group of between ₹75,001-2,00,000 relative to the income group of greater than ₹2,00,000 (OR=8.86, p<0.01). The results also show that the households which incurred catastrophic OOP expenditure on health care are more likely to forgo health care subsequently. Population size of the households also plays an important role in determining the treatment forgone. Female headed households are less likely to forgo treatment than the male headed households, though the result is not statistically significant.