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Impact of Out of Pocket Health Expenditure on Consumption Pattern of Below Poverty Line Households in India

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  • Anushree S. Panikkassery

Abstract

Financial burden from health expenditure is a serious cause of concern for low-income and developing countries. Studies have shown that low public investment in health, lack of adequate safety net mechanisms and poor quality of public health system in these countries are few basic grounds for placing high financial burden on people. In order to make both ends meet during illness, poor people resort to various alternative means. One of the popular strategies adopted is to reduce or reallocate the consumption bundle, so as to meet the medical expenditure. The impact of out of pocket (OOP) health expenditure on the consumer expenditure has immediate and direct impact especially among the poor sections of the society. This article aims to study the impact of out of pocket health expenditure on the constituents of consumer expenditure and how the composition of consumer expenditure differs with the levels of out of pocket expenditure among different consumption quintiles. The study uses IHDS household level survey data for the year 2011–2012. A mean comparison test is carried out to check whether significant difference exists in the consumption bundles of households with and without medical expenditure. A system of Engel curves is estimated with seemingly unrelated regression equation (SURE) to study the impact of out of pocket medical expenses on the consumption bundle. The results show that there exists significant difference in the share of different consumption items in the consumption bundles of households with and without out of pocket expenditure. Despite having larger share for food expenditure, poor households tend to protect the consumption of food share in the bundle. Compensation for rise in medical expenses is reflected in the reduced share of non-food expenditure items like fuel, education, entertainment, clothing and footwear. With high share of out of pocket expenditure, poor households in the states with high public health expenditure mainly reduced their education expenditure whereas consumption of most of the non-food items were reduced by poor households in low public health expenditure states.

Suggested Citation

  • Anushree S. Panikkassery, 2020. "Impact of Out of Pocket Health Expenditure on Consumption Pattern of Below Poverty Line Households in India," Millennial Asia, , vol. 11(1), pages 27-53, April.
  • Handle: RePEc:sae:millen:v:11:y:2020:i:1:p:27-53
    DOI: 10.1177/0976399619900608
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    References listed on IDEAS

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    1. 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.
    2. Nguyen, Kim Thuy & Hai Khuat, Oanh Thi & Ma, Shuangge & Pham, Duc Cuong & Hong Khuat, Giang Thi & Ruger, Jennifer Prah, 2012. "Coping with health care expenses among poor households: Evidence from a rural commune in Vietnam," Social Science & Medicine, Elsevier, vol. 74(5), pages 724-733.
    3. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    4. Chad Meyerhoefer & David Sahn & Stephen Younger, 2007. "The joint demand for health care, leisure, and commodities: Implications for health care finance and access in Vietnam," Journal of Development Studies, Taylor & Francis Journals, vol. 43(8), pages 1475-1500.
    5. Rama Pal, 2013. "Out-of-Pocket Health Expenditure: Impact on the Consumption of Indian Households," Oxford Development Studies, Taylor & Francis Journals, vol. 41(2), pages 258-279, June.
    6. Md. Azmal Kabir & Ataur Rahman & Sarah Salway & Jane Pryer, 2000. "Sickness among the urban poor: a barrier to livelihood security," Journal of International Development, John Wiley & Sons, Ltd., vol. 12(5), pages 707-722.
    7. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
    8. Masha F. Somi & James R. G. Butler & Farshid Vahid & Joseph D. Njau & Salim Abdulla, 2009. "Household responses to health risks and shocks: A study from rural Tanzania raises some methodological issues," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 200-211.
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    3. Ahmed Abdelmajed Alkhodary & Syed Mohamed Aljunid & Aniza Ismail & Amrizal Muhammad Nur & Suzana Shahar, 2022. "Health Care Utilization and Out-of-Pocket Payments among Elderly with Cognitive Frailty in Malaysia," IJERPH, MDPI, vol. 19(6), pages 1-18, March.

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