Innovative Health Financing in India: A

Transcript:Innovative Health Financing in India: A:
Innovative Health Financing in India: A Comparative Study of Three States Montu Bose TERI University Email: monbose@gmail.com & Arijita Dutta University of Calcutta Email: dutta.arijita@gmail.com 6th IGC-Jadavpur University-ISI West Bengal Growth Conference, JU, 28th December 2016 Background Over the years, public health spending has been low NHA 2013-14: public spending on health is only 1.15% of GDP A large share of OOP expenditure in total health spending Medicine has the maximum share in total OOP spending 2 Contd… NHM: strengthen the health system, universal access to affordable, equitable and quality health care RSBY (CMCHIS): financial protection against high OOP expenditure, improve the access to quality healthcare service Medicine: Tamil Nadu Medical Services Corporation (TNMSC), Rajasthan Medical Services Corporation (RMSC) & Fair Price Medicine Shop, West Bengal (FPMS) 3 Nature of the Medicine Distribution Schemes Similarities: All of them primarily aim to reduce OOPE on medicine and total OOPE Target to increase utilization of medical services Dissimilarities: TN & Rajasthan offers huge subsidies on medicine supply in public sector, while in FPMS, there is no financial burden on the government The former targets utilization only in public sector hospitals, while the latter has no such specifications. 4 Objectives Study the utilization pattern of public in-patient care facilities for the three states Examine the effectiveness of the strategies adopted by the states to arrest high OOP expenditure and Analyze the extent of equity in public in-patient care services in the states 5 Data National Sample Survey: NSS 71st round (2014) – Social Consumption: Health NSS 60th round (2004) – Morbidity & Health Care DDGs – State Government (2015-16 Expenditure Budget – Department of Health & Family Welfare) PIP – NHM (2013-14) 6 Methodology Exploratory Data Analysis Benefit Incidence Analysis j = economic group (MPCE); i = service (in-patient care) Net subsidy: difference between private and public OOPE Private OOPE: modal OOPE for state, sector, MPCE, disease group, duration of stay 7 Subsidy Estimation: Budget & NHM Each expenditure head has been cross-classified for healthcare functions (HC) – SHA 2011 Calculated the total public expenditure on IP care (Ω) Modal OOPE in Private hospital (αsmd) ρsmd = αsmd x βsmd (no. of patients utilizing public facilities) The share (ρsmd/∑ρsmd) of each category has been weighted with Ω to get the disease specific subsidy for each sector (Гsmd) 8 Results Utilization: 9 10 11 Note: 2014 figures are converted into 2004 prices; Medical: Professional