A Rural Community based study on Morbidity, Health care Utilization and Health Expenditure in Tarakeswar Block, Hoogly District, West Bengal

Abstract

Background: Rural community based recent study on morbidity, health care utilization and health expenditure is a rarity in India especially in West Bengal. Objectives: To find out the morbidity pattern, health care utilization and health expenditure in rural area of Tarakeswar block, Hoogly district, West Bengal. Methods: House to house survey of 720 families (total 2759 persons) from rural area of Tarakeswar block, Hoogly district, West Bengal, selected by 30 cluster sampling technique during 2013-14 with help of a predesigned pre-tested schedule by post-graduate students with one month recall. Results: Total 650 persons (23.6%) suffered from 728 monthly episodes (263.8/1000) of illnesses, more acute (147/1000) than chronic (117/1000), significantly more among males (279.9/1000) than females (246/1000). Major types of illnesses were Gastrointestinal (5.8%), cardiovascular (4.9%), respiratory (4.2%) and musculoskeletal (2.3%) including non-specific fevers (2.6%). These were primarily managed by government facilities (71.5%) and govt. doctors (66.1%) of allopathic system (93.4%). Total health expenditure (out of pocket) was 3.1% of their income, with INR 211.3 per acute illness episode and INR 84.6 per chronic illness episode. Treatment was major component both for acute (62%) and chronic (83%) illness expenditures; however, wage loss was considerable for acute illnesses (27%). These expenditures were significantly associated with social class and education (p=0.000...). Health insurance was practically nil (0.51%).Conclusions: There was considerable morbidity and out of pocket expenditure on health by study population. Proper implementation of any health insurance is absolutely essential.