|
English Français |
Ekta Pandey, Department of Humanities and Social Sciences - Indian Institute of Technology Delhi
Massimo Mucciardi, University of Messina (Italy)
Mary Ellen Toffle, Università di Messina
Out of pocket payment (OOP) is one of the least equitable health financing mechanisms. Lack of insurance and the uncertainty of health service availability, the risk of impoverishment with an episode of illness tremendously increases. The Indian health system is heavily financed by OOP and insurance coverage is also below adequate levels. This study aims to understand the impact of OOP on the standard of living in India using classical and spatial approaches. Taking the headcount ratio into consideration, the poverty risk is almost the same in rural and urban areas in terms of net expenses. A headcount ratio increase of approximately 6.4% is seen after adjusting for health expenditures across both rural and urban areas. A higher poverty gap is seen in rural areas (Rs13.1) than urban areas where an increase in the poverty gap was Rs10.6 if health expenditures are included. The results clearly indicate that the risk of impoverishment even with a single episode of illness is very high in India. Lastly, the spatial approach, through spatial regression, indicates that in the areas where there is low Public Health Expenditure (PHE), the Normalized Poverty Impact (NPI) is greater.
Keywords: Health and morbidity, Policy evaluation, Demographic and social surveys, Spatial statistics