Abstract
We assessed the burden of cancer on households’ out-of-pocket health spending, non-medical consumption, workforce participation, and debt and asset sales using data from a nationally representative health and morbidity survey in India for 2004 of nearly 74 thousand households. Propensity scores were used to match households containing a member diagnosed with cancer (i.e. cancer-affected households) to households with similar socioeconomic and demographic characteristics (controls). Our estimates are based on data from 1,645 households chosen through matching. Cancer-affected households experienced higher levels of outpatient visits and hospital admissions and increased out-of-pocket health expenditures per member, relative to controls. Cancer-affected households spent between Indian Rupees (INR) 66 and INR 85 more per member on healthcare over a 15-day reference period, than controls and additional expenditures (per member) incurred on inpatient care by cancer-affected households annually is equivalent to 36% to 44% of annual household expenditures of matched controls. Members without cancer in cancer-affected households used less health-care and spent less on healthcare. Overall, adult workforce participation rates were lower by between 2.4 and 3.2 percentage points compared to controls; whereas workforce participation rates among adult members without cancer were higher than in control households. Cancer-affected households also had significantly higher rates of borrowing and asset sales for financing outpatient care that were 3.3% to 4.0% higher compared to control households; and even higher for inpatient care.
Highlights
The growth story of India has attracted much attention from economists, over the last decade where annual average growth rates of income per capita have averaged 5.7%
Even as these health and economic gains are being experienced, Indian health policymakers are faced with the challenge of non-communicable chronic diseases (NCD)
According to the Global Burden of Disease (GBD) Study, ischemic heart disease, diabetes, stroke and asthma collectively accounted for almost 18% of years of life lost due to premature death in India in 2010, almost double their share in 1990 [1]
Summary
The growth story of India has attracted much attention from economists, over the last decade where annual average growth rates of income per capita have averaged 5.7%. An Indian enjoyed an income of US$ 840 in 2011, nearly 5 times as high as his or her counterpart in 1960. Health gains have accompanied improved economic outcomes. In India, life expectancy at birth increased from 39 years in 1950 to 65 years in 2010, an increase of almost 67%. Even as these health and economic gains are being experienced, Indian health policymakers are faced with the challenge of non-communicable chronic diseases (NCD). According to the Global Burden of Disease (GBD) Study, ischemic heart disease, diabetes, stroke and asthma collectively accounted for almost 18% of years of life lost due to premature death in India in 2010, almost double their share in 1990 [1]
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