Gender Disparity in Health Expenses, Health Insurance Financing and Out-of-Pocket Expenses for Inpatient Care in India

  • Parimala Mohanty MPH Scholar, School of Public Health, KIIT Deemed to be University, Bhubaneswar, India.
  • Pratap Kumar Jena Associate Professor, School of Public Health, KIIT Deemed to be University, Bhubaneswar, India.
  • Dr. (Prof.) Jugal Kishore Jugal Kishore, Professor and Head, Department of Community Medicine, Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi.
Keywords: Gender Disparity, Insurance, Healthcare Expenditures, NSSO

Abstract

Background: Socially constructed gender and the economic status have strong bearing on the household out-of-pocket health expenditure and resulting in unequal distribution of health services.

Objective: To assess the gender disparity in total health expenses, health insurance financing and out-of-pocket expenses for various ailments during inpatient care in India.

Methods: The nationally representative health consumption data from the 71st Round (2014) of National Sample Survey Organization was analyzed. Socio-economic status was estimated using ‘Principal Component Analysis’. Respective sample weights have been applied in the calculation of the results. The analysis is done with R studio software. The stratified analysis of gender difference in financing for total heath expenses, insurance, out-of-pocket expenses was accessed across three socio-economic-status groups to understand gender and its association between social statuses.

Result: The average total health expense for male inpatient care of various ailments was ranged between Rs. 9589.5 and Rs. 85857.9, whereas for female the average health expenses were ranged between Rs. 7847.8 and Rs. 55604.2. The average insurance financing for male inpatient care of various ailments was ranged between Rs. 906.6 and Rs. 10677.2 and for females, it ranged between Rs. 394.8 and Rs. 6063.2. The average OOPEs for male inpatient care of various ailments were ranged between Rs. 9141.8 and Rs. 75180.6, similarly for females, the average OOPEs ranged between Rs. 7459.3 and 49583.2.The average total insurance financing in lower SES for inpatient care was usually higher for males than females in low (1.3 to 19.9 times), middle (1.2 to 3.4 times) and high (1.1 to 2.4 times) SES groups and the average OOPEs for inpatient care was higher for males than females in low (1.1 to 2.2 times), middle (1.1 to 1.7 times) and high (1.1 to 2.3 times) SES groups for most of the ailments except a few.

Conclusion: Overall insurance coverage is low particularly for females. The gender disparity in lower average health expenses, average insurance financing and out-of-pocket expenses during inpatient care in India is a concern, which requires policy interventions to promote equity.

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Published
2019-12-19