Determinants of Healthcare Expenditure in Eastern Uttar Pradesh: An Empirical Investigation of In-Patient, Out-Patient and COVID-19 Hospitalization

Abstract

Introduction: The NSSO divided Uttar Pradesh into the Northern Upper Gangetic Plains, Central, Eastern, Southern, and Southern Upper Gangetic Plains NSS zones. There are eighteen districts in Eastern Uttar Pradesh. In Eastern Uttar Pradesh, the districts have a sex ratio of 1020 to 867 with a literacy rate ranging from 61% to 40.1%. Additionally, in terms of health, the eastern region of Uttar Pradesh had an average medical expenditure of Rs. 22421.82 in 2018, which is less than the amount in Uttar Pradesh and all of India. Rather, among all the NSS regions in Uttar Pradesh in 2018, the Eastern region had the lowest average monthly per capita expenditure of Rs. 1673.292. According to the author's calculations based on the 75th round of the NSSO, the Eastern area of Uttar Pradesh had the lowest average total health per person of any NSS region in 2018 at Rs. 4065.996. The current study examines relevant determinants that affect health care expenditures in eastern Uttar Pradesh for both in-patient and out-patient as well as Covid hospitalization scenario in an effort to better understand why the U.P. and all of India have such poor health.

Objective: The purpose of this research is to look into the determinants that affect healthcare expenditure in the Eastern region of Uttar Pradesh for in-patient care, out-patient care and COVID-19 hospitalization. The results are based on primary survey data from an ICSSR (New Delhi)-sponsored project

Methods:  The Heckman two-step selection model was employed to examine decisions made by households and individuals to seek medical care.

Results: The study's findings show that heads of families between the ages of 31 and 59, as well as those with household incomes between Rs. 5001 and Rs. 25000 and higher, are common factors associated with healthcare expenditure in cases of in-patient, out-patient, and COVID-19 hospitalization. Moreover, private healthcare providers and chronic diseases are also more responsible determinants for higher healthcare expenditure in the study area in the above three cases. Additionally, female gender and OBC category were potential determinants to significantly increase total health care expenditure in case of COVID-19 hospitalization

Conclusions: The responsible determinants influencing health care spending in the study area were private health care providers. In order to control health care, the government should therefore move swiftly to step in and justify its privatization. Stated differently, the current study also recommends that, in order to safeguard the interests of the underprivileged segments of society, particularly in the study area and throughout India in general, the commercialization and privatization of health facilities and services should be stopped right now.