Abstract 12031: Out of Pocket Expenditure for In-Patient Care of Cardiovascular Disease in India: A Gender-Based Analysis Using National Sample Survey Data

Abstract

Introduction: This study aims to examine the out-of-pocket expenditure (OOPE) pattern for hospitalisation in cardiovascular diseases (CVD) from a gender perspective. Methods: This study is based on 75 th round National Sample Survey (NSS) data (2017-2018), conducted by Government of India, covering the sample of 1,13,823 households from all States and Union Territories of India. NSS data considers CVD as Hypertension (HTN) and Heart Disease (HD). The sample size of hospitalisation cases in HTN and HD are 1418 and 4726 respectively based on 365 days recall period from the date of survey. Here, average OOPE per hospitalisation is estimated as μ Medical expenditure includes costs on doctor’s fee, medicine, diagnostic tests, bed charges, and other medical expenses. To analyse the data statistical and econometric tools like, multivariate regression, t test, χ2 test, ANOVA are used. Results: Multivariate analysis confirms that average OOPE per hospitalisation of CVD is significantly lower for female than male (β = -0.233, p = 0.000, CI: -0.348, -0.118) even after controlling socio-economic and demographic factors including place of residence, age, education, income status (Monthly Per capita Consumption Expenditure ,MPCE), social groups, occupation of the household, zones, marital status, household size, and, possession of health insurance. The average OOPE for male is significantly higher than the female, 1.6 and 1.7 times for HD and HTN respectively. For HD, this gap increases with the increase in education level. Across the six zones, average OOPE in both HTN and HD is higher for male than the female except Eastern zone. This gender gap in OOPE is more common among married and widow/divorced as compared to the single. Conclusion: Gender disparity prevails in OOPE for cardiovascular disease, which needs attention at the policy level go achieve the development goals. Fig:Distribution of OOPE per hospitalisation between Male and Female across Socio-economic strata ( in INR '000.)