Household Health Care Expenditure and Utilization of Health Care Services: A Study in Dibrugarh District of Assam

Abstract

Indian health care system is a complex one with the existence of high out of pocket health expenditure, low

spending on health sector and also high cost of medical services etc. Increasing cost of medical services has

become a serious concern over the years, heavy amounts of medical expenses creates financial pressure on

households and the situation become more worse when they do not have any kind of financial protection and

an even source of income. The aim of the present study was to investigate the utilisation and expenditure

on health care services at household level. This study was conducted among 225 households of Dibrugarh

district of Assam. There were 719 reported illness cases during the reference period, out of which 85.2%

cases were treated at medical institutions, 9.3% cases were not treated due to financial constraints. The

coverage of health insurance was found to be very low, only 12.45% households had any kind of health

insurance. In the absence of any kind of financial support from any sources, some households had to borrow

for medical expenditure. Expenditure per illness cases was highest in private hospital; sample households

incurred average monthly expenditure of 11.35% of their income on health care. Regression analysis

revealed that income, place of residence and educational qualification of the head of the household were the

significant determinants of household health care expenditure. It is necessary for the government to improve

health infrastructure, spending on health sector must be increase along with. Expansion of health insurance

coverage particularly in rural and remote areas is much needed so that people can understand the benefits of

being enrolled in health insurance.