Costs incurred and determinants of out‐of‐pocket payments for child delivery care in India: Evidence from a nationally representative household survey
Summary In India, out‐of‐pocket (OOP) expenditure on health care services has been showing an increasing trend. The cost and willingness to pay determines the use of facility‐based maternal health services. Hence, the current study was done to find the costs and determinants of OOP payments on child...
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| Veröffentlicht in: | The International journal of health planning and management 2020-01, Vol.35 (1), p.e167-e177 |
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| container_title | The International journal of health planning and management |
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| creator | Krishnamoorthy, Yuvaraj Ganesh, Karthika Sakthivel, Manikandanesan Priyan, Shanthosh Rehman, Tanveer Surendran, Gayathri |
| description | Summary
In India, out‐of‐pocket (OOP) expenditure on health care services has been showing an increasing trend. The cost and willingness to pay determines the use of facility‐based maternal health services. Hence, the current study was done to find the costs and determinants of OOP payments on childbirth care in India. We analyzed the most recent National Family Health Survey‐4 data (NFHS‐4) gathered from the Demographic Health Survey (DHS) program. Stratification and clustering in the sample design were accounted for by using the “svyset” command. Out of 43 507 women, 26 916 (61.9%) had incurred OOP expenditure during their most recent institutional delivery. The average OOP expenditure for delivery care was INR 5985 ($93.3) with median cost being INR 1000 ($15.6). About 80% of women who had OOP expenditure reported that they handled the financial situation by utilizing the money in their bank/savings account. Determinants of OOP expenses were the age of mother, education, religion, state of residence, number of antenatal visits place of delivery, and mode of delivery (P < .05). Out‐of‐pocket expenditure for accessing care is one of the key determinants of service utilization which, if not addressed by the health system, can deter women from having institutional deliveries in the future. |
| doi_str_mv | 10.1002/hpm.2953 |
| format | Article |
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In India, out‐of‐pocket (OOP) expenditure on health care services has been showing an increasing trend. The cost and willingness to pay determines the use of facility‐based maternal health services. Hence, the current study was done to find the costs and determinants of OOP payments on childbirth care in India. We analyzed the most recent National Family Health Survey‐4 data (NFHS‐4) gathered from the Demographic Health Survey (DHS) program. Stratification and clustering in the sample design were accounted for by using the “svyset” command. Out of 43 507 women, 26 916 (61.9%) had incurred OOP expenditure during their most recent institutional delivery. The average OOP expenditure for delivery care was INR 5985 ($93.3) with median cost being INR 1000 ($15.6). About 80% of women who had OOP expenditure reported that they handled the financial situation by utilizing the money in their bank/savings account. Determinants of OOP expenses were the age of mother, education, religion, state of residence, number of antenatal visits place of delivery, and mode of delivery (P < .05). Out‐of‐pocket expenditure for accessing care is one of the key determinants of service utilization which, if not addressed by the health system, can deter women from having institutional deliveries in the future.</description><identifier>ISSN: 0749-6753</identifier><identifier>EISSN: 1099-1751</identifier><identifier>DOI: 10.1002/hpm.2953</identifier><identifier>PMID: 31709605</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Childbirth & labor ; Clustering ; Cost control ; costs and cost analysis ; delivery ; Demographics ; Expenditures ; Health ; Health administration ; Health care expenditures ; health expenditures ; Health services ; Health status ; Health surveys ; India ; Maternal characteristics ; Money ; Payments ; Polls & surveys ; Prenatal care ; Religion ; Residence ; Savings accounts ; Stratification ; Willingness to pay ; Women ; Womens health</subject><ispartof>The International journal of health planning and management, 2020-01, Vol.35 (1), p.e167-e177</ispartof><rights>2019 John Wiley & Sons, Ltd.</rights><rights>2020 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3493-9601d4461a56b36c49390b566ecc9e98b8916cb1d00e346c31a2c718770271963</citedby><cites>FETCH-LOGICAL-c3493-9601d4461a56b36c49390b566ecc9e98b8916cb1d00e346c31a2c718770271963</cites><orcidid>0000-0003-4688-510X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhpm.2953$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhpm.2953$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,30999,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31709605$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krishnamoorthy, Yuvaraj</creatorcontrib><creatorcontrib>Ganesh, Karthika</creatorcontrib><creatorcontrib>Sakthivel, Manikandanesan</creatorcontrib><creatorcontrib>Priyan, Shanthosh</creatorcontrib><creatorcontrib>Rehman, Tanveer</creatorcontrib><creatorcontrib>Surendran, Gayathri</creatorcontrib><title>Costs incurred and determinants of out‐of‐pocket payments for child delivery care in India: Evidence from a nationally representative household survey</title><title>The International journal of health planning and management</title><addtitle>Int J Health Plann Manage</addtitle><description>Summary
In India, out‐of‐pocket (OOP) expenditure on health care services has been showing an increasing trend. The cost and willingness to pay determines the use of facility‐based maternal health services. Hence, the current study was done to find the costs and determinants of OOP payments on childbirth care in India. We analyzed the most recent National Family Health Survey‐4 data (NFHS‐4) gathered from the Demographic Health Survey (DHS) program. Stratification and clustering in the sample design were accounted for by using the “svyset” command. Out of 43 507 women, 26 916 (61.9%) had incurred OOP expenditure during their most recent institutional delivery. The average OOP expenditure for delivery care was INR 5985 ($93.3) with median cost being INR 1000 ($15.6). About 80% of women who had OOP expenditure reported that they handled the financial situation by utilizing the money in their bank/savings account. Determinants of OOP expenses were the age of mother, education, religion, state of residence, number of antenatal visits place of delivery, and mode of delivery (P < .05). Out‐of‐pocket expenditure for accessing care is one of the key determinants of service utilization which, if not addressed by the health system, can deter women from having institutional deliveries in the future.</description><subject>Childbirth & labor</subject><subject>Clustering</subject><subject>Cost control</subject><subject>costs and cost analysis</subject><subject>delivery</subject><subject>Demographics</subject><subject>Expenditures</subject><subject>Health</subject><subject>Health administration</subject><subject>Health care expenditures</subject><subject>health expenditures</subject><subject>Health services</subject><subject>Health status</subject><subject>Health surveys</subject><subject>India</subject><subject>Maternal characteristics</subject><subject>Money</subject><subject>Payments</subject><subject>Polls & surveys</subject><subject>Prenatal care</subject><subject>Religion</subject><subject>Residence</subject><subject>Savings accounts</subject><subject>Stratification</subject><subject>Willingness to pay</subject><subject>Women</subject><subject>Womens health</subject><issn>0749-6753</issn><issn>1099-1751</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp1kcFqFTEUhoNY7LUKPoEE3LiZNmeSSW7cyaXaQkUXuh4ymTPc1JlkTGZumZ2P4NrH80maaauC4CaB83_5yOEn5AWwU2CsPNuPw2mpK_6IbIBpXYCq4DHZMCV0IVXFj8nTlK4ZyxnoJ-SYg2JasmpDfu5CmhJ13s4xYkuNb2mLE8bBeeNzEjoa5unX9x-hy8cY7Fec6GiWAde0C5HavevXR707YFyoNRGzj1761pk39PzgWvQWaRfDQA31ZnLBm75faMQxYsqePDog3Yc54T5kV5rjAZdn5KgzfcLnD_cJ-fLu_PPuorj6-P5y9_aqsFxoXuQ9oBVCgqlkw6XNM82aSkq0VqPeNlsN0jbQMoZcSMvBlFbBVilWKtCSn5DX994xhm8zpqkeXLLY98Zj_lJdcuCyqgQXGX31D3od5pi3WSkhBSih-F-hjSGliF09RjeYuNTA6rWvOvdVr31l9OWDcG4GbP-AvwvKQHEP3Lgel_-K6otPH-6Et4RKofU</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Krishnamoorthy, Yuvaraj</creator><creator>Ganesh, Karthika</creator><creator>Sakthivel, Manikandanesan</creator><creator>Priyan, Shanthosh</creator><creator>Rehman, Tanveer</creator><creator>Surendran, Gayathri</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4688-510X</orcidid></search><sort><creationdate>202001</creationdate><title>Costs incurred and determinants of out‐of‐pocket payments for child delivery care in India: Evidence from a nationally representative household survey</title><author>Krishnamoorthy, Yuvaraj ; Ganesh, Karthika ; Sakthivel, Manikandanesan ; Priyan, Shanthosh ; Rehman, Tanveer ; Surendran, Gayathri</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3493-9601d4461a56b36c49390b566ecc9e98b8916cb1d00e346c31a2c718770271963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Childbirth & labor</topic><topic>Clustering</topic><topic>Cost control</topic><topic>costs and cost analysis</topic><topic>delivery</topic><topic>Demographics</topic><topic>Expenditures</topic><topic>Health</topic><topic>Health administration</topic><topic>Health care expenditures</topic><topic>health expenditures</topic><topic>Health services</topic><topic>Health status</topic><topic>Health surveys</topic><topic>India</topic><topic>Maternal characteristics</topic><topic>Money</topic><topic>Payments</topic><topic>Polls & surveys</topic><topic>Prenatal care</topic><topic>Religion</topic><topic>Residence</topic><topic>Savings accounts</topic><topic>Stratification</topic><topic>Willingness to pay</topic><topic>Women</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krishnamoorthy, Yuvaraj</creatorcontrib><creatorcontrib>Ganesh, Karthika</creatorcontrib><creatorcontrib>Sakthivel, Manikandanesan</creatorcontrib><creatorcontrib>Priyan, Shanthosh</creatorcontrib><creatorcontrib>Rehman, Tanveer</creatorcontrib><creatorcontrib>Surendran, Gayathri</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>The International journal of health planning and management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krishnamoorthy, Yuvaraj</au><au>Ganesh, Karthika</au><au>Sakthivel, Manikandanesan</au><au>Priyan, Shanthosh</au><au>Rehman, Tanveer</au><au>Surendran, Gayathri</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Costs incurred and determinants of out‐of‐pocket payments for child delivery care in India: Evidence from a nationally representative household survey</atitle><jtitle>The International journal of health planning and management</jtitle><addtitle>Int J Health Plann Manage</addtitle><date>2020-01</date><risdate>2020</risdate><volume>35</volume><issue>1</issue><spage>e167</spage><epage>e177</epage><pages>e167-e177</pages><issn>0749-6753</issn><eissn>1099-1751</eissn><abstract>Summary
In India, out‐of‐pocket (OOP) expenditure on health care services has been showing an increasing trend. The cost and willingness to pay determines the use of facility‐based maternal health services. Hence, the current study was done to find the costs and determinants of OOP payments on childbirth care in India. We analyzed the most recent National Family Health Survey‐4 data (NFHS‐4) gathered from the Demographic Health Survey (DHS) program. Stratification and clustering in the sample design were accounted for by using the “svyset” command. Out of 43 507 women, 26 916 (61.9%) had incurred OOP expenditure during their most recent institutional delivery. The average OOP expenditure for delivery care was INR 5985 ($93.3) with median cost being INR 1000 ($15.6). About 80% of women who had OOP expenditure reported that they handled the financial situation by utilizing the money in their bank/savings account. Determinants of OOP expenses were the age of mother, education, religion, state of residence, number of antenatal visits place of delivery, and mode of delivery (P < .05). Out‐of‐pocket expenditure for accessing care is one of the key determinants of service utilization which, if not addressed by the health system, can deter women from having institutional deliveries in the future.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31709605</pmid><doi>10.1002/hpm.2953</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-4688-510X</orcidid></addata></record> |
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| subjects | Childbirth & labor Clustering Cost control costs and cost analysis delivery Demographics Expenditures Health Health administration Health care expenditures health expenditures Health services Health status Health surveys India Maternal characteristics Money Payments Polls & surveys Prenatal care Religion Residence Savings accounts Stratification Willingness to pay Women Womens health |
| title | Costs incurred and determinants of out‐of‐pocket payments for child delivery care in India: Evidence from a nationally representative household survey |
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