Forced sale of resources to meet hospitalization expenses


About a part of all rural households and one in five urban families in India are forced into money owing or sale of resources to meet hospitalization expenses. This is true across income levels, revealed by the National Health Profile 2017 recently published by the Central Bureau of Health Intelligence.

In rural India, about two-thirds – ranging from 65.6% in the poorest to 68% for the richest – depend on the household income or investments, while 27% of the poorest household and 23% of the richest households depend on borrowings for hospitalization costs. In urban India, 68% of the poorest and about 80% of the most well-off households depend on their own income and savings.

As they get richer, their dependence on borrowings goes down from 22% among the poorest to 14% among the richest. In rural India, about 1% whether rich or poor meet hospitalization costs through sale of resources. This is insignificant among urban households. Roughly 5% of rural and urban households are helped out by friends and relatives to meet up the cost.

The data on hospitalization was from the health expenditure survey conducted by the National Sample Survey Organisation from January 2013 to June 2014. The data also shows that getting hospitalized was most costly in Gujarat for rural households and in Assam for those who lived in towns and cities.

The standard cost per hospitalization case in rural areas was Rs 32,500 in Gujarat, over four times as expensive as in Uttar Pradesh. Similarly, each hospitalization in urban Assam cost on an average about Rs 52,368, nearly seven times as much as in urban Delhi.

Next to Assam, the urban areas of Goa and Himachal Pradesh were the most costly places to get in-patient treatment, costing over Rs 37,000 and Rs 35,200 per hospitalization case.

In states with very high total per capita spending on health, such as Uttarakhand, Kerala ,Jammu Kashmir and Himachal Pradesh,  the standard expenses on each hospitalization was not the highest. This could be due to higher spending on out-patient costs. In many of these states, the presence of a healthy public hospital network could also be the reason for lower expenditure on hospitalisation as quite a few of them also have the highest government spending per capita on health.

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