IDEAS home Printed from https://ideas.repec.org/a/sae/inddev/v13y2019i2p121-134.html

Impoverishment Due to Out-of-pocket Health Expenditures: Measurement and Comparison Across Different Surveys in India

Author

Listed:
  • Roopali Goyanka
  • Charu C. Garg
  • Sheela Prasad

Abstract

Various estimates of impoverishment on account of out-of-pocket expenditure (OOPE) on health are available for India, covering different time periods, but there is a void in terms of comparable estimates. This article uses national level surveys conducted by National Sample Survey Organization for measurement of living standards (Consumption Expenditure Survey [CES]) for 2004–2005 and 2011–2012 and Health and Morbidity Survey (HMS) for 2004 and 2014 to quantify the trends in impoverishment estimates over time and identify the factors explaining these trends. Using consistent methodology, it is estimated that the increase in the number of persons impoverished due to OOPE using HMS is 19.78 million (from 77.9 million to 97.78 million) between 2004 and 2014, while using CES, the increase is 2.90 million (from 51.48 to 54.38 million) between 2004–2005 and 2011–2012. Expenditure on outpatient care including drugs led to 72 million people being pushed below poverty line in 2014. Most of the increase in impoverishment has come in lower income quintiles both in rural and urban areas. Government needs to focus on reducing OOPE for bottom three income quintiles and more specifically the household expenditure on medicines.

Suggested Citation

  • Roopali Goyanka & Charu C. Garg & Sheela Prasad, 2019. "Impoverishment Due to Out-of-pocket Health Expenditures: Measurement and Comparison Across Different Surveys in India," Indian Journal of Human Development, , vol. 13(2), pages 121-134, August.
    • Handle: RePEc:sae:inddev:v:13:y:2019:i:2:p:121-134
    DOI: 10.1177/0973703019872360
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0973703019872360
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0973703019872360?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Martin Browning & Thomas F. Crossley & Guglielmo Weber, 2003. "Asking consumption questions in general purpose surveys," Economic Journal, Royal Economic Society, vol. 113(491), pages 540-567, November.
    2. Kaushalendra Kumar & Ashish Singh & Santosh Kumar & Faujdar Ram & Abhishek Singh & Usha Ram & Joel Negin & Paul R Kowal, 2015. "Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-19, August.
    3. United Nations UN, 2015. "Transforming our World: the 2030 Agenda for Sustainable Development," Working Papers id:7559, eSocialSciences.
    4. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    5. Winter, Joachim, 0000. "Design effects in survey-based measures of household consumption," Sonderforschungsbereich 504 Publications 02-34, Sonderforschungsbereich 504, Universität Mannheim;Sonderforschungsbereich 504, University of Mannheim.
    6. repec:wbk:wbpubs:25338 is not listed on IDEAS
    7. Menno Pradhan, 2001. "Welfare Analysis with a Proxy Consumption Measure – Evidence from a Repeated Experiment in Indonesia," Tinbergen Institute Discussion Papers 01-092/2, Tinbergen Institute.
    8. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    9. repec:wbk:wbpubs:14080 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sunil Khosla & Pradyot Ranjan Jena, 2024. "Can a Universal Public Health Insurance Policy Dent Vulnerability to Poverty? Empirical Evidence from Rural India," Margin: The Journal of Applied Economic Research, National Council of Applied Economic Research, vol. 18(3-4), pages 255-281, November.
    2. Mishra, Shruti & Goli, Srinivas, 2026. "Limited Protection: Health Insurance’s Uneven Role in Mitigating Catastrophic Health Expenditure Across India’s Economic, Regional, and Disease Groups," EconStor Preprints 340189, ZBW - Leibniz Information Centre for Economics.
    3. Roopali Goyanka & Charu C. Garg, 2023. "Out-of-pocket Expenditure on Medicines and Financial Risk Protection in India: Is the Sustainable Development Goal in Sight?," Indian Journal of Human Development, , vol. 17(1), pages 28-43, April.
    4. Taslima Rahman & Dominic Gasbarro & Khurshid Alam, 2022. "Financial risk protection in health care in Bangladesh in the era of Universal Health Coverage," PLOS ONE, Public Library of Science, vol. 17(6), pages 1-18, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kumar, Kaushalendra & Singh, Abhishek & James, K.S. & McDougal, Lotus & Raj, Anita, 2020. "Gender bias in hospitalization financing from borrowings, selling of assets, contribution from relatives or friends in India," Social Science & Medicine, Elsevier, vol. 260(C).
    2. Joachim Winter, 2004. "Response bias in survey-based measures of household consumption," Economics Bulletin, AccessEcon, vol. 3(9), pages 1-12.
    3. Shivendra Sangar & Varun Dutt & Ramna Thakur, 2019. "Economic burden, impoverishment, and coping mechanisms associated with out‐of‐pocket health expenditure in India: A disaggregated analysis at the state level," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 301-313, January.
    4. Rahman, Md Mizanur & Jung, Jenny & Islam, Md Rashedul & Rahman, Md Mahfuzur & Nakamura, Ryota & Akter, Shamima & Sato, Motohiro, 2022. "Global, regional, and national progress in financial risk protection towards universal health coverage, 2000–2030," Social Science & Medicine, Elsevier, vol. 312(C).
    5. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    6. Javkhlanbayar Dorjdagva & Enkhjargal Batbaatar & Mikael Svensson & Bayarsaikhan Dorjsuren & Munkhsaikhan Togtmol & Jussi Kauhanen, 2021. "Does social health insurance prevent financial hardship in Mongolia? Inpatient care: A case in point," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-12, March.
    7. repec:ebl:ecbull:v:3:y:2004:i:9:p:1-12 is not listed on IDEAS
    8. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    9. Martin Browning & Thomas Crossley, 2009. "Are Two Cheap, Noisy Measures Better Than One Expensive, Accurate One?," American Economic Review, American Economic Association, vol. 99(2), pages 99-103, May.
    10. Luisa Natali & Marta Moratti, 2012. "Measuring Household Welfare: Short versus long consumption modules," Papers inwopa671, Innocenti Working Papers.
    11. Maria-Carmen García-Centeno & Román Mínguez-Salido & Raúl del Pozo-Rubio, 2021. "The Classification of Profiles of Financial Catastrophe Caused by Out-of-Pocket Payments: A Methodological Approach," Mathematics, MDPI, vol. 9(11), pages 1-20, May.
    12. Xu, Ke & Ravndal, Frode & Evans, David B. & Carrin, Guy, 2009. "Assessing the reliability of household expenditure data: Results of the World Health Survey," Health Policy, Elsevier, vol. 91(3), pages 297-305, August.
    13. Chen, Mingsheng & Xu, Lizheng & Si, Lei & Wang, Zhonghua & Jan, Stephen, 2023. "Examining the level and distribution of catastrophic health expenditure from 2013 to 2018: A province-level study in China," Economic Modelling, Elsevier, vol. 121(C).
    14. Winter, Joachim, 0000. "Design effects in survey-based measures of household consumption," Sonderforschungsbereich 504 Publications 02-34, Sonderforschungsbereich 504, Universität Mannheim;Sonderforschungsbereich 504, University of Mannheim.
    15. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.
    16. Uğur Ercan, 2021. "The Determinants of Turkey Household Catastrophic Health Expenditures: A Different Approach by Data Mining," Alphanumeric Journal, Bahadir Fatih Yildirim, vol. 9(2), pages 229-246, December.
    17. Hubert Amu & Abdul-Aziz Seidu & Ebenezer Agbaglo & Robert Kokou Dowou & Edward Kwabena Ameyaw & Bright Opoku Ahinkorah & Kwaku Kissah-Korsah, 2021. "Mixed effects analysis of factors associated with health insurance coverage among women in sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-15, March.
    18. Bernal Lobato, N., 2014. "Essays in applied microeconomics," Other publications TiSEM 9b638b3d-2f83-452a-b2c8-c, Tilburg University, School of Economics and Management.
    19. Erich Battistin, 2002. "Errors in Survey Reports of Consumption Expenditures," 10th International Conference on Panel Data, Berlin, July 5-6, 2002 C4-2, International Conferences on Panel Data.
    20. Shankar Prinja & Gunjeet Kaur & Rakesh Gupta & Saroj Kumar Rana & Arun Kumar Aggarwal, 2019. "Out‐of‐pocket expenditure for health care: District level estimates for Haryana state in India," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 277-293, January.
    21. Lopreite, Milena & Puliga, Michelangelo & Riccaboni, Massimo & De Rosis, Sabina, 2021. "A social network analysis of the organizations focusing on tuberculosis, malaria and pneumonia," Social Science & Medicine, Elsevier, vol. 278(C).

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:inddev:v:13:y:2019:i:2:p:121-134. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.