Can the Rural Poor in India Afford to Treat Non-Communicable Diseases?

Tropical Medicine and International Health; September 4, 2012, DOI: 10.1111/j.1365-3156.2012.03070.x

10 Pages Posted: 7 Sep 2012

See all articles by Erika Binnendijk

Erika Binnendijk

Erasmus University Rotterdam (EUR)

Ruth Koren

Tel Aviv University - Professor Sackler Faculty of Medicine

David M. Dror

Micro Insurance Academy (MIA)

Date Written: 2012

Abstract

Objective: Non-communicable diseases (NCD) are on the increase in low-income countries, where healthcare costs are paid mostly out-of-pocket. We investigate the financial burden of NCD vs. communicable diseases (CD) among rural poor in India and assess whether they can afford to treat NCD.

Methods: We used data from two household surveys undertaken in 2009–2010 among 7389 rural poor households (39 205 individuals) in Odisha and Bihar. All persons from the sampled households, irrespective of age and gender, were included in the analysis. We classify self-reported illnesses as NCD, CD or ‘other morbidities’ following the WHO classification.

Results: Non-communicable diseases accounted for around 20% of the diseases in the month preceding the survey in Odisha and 30% in Bihar. The most prevalent NCD, representing the highest share in outpatient costs, were musculoskeletal, digestive and cardiovascular diseases. Cardiovascular and digestive problems also generated the highest inpatient costs. Women, older persons and less-poor households reported higher prevalence of NCD. Outpatient costs (consultations, medicines, laboratory tests and imaging) represented a bigger share of income for NCD than for CD. Patients with NCD were more likely to report a hospitalisation.

Conclusion: Patients with NCD in rural poor settings in India pay considerably more than patients with CD. For NCD cases that are chronic, with recurring costs, this would be aggravated. The cost of NCD care consumes a big part of the per person share of household income, obliging patients with NCD to rely on informal intra-family cross-subsidisation. An alternative solution to finance NCD care for rural poor patients is needed.

Keywords: India, non-communicable diseases, health financing, rural, low-income population

Suggested Citation

Binnendijk, Erika and Koren, Ruth and Dror, David M., Can the Rural Poor in India Afford to Treat Non-Communicable Diseases? (2012). Tropical Medicine and International Health; September 4, 2012, DOI: 10.1111/j.1365-3156.2012.03070.x, Available at SSRN: https://ssrn.com/abstract=2142541

Erika Binnendijk

Erasmus University Rotterdam (EUR) ( email )

Burgemeester Oudlaan 50
3000 DR Rotterdam, Zuid-Holland 3062PA
Netherlands

Ruth Koren

Tel Aviv University - Professor Sackler Faculty of Medicine ( email )

Ramat Aviv
Tel-Aviv, 6997801
Israel

David M. Dror (Contact Author)

Micro Insurance Academy (MIA) ( email )

New Delhi, NCR
India
+41 78 790 6789 (Phone)

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