Equity in the utilisation of health care services in India: Implications for paths to UHC
نویسنده
چکیده
Pursuit of equity in health and health care has been the key feature of health policy in India. Despite the policy significance, the volume of literature on this important topic is very inadequate in the Indian context. This paper, for the first time seeks to provide evidence on horizontal inequity in health care utilization in 16 major states and north-eastern region of India. The number of outpatient care visits in the past 15 days, number of hospitalizations and length of stay in hospital over 12 months period were extracted from 60 round (2004) data of National Sample Survey. All these measures of health care utilization were standardized for need differences using demographic characteristics and morbidity indicators and controlling for other socioeconomic factors. Need standardized concentration indices were used to measure income related inequities in health care utilization. Absolute inequalities are found between states in the proportion of the population reporting a visit to an outpatient provider, from as low as 4 percent in Bihar to as high as 22 percent in Kerala. Notwithstanding, after standardization, no violation of principle of horizontal equity is found in outpatient care in many states. Significant inequity is observed with respect to the utilization of inpatient care, favouring the rich in all states except Kerala, Himachal Pradesh and North-east. In light of the above evidences, it will be necessary to embed a pro-poor policy bias within the UHC framework to achieve equity in health care.
منابع مشابه
Inequity in Hospitalization Care: A Study on Utilization of Healthcare Services in West Bengal, India
Background Out of eight commonly agreed Millennium Development Goals (MDG), six are related to the attainment of Universal Health Coverage (UHC) throughout the globe. This universalization of health status suggests policies to narrow the gap in access and benefit sharing between different socially and economically underprivileged classes with that of the better placed ones and a consequent expa...
متن کاملEquity in the Utilization of Healthcare Services in India: Evidence from National Sample Survey
Background The pursuit of equity in health and healthcare has been the key feature of health policy in India. However, despite the policy significance, the volume of literature available on this issue is scarce. Therefore, this paper is an attempt to examine the horizontal inequities in healthcare utilization, consisting of outpatient and inpatient care in 15 major states and north-eastern regi...
متن کاملContribution of Nepal’s Free Delivery Care Policies in Improving Utilisation of Maternal Health Services
Background Nepal has made remarkable improvements in maternal health outcomes. The implementation of demand and supply side strategies have often been attributed with the observed increase in utilization of maternal healthcare services. In 2005, Free Delivery Care (FDC) policy was implemented under the name of Maternity Incentive Scheme (MIS), with the intention of reducing transport costs asso...
متن کاملEthical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage
This article discusses what ethicists have called “unacceptable trade-offs” in health policy choices related to universal health coverage (UHC). Since the fiscal space is constrained, trade-offs need to be made. But some trade-offs are unacceptable on the path to universal coverage. Unacceptable choices include, among other examples from low-income countries, to expand coverage for services wit...
متن کامل