A cross-sectional study on the extent of out-of-pocket expenditure and financial risk protection for hospitalized patients in a Tertiary Care Hospital in North-east India

Rajkumari Bishwalata; Ningthoukhongjam Shugeta Devi; Jangkholun Touthang; Rajkumari Joshna

Volume : IX, Issue : V, May - 2020

A cross-sectional study on the extent of out-of-pocket expenditure and financial risk protection for hospitalized patients in a Tertiary Care Hospital in North-east India

Rajkumari Bishwalata, Ningthoukhongjam Shugeta Devi, Jangkholun Touthang, Rajkumari Joshna

Abstract :

Introduction: Out of pocket expenditure (OOPE) is the direct payment made by individuals to health care providers at the time of service use which excludes any pre–payment or health services. OOPE has pushed sixty three million people below poverty line as on 2011 census India. Not many studies has been done to assess OOPE among hospitalized patients in North East India and this study plans to assess the extent and burden of out–of–pocket expenditure among the family members of hospitalized patients and to find the number of beneficiaries availing benefit of financial risk protection for hospitalization. Materials and methods: A cross sectional study was done among patients hospitalized in a Government tertiary care Hospital in North East India was during the month of October to November 2019. A semi–structured questionnaire consisting of socio–demographic characteristics, questions on health expenses, health insurance and assurance schemes, etc were used. Data was analysed using percentages, median, inter–quartile range, etc. Ethical clearance was obtained from institutional ethics committee. Results: Median expenditure on health was INR 12770 (IQR= 6785–30510) for rural and INR 11060 (IQR= 6335–25460) for urban per patient during last one year. Some of the patients (4, 1.2%) had to sell land but majority (209, 60.6%) had borrowed money to pay for treatment. One patient had joined health insurance scheme but did not know about its provisions. Majority (286, 83%) were aware of the available health assurance schemes CMHT (Chief Minister gi hakselgi tenbang) and PMJAY (Pradhan Mantri Jan Arogya Yojana) but only less than a fourth (77, 22.3%) has joined the schemes. Conclusion: Expenditure on health increased in all patients during the last one year. Although 2/5thof the respondents are BPL (Below poverty line) or AAY (Antyodaya Anna Yojana) card holders only around a fifth had joined the health assurance schemes. Sensitisation programmes of the available schemes as well as mobilisation by grass root level workers particularly among the lower socio–economic sections needs to be taken up.