Do Acute Health Care Needs of the Poor Crowd out Their Chronic Care Utilization? Evidence From Rural India

Abstract

Acute ailments tend to get priority when the poor are ill and seek health care. In rural areas, much of the public health facilities are better equipped to provide treatment for either acute ailments or reproductive and child health needs. Treatment for chronic ailments mainly occur in secondary or tertiary hospitals located in sub-division or district headquarters or in the big cities, which makes treatment for chronic ailments more expensive. This paper uses 2012 data from Birbhum Population Survey in India to test whether there is a crowd-out effect on treatment of chronic ailments in the presence of acute ailments in the household. We also test whether households ration the amount they spend on care for chronic ailments based on age and gender. Results indicate that households prioritize treatment of acute conditions, reduce resources and efforts to treat chronic health care needs in the presence of acute ailments and these tradeoffs are particularly strong in poor households and often work against the female and elderly members within the households.