How to Avert Catastrophic Expense in General Ward Patients of Public Hospitals: Some insights from Tertiary Care Hospital

Abstract

Introduction: Catastrophic expense estimation is done by the standard methods (40% of ability to pay or 10% total expenditure). This is of not much use for the hospitals and institutions who aim to improve financial protection for achieving UHC. In hospitals, patients with Below Poverty Line (BPL) cards are offered free treatment subject to restrictions. Patients generally bear the extra expense on medicines and supplies. Study was done to ascertain extent of OOP among general ward patients and to know impact of financial protection in terms of poor free status.
Methods: Data of 190 patients was collected at discharge from ‘General Ward’ of a tertiary care hospital of north India regarding their expense on medicines, supplies, diagnostics and user fees. Information on their poor free status, total household monthly income and expenditure, and total family members and earning members was also captured from them. They were asked if they had to take some loan or dispose of the assets for taking treatment.
Results: We found that although poor free status confers some protection; as overall medical expenses were lower in this group, but still even poor free have to incur huge expense and have to borrow money or dispose off assets. Huge expense is on medicines and also supplies. Institute offers substantial protection on user fee and diagnostics. Study also highlights the need to offer financial protection to NOT poor free patients in departments with diseases likely to incur large expense.