Out-of-pocket healthcare payments on chronic conditions impoverish urban poor in Bangalore, India

115Citations
Citations of this article
257Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Background: The burden of chronic conditions is on the rise in India, necessitating long-term support from healthcare services. Healthcare, in India, is primarily financed through out-of-pocket payments by households. Considering scarce evidence available from India, our study investigates whether and how out-of-pocket payments for outpatient care affect individuals with chronic conditions. Methods. A large census covering 9299 households was conducted in Bangalore, India. Of these, 3202 households that reported presence of chronic condition were further analysed. Data was collected using a structured household-level questionnaire. Out-of-pocket payments, catastrophic healthcare expenditure, and the resultant impoverishment were measured using a standard technique. Results: The response rate for the census was 98.5%. Overall, 69.6% (95%CI=68.0-71.2) of households made out-of-pocket payments for outpatient care spending a median of 3.2% (95%CI=3.0-3.4) of their total income. Overall, 16% (95%CI=14.8-17.3) of households suffered financial catastrophe by spending more than 10% of household income on outpatient care. Occurrence and intensity of financial catastrophe were inequitably high among poor. Low household income, use of referral hospitals as place for consultation, and small household size were associated with a greater likelihood of incurring financial catastrophe. The out-of-pocket spending on chronic conditions doubled the number of people living below the poverty line in one month, with further deepening of their poverty. In order to cope, households borrowed money (4.2% instances), and sold or mortgaged their assets (0.4% instances). Conclusions: This study provides evidence from India that the out-of-pocket payment for chronic conditions, even for outpatient care, pushes people into poverty. Our findings suggest that improving availability of affordable medications and diagnostics for chronic conditions, as well as strengthening the gate keeping function of the primary care services are important measures to enhance financial protection for urban poor. Our findings call for inclusion of outpatient care for chronic conditions in existing government-initiated health insurance schemes. © 2012 Bhojani et al.; licensee BioMed Central Ltd.

References Powered by Scopus

Household catastrophic health expenditure: A multicountry analysis

1555Citations
N/AReaders
Get full text

Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data

499Citations
N/AReaders
Get full text

Responding to the threat of chronic diseases in India

479Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Action to address the household economic burden of non-communicable diseases

171Citations
N/AReaders
Get full text

Prevalence and outcomes of multimorbidity in South Asia: A systematic review

126Citations
N/AReaders
Get full text

Catastrophic health expenditures and its inequality in elderly households with chronic disease patients in China

122Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Bhojani, U., Thriveni, B., Devadasan, R., Munegowda, C., Devadasan, N., Kolsteren, P., & Criel, B. (2012). Out-of-pocket healthcare payments on chronic conditions impoverish urban poor in Bangalore, India. BMC Public Health, 12(1). https://doi.org/10.1186/1471-2458-12-990

Readers over time

‘12‘13‘14‘15‘16‘17‘18‘19‘20‘21‘22‘23‘24015304560

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 110

64%

Researcher 40

23%

Professor / Associate Prof. 12

7%

Lecturer / Post doc 9

5%

Readers' Discipline

Tooltip

Medicine and Dentistry 81

49%

Social Sciences 34

20%

Economics, Econometrics and Finance 27

16%

Nursing and Health Professions 25

15%

Save time finding and organizing research with Mendeley

Sign up for free
0