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Inpatient care of the elderly in Brazil and India: Assessing social inequalities

Author

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  • Channon, Andrew Amos
  • Andrade, Monica Viegas
  • Noronha, Kenya
  • Leone, Tiziana
  • Dilip, T.R.

Abstract

The rapidly growing older adult populations in Brazil and India present major challenges for health systems in these countries, especially with regard to the equitable provision of inpatient care. The objective of this study was to contrast inequalities in both the receipt of inpatient care and the length of time that care was received among adults aged over 60 in two large countries with different modes of health service delivery. Using the Brazilian National Household Survey from 2003 and the Indian National Sample Survey Organisation survey from 2004 inequalities by wealth (measured by income in Brazil and consumption in India) were assessed using concentration curves and indices. Inequalities were also examined through the use of zero-truncated negative binomial models, studying differences in receipt of care and length of stay by region, health insurance, education and reported health status. Results indicated that there was no evidence of inequality in Brazil for both receipt and length of stay by income per capita. However, in India there was a pro-rich bias in the receipt of care, although once care was received there was no difference by consumption per capita for the length of stay. In both countries the higher educated and those with health insurance were more likely to receive care, while the higher educated had longer stays in hospital in Brazil. The health system reforms that have been undertaken in Brazil could be credited as a driver for reducing healthcare inequalities amongst the elderly, while the significant differences by wealth in India shows that reform is still needed to ensure the poor have access to inpatient care. Health reforms that move towards a more public funding model of service delivery in India may reduce inequality in elderly inpatient care in the country.

Suggested Citation

  • Channon, Andrew Amos & Andrade, Monica Viegas & Noronha, Kenya & Leone, Tiziana & Dilip, T.R., 2012. "Inpatient care of the elderly in Brazil and India: Assessing social inequalities," Social Science & Medicine, Elsevier, vol. 75(12), pages 2394-2402.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:12:p:2394-2402
    DOI: 10.1016/j.socscimed.2012.09.015
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    References listed on IDEAS

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    1. dos Santos, Anderson Moreira Aristides & Triaca, Lívia Madeira & Tejada, Cesar Augusto Oviedo, 2021. "Evolution of inequalities in health care use among older people in Brazil: Evidence for the period 1998–2019," The Journal of the Economics of Ageing, Elsevier, vol. 20(C).
    2. Mohanty, Sanjay K. & Khan, Junaid & Maiti, Suraj & Kämpfen, Fabrice & Maurer, Jürgen & O'Donnell, Owen, 2025. "Healthcare inequity arising from unequal response to need in the older (45+ years) population of India: Analysis of nationally representative data," Social Science & Medicine, Elsevier, vol. 364(C).

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