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Trop Med Int Health. 2014 May;19(5):581-91. doi: 10.1111/tmi.12281. Epub 2014 Feb 24.

The household-level economic burden of heart disease in India.

Author information

1
Public Health Foundation of India, New Delhi, India; Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Abstract

OBJECTIVES:

To estimate healthcare use and financial burden associated with heart disease among Indian households.

METHODS:

Data from the 2004 round household survey of the National Sample Survey in India were used to assess the implications of heart disease for out-of-pocket health spending, spending on items other than health care, employment and healthcare financing patterns, by matching households with a member self-reporting heart disease (cardiovascular disease (CVD)-affected households) to (control) households with similar socio-economic and demographic characteristics. Propensity score matching methods were used.

RESULTS:

Compared with control households, CVD-affected households had more outpatient visits and inpatient stays, spent an extra INT$ (International Dollars) 232 (P < 0.01) per member on inpatient care annually, had lower non-medical spending (by INT$5 (P < 0.01) per member for a 15-day reference period), had a share of out-of-pocket health spending in total household expenditure that was 16.5% higher (P < 0.01) and relied more on borrowing and asset sales to finance inpatient care (32.7% vs. 12.8%, P < 0.01). Members of CVD-affected households had lower employment rates than members of control households (43.6% vs. 46.4%, P < 0.01), and elderly members experienced larger declines in employment than younger adults. CVD-affected households with lower socio-economic status were at heightened financial risk.

CONCLUSION:

Non-communicable conditions such as CVD can impose a serious economic burden on Indian households.

KEYWORDS:

India; cardiovascular disease; economic burden; heart disease; matching

PMID:
24612174
DOI:
10.1111/tmi.12281
[Indexed for MEDLINE]
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