Ninth International Conference on Health, Wellness & Society

Abstract

The aim of this paper is to examine trends and patterns of hospitalization rates at public health facilities, inequality on healthcare utilization across the states of India over time, and to identify the factors associated with healthcare utilization. Bi variate, multivariate analysis, Concentration Index and Concentration Curve were used with the help of nationwide data on health survey of two round 60th (2004) and 71st (2014) by National Sample Survey Organisation, Government of India. Hospitalization rates in public health facilities was high for the poorer states in India. Hospitalization rates in public health facilities has increased over a decade in poorer states like Bihar 15% in 2004 to about 40% in 2014. Hospitalization episodes in public health facilities were highest due to non-communicable diseases. Though, economically weaker population were more likely to hospitalize at public healthcare facilities, the result being a wide gap between rich and poor on utilization of public healthcare facilities. Relative health spending also varied over the time period across socio-economic status of households in states of India. Health spending is an important indicator of the utilization of public healthcare facilities. Out-of-pocket expenditure of poorer states like Bihar was 6 times higher from Tamil Nadu during 2004 and relatively high even in 2014. However, a large share of health expenditure is borne by households’ income/saving or from borrowing which may reflect on equality in healthcare utilization, as well as relative spending on in-patients care which needs to be taken care of through states specific health insurance schemes.