The Study of Catastrophic Health Expenditure (CHE) for Hospitalization in Urban Kerala

Abstract

Abstract Health financing in the post-Covid period is considered the primary policy tool for the government to fortify and reinforce public healthcare infrastructure, mitigating emergency susceptibilities and meeting societal health disparities. Kerala, the southernmost urbanised province of India, despite having the best human development index (HDI) in the country, now faces rising cases of healthcare breakdown. The rising household healthcare costs and expenses incurred during hospitalisation are now making demand-side financing models such as publicly-funded health insurance (PFHI) schemes crucial for accessing healthcare services. The presence of supply-side moral hazards in the roll-out of PFHI leads to unnecessary care, exacerbating the already existing inequities in the incidence of out-of-pocket expenses (OOPE). In this context, the study, through descriptive statistics, logistic regression, and the concentration index by looking at the unit-level data from the 75th round of the National Sample Survey, attempts to determine the determinants of and inequalities in the incidence of Catastrophic Health Expenditure (CHE). The study finds considerable deficiencies in financial risk protection and equity in hospitalisation expenditure. The paper looks at pre-existing inequalities and finds that multi-sectoral collaboration is imperative to attain Universal health coverage.