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Sub-national health accounts: Experience from Punjab State in India

Author

Listed:
  • Pankaj Bahuguna
  • Indranil Mukhopadhyay
  • Akashdeep Singh Chauhan
  • Saroj Kumar Rana
  • Sakthivel Selvaraj
  • Shankar Prinja

Abstract

Introduction: Public health spending in India has been traditionally one of the lowest globally. Punjab is one of the states with highest proportion of out-of-pocket expenditures for healthcare in India. We undertook this study to produce the sub-national health accounts (SNHA) for Punjab state in India. Methodology: We used System of Health Accounts (SHA) 2011 framework for preparing health accounts for Punjab state. Data on health spending by government was obtained from concerned public sector departments both at state and central level. Estimates on Out-of-Pocket Expenditures (OOPE) expenditure were derived from National Sample Survey (NSS) 71st round data, Consumer Expenditure Survey (CES) data and Pharmatrac. Primary surveys were done for assessing health expenditure data by firms and non-governmental organizations. All estimates of healthcare expenditures reported in our paper pertain to 2013–14, and are reported in both Indian National Rupee (INR) and United States Dollar (US $),using average conversion rate of INR 60.50 per US $. Results: In 2013–14, the current health expenditures (CE) in Punjab was INR 134,680million (US $ 2245 million) which was 4.02% of its gross state domestic product (GSDP).However, public spending on health was 0.95% of GSDP i.e. 21% of the total health expenditure (THE), while 79% was private expenditure. In per capita terms, THE in Punjab was INR 4963 (US $ 82.03). In terms of functions, medical goods (41.6%) and curative care (37%) consumed larger share of expenditure in the Punjab state. Households spent 52% of expenditures for medicines and other pharmaceutical goods. Risk pooling mechanisms are being adopted to a lesser extent in the state. Conclusion: The healthcare in Punjab is largely financed through private OOPE. Currently, public health spending in Punjab is inadequate to meet the healthcare demands of population, which is less than 1% of state’s GSDP. Monitoring public resources is very important for better resource allocations. Health Accounts production is useful in order to assess future trends and impact of health financing policies on goals of universal health coverage and should be made a part of routine monitoring system both at national and sub-national level.

Suggested Citation

  • Pankaj Bahuguna & Indranil Mukhopadhyay & Akashdeep Singh Chauhan & Saroj Kumar Rana & Sakthivel Selvaraj & Shankar Prinja, 2018. "Sub-national health accounts: Experience from Punjab State in India," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-17, December.
    • Handle: RePEc:plo:pone00:0208298
    DOI: 10.1371/journal.pone.0208298
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    References listed on IDEAS

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    1. Ankur Sangwan & Shankar Prinja & Sameer Aggarwal & Jagnoor Jagnoor & Pankaj Bahuguna & Rebecca Ivers, 2017. "Cost of Trauma Care in Secondary- and Tertiary-Care Public Sector Hospitals in North India," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 681-692, October.
    2. Planning Commission, 2011. "High Level Expert Group Report on Universal Health Coverage for India," Working Papers id:4646, eSocialSciences.
    3. Shankar Prinja & Pankaj Bahuguna & P V M Lakshmi & Tushar Mokashi & Arun Kumar Aggarwal & Manmeet Kaur & K Rahul Reddy & Rajesh Kumar, 2014. "Evaluation of Publicly Financed and Privately Delivered Model of Emergency Referral Services for Maternal and Child Health Care in India," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-11, October.
    4. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    5. Susmita Chatterjee & Carol Levin & Ramanan Laxminarayan, 2013. "Unit Cost of Medical Services at Different Hospitals in India," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.
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