A study to assess the economic burden faced by rural households due to Out-of-pocket expenditure on healthcare in Uttar Kannada and Udupi districts of Karnataka.

Abstract

Background and Purpose:Various studies reveal that in India more than 80 percent of health care financing is mainly in the form of out-of-pocket (OOP). As a felt need, this study was conducted with the objectives to assess the economic burden faced by rural households due to out-of-pocket payments.Material and Methods:A community-based cross-sectional study was conducted for a period of 2 years among 550 households in the rural areas of Uttar Kannada and Udupi districts. Households were selected using the multistage sampling technique and interviewed using a pre-designed and pre-tested proforma. Descriptive statistics were applied, and the data were analyzed using proportions and percentages. A Chi-square test was used to find the association between different attributes. Statistical significance was set at a 0.05% level of significance (P < 0.05).Findings:It was observed that 5 (1.99%) households spent Rs 50000 to 1 lakh, and 26 (10.36%) spent more than 1 lakh among insured households compared to 30 (17.96%) and 14 (8.38%) households, respectively among non-insured households. This difference was found to be statistically significant with P value <0.0001. Avoidance of hospital admission and medications were found to be more among noninsured households compared to insured households, which was statistically significant with P value <0.001. Almost half of those who did not have health insurance borrowed money, took a loan on property and NGOs, and sold valuables compared to those who had health insurance, and this difference was statistically significant with P value <0.001.Conclusion:During the study, it was seen that households that did not have health insurance had higher expenditure on health services, avoided hospitalization and medication, and sold valuables as a source of out-of-pocket expenditure when compared to those who had health insurance, and the difference was found to be statistically significant.