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. 2018 May 10;13(5):e0196835.
doi: 10.1371/journal.pone.0196835. eCollection 2018.

Triple burden of disease and out of pocket healthcare expenditure of women in India

Laishram Ladusingh  1 , Sanjay Kumar Mohanty  2 , Melody Thangjam  3
Affiliations

Triple burden of disease and out of pocket healthcare expenditure of women in India

Laishram Ladusingh et al. PLoS One. .

Abstract

Aim: Women, unlike men, are subjected to triple burden of disease, namely, non-communicable and communicable diseases and reproductive health related diseases. To assess prevalence of triple burden of disease of currently married women and to contrast out of pocket maternal care expenditure of these diseases in India.

Subject and methods: This study uses nationally representative unit level data from the 71st round (2014) of the National Sample Survey Organisation. Descriptive statistics and bivariate analysis are employed to assess triple burden of diseases by background of currently married women. Mean out of pocket (OOP) expenditure for healthcare care by demographic and household characteristics of women are also compared by type of diseases. Two parts model is adopted for assessment of determents of out of pocket healthcare expenditure of women.

Results: Overall medical and non-medical expenses of non-communicable disease are much higher than those of other disease and disability, reproductive health related and communicable diseases. OOP expenditure for treatment of non-communicable diseases, reproductive health and related diseases and other disease and disability are significantly higher than the inpatient treatment of communicable diseases and the differences are statistically significant.

Conclusion: Out of pocket expenditure for treatment of non-communicable diseases is the highest, followed by that of other diseases & disability, then reproductive health related diseases and the least is for communicable diseases. OOP expenditures for maternal healthcare in private health facilities are much higher than in public health facilities regardless of types of disease. Women from households having insurance of any member spent less than that of women from households not having health insurance. There is an urgent need to expand the outreach of the public health system in India to rural areas.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Box plot of annual OOP healthcare expenditure (log scale) by type of diseases.
Note: CD–Communicable Disease, NCD- Non Communicable Disease, ODAD- Other disease & disability, RHRH- Reproductive health related disease.
Fig 2
Fig 2. Histogram and density of out of pocket expenditure for healthcare (in log scale).
See this image and copyright information in PMC

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