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Short but not sweet - new evidence on short duration morbidities from India


  • Das, Jishnu
  • Sanchez-Paramo, Carolina


India spends 6 percent of its GDP on health-three times the amount spent by Indonesia and twice that of China-and spending on non-chronic morbidities is three times that of chronic illnesses. It is normally assumed that the high spending on non-chronic illnesses reflects the prevalence of morbidities with high case-fatality or case-disability ratios. But there is little data that can be used to separate out spending by type of illness. The authors address this issue with a unique dataset where 1,621 individuals in Delhi were observed for 16 weeks through detailed weekly interviews on morbidity and health-seeking behavior. The authors'findings are surprising and contrary to the normal view of health spending. They define a new class of illnesses as"short duration morbidities"if they are classified as non-chronic in the international classification of disease and are medically expected to last less than two weeks. The authors show that short duration morbidities are important in terms of prevalence, practitioner visits, and household health expenditure: Individuals report a short duration morbidity in one out of every five weeks. Moreover, one out of every three weeks reported with a short duration morbidity results in a doctor visit, and each week sick with such a morbidity increases health expenditure by 25 percent. Further, the absolute spending on short duration morbidities is similar across poor and rich income households. The authors discuss the implications of these findings in understanding household health behavior in an urban context, with special emphasis on the role of information in health-seeking behavior.

Suggested Citation

  • Das, Jishnu & Sanchez-Paramo, Carolina, 2003. "Short but not sweet - new evidence on short duration morbidities from India," Policy Research Working Paper Series 2971, The World Bank.
  • Handle: RePEc:wbk:wbrwps:2971

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    References listed on IDEAS

    1. Kamat, Vinay R., 1995. "Reconsidering the popularity of primary health centers in India: A case study from rural Maharashtra," Social Science & Medicine, Elsevier, vol. 41(1), pages 87-98, July.
    2. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    3. Saradamma, Rema Devi & Higginbotham, Nick & Nichter, Mark, 2000. "Social factors influencing the acquisition of antibiotics without prescription in Kerala State, south India," Social Science & Medicine, Elsevier, vol. 50(6), pages 891-903, March.
    4. Schultz, T. Paul & Tansel, Aysit, 1997. "Wage and labor supply effects of illness in Cote d'Ivoire and Ghana: instrumental variable estimates for days disabled," Journal of Development Economics, Elsevier, vol. 53(2), pages 251-286, August.
    5. Foster, Andrew D, 1994. "Poverty and Illness in Low-Income Rural Areas," American Economic Review, American Economic Association, vol. 84(2), pages 216-220, May.
    6. Jonathan Morduch, 1995. "Income Smoothing and Consumption Smoothing," Journal of Economic Perspectives, American Economic Association, vol. 9(3), pages 103-114, Summer.
    7. Dow, W & Gertly, P & Schoeni, R-F & Strauss, J & Thomas, D, 1997. "Health Care Prices, Health and Labor Outcomes : Experimental Evidence," Papers 97-01, RAND - Labor and Population Program.
    8. Richard G. Frank & Paul J. Gertler, 1987. "The Effect of Mental Distress on Income: Results from a Community Survey," NBER Working Papers 2433, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Das, Jishnu & Hammer, Jeffrey & Sánchez-Paramo, Carolina, 2012. "The impact of recall periods on reported morbidity and health seeking behavior," Journal of Development Economics, Elsevier, vol. 98(1), pages 76-88.
    2. Das, Jishnu & Hammer, Jeffrey, 2005. "Which doctor? Combining vignettes and item response to measure clinical competence," Journal of Development Economics, Elsevier, vol. 78(2), pages 348-383, December.
    3. Jishnu Das & Quy-Toan Do & Jed Friedman & David McKenzie, 2008. "Mental Health Patterns and Consequences: Results from Survey Data in Five Developing Countries," World Bank Economic Review, World Bank Group, vol. 23(1), pages 31-55, August.
    4. Das, Jishnu & Hammer, Jeffrey, 2007. "Money for nothing: The dire straits of medical practice in Delhi, India," Journal of Development Economics, Elsevier, vol. 83(1), pages 1-36, May.
    5. Das, Jishnu & Das, Ranendra Kumar & Das, Veena, 2012. "The mental health gender-gap in urban India: Patterns and narratives," Social Science & Medicine, Elsevier, vol. 75(9), pages 1660-1672.
    6. Das, Jishnu & Hammer, Jeffrey, 2004. "Strained mercy : The quality of medical care in Delhi," Policy Research Working Paper Series 3228, The World Bank.
    7. Das, Jishnu & Hammer, Jeffrey, 2004. "Which doctor? Combining vignettes and item response to measure doctor quality," Policy Research Working Paper Series 3301, The World Bank.
    8. Das, Jishnu & Do, Quy-Toan & Friedman, Jed & McKenzie, David & Scott, Kinnon, 2007. "Mental health and poverty in developing countries: Revisiting the relationship," Social Science & Medicine, Elsevier, vol. 65(3), pages 467-480, August.


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