Out-of-pocket expenditure (OOPE) as a share of total health expenditure and foreign aid for health has both come down as per the findings of the National Health Accounts (NHA) estimates for India for 2017-18 released on Monday by Health Secretary Rajesh Bhushan.
As a share of total health expenditure, OOPE has come down to 48.8% in 2017-18 from 64.2% in 2013-14. Even in case of per capita OOPE, there has been decline from ₹2,336 to ₹2,097 between 2013-14 to 2017-18.
“One of the factors attributing to this decline is the increase in utilisation and reduction in cost of services in Government health facilities. If we compare NHA 2014-15 and 2017-18 there has been a decline in OOPE for Government hospitals to the tune of 50%,” said Mr. Bhushan.
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This is the fifth consecutive NHA report produced by National Health Systems Resource Centre, designated as National Health Accounts Technical Secretariat in 2014 by the Health Ministry. The NHA estimates are prepared by using an accounting framework based on internationally accepted System of Health Accounts 2011, provided by the World Health Organization.
Mr. Bhushan releasing the report said that the NHA estimates for 2017-18 clearly showed that there had been an increase in the share of Government health expenditure in the total GDP of the country.
“It has increased from 1.15% in 2013-14 to 1.35% in 2017-18. Additionally, the share of Government Health Expenditure in total health expenditure has also increased over time. In 2017-18, the share of Government expenditure was 40.8%, which is much higher than 28.6% in 2013-14,” he said.
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The report further indicates that in per capita terms, the Government health expenditure has increased from ₹1,042 to ₹1,753 between 2013-14 to 2017-18.
The share of primary healthcare in current Government health expenditure has increased from 51.1% in 2013-14 to 54.7% in 2017-18.
“The primary and secondary care accounts for more than 80% of the current Government health expenditure. There has been an increase in share of primary and secondary care in case of Government health expenditure. In case of private sector, share of tertiary care has increased but primary and secondary care show a declining trend. Between 2016-17 and 2017-18 in Government sector the share of primary and secondary care has increased from 75% to 86%. In private sector, the share of primary and secondary care has declined from 84% to 74%,’’ said the report.
Also the share of social security expenditure on health, which includes the social health insurance programme, Government financed health insurance schemes, and medical reimbursements made to Government employees, has increased.
As a per cent of total health expenditure, the increase is from six per cent in 2013-14 to around nine per cent in 2017-18. “The findings also depict that the foreign aid for health has come down to 0.5%, showcasing India’s economic self-reliance,’’ said Mr. Bhushan.