Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South India

Background: The global healthcare financing landscape highlights the heavy out-of-pocket expenditure (OOPE) burden on households, particularly in low- and middle-income countries like India. Despite efforts towards Universal Health Coverage (UHC), challenges persist. This study in Puducherry aims to...

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Main Authors: Deepthi Paulraj, Vignesh Loganathan, Anurag Gola, Sitanshu Sekhar Kar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-06-01
Series:Journal of Family Medicine and Primary Care
Subjects:
Online Access:https://journals.lww.com/10.4103/jfmpc.jfmpc_1944_24
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author Deepthi Paulraj
Vignesh Loganathan
Anurag Gola
Sitanshu Sekhar Kar
author_facet Deepthi Paulraj
Vignesh Loganathan
Anurag Gola
Sitanshu Sekhar Kar
author_sort Deepthi Paulraj
collection DOAJ
description Background: The global healthcare financing landscape highlights the heavy out-of-pocket expenditure (OOPE) burden on households, particularly in low- and middle-income countries like India. Despite efforts towards Universal Health Coverage (UHC), challenges persist. This study in Puducherry aims to estimate the prevalence and amount of OOPE and catastrophic health expenditure (CHE), with a focus on comparing the findings with a 2016 study conducted in the same study setting. Methods: A cross-sectional study in rural and urban areas collected data from 378 households using a pilot-tested National Sample Survey Office (NSSO) questionnaire. Utilizing a systematic random sampling method, 189 households from each setting were selected. Data analysis was done using SPSS version 23, with OOPE and CHE prevalence presented as percentages with a 95% confidence interval (CI). Results: Overall, 46.6% (n = 378) of all households and 91.6% (n = 192) of households that utilized healthcare services in the past 6 months experienced OOPE. 36.5% of households incurred direct medical expenses, with higher prevalence in urban areas. Non-medical expenditures were reported by 41.5% of households, more prominently in rural settings. Moreover, 13.2% of households experienced CHE, with a higher proportion in rural areas. The study highlights a notable decrease in OOPE from 2016 to 2023, with higher expenditure risks associated with chronic diseases. Conclusion: The study unveils healthcare spending patterns in urban and rural Puducherry, emphasizing the significant burden of out-of-pocket expenses and CHEs. It underscores the urgency for interventions to enhance healthcare affordability, particularly in rural areas, where disparities are more pronounced, necessitating targeted efforts to alleviate economic strains and improve access to healthcare.
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spelling doaj-art-b79c667116fe4887a0923788c96dcb2a2025-08-20T03:15:39ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352025-06-011462458248310.4103/jfmpc.jfmpc_1944_24Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South IndiaDeepthi PaulrajVignesh LoganathanAnurag GolaSitanshu Sekhar KarBackground: The global healthcare financing landscape highlights the heavy out-of-pocket expenditure (OOPE) burden on households, particularly in low- and middle-income countries like India. Despite efforts towards Universal Health Coverage (UHC), challenges persist. This study in Puducherry aims to estimate the prevalence and amount of OOPE and catastrophic health expenditure (CHE), with a focus on comparing the findings with a 2016 study conducted in the same study setting. Methods: A cross-sectional study in rural and urban areas collected data from 378 households using a pilot-tested National Sample Survey Office (NSSO) questionnaire. Utilizing a systematic random sampling method, 189 households from each setting were selected. Data analysis was done using SPSS version 23, with OOPE and CHE prevalence presented as percentages with a 95% confidence interval (CI). Results: Overall, 46.6% (n = 378) of all households and 91.6% (n = 192) of households that utilized healthcare services in the past 6 months experienced OOPE. 36.5% of households incurred direct medical expenses, with higher prevalence in urban areas. Non-medical expenditures were reported by 41.5% of households, more prominently in rural settings. Moreover, 13.2% of households experienced CHE, with a higher proportion in rural areas. The study highlights a notable decrease in OOPE from 2016 to 2023, with higher expenditure risks associated with chronic diseases. Conclusion: The study unveils healthcare spending patterns in urban and rural Puducherry, emphasizing the significant burden of out-of-pocket expenses and CHEs. It underscores the urgency for interventions to enhance healthcare affordability, particularly in rural areas, where disparities are more pronounced, necessitating targeted efforts to alleviate economic strains and improve access to healthcare.https://journals.lww.com/10.4103/jfmpc.jfmpc_1944_24catastrophic health expenditurechehouseholdmedical expensesoopeout-of-pocket expenditure
spellingShingle Deepthi Paulraj
Vignesh Loganathan
Anurag Gola
Sitanshu Sekhar Kar
Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South India
Journal of Family Medicine and Primary Care
catastrophic health expenditure
che
household
medical expenses
oope
out-of-pocket expenditure
title Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South India
title_full Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South India
title_fullStr Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South India
title_full_unstemmed Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South India
title_short Household healthcare expenditure: A cross-sectional analysis of urban and rural Puducherry, South India
title_sort household healthcare expenditure a cross sectional analysis of urban and rural puducherry south india
topic catastrophic health expenditure
che
household
medical expenses
oope
out-of-pocket expenditure
url https://journals.lww.com/10.4103/jfmpc.jfmpc_1944_24
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AT anuraggola householdhealthcareexpenditureacrosssectionalanalysisofurbanandruralpuducherrysouthindia
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