Friday, December 13, 2019

Household health survey



The National Statistical Office (NSO) recently released findings of the 75th round of National Sample Survey relating to Household expenditure on health (see here). The findings highlight some important socio-economic trends, especially related to the health of the nation. The following are some of the noteworthy points:
(1)   7.5% of the respondents reported having some ailment within 15 days preceding the survey.
The urban population, especially urban women, may be the unhealthiest segment of the population. 10% of urban women reported ailment, as compared to all India average of 7.5%. In urban population 9.1% people reported ailments as compared to 6.8% for the rural population.
~28% of the people in 60+ age group reported ailment, whereas only ~11% were ailing in 45-59 age group.
(2)   ~3% of the respondents were admitted to a hospital in preceding 365days. However, for persons in 60+ age category this ratio was 8.5%. While more women reported ailment, the hospitalization rate was higher for male in general, and urban male in particular.
(3)   More people (55%) availed treatment in a private hospital, as compared to government hospital (42%). Charitable hospitals accounted for ~3% of the patients.
(4)   Insofar as the ailment wise treatment is concerned - private doctors/clinics were approached for 43% of the ailments. Government hospitals (30%) and private hospitals (23%) were approached for lesser number of ailments.
(5)   Only 14% of rural population and 19% of urban population is covered by medical insurance. Most of the rural coverage is through government sponsored health insurance schemes. About 9% (out of 19%) urban population is also covered through government schemes. Only 1% of rural population is covered as employee of government/PSU, while for urban population this ratio is 6%.
(6) Allopathy is the preferred method of treatment for 95% of the population in both rural and urban areas.
(7)   On an average, Indian spend Rs26475 per hospitalization in urban areas and Rs16676 in rural areas. The average expense in case of a government hospital is Rs4452, whereas for a private hospital it is 7 times higher at Rs31845.
(8)   Childbirths are now mostly institutional. In rural areas 90% deliveries took place in hospitals. For urban areas this ratio was 96%.
The notable point is that in government hospitals, only 17% child births were done through surgery, while for private hospitals, this ratio was staggering at 55%.
(9)   97% of both boys and girls had received vaccination in rural India. 98% of boys and 97% of girls had received vaccination in urban India. 59% of boys and 60% of girls at all-India level had been fully immunised (i.e., received all 8 prescribed vaccinations).
I read three primary trends from these data points.
(a)   Population is increasingly becoming unhealthy and the insurance cover is not adequate.
(b)   Private hospitals may be disproportionately expensive, and may require more regulation.
(c)    Healthcare may become a major crisis in 20-25yrs, as the demography begins to change.

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