Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Financial, physical and cultural access to inpatient care in India
Parimala mohanty

Last modified: 2018-08-07


Background: Access to healthcare services is an important tool to achieve universal health coverage. In this context, this study explores various types of access in utilizing inpatient care in India.

Materials and methods: The national sample survey data on health consumption (NSSO-2014) was analyzed to examine financial access (insurance & out-of-pocket exceeding 25% of annual household expenses), physical access (rural residence & transport cost), and cultural access (social group and religion) to inpatient care.

Results: For any ailment, more people from rural (range:56-75.1%) sector,  socially backward group (range: 65-79.5%), Hindu (71-83.8%) religion were hospitalized than their counterparts. Average transport cost was INR777.1 and it was as high as 100% of out-of-pocket payments. About 80.5% inpatients had no insurance and 38.5% of inpatients had no financial access. The regression models suggest urban people had less financial access than rural (AOR:0.53;CI:0.48-0.58) people. Forward caste (AOR:2.43;CI:2.11-2.79) and backward caste (AOR:2.12;CI: 1.87-2.40) had more financial access than tribal population.  Religion and gender remained insignificant predictors of financial access.

Conclusions: The study suggests limited insurance coverage and financial access to inpatient group and with more concentration in urban and tribal population. Implementing affordable and accessible health care with due care for contextual predictors must be given priority.