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Out-of-pocket expenditure and catastrophic health expenditure for hospitalization due to injuries in public sector hospitals in North India

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  • Shankar Prinja
  • Jagnoor Jagnoor
  • Deepshikha Sharma
  • Sameer Aggarwal
  • Swati Katoch
  • P V M Lakshmi
  • Rebecca Ivers

Abstract

Background: Injuries are a major public health problem, resulting in high health care demand and economic burden. They result in loss of disability adjusted life years (DALYs) and high out-of-pocket expenditure. However, there is little evidence on the economic burden of injuries in India. We undertook this study to report out-of-pocket expenditure and the prevalence of catastrophic health expenditure for injuries related hospitalizations in public sector hospitals in North India. Further, we also evaluate the determinants of catastrophic health expenditure. Methods and analysis: A prospective observational study was conducted. Participants were recruited from three hospitals for all injury cases. Data were collected via face-to-face baseline interviews and follow-up interviews over the phone at 1, 2, 4 and 12 months post-injury. Prevalence of catastrophic health expenditure (more than 30% of consumption expenditure) and impoverishment (International dollar 1.90) were estimated. Results: Road traffic injuries (57%) were the leading cause of injury. Direct out-of-pocket expenditure for hospitalizations was INR 16,768 (USD 263) while indirect productivity loss was INR 8,164 (USD 128). The prevalence of catastrophic expenditure was 22.2% with 12.2% slipping below poverty line. Prevalence of catastrophic health expenditure and impoverishment was higher and significantly associated with poorest quintile, tertiary care hospital and increased duration of hospitalization (p

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  • Shankar Prinja & Jagnoor Jagnoor & Deepshikha Sharma & Sameer Aggarwal & Swati Katoch & P V M Lakshmi & Rebecca Ivers, 2019. "Out-of-pocket expenditure and catastrophic health expenditure for hospitalization due to injuries in public sector hospitals in North India," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-17, November.
    • Handle: RePEc:plo:pone00:0224721
    DOI: 10.1371/journal.pone.0224721
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    2. Shankar Prinja & Akashdeep Singh Chauhan & Anup Karan & Gunjeet Kaur & Rajesh Kumar, 2017. "Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-19, February.
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    1. Herberholz, Chantal & Phuntsho, Sonam, 2021. "Medical, transportation and spiritual out-of-pocket health expenditure on outpatient and inpatient visits in Bhutan," Social Science & Medicine, Elsevier, vol. 273(C).
    2. Bhed Ram & Ramna Thakur, 2022. "Measuring the burden of accidental injuries in India: a cross-sectional analysis of the National Sample Survey (2017–18)," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-18, December.

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