Estimation of out-of-pocket expenditure and catastrophic health expenditure among households of urban areas of Haryana (India).

Abstract

The health system financing of almost all low- and middle-income countries, including India, relies heavily on out-of-pocket (OOP) payments. Out-of-pocket expenditure (OOPE) for patient care has been known to cause maximum impoverishment. It can have debilitating consequences for the urban population or households. It is necessary to study patient care costs and the related factors among the households of an urban area to determine their vulnerability to catastrophic expenditure and to protect them from it. The objective of the study is to estimate the out-of-pocket and catastrophic health expenditure in the urban population of Rohtak city, Haryana (India). This was a cross-sectional study conducted over a period of one year among urban households of District Rohtak, Haryana (India), who have been residing in the study area for at least one year. A sample size of 390 households was selected using simple random sampling. The study proforma as per the National Sample Survey Office (NSSO) was used to elicit and record relevant information. The majority, i.e., 81.8% of households, incurred OOPE while seeking treatment from health facilities. On multiple logistic regression analysis to identify significant determinants like medical insurance, age, chronic disease, duration of stay in hospital, and level of healthcare facility availed of net out-of-pocket (OOP) expenditure incurred on IPD treatment revealed no significant odds for incurring net out-of-pocket (OOP) expenditure (<i>P</i> > 0.05). The majority of households in the study area incurred high OOP health expenditure and only 11.8% were having medical insurance, which highlights the need for active financial protection to bring down the OOP expenditure.