MORBIDITY PATTERN OF HOSPITALIZATION AND ASSOCIATED OUT OF POCKET EXPENDITURE: EVIDENCE FROM NSSO (2017-2018)
Keywords:Morbidity, Health Care Utilization, Out Of Pocket Expenditure
In 2018, according to the National Sample Survey Report, the number of cases of hospitalization per 1000 persons in 365 days was 29 in India (26 per 1000 in rural and 34 per 1000 in urban areas). Between 2004 and 2014, for example, the average medical expenditure per hospitalization for urban patients increased by about 176%, and for rural patients, it jumped by a little over 160%. Most of these hospitalizations are for infections, but a significant number also for treatment for cancer and blood-related diseases. The increase in access to healthcare has also brought with it a massive spike in costs. India is rapidly undergoing an epidemiological transition with a sudden change in the disease profile of its population. This study aimed to analyze hospitalization due to different factors like age and morbidity and its effect on health care utilization from nationally representative data from 2018 among the total population of India. 75th round of National Sample Survey Organisation (NSSO) conducted in July 2017- June 2018 has been used to examine what are the determinant factors that affect the hospitalization and mean monthly disease-specific expenditure in the different age group populations in India. We have used cross-tabulation to understand the association between morbidity patterns and healthcare utilization with other socio-demographic variables. A set of logistic regression analyses was carried out to understand the role of age patterns on hospitalization. A log-linear regression model was used to understand the significant predictors of out-of-pocket expenditure (OOPE).
Baji, P., et al., (2012). Changes in equity in out-of-pocket payments during the period of health care reforms: evidence from Hungary. Int. J. Equity Health 11, 36. Retrieved from https://doi.org/10.1186/1475-9276-11-36 DOI: https://doi.org/10.1186/1475-9276-11-36
Bock, J.-O., et al., (2014). Inequalities in out-of-pocket payments for health care services among elderly Germans-results of a population-based cross-sectional study. Int. J. Equity Health 13, 3. http://dx.doi.org/10.1186/1475-9276-13-3. Retrieved from https://doi.org/10.1186/1475-9276-13-3 DOI: https://doi.org/10.1186/1475-9276-13-3
Bose M, Dutta A. (2014) Access to Non-hospitalization Care in West Bengal: A Demand-side Assessment Based on NSS Data. Indian Journal of Human Development: forthcoming. Retrieved from https://doi.org/10.1177/0973703020140105 DOI: https://doi.org/10.1177/0973703020140105
Gupt, A., et al., (2016). Out of pocket expenditure for hospitalization among below poverty line households in district Solan, Himachal Pradesh, India, 2013.PLoSOne11(2),e0149824. Retrieved from http://dx.doi.org/10.1371/journal.pone.014984 DOI: https://doi.org/10.1371/journal.pone.0149824
International Institute for Population Sciences [IIPS] and World Health Organisation [WHO], (2006). Health system performance assessment: World Health Survey, 2003, West Bengal. Mumbai: IIPS.
Kastor A, Mohanty SK. (2018) Disease and age pattern of hospitalization and associated costs in India: 1995-2014. BMJ Open;8:e016990. Retrieved from https://doi.org/10.1136/bmjopen-2017-016990 DOI: https://doi.org/10.1136/bmjopen-2017-016990
Kumar, K., et al., (2015). Socioeconomic diﬀerentials in impoverishment eﬀects of out-ofpocket health expenditure in China and India: evidence from WHO SAGE. PLoS One 10 (8), e0135051. Retrieved from http://dx.doi.org/10.1371/journal.pone.0135051 DOI: https://doi.org/10.1371/journal.pone.0135051
Mohanty, S.K., et al., (2013). Out-of-pocket expenditure on health care among elderly and non-elderly households in India. Soc. Indicat. Res. 115 (3), 1137-1157. Retrieved from https://doi.org/10.1007/s11205-013-0261-7 DOI: https://doi.org/10.1007/s11205-013-0261-7
Mohanty, S.K., et al., (2016). Pattern, growth and determinant of household health spending in India, 1993–2012. 24, pages 215–229. Retrieved from https://link.springer.com/article/10.1007/s10389-016-0712-0 DOI: https://doi.org/10.1007/s10389-016-0712-0
National Sample Survey Organization (NSSO) [internet]. Retrieved from http://mospi.nic.in/Mospi_New/Admin/ publication.aspx
Rajaratnam JK, Marcus JR, Levin-Rector A, et al. (2010) Worldwide mortality in men and women aged 15-59 years from 1970 to: a systematic analysis. Lancet 2010;375:1704-20. Retrieved from https://doi.org/10.1016/S0140-6736(10)60517-X DOI: https://doi.org/10.1016/S0140-6736(10)60517-X
Russo, C. A. and Elixhauser, A. (2006) Hospitalizations in the Elderly Population, 2003. Statistical Brief #6. May. Agency for Healthcare Research and Quality, Rockville, Md. Retrieved from http://www.hcup-us.ahrq.gov/reports/ statbriefs/sb6.pdf
Saikia, N., Bora, J.K., (2016). Gender diﬀerence in healthcare expenditure: evidence from India human development survey. PLoS One 11 (7), e0158332. http://dx.doi.org/10. 1371/journal.pone.0158332 DOI: https://doi.org/10.1371/journal.pone.0158332
Shahrawat R, Rao KD. (2012) Insured yet Vulnerable: Out-of-Pocket Payments and India's Poor. Health Policy Plan; 27: 213-21. Retrieved from https://doi.org/10.1093/heapol/czr029 DOI: https://doi.org/10.1093/heapol/czr029
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