Affording what's free and paying for choice: comparing the cost of public and private hospitalizations in urban Kerala

Lévesque, Jean‐Frédéric; Haddad, Slim; Narayana, D.; Fournier, Pierre

doi:10.1002/hpm.879

Cited by 26 publications

(22 citation statements)

References 29 publications

(28 reference statements)

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“…Figure 1 shows the occurrence of hospitalizations due to all causes according to family income and birth weight in the three cohorts. In all three studies, children from families earning three times the monthly minimum wage or less were twice as likely to be hospitalized than children with higher incomes (χ 2 …”

Section: Resultsmentioning

confidence: 99%

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Hospitalizations during infancy in three population-based studies in Southern Brazil: trends and differentials

et al. 2008

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Section: Resultsmentioning

confidence: 99%

“…Moreover, the indirect costs of hospitalization, including absenteeism, unemployment, disability, and premature death, are also substantial 2,3 . A number of studies demonstrate that among young people, children under age one year are at greatest risk of undergoing the most costly hospitalizations 1,4 .…”

Section: Introductionmentioning

confidence: 99%

Hospitalizations during infancy in three population-based studies in Southern Brazil: trends and differentials

et al. 2008

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“…One of the major challenges facing universalization of healthcare in India is shortage of staff in public sector [14], [45]. Our model does not pose any steep augmentation of human resource production.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies from India have cited reasons such as high absenteeism, poor quality of services, rampant corruption and long travel distances as prominent reasons for poor access of public sector health facilities [12], [13], [14], [15]. Those accessing private providers largely encounter unlicensed practitioners who deliver poor quality care.…”

Section: Introductionmentioning

confidence: 99%

The Cost of Universal Health Care in India: A Model Based Estimate

et al. 2012

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IntroductionAs high out-of-pocket healthcare expenses pose heavy financial burden on the families, Government of India is considering a variety of financing and delivery options to universalize health care services. Hence, an estimate of the cost of delivering universal health care services is needed.MethodsWe developed a model to estimate recurrent and annual costs for providing health services through a mix of public and private providers in Chandigarh located in northern India. Necessary health services required to deliver good quality care were defined by the Indian Public Health Standards. National Sample Survey data was utilized to estimate disease burden. In addition, morbidity and treatment data was collected from two secondary and two tertiary care hospitals. The unit cost of treatment was estimated from the published literature. For diseases where data on treatment cost was not available, we collected data on standard treatment protocols and cost of care from local health providers.ResultsWe estimate that the cost of universal health care delivery through the existing mix of public and private health institutions would be INR 1713 (USD 38, 95%CI USD 18–73) per person per annum in India. This cost would be 24% higher, if branded drugs are used. Extrapolation of these costs to entire country indicates that Indian government needs to spend 3.8% (2.1%–6.8%) of the GDP for universalizing health care services.ConclusionThe cost of universal health care delivered through a combination of public and private providers is estimated to be INR 1713 per capita per year in India. Important issues such as delivery strategy for ensuring quality, reducing inequities in access, and managing the growth of health care demand need be explored.

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“…In urban Kerala, even non-poor families chose to utilize public hospitals for non-communicable disease hospitalisation, while preferring private facilities for acute illness-related hospitalisation in 1995-96. [54] While hospitalisation, surgery, medication and laboratory tests are the major drivers of cost, clinical practices driven by profit can substantially increase costs in the absence of well-defined management practices and clinical goal-setting. [55] Along with effective service delivery, innovative financing mechanisms will have to be developed to ensure risk pooling, and reduced financial burden on poor households.…”

Section: Discussionmentioning

confidence: 99%

Challenges in diabetes management with particular reference to India

Venkataraman¹,

Kannan²,

Mohan³

2009

Int J Diab Dev Ctries

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Diabetes was estimated to be responsible for 109 thousand deaths, 1157 thousand years of life lost and for 2263 thousand disability adjusted life years (DALYs) in India during 2004. However, health systems have not matured to manage diabetes effectively. The limited studies available on diabetes care in India indicate that 50 to 60% of diabetic patients do not achieve the glycemic target of HbA1c below 7%. Awareness about and understanding of the disease is less than satisfactory among patients, leading to delayed recognition of complications. The cost of treatment, need for lifelong medication, coupled with limited availability of anti-diabetic medications in the public sector and cost in the private sector are important issues for treatment compliance. This article attempts to highlight the current constraints in the health system to effectively manage diabetes and the need for developing workable strategies for ensuring timely and appropriate management with extensive linkage and support for enhancing the availability of trained manpower, investigational facilities and drugs.

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Affording what's free and paying for choice: comparing the cost of public and private hospitalizations in urban Kerala

Abstract: Hospitalization incurs significant expenditure in urban Kerala. Greater availability of free medical services in the public sector and financial protection against the cost of hospitalization are warranted.

Cited by 26 publications

References 29 publications

Hospitalizations during infancy in three population-based studies in Southern Brazil: trends and differentials

Hospitalizations during infancy in three population-based studies in Southern Brazil: trends and differentials

The Cost of Universal Health Care in India: A Model Based Estimate

Challenges in diabetes management with particular reference to India

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