Comparative Assessment of Economic Burden of Disease in Relation to Out of Pocket Expenditure.

Background: The economic costs associated with morbidity pose a great financial risk on the population. Household's over-dependence on out-of-pocket (OOP) health expenditure and their inability to cope up with the economic costs associated with illness often push them into poverty. The current paper aims to measure the economic burden and resultant impoverishment associated with OOP health expenditure for a diverse set of ailments in India. Methods: Cross-sectional data from National Sample Survey Organization (NSSO) 71st Round on "Key Indicators of Social Consumption: Health" has been employed in the study. Indices, namely the payment headcount, payment gap, concentration index, poverty headcount and poverty gap, are defined and computed. The measurement of catastrophic burden of OOP health expenditure is done at 10% threshold level. Results: Results of the study reveal that collectively non-communicable diseases (NCDs) have higher economic and catastrophic burden, individually infections rather than NCDs such as Cardio Vascular Diseases and cancers have a higher catastrophic burden and resultant impoverishment in India. Ailments such as gastro-intestinal, respiratory, musco-skeletal, obstetrics, and injuries also have a substantial economic burden on population and push them below the poverty line. Results also show that despite the pro-poor concentration of infections, their economic burden is more concentrated among the wealthier consumption groups. Conclusion: The study concludes that universal health coverage through adequate provision of pooled resources for health care and community-based health insurance is critical to reduce the economic burden and impoverishment related to OOP health expenditure. Measures should also be instituted to insulate people from economic burden on morbidity, especially the NCDs.