About a quarter of all rural households and one in five urban families in India are forced into debt or sale of assets to meet hospitalization costs. This is true across income levels, revealed the National Health Profile 2017 published recently by the Central Bureau of Health Intelligence.
In rural India, about two-thirds – ranging from 65.6% in the poorest to 68% for the richest – depend on the household income or savings, while 27% of the poorest household and 23% of the richest households depend on borrowings for hospitalization costs. In urban India, 68% of the poorest and about 80% of the most well-off households depend on their own income and savings.
As they get richer, their reliance on borrowings goes down from 22% among the poorest to 14% among the richest. In rural India, about 1% whether rich or poor meet hospitalization costs through sale of assets. This is negligible among urban households. Roughly 5% of rural and urban households are helped out by friends and relatives to meet the cost.
The data on hospitalization was from the health expenditure survey conducted by the National Sample Survey Organisation from January 2013 to June 2014. The data also shows that getting hospitalized was most expensive in Gujarat for rural households and in Assam for those who lived in towns and cities.
The average cost per hospitalization case in rural areas was Rs 32,500 in Gujarat, over four times as expensive as in Uttar Pradesh. Similarly, each hospitalization in urban Assam cost on an average about Rs 52,368, nearly seven times as much as in urban Delhi.
Next to Assam, the urban areas of Goa and Himachal Pradesh were the most expensive places to get in-patient treatment, costing over Rs 37,000 and Rs 35,200 per hospitalization case.
Interestingly, in states with very high total per capita spending on health, such as Himachal Pradesh, Uttarakhand, Kerala and Jammu and Kashmir, the average expenditure on each hospitalization was not among the highest. This could be due to higher spending on out-patient costs. In many of these states, the presence of a robust public hospital network could also be the reason for lower expenditure on hospitalisation as several of them also have the highest government spending per capita on health.