Impoverishment Effect of Out of Pocket Health Spending in India: A Comparison Between Households with Elderly and Households without Elderly

Abstract Background: The share of out-of-pocket health spending (OOPS) to household consumption expenditure is very high, around 67 percent, making health care costs catastrophic and leading to impoverishment effects in the medium to longrun. In this study, we have examined the impoverishment effects of OOPS on households with elderly and without elderly.Methods:Our study extracted households with the hospitalized member in the last 365 days (N=80105) in the first phase and thereafter, it divided households with elderly (N = 23708), and households without elderly (N = 56397). Further, we have categorized a household’s impoverishment as a binary variable (Yes or No) after paying health services. The study has employed bivariate and logistics regression to examine the relationship between outcome variables and selected socio-demographic characteristics of households. Results. Our findings show that OOPS among elderly households is on the upswing. By controlling for other factors, households with two elderly individuals are 6% more likely to be impoverished than the households without elderly. The prevalence of poverty among households with at least one elderly person is 10.5%, while it is 9.8% among households with elderly. As a result of the greater out-of-pocket expenditure, a higher percentage of elderly households in most Indian states are impoverished than households without elderly.Conclusion:The findings of the current study call for financial protection and regional level policies for the identified households. There is also a need to expand the insurance coverage, especially the households with elderly.