The Geriatric Health Care Financing within the Health Care Policy in Kerala
Niranjana Govind *
Government College Kodanchery, India.
K. P. Shabeer
Government Arts and Science College Kozhikode, India.
*Author to whom correspondence should be addressed.
Abstract
Background: According to United Nations, one of the major concerns that the world economy faces is population ageing. With India being the most populous country in the world, the share of elderly population in the country is also rising tremendously. Compared to other States, Kerala has the highest share of elderly population. As elderly are succumbed to health deteriorations and illnesses, their well-being is a major concern. With a strong health care system, demand for health care has increased through past years, in the state.
Objectives: Thus, the study aims to look into the health care financing, including health expenditure, health insurance coverage, financial catastrophe and coping mechanism of elderly population in Kerala.
Methodology: The study is based on Minimum Standard Approach, popularized by WHO and employs Multistage Random Sampling technique. Study area has been divided into three regions and a district from each region has been selected based on size of elderly population. Selected districts are Thiruvananthapuram, Ernakulam and Kozhikode. Sample size calculated using Krejcie and Morgan table and is estimated as 400 elderly households. Tools of analysis include descriptive and inferential statistics like Analysis of Covariance (ANCOVA).
Results: Results reveal that 92% of the surveyed households reported presence of Out-of-pocket (OOP) healthcare expenditure, with significant disparity in health spending, and catastrophic expenditures are prevalent among the studied group. Mean expenditure was observed to be 3412.35 Rs. Purchase of medicines was observed to be the most important component of OOP expenditure, followed by diagnostic tests and travel expenses. Determinants of OOP health expenditure were analysed using ANCOVA and coefficients like use of private health care, chronic diseases and the number of elderly were observed to have a significant effect on OOP health expenditure.
Conclusion: In spite of wide health insurance coverage, gaps exists and there is a need for more inclusive policies among the low-income category. A heavy reliance on income, savings and family members, as coping mechanism have been observed.
Keywords: Geriatric health, health financing, health care demand, elderly population