Out of pocket expenditure to deliver at public health facilities in India: a cross sectional analysis

Issac, Anns; Chatterjee, Susmita; Srivastava, Aradhana; Bhattacharyya, Sanghita

doi:10.1186/s12978-016-0221-1

Cited by 39 publications

(38 citation statements)

References 25 publications

(23 reference statements)

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“…Medicine contributed the major portion of overall OOPE and higher overall OOPE for care seeking was associated with a priority illness which is consistent to findings in this study. A study conducted in India on OOPE to deliver public health facilities showed that an overall median OOPE was USD 11.48 (Issac et al 2016). Similar to this study, a significant predictor for high OOPE was caste.…”

Section: Discussionmentioning

confidence: 99%

“…Globally, each year 19 million neonates have life-threatening conditions including intrapartum related brain injury, pathological jaundice, severe bacterial infections and preterm birth which require specialized care (Bhutani et al 2013;Blencowe et al 2013;Lawn et al 2013;Lee et al 2013;Seale et al 2013). Of these, 2.9 million neonates die due to complications from preterm birth (34%), intrapartum-related conditions (25%), and infections (22%) (Lawn et al 2014). Almost all of these deaths take place in LMICs and most of them occur in families who are poor and have least access to services (Lawn et al 2005).…”

Section: Introductionmentioning

confidence: 99%

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Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Sunny

Gurung

et al. 2020

Matern Child Health J

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Background Almost all preventable neonatal deaths take place in low-and middle-income countries and affect the poorest who have the least access to high quality health services. Cost of health care is one of the factors preventing access to quality health services and universal health coverage. In Nepal, the majority of expenses related to newborn care are borne by the caregiver, regardless of socioeconomic status. We conducted a study to assess the out of pocket expenditure (OOPE) for sick newborn care in hospitals in Nepal. Methods This cross-sectional study of hospital care for newborns was conducted in 11 hospitals in Nepal and explored OOPE incurred by caregivers for sick newborn care. Data were collected from the caregivers of the sick newborn on the topics of cost of travel, accommodation, treatment (drugs, diagnosis) and documented on a sick newborn case record form. Results Data were collected from 814 caregivers. Cost of caregivers' stay accounted for more than 40% of the OOPE for sick newborn care, followed by cost of travel, and the baby's stay and treatment. The overall OOPE ranged from 13.6 to 226.1 US dollars (USD). The median OOPE was highest for preterm complications ($33.2 USD; CI 14.0-226.1), followed by hyperbilirubinemia ($31.9 USD; CI 14.0-60.7), respiratory distress syndrome ($26.9 USD; 15.3-121.5), neonatal sepsis ($ 25.8 USD; CI 13.6-139.8) and hypoxic ischemic encephalopathy ($23.4 USD;. Discussion for practice In Nepal, OOPE for sick newborn care in hospitals varied by neonatal morbidity and duration of stay. The largest proportion of OOPE were for accommodation and travel. Affordable and accessible health care will substantially reduce the OOPE for sick newborn care in hospitals.Keywords Catastrophic health expenditure · Neonatal care · Nepal · Out-of-pocket expenditure Abbreviations ANC

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Sunny

Gurung

et al. 2020

Matern Child Health J

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“…Several studies have highlighted that the out of pocket expenditure for institutional delivery is higher than the monetary incentive provided by the government in many settings [67–69]. …”

Section: Discussionmentioning

confidence: 99%

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Bhattacharyya

Srivastava

Saxena

et al. 2018

Global Health Action

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Background: Persistently high maternal mortality levels are a concern in developing countries. In India, monetary incentive schemes have increased institutional delivery rates appreciably, but have not been equally successful in reducing maternal mortality. Maternal outcomes are affected by quality of obstetric care and socio-cultural norms. In this light there is need to examine the quality of care provided to women delivering in institutions. Objective: This study aimed to examine pregnant women’s expectations of high-quality care in public health facilities in Uttar Pradesh, India, and to contrast this with provider’s perceptions of the same, as well as the barriers that limit their ability to provide high-quality care. Methods: A qualitative descriptive analysis was conducted on data from two studies – focus group discussions with rural women in their last trimester of pregnancy (conducted in 2014) to understand women’s experience and satisfaction with maternal care services, and in-depth interviews with care providers (conducted in 2016–17) to understand provision of person-centred care. Provider perspectives were matched with themes of women’s perspectives on quality of childbirth care in facilities. Results: Major themes of care prioritised by women included availability of doctors at the facility; availability of medicines; food; ambulance services; maintenance of cleanliness and hygiene; privacy; good and safe delivery with no complications; client-provider interaction; financial cost of care. Many women also voiced no expectation of care, indicating disillusionment from the existing system. Providers concurred with women on all themes of care except availability of doctors, as they felt that trained nurses were proficient in conducting deliveries. Conclusions: This study shows that women have clear expectations of quality care from facilities where they go to deliver. Understanding their expectations and matching them with providers’ perspectives of care is critical for efforts to improve the quality of care and thereby impact maternal outcomes.

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“…Previous studies have documented the out‐of‐pocket fees paid by mothers in lower income and middle‐income countries . Very few studies have looked at out‐of‐pocket fees in higher income countries.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have documented the out-of-pocket fees paid by mothers in lower income and middle-income countries. 23,24 Very few studies have looked at out-of-pocket fees in higher income countries. One previous study from Australia has estimated costs associated with maternity care practitioners and treatments during pregnancy in 2009.…”

Section: T a B L E 3 Services Covered Undermentioning

confidence: 99%

Out‐of‐pocket expenditure on health care by Australian mothers: Lessons for maternal universal health coverage from a long‐established system

Callander

Topp

Fox

et al. 2019

Birth

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Background Designing effective universal health care systems has challenges, including the use of patient co‐payments and the role of the public and private systems. This study sought to quantify the total amount of out‐of‐pocket fees incurred by women who gave birth in private and public hospitals within Australia—a country with universal health coverage—and assess the impact that variation in birth type has on out‐of‐pocket fees. Methods Data came from a linked administrative data set of all women who gave birth in the Australian state Queensland between July 1, 2012, and June 30, 2015, plus their resultant children. Propensity score matching was used to create two similar cohorts of women who gave birth in private and public hospitals. Results The mean total out‐of‐pocket fees for care from conception to the child's first birthday was $2813 (±2683 standard deviation) and $623 (±1202) for women who gave birth in private and public hospitals, respectively. Total fees were higher in both public and private hospitals for women who had a cesarean birth ($716 [±1419] and $3010 [±2988]) than for women who had a vaginal birth without instruments ($556 [±1044] and $2560 [±2284]). Discussion Australia's strong policy incentives for women to take out private health insurance are leaving women with large out‐of‐pocket costs. This should hold important lessons for other countries implementing a universal health care system, to ensure that using a combination of public and private practitioners does not undermine the intention of universal care.

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Out of pocket expenditure to deliver at public health facilities in India: a cross sectional analysis

Cited by 39 publications

References 25 publications

Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Out of Pocket Expenditure for Sick Newborn Care in Referral Hospitals of Nepal

Do women’s perspectives of quality of care during childbirth match with those of providers? A qualitative study in Uttar Pradesh, India

Out‐of‐pocket expenditure on health care by Australian mothers: Lessons for maternal universal health coverage from a long‐established system

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