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A recent study on gender disparities in health-care expenditure (HCE) in India, published in “Science Direct”, one of the world's leading source for scientific, technical, and medical research, has said that though globally women live longer than men “because of the biological and behavioral advantages of being a female”, in India “life expectancy gap for females versus males is nearly zero or marginally higher” because of “gender-based discrimination in breastfeeding, food allocation, immunization, access to health-care services, and finance for treatment.”
Authored by scholars Moradhvaja and Nandita Saikiaa, who are with the Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, and the International Institute for Applied Systems Analysis, Laxenburg, Austria, respectively, the study says, “The in-patient HCE for males is substantially higher than that of females (Rs 23,666 for males versus Rs 16,881 for females).”
Based on an analysis of 35,515 adults who received in-patient care in a survey carried out by the Government of India’s data collection body, National Sample Survey Organization (NSSO), the study says, “In-patient health expenditure is higher among males than females irrespective of the type of disease and duration of the stay in the hospital.”
“The amount of healthcare expenditure in hospitalization is systematically higher among male patients than the female patients across the demographic and socio-economic characteristics, although extent of this difference varies from one group to another. On average, health care expenditure on men is about Rs 8,397 more than that of women.”
Noting that there is “absence of gender difference in health care expenditure only in case of communicable diseases”, the study finds, “Average healthcare expenditure towards doctor fee, medicine costs, diagnostic test costs, and other medical items for inpatients are invariably higher among the males compared to females”, adding, “The result indicates that females are facing discriminatory behaviour in healthcare spending for inpatient care.”
According to the study, “The percentage of females hospitalized with income or savings as health care finance is higher than that of males (51.02% vs 45.73%)”, but “the percentage of males hospitalized with distressed financing is higher than that of females irrespective of background characteristics.”
Stating that “as level of education increases, the percentage share of HCF through current income or savings increases as well”, the study says, “While there is no substantial difference in the HCF pattern between in-patients belonging to the Hindu and Muslim religions, the percentage of distressed financing is less among in-patients belonging to other religions.”
“The probability of using distressed sources for HCF decreases among inpatients aged 60 and above”, the study says, adding, “This implies that households avoid using distressed resources to provide in-patient care for older age groups.” ;
The study finds that “rural Indian households are more likely to pay in-patient care costs through borrowing, sale of assets, and contributions from friends and relatives compared to their urban counterparts.”
Stating that “as level of education increases, the percentage share of HCF through current income or savings increases as well”, the study says, “While there is no substantial difference in the HCF pattern between in-patients belonging to the Hindu and Muslim religions, the percentage of distressed financing is less among in-patients belonging to other religions.”
“The probability of using distressed sources for HCF decreases among inpatients aged 60 and above”, the study says, adding, “This implies that households avoid using distressed resources to provide in-patient care for older age groups.” ;
The study finds that “rural Indian households are more likely to pay in-patient care costs through borrowing, sale of assets, and contributions from friends and relatives compared to their urban counterparts.”
It adds, “The education level of the head of the household has a significant effect on sources of finance for health-care. Lack of formal education of the household head is consistently shown to have higher chances of meeting HCF from borrowing, selling assets, or a combination of all these sources, whereas an educated head of household has a lower chance of borrowing, selling assets, and asking for contributions rather than using current income/savings.”
The study says, “In-patients belonging to deprived castes such as SC/ST, tend to finance in-patient care from borrowing, sale of assets, and contributions from relatives, rather than using income/savings. Like-wise, poorer households are more likely to borrow for in-patient care than richer households. Households with higher dependency ratios are more likely to finance in-patient care through sale of assets and contributions from friends than from income/savings.”
“Patients hospitalized for the treatment of non-communicable and other diseases, have a greater chance of borrowing and selling assets than those undergoing treatment for communicable diseases”, says the study, adding, “Longer periods of hospitalization lead to borrowing and sale of assets, alongside seeking help from friends and relatives.”
It underlines, “Patients using a private facility have a greater chance of resorting to distressed financing than paying through current income/savings, compared to those using a public facility. As the doctors’ fees and transportation costs increase, the chances of using distressed resources for HCF also increase.”
“It is important to note that as age increases, the probability of using ‘borrowing’ as a source of HCF decreases continuously for both genders, yet the gap between the genders is notable. Females have a lower chance of paying for hospitalization through the sale of assets and contributions from relatives. In contrast, the chance of borrowing for men’s health care increases with the onset of adulthood, and declines once a man becomes old”, the study says.
Study says, “Only 27% of Indian women are engaged in paid jobs, and the rest are involved in unpaid household chores and care-giving, that is, non-economic activities. Since household chores and care-giving do not yield direct economic benefits, the relative importance of women’s health is underestimated.”
The study says, “In-patients belonging to deprived castes such as SC/ST, tend to finance in-patient care from borrowing, sale of assets, and contributions from relatives, rather than using income/savings. Like-wise, poorer households are more likely to borrow for in-patient care than richer households. Households with higher dependency ratios are more likely to finance in-patient care through sale of assets and contributions from friends than from income/savings.”
“Patients hospitalized for the treatment of non-communicable and other diseases, have a greater chance of borrowing and selling assets than those undergoing treatment for communicable diseases”, says the study, adding, “Longer periods of hospitalization lead to borrowing and sale of assets, alongside seeking help from friends and relatives.”
It underlines, “Patients using a private facility have a greater chance of resorting to distressed financing than paying through current income/savings, compared to those using a public facility. As the doctors’ fees and transportation costs increase, the chances of using distressed resources for HCF also increase.”
“It is important to note that as age increases, the probability of using ‘borrowing’ as a source of HCF decreases continuously for both genders, yet the gap between the genders is notable. Females have a lower chance of paying for hospitalization through the sale of assets and contributions from relatives. In contrast, the chance of borrowing for men’s health care increases with the onset of adulthood, and declines once a man becomes old”, the study says.
Study says, “Only 27% of Indian women are engaged in paid jobs, and the rest are involved in unpaid household chores and care-giving, that is, non-economic activities. Since household chores and care-giving do not yield direct economic benefits, the relative importance of women’s health is underestimated.”
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