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How much do government and households spend on an episode of hospitalisation in India? A comparison for public and private hospitals in Chhattisgarh state

Samir Garg (), Narayan Tripathi (), Alok Ranjan () and Kirtti Kumar Bebarta ()
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Samir Garg: State Health Resource Centre
Narayan Tripathi: State Health Resource Centre
Alok Ranjan: Indian Institute of Technology
Kirtti Kumar Bebarta: State Health Resource Centre

Health Economics Review, 2022, vol. 12, issue 1, 1-15

Abstract: Abstract Background Improvements in the financing of healthcare services are important for developing countries like India to make progress towards universal health coverage. Inpatient-care contributes to a big share of total health expenditure in India. India has a mixed health-system with a sizeable presence of private hospitals. Existing studies show that out-of-pocket expenditure (OOPE) incurred per hospitalisation in private hospitals was greater than public facilities. But, such comparisons have not taken into account the healthcare spending by government. Methods For a valid comparison between public and for-profit private providers, this study in Indian state of Chhattisgarh assessed the combined spending by government and households per episode of hospitalisation. The supply-side and demand-side spending from public and private sources was taken into account. The study used two datasets: a) household survey for data on hospital utilisation, OOPE, cash incentives received by patients and claims raised under publicly funded health insurance (PFHI) schemes (n = 903 hospitalisation episodes) b) survey of public facilities to find supply-side government spending per hospitalisation (n = 64 facilities). Results Taking into account all relevant demand and supply side expenditures, the average total spending per day of hospitalisation was INR 2833 for public hospitals and INR 6788 for private hospitals. Adjusted model for logarithmic transformation of OOPE while controlling for variables including case-mix showed that a hospitalisation in private hospitals was significantly more expensive than public hospitals (coefficient = 2.9, p

Keywords: Supply-side spending; Demand-side spending; Health expenditure; Universal health coverage; UHC; Provider mix; Purchasing; India; Efficiency (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1186/s13561-022-00372-0

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