ArticleBMC public health2019
Do poor people in the poorer states pay more for healthcare in India?
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 64 citations in OpenAlex.
- Article
- Assessment of out-of-pocket (OOP) expenditures on essential medicines for acute and chronic illness: a comparative study across regional and socioeconomic groups in India.BMC public health · 2025Article
- Estimates of life expectancy and premature mortality among multidimensional poor and non-poor in India.BMC public health · 2024Article
- Exploring the road to public healthcare accessibility: a qualitative study to understand healthcare utilization among hard-to-reach groups in Kerala, India.International journal for equity in health · 2024Article
- Centre-level variation in the survival of patients receiving haemodialysis in India: findings from a nationwide private haemodialysis network.The Lancet regional health. Southeast Asia · 2024Article
- Reproductive and child health transition among selected empowered action groups states of India: A district-level analysis.PloS one · 2024Article
- Determinants of out-of-pocket expenditure on medicines among adults in Saudi Arabia: a cross-sectional study.Frontiers in medicine · 2024Article
- Cancer care and economic burden-A narrative review.Journal of family medicine and primary care · 2023Review
- In search of a fix to the primary health care chasm in India: can institutionalizing a public health cadre and inducting family physicians be the answer?The Lancet regional health. Southeast Asia · 2023Review
- Review
- Examining the rural-urban divide in predisposing, enabling, and need factors of unsafe abortion in India using Andersen's behavioral model.BMC public health · 2022Article
- Components of Out-of-Pocket Expenditure and Their Relative Contribution to Economic Burden of Diseases in India.JAMA network open · 2022Article
- Harnessing Bourdieu's social theory to understand the deteriorating doctor-patient-nurse relationship in West Bengal government hospitals.Frontiers in sociology · 2022Article
- Economic gradient of onset of disability in India.BMC public health · 2021Article
- Addressing data and methodological limitations in estimating catastrophic health spending and impoverishment in India, 2004-18.International journal for equity in health · 2021Article
- Demographics, Pattern of Care, and Outcome Analysis of Malignant Melanomas - Experience From a Tertiary Cancer Centre in India.Frontiers in oncology · 2021Article
- Understanding equity of institutional delivery in public health centre by level of care in India: an assessment using benefit incidence analysis.International journal for equity in health · 2020Article
- Mapping fear among doctors manning screening clinics for COVID19. Results from cloud based survey in Eastern parts of India.Journal of family medicine and primary care · 2020Article
- Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRising health spending is associated with high out-of-pocket expenditure (OOPE), catastrophic health spending (CHS), increasing poverty, and impoverishment. Though studies have examined poverty and impoverishment effect of health spending in India, there is limited research on the regional patterns of health spending by type of health centers. This paper tests the hypothesis that the poor people from the poorer states of India pay significantly more for hospitalization in public health centers than those in the richer states of India.
methodsData from the Social Consumption of Health Survey (71st round, 2014), carried out by the National Sample Survey (NSS) is used in the analyses. Descriptive statistics, log-linear regression model and tobit model were used to examine the determinants and variations in health spending.
resultsInter-state variations in the utilization of public health services and the OOPE on hospitalization are high in India. States with high levels of poverty make higher use of the public health centers and yet incur high OOPE. In 2014, the mean OOPE per episode of hospitalization in public health centers in India was ₹5688 and ₹4264 for the economically poor households. It was lowest in the economically developed state of Tamil Nadu and highest in the economically poorer state of Bihar. The OOPE per episode of hospitalization in public health centers among the poor in the poorer states was at least twice that in Tamil Nadu. Among the poor using public health centers, the share of direct cost account 24% in Tamil Nadu compared to over 80% in Bihar, Odisha and other poorer states. Adjusting for socio-economic correlates, the cost of hospitalization per episode (CHPE) among the poor using public health centers was 51% lower than for the non-poor using private health centers in India.
conclusionThe poor people in the poorer states in India pay significantly more to avail hospitalization in public health centers than those in the developed states. Provision of free medicines, surgery and free diagnostic tests in public health centers may reduce the high OOPE and medical poverty in India.
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