Incidence of Out-of-pocket Health Expenditure led Impoverishment among Rural Households: An Empirical Study in Himachal Pra
DOI:
https://doi.org/10.48001/978-81-966500-9-4_2Keywords:
Health, Expenditure, Rural, HouseholdAbstract
The healthcare system in India is characterised by high out-of-pocket (OOP) expenditure, which varies across states and different population groups. This study aims to examine the levels of impoverishment caused by OOP health payments and their determinants among rural households in Himachal Pradesh, India. The study uses cross-sectional data from a survey of 300 rural households from two districts of Himachal Pradesh. We study the level of catastrophic health expenditure (CHE) at two different thresholds i.e., 10 percent and 25 percent of households consumption expenditure. Using the state poverty line for rural areas, the study also estimates the levels of impoverishment due to high OOP payments. The study employs multiple logistic regression models to identify the factors associated with the incidence of impoverishment. The incidence of CHE due to OOP health payments at 10 per cent and 25 per cent level of total consumption expenditure is 69.33 per cent and 38.67 per cent, respectively, in Sirmaur district; and 70 per cent and 34.67 per cent, respectively, for Solan district. Similarly, the level of impoverishment is 25.33 per cent and 16 per cent in Sirmaur and Solan, respectively.
Factors such as seeking outpatient care, presence of chronic disease patients and travelling for
healthcare are main covariates of impoverishment. The study concludes that OOP healthcarepayments pose a significant financial risk in Himachal Pradesh. This risk can be minimized by covering the outpatients and needs of chronic disease patients under social health insurance. In addition, the travelling-related financial risks for patients can be mitigated by increasing the
participation of private healthcare providers in social health insurance schemes and government
investment in strengthening the access to healthcare facilities.
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