Health Expenditure at House Level in DelhiPresenting

Authors: Surbhi Batra, J Kishore, GK Ingle,
Introduction: In the present era to allocate resources judiciously in the health sector the policy making bodies need to have a deeper understanding of the health seeking behavior of the common man, which has two components: 1) utilization of the available resources 2) expenses on treatment. Information on these issues is not extensively studied. Objectives: To study the health expenditure and utilization of resources by the people in Delhi Methods: 200 families chosen by stratified random sampling from 4 out of 9 districts according to socioeconomic status. After obtaining voluntary informed consent information on family size, loans, savings (total), insurance, expenditure per month on food, clothing, education, luxuries, housing, recreation and health including self-medication, indigenous medicine, treatment of chronic illness, was obtained using pre-tested questionnaire. The data was analyzed by using computer software package Epi-Info and ANOVA test and Mann-Whitney were used for statistical significance at 5% level. Results: A higher mean age of head of household and per capita income in posh and middle class colony was observed. There were significant differences in savings, insurance cover, per capita and total incomes, and expenditure on food, clothing, housing, transport, recreation in different areas of Delhi. Expenditure on smoking was more in middle class and posh colonies in spite of lower smoking rates. Both areas had more health seeking behavior and expenditure on health particularly over the counter medicine, on alternative system of medicine, private health care compared to slum and resettlement areas. It was also observed that upper strata of Delhi spent more for their chronic diseases whereas people from slum and resettlement prefer more government hospitals for tuberculosis, and other lung diseases. Conclusion: Residents of posh and middle class colonies spends more on their health which could be due to their higher per capita income, suffering from chronic diseases and preference to private health care set up. This study concluded that more expenditure does not ensure freedom from illnesses and special emphasis is required on preventive health services.