“ Private Hospitals Generally Offer Better Treatment and Facilities ”: Out-of-Pocket Expenditure on Healthcare and the Preference for Private Healthcare Providers in South India

Sagarika Kamath, Mahalakshmi Poojary, Harshith Shetty, Kshithija Umesh, Soham Kar, Vani Lakshmi Ramesh, Gaurav Hajare, Albi Thomas, Helmut Brand, Selim Jahangir () and Rajesh Kamath ()
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Sagarika Kamath: Department of International Health, Care and Public Health Research Institute—CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
Mahalakshmi Poojary: Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Harshith Shetty: Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Kshithija Umesh: Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Soham Kar: Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Vani Lakshmi Ramesh: Department of Data Science, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Gaurav Hajare: Directorate of Online Education, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Albi Thomas: Directorate of Online Education, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Helmut Brand: Department of International Health, Care and Public Health Research Institute—CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
Selim Jahangir: Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Rajesh Kamath: Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India

IJERPH, 2024, vol. 21, issue 10, 1-15

Abstract: Out-of-pocket expenditure (OOPE) directly reflects households’ financial burden for healthcare. Despite efforts to enhance accessibility and affordability through government initiatives and insurance schemes, OOPE remains problematic, especially in rural areas with inadequate public healthcare infrastructure. This study examines factors influencing OOPE in Karnataka’s Dakshina Kannada, Udupi, and Shimoga districts, investigating socioeconomic characteristics, healthcare infrastructure, and accessibility to inform policies for equitable healthcare access and reduced household financial strain. Using purposive sampling, 61 semi-structured interviews were conducted in rural and urban South Karnataka, recorded in Kannada after obtaining consent, and thematically analyzed. Results revealed mixed perceptions of healthcare quality, cost, and accessibility between government and private hospitals. Government facilities were lauded for improved infrastructure and affordability, while private hospitals were preferred for quality and personalized care despite higher costs. Health insurance significantly impacted OOPE reduction. Participants emphasized the need for increased awareness of government insurance programs and improved quality in public hospitals. The study concludes that private hospitals are favored for superior care despite expenses, while government hospitals are valued for affordability. Expanding insurance coverage and improving public awareness are crucial for enhancing healthcare accessibility and affordability.

Keywords: out-of-pocket expenditure; healthcare access; affordability; government hospital; private hospitals; insurance; India (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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