Out-of-pocket Health Care Expenditure and Impoverishment Effect: A Comparative Study of Rural–Urban Health Care in Odisha

Abstract

Healthcare disparities are generally made worse by out-of-pocket (OOP) health care expenses in an underdeveloped state like Odisha, India. This article examines the rural–urban differences in OOP medical expenditure (ME) on various disease conditions and its impoverishment effect at the household level. The present study is based on the secondary source of data from the National Sample Survey (NSS) of the 75th round, entitled ‘Social Consumption of Health Schedule 25.0’, which has been collected as a unit level of data during July 2017–June 2018. Descriptive statistics, a linear regression model and a generalised linear model (GLM) with log-link and gamma distribution were used to examine the determinants and variations in health care spending. The proportion of impoverishment in rural households is due to more OOP health care expenses in private hospitals as compared to public and other hospitals in Odisha. It is also found that the OOP payment tends to increase significantly with increasing expenditure on hospitalisation and medicine of ailing persons in Odisha. However, education, employment, females, high social group people and diseases like malaria significantly determine a positive result for the OOP health care spending in urban regions as compared to rural regions in Odisha. In terms of spending on health care, households with high healthcare requirements are at a greater disadvantage. To reduce the impact of OOP medical expenses, it is suggested that government spending should be increased, particularly for the population and districts that are less advantaged.