Abstract
BackgroundGeneration of resources for providing health care services is an important issue in developing countries. User charges in the form of Surgical Package Program (SPP) were introduced in all district hospitals of Haryana to address this problem. We evaluate the effect of this SPP program on surgical care utilization and out-of-pocket (OOP) expenditures.MethodsData on 25437 surgeries, from July 2006 to June 2013 in 3 districts of Haryana state, was analyzed using interrupted time series analysis to assess the impact of SPP on utilization of services. Adjustment was made for presence of any autocorrelation and seasonality effects. A cross sectional survey was undertaken among 180 patients in District hospital, Panchkula during June 2013 to assess the extent of out of pocket (OOP) expenditure incurred, financial risk protection and methods to cope with OOP expenditure. Catastrophic health expenditure, estimated as any expenditure in excess of 10% of the household consumption expenditure, was used to assess the extent of financial risk protection.ResultsUser charges had a negative effect on the number of surgeries in public sector district hospitals in all the 3 districts. The mean out-of-pocket expenditure incurred by the patients was Rs.4564 (USD 74.6). The prevalence of catastrophic expenditure was 5.6%. A higher proportion among the poorest 20% population coped through borrowing money (47.2%), while majority (86.1%) of those belonging to richest quintile paid from their monthly income or savings, or had insurance.ConclusionThere is a need to increase the public financing for curative services and it should be based on the needs of population. Any form of user charge in public sector hospitals should be removed.
Highlights
India has a surgical rate of 369 per 100,000 population and total number of surgeries in the range of 37,04,446–44,38,792
We evaluate the effect of this Surgical Package Program (SPP) program on surgical care utilization and out-of-pocket (OOP) expenditures
User charges had a negative effect on the number of surgeries in public sector district hospitals in all the 3 districts
Summary
India has a surgical rate of 369 per 100,000 population and total number of surgeries in the range of 37,04,446–44,38,792. It has a large share of the burden of surgical diseases [1]. The high disease burden translates to soaring financial costs. This combination leads to worsening of existing poverty [3]. There are a number of calls to universalizing health care in India (HLEG, 12th Five Year Plan) [6], resource generation remains a major issue [7]. We evaluate the effect of this SPP program on surgical care utilization and out-of-pocket (OOP) expenditures
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.