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

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Out-of-pocket and Catastrophic Health Expenditure on Hospitalization in India: Role of Health Insurance
Vineeta Sharma

Last modified: 2018-08-07


Background: In pursuit of achieving Universal Health Coverage (UHC) in low and middle income countries, increasing health insurance coverage is seen as one means to address health disparity and reduce catastrophic health costs. This study examined enrolment, out of pocket expenditure (OOPE) and catastrophic healthcare expenditure (CHE) for the insured and uninsured and CHE for public and private healthcare facilities in India.

Materials and Methods: The data from National Sample Survey (71st Round) 2014 on Health was extracted and analyzed. Variables of enrolment, hospitalization, OOPE and CHE were descriptively analyzed. Logistic multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOPE were conducted, taking into account gender, socio-economic status, residence, type of facility.

Results: Insurance coverage was 18.5%. Average OOPE on hospitalization was INR 17,607. Average OOPE was INR 20,543 and INR 16,942 among insured and non-insured, respectively. Of households with at least one member hospitalized, 39.6 % experienced CHE, with not much difference between insured and non-insured. CHE was three times higher in private facilities than those in public facilities.

Conclusions: Study finds that insurance coverage was low, OOPE was higher among the insured and CHE was higher in private facilities as compared to public facilities.


Keywords: Catastrophic Health Expenditure, Healthcare, Insurance coverage, Hospitalization, Out of Pocket Expenditure