Cost of hospitalization for non-communicable diseases in India: are we pro-poor?

Tripathy, JP; Prasad, BM; Shewade, HD; Kumar, AM; Zachariah, R; Chadha, S; Tonsing, J; Harries, AD; (2016) Cost of hospitalization for non-communicable diseases in India: are we pro-poor? Tropical medicine & international health. ISSN 1360-2276 DOI:

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To estimate out-of-pocket (OOP) expenditure due to hospitalization from NCDs and its impact on households in India. The study analysed nationwide representative data collected by the National Sample Survey Organization in 2014 that reported health service utilization and health care related OOP expenditure by income quintiles and by type of health facility (public or private). The recall period for inpatient hospitalization expenditure was 365 days. Consumption expenditure was collected for a recall period of one month. OOP expenditure amounting to >10% of annual consumption expenditure was termed as catastrophic. Weighted analysis was performed. The median expenditure per episode of hospitalisation due to NCDs was USD 149 - this was ~3 times higher among the richest quintile compared to poorest quintile. There was a significantly higher prevalence of catastrophic expenditure among the poorest quintile, more so for cancers (85%), psychiatric and neurological disorders (63%) and injuries (63%). Mean private sector OOP hospitalization expenditure was nearly five times higher than in the public sector. Medicines accounted for 40% and 27% of public and private sector OOP hospitalization expenditure respectively. Strengthening of public health facilities is required at community level for the prevention, control and management of NCDs. Promotion of generic medicines, better availability of essential drugs and possible subsidization for the poorest quintile will be measures to consider to reduce OOP expenditure in public sector facilities. This article is protected by copyright. All rights reserved.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 27253634
Web of Science ID: 382563500010


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