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Arun Aggarwal

Arun Aggarwal

School of Public Health | India

Title: Catastrophic expense among general ward indoor patients in tertiary care hospital of North India

Biography

Biography: Arun Aggarwal

Abstract

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.
Catastrophic expenses by the standard methods (40% of ability to pay or 10% total expenditure) are of not much use for the hospitals and institutions to improve financial protection to improve Universal Health Coverage. 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. Other schemes for poor patients follow stringent income certification process that poor find difficult to follow when in crisis.
This study on ‘General Ward ‘patients gives insight into the influence of various predictors like medical expense (including only direct medical costs) and financial protection mechanisms in terms of poor free status on evidence of catastrophe in form of availing loans and disposing assets.
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. Top ten departments and disease conditions where substantial expense occurs are also listed. Study also highlights the need to offer financial protection to NOT poor free patients in departments with diseases likely to incur large expense.

Recent Publications

  1. S Prinja, R Gupta, P Bahuguna, A Sharma, AK Aggarwal, A Phogat, (2016). A composite indicator to measure universal health care coverage in India: way forward for post-2015 health system performance monitoring framework. Health Policy and Planning, czw097, Publication date 2016/8/6
  2. D Balasubramanian, S Prinja, AK Aggarwal (2015). Effect of user charges on secondary level surgical care utilization and out-of-pocket expenditures in Haryana State, India. PloS one 10 (5), e0125202, Date of Publication 2015/5/4
  3. S Prinja, P Bahuguna, PVM Lakshmi, T Mokashi, AK Aggarwal, M Kaur, .. (2014). Evaluation of publicly financed and privately delivered model of emergency referral services for maternal and child health care in India. PloS one 9 (10), e109911, Date of Publication 2014/10/31
  4. S Prinja, N Manchanda, AK Aggarwal, M Kaur, G Jeet, R Kumar (2013). Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India. Indian Journal of Medical Research 2013, 138 (6):1003
  5. AK Aggarwal, P Kumar, S Pandit, R Kumar (2013). Accuracy of WHO verbal autopsy tool in determining major causes of neonatal deaths in India. PLoS One 8 (1), e54865, Date of Publication 2013/1/25

 

 

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