Measuring catastrophe in paying for healthcare: A comparative methodological approach by using National Sample Survey, India

Dwivedi, Rinshu; Pradhan, Jalandhar; Athe, Ramesh

doi:10.1002/hpm.3272

Cited by 11 publications

(7 citation statements)

References 73 publications

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“…In the present study, households spending more than 10 percent of their total consumption expenditure on health are considered to be catastrophic. This is because the 10% threshold is the most widely used threshold level [35,[38][39][40].…”

Section: Methodsmentioning

confidence: 99%

Uneven economic burden of non-communicable diseases among Indian households: A comparative analysis

Behera

Pradhan

2021

PLoS ONE

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Background Non-communicable diseases (NCDs) are the leading global cause of death and disproportionately concentrate among those living in low-income and middle-income countries. However, its economic impact on households remains less well known in the Indian context. This study aims to assess the economic impact of NCDs in terms of out-of-pocket expenditure (OOPE) and its catastrophic impact on NCDs affected households in India. Materials and methods Data were collected from the 75th round of the National Sample Survey Office, Government of India, conducted in the year 2017–18. This is the latest round of data available on health, which constitutes a sample of 113,823 households. The collection of data is based on a stratified multi-stage sampling method. Generalised Linear Regression model was employed to identify the socio-economic covariates associated with the catastrophic health expenditure (CHE) on hospitalisation. Results The result shows a higher burden of OOPE on NCDs affected households. The mean expenditure by NCDs households in public hospitals is INR 13,170 which is more than twice as compared to the non-NCDs households INR 6,245. Particularly, the proportion of total medical expenditure incurred on medicines (0.39) and diagnostics (0.15) is troublesome for households with NCDs, treated in public hospitals. Moreover, results from the generalised linear regression model confirm the significant relationship between CHE with residence, caste, religion, household size, and economic status of households. The intensity of CHE is more for the households who are poor, drinking unsafe water, using firewood as cooking fuel, and household size of 1–5 members. Conclusion Therefore, an urgent need for a prevention strategy should be made by the government to protect households from the economic burden of NCDs. Specifically, to reduce the burden of CHE associated with NCDs, a customised disease-specific health insurance package should be introduced by the government of India in both public and private facilities.

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Section: Methodsmentioning

confidence: 99%

Uneven economic burden of non-communicable diseases among Indian households: A comparative analysis

Behera

Pradhan

2021

PLoS ONE

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“…19 In resource-limited countries, with high out-of-pocket expenditure (OOPE), low-cost technology proves to be beneficial in reducing catastrophic expenditure due to expensive surgical procedures. [20][21][22] In India, Health Technology Assessment (HTA) has been launched for assessment, evaluation, and analysis of the costeffectiveness of available health technologies in country. It is aimed to reduce OOPE and maximize the health benefits.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Scoping Review to Evaluate the Clinical Efficacy of Indigenously Produced, Patient-Specific Acrylic Cranial Prosthesis in Decompressive Craniectomy in India

Guleria,

Nalin,

Kumar

2023

Indian Journal of Neurosurgery

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Background Health Technology Assessment in India assesses, evaluates, and carries out cost-effectiveness of available health technologies in the country for evidence-based decision-making. Current study carried out a scoping review to assess clinical efficacy of poly-methyl-methacrylate (PMMA) after decompressive craniectomy using various prototyping techniques in published literature. Methods The O'Malley methodology and Preferred Reporting Items for Systematic Reviews and Metanalysis for Scoping Reviews—PRISMA-ScR—checklist were used to assess published literature from year 2008 to 2023. Results A total of 507 records were identified after searching electronic databases. After removing duplicate studies and studies that did not meet inclusion criteria, a total of 12 studies were included for review. A total of four studies were described as experimental and eight were case reports/series. The sample size of intervention studies varied between 10 and 30 patients with a mean age of 36.7 years. In a total of seven studies, cranioplasty was done by a self-made PMMA prosthesis fabricated using a novel three-dimensional-printed cranial model fabrication technique. In experimental study, objective criteria like operative Glasgow Outcome Scale, Cranial Index of Symmetry score, and Visual Analog Score for Cosmesis were employed. Conclusion Clinical assessment for cranial symmetry was observed favorable for PMMA with fewer complications, though sample size was inadequate (range: 10–30) with comparator group in two studies.

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“…First, while several previous studies have shown increasing inequality in out-of-pocket payments and incidence of CHE in the overall population over time, 2,22,30 few have found a higher incidence of CHE among elderly households. 2,31 The present study used the household old-age dependency approach to capture the effect of old-age members on household CHE. 32 Second, we used the capacity-to-pay approach for estimating CHE and estimated concentration curve as it addresses equity consideration.…”

Section: Introductionmentioning

confidence: 99%

“…We made a number of improvements to the existing literature. First, while several previous studies have shown increasing inequality in out‐of‐pocket payments and incidence of CHE in the overall population over time, 2,22,30 few have found a higher incidence of CHE among elderly households 2,31 . The present study used the household old‐age dependency approach to capture the effect of old‐age members on household CHE 32 .…”

Section: Introductionmentioning

confidence: 99%

Old‐age dependency and catastrophic health expenditure: Evidence from Longitudinal Ageing Study in India

Mohanty

Sahoo

Rashmi

2022

Health Planning & Management

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Background Out‐of‐pocket (OOP) payments and catastrophic health expenditure (CHE) have a strong age gradient. Though studies have examined the socio‐demographic and geographic inequality in OOP payments and CHE in India, the role of old‐age dependency in financial catastrophe remains unclear. Disaggregated estimates of CHE by the level of old‐age dependency of households may help identify the most vulnerable sub‐group and provide evidence for specific policies for the financial protection and health care of the elderly. The present study aims to estimate the incidence and intensity of CHE by the old‐age dependency of households among middle‐aged adults and the elderly in India. Methods A total of 42,949 households from the Longitudinal Aging Study in India (LASI), 2017–18, covering households with at least one‐member aged 45+ years, were included in the analysis. Households were classified into three mutually exclusive groups: no old‐age dependency, low old‐age dependency, and high old‐age dependency. The incidence and intensity of CHE were estimated using the capacity‐to‐pay (CTP) approach. Concentration indices and concentration curves examine the extent of socioeconomic inequality in CHE. Binary logistic regression helps to understand the potential predictors of CHE across each type of old‐age‐dependent household. Results We estimated the overall incidence of CHE at 24.6% (95% CI: 23.3–25.8) among middle‐aged adults and the elderly in India. The incidence was 33.2% (95% CI: 31.4–35.1) among households with high old‐age dependency, 23.1% (95% CI: 20.8–25.5) among those with low old‐age dependency, and 20.4% (95% CI: 19.0–21.7) among no old‐age dependency households. CHE intensity was highest among households with low old‐age dependency compared to those no old‐age dependents. Catastrophic health expenditure was higher among the poorer households in each type of old‐age dependency. Among all households, the odds of incurring CHE were higher among households with high old‐age dependency (AOR: 1.52; 95% CI: 1.36–1.69) than those with no old‐age dependency. Lower‐income households, households with pensions as the main source of income, households belonging to scheduled castes, and households residing in rural areas had higher odds of incurring CHE. The co‐variates of CHE varied significantly across the type of old‐age dependency households. A household's enrolment into a health insurance scheme did not necessarily lower its CHE. Conclusion Households with high old‐age dependency had a higher probability of incurring CHE in India. Providing preventive and curative geriatric care in primary health centres (PHC) is recommended.

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Measuring catastrophe in paying for healthcare: A comparative methodological approach by using National Sample Survey, India

Cited by 11 publications

References 73 publications

Uneven economic burden of non-communicable diseases among Indian households: A comparative analysis

Uneven economic burden of non-communicable diseases among Indian households: A comparative analysis

A Scoping Review to Evaluate the Clinical Efficacy of Indigenously Produced, Patient-Specific Acrylic Cranial Prosthesis in Decompressive Craniectomy in India

Old‐age dependency and catastrophic health expenditure: Evidence from Longitudinal Ageing Study in India

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