Gender Disparities in Health-care Expenditure (HCE) and Financing Strategies (HCFS) for In-patient Care in India

15740 9 86525 2 245440 document 86525 1-s2.0-S2352827318302787-main.pdf application/pdf 5f3644187ffd75bcfacbe086c51a12b7 MD5 675530 2019-02-11 08:12:37 https://pure.iiasa.ac.at/id/eprint/15740/1/1-s2.0-S2352827318302787-main.pdf 15740 1 1 application/pdf text en public cc_by_nc_nd_4

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accepted 86531 2 245452 document 86531 lightbox.jpg image/png 30acc86b8572f902bb30ea57856c37db MD5 25749 2019-02-11 08:22:45 https://pure.iiasa.ac.at/id/eprint/15740/2/lightbox.jpg 15740 2 2 image/png other Thumbnails conversion from text to thumbnail_lightbox en public

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http://eprints.org/relation/isVersionOf https://pure.iiasa.ac.at/id/document/86525 http://eprints.org/relation/isVolatileVersionOf https://pure.iiasa.ac.at/id/document/86525 http://eprints.org/relation/isIndexCodesVersionOf https://pure.iiasa.ac.at/id/document/86525 archive 353 disk0/00/01/57/40 2019-02-11 08:14:29 2021-08-27 17:31:25 2019-02-11 08:14:29 article show Moradhvaj Saikia N. 2182 0000-0001-6735-6157 Gender Disparities in Health-care Expenditure (HCE) and Financing Strategies (HCFS) for In-patient Care in India pub prog_pop Gender; health-care finance; distressed financing; India Background Despite the presence of a vast literature on health-care expenditure (HCE) and health-care financing strategies (HCFS) in low- and middle income countries, there is limited evidence of gender disparity in HCFS for in-patient care. Objective We examined gender disparities in HCE and HCFS for in-patient care among adults aged 15 and above in India, a South Asian population giant, widely known for gender-based discrimination in sex-selective abortion, nutrition and access to healthcare. Data and Methods Using data from a nationally representative large-scale population-based survey, we investigated the relationship between the gender of adult patients and HCE as well as sources of health-care financing. Simple percentage distribution, cross-tabulation, two level random intercempt model and multinomial logit regression were carried out to examine the role of gender in HCE and sources of health-care financing for in-patient care. Results Average HCE is lower for females in adult age groups, irrespective of type of diseases and duration of stay in the hospital. This result remained unchanged after controlling other background variables of the patients. Females are also discriminated against more when health care has to be paid for by borrowing, sale of assets, or contributions from friends and relatives (distressed financing). Multinomial logit results show that the probability of distressed financing is less for females than for males (Borrowing: β=-0.27; CI:-0.37--0.17; p=0.001; selling assets/contribution from friends and relatives (β=-0.27; CI: -0.39--0.14; p=0.001). The predicted probability of using health-care finance implies that the health of adult men is considered to be more important in terms of resorting to distressed financing than that of their female counterparts. Conclusion HCE on adult women inpatients is systematically lower than that of adult men inpatients. Further, women in India have less access to in-patient care through distressed HCFS. 2019-12 published Elsevier 10.1016/j.ssmph.2019.100372 2968 public SSM - Population Health 9 e100372 TRUE 2352-8273 FALSE no info:eu-repo/semantics/article