Prevalence of catastrophic health expenditure and its associated factors, due to out-of-pocket health care expenses among households with and without chronic illness in Bangalore, India: a longitudinal study.

Background: India, one of the economic powerhouses of the world, is lacking in health development.Moreover, it is facing 'Triple burden of disease'. Indians have one of highest proportion of out-of-pocket (OOP) health expenses. Salient reasons are poor quality public health care, costly private care and lack of health insurance. This has led to catastrophic health expenditure (CHE). Another contributor to this CHE is the chronic illness, which require long-term follow-up. It is estimated that catastrophic health expenditure impoverishes 3.3% of Indians every year. This study was undertaken with an aim to estimate the prevalence of catastrophic health expenditure and its associated factors.

Methods: A longitudinal study with one-year follow-up period was conducted among 350 households of an urban area in Bangalore city. Simple random sampling method was used to select the study sample. Data collection done using pre-tested, semi-structured questionnaire by interview method.

Results: Chronic illness mean health expenditure was 1155.67 INR (56.09% of the direct cost was spent on drugs). In acute illness, mean health expenditure was 567.45 INR (59.54% of the direct cost was spent on drugs). Fourty eight (14.86%) of the households experienced CHE in the one year Statistically significant association was found between socio-economic status and catastrophic health expenditure. Eighty-five 42% of the households who experienced CHE had a member with chronic illness in it.

Conclusion: Reducing the financial burden of high health care expenses is possible by improving the government health care system, free quality regular supply of medications to chronic disease patients and to improve the beneficiaries under insurance schemes.