Healthcare financing (in public and private both ends) is a challenging priority in India where low public healthcare expenditure causing unaffordable cost of treatment. Introduction of health insurance is considered as a major invension in healthcare. The main focal point of the study is to visualize the changes in the insurance coverage and healthcare spending pattern and to assess the relationship between health insurance and healthcare cost emphasising out of pocket expenditure (OOPE) on healthcare in India. Financing for healthcare by the government and individuals is a challenging priority in India due to its overflowing population, inadequate resources, and low disposable income. Public health expenditure in India has remained the lowest in GDP even in comparison to it its neighboring low economic South Asian countries.1 India, along with Vietnam, Bangladesh, and China, has some of the highest load of OOPE for health care in Asia.2 The household can be forced into penury as a consequence of OOPE. Around 150 million among all the global people have to tackle financial catastrophe and impoverishment due to OOPE suffered by about 100 million every year.3 While 90% of them belong to low-income nations. Data Source Data were taken from the 60th and 71st round of the National Sample Survey Organization’s (NSSO) “Morbidity and health care” survey, conducted during the period 2004-05 and 2014-15 respectively by the Ministry of Statistics and Programme Implementations of Government of India. The national representative survey consists of a sample size of 73868 households (47, 302 rural and 26, 566 urban households) in the 60th round and 65932 households (36, 480 rural, and 29, 452 urban households) in the 71st. The cross-sectional survey’s sample was selected using a two-stage stratified design where first-stage units(FSU) for rural and urban areas are census villages and urban blocks respectively and for second stage unit (SSU) is the household.21-22 The data covers ailment type, no. of hospitalization days, diseases nature, OOPE and utilization of health sector service, concerning individual as well as household socioeconomic backgrounds combinedly. Key outcome variable & Correlates From the household-level data, the amount of medical insurance premium paid for household members and the household’s usual consumption for health expenditure in a month was taken as the dependent variable in the study. Incidence of hospitalization of members including their sex, educational qualification, inpatient time-period, sector, household size, occupation, social group, outpatient status, and any coverage of health insurance schemes wasmarked as a predictor variable in the study. The reference period for outpatient treatment for 15 days was taken and for inpatient cases, reference periods of both the last 365 as well as for the last 15 days were considered. From NSSO 60th round data to some extent same information including insurance status was taken for comparing purposes concerning the socio-economical and demographical characteristics.
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Alina Grace
Managing Editor
Epidemiology: Open Access