Upendra Bhojani|BS Thriveni|Roopa Devadasan|CM Munegowda|Narayanan Devadasan|Patrick Kolsteren|Bart Criel
Out-of-pocket healthcare payments on chronic conditions impoverish urban poor in Bangalore, India
Institute of Public Health|Institute of Public Health|Institute of Public Health|Institute of Public Health|Institute of Public Health|Instituut voor Tropische Geneeskunde|Instituut voor Tropische Geneeskunde
burden chronic conditions rise india necessitating longterm support healthcare services healthcare india primarily financed outofpocket payments households considering scarce evidence available india study investigates whether outofpocket payments outpatient care affect individuals chronic conditions large census covering 9299 households conducted bangalore india 3202 households reported presence chronic condition analysed data collected using structured householdlevel questionnaire outofpocket payments catastrophic healthcare expenditure resultant impoverishment measured using standard technique response rate census 985 overall 696 95ci680712 households made outofpocket payments outpatient care spending median 32 95ci3034 total income overall 16 95ci148173 households suffered financial catastrophe spending 10 household income outpatient care occurrence intensity financial catastrophe inequitably high among poor low household income use referral hospitals place consultation small household size associated greater likelihood incurring financial catastrophe outofpocket spending chronic conditions doubled number people living poverty line one month deepening poverty order cope households borrowed money 42 instances sold mortgaged assets 04 instances study provides evidence india outofpocket payment chronic conditions even outpatient care pushes people poverty findings suggest improving availability affordable medications diagnostics chronic conditions well strengthening gate keeping function primary care services important measures enhance financial protection urban poor findings call inclusion outpatient care chronic conditions existing governmentinitiated health insurance schemes