[Maneesh et. al., Vol.6 (Iss.

5): May 2018] ISSN- 2350-0530(O), ISSN- 2394-3629(P)

(Received: May 09, 2018 - Accepted: May 30, 2018) DOI: 10.5281/zenodo.1291082

Science

PATTERN OF HEALTH CARE EXPENDITURE OF PRIVATE AND

PUBLIC: A CASE STUDY OF HOSPITAL PATIENTS IN KANNUR
DISTRICT, KERALA, INDIA
Maneesh P *1, Aicha EL ALAOUI 2
*1
Ph.D., Research Scholar, Department of Econometrics, School of Economics, Madurai
Kamaraj University, Madurai, Tamil Nadu, India
2
Associate Professor, University Sultan My Slimane, BeniMellal, Morocco. Member of
Laboratory of Economic and Social Sciences, BeniMellal

Abstract
In Kerala, the disturbing trend is that the public health care system is getting alienated from the
people since 1980’s. About 30% of the lower income families seeks medical service from the
government hospitals. This is because of the fall in the quality of the services of the government
hospitals. In the present situation, the rate of utilization of the private sector can be increased
drastically pointing to the poor performance of the public health care system. The government
hospital has some problems like poor physical or infrastructure facilities, ineffective leadership
and unsatisfactory supply of drugs and medical supplies faculty of staffing procedure. These above
stated problems do not exist in private hospitals. Therefore, the present study carried out to assess
the healthcare expenditure of government and private hospitals patients in Kannur district. The
study was conducted during 2015-16. The sample size of the survey contains a total of 120
respondents from Kannur district. The study analyses the interrelationship between health care
expenditure and major socioeconomic factors such as monthly income, age, gender, marital status
and occupation. The health care expenditure divided into two-direct and indirect health care cost.
The direct health care cost includes- user fee charge, medical charge, diagnostic charge and
surgical cost. The indirect health care cost comprises of transportation charge, food and bevarages
charge and accommodation charges. The study found that the direct cost of health care is high in
both private and public sector hospitals. Finally, the study suggests that an initiative along the role
of government is requested to secure the health demands of poor as health care costs are growing
over time.

Keywords: Healthcare Expenditure; Private-Public Hospitals; Socio-Economic Condition;

Hospital's Performance.

Cite This Article: Maneesh P, and Aicha EL ALAOUI. (2018). “PATTERN OF HEALTH CARE
EXPENDITURE OF PRIVATE AND PUBLIC: A CASE STUDY OF HOSPITAL PATIENTS
IN KANNUR DISTRICT, KERALA, INDIA.” International Journal of Research -
Granthaalayah, 6(5), 431-449. https://doi.org/10.5281/zenodo.1291082.

Http://www.granthaalayah.com ©International Journal of Research - GRANTHAALAYAH [431]

[Maneesh et. al., Vol.6 (Iss.5): May 2018] ISSN- 2350-0530(O), ISSN- 2394-3629(P)
(Received: May 09, 2018 - Accepted: May 30, 2018) DOI: 10.5281/zenodo.1291082
1. Introduction

India is the second largest populated country in the world. Health is an important determinant of
wellbeing and health care is regarded as a public right, and an important responsibility of
governments is to provide the care to all people irrespective of race, religion, caste or creed, rural
or urban, rich or poor, and so on.

The effort to improve the health status of the population is a major thrust and it is under the social
development program being undertaken in India. Public health programmes play a very significant
role in the physical and mental wellbeing of every nation. The improvement of the health status of
people is connected to number of factors such as household income, public expenditure on
healthcare delivery system, availability of private healthcare facilities and general environmental
conditions affecting incidence of diseases. The health status of the population of a nation was
assumed to affect utility of the people directly by the value that individual place on good health
and indirectly through increasing healthy time and labour income of the person. The rising of
income levels, the households are able to spend on better healthcare, education and nutrition
leading to an improvement in health status. The improved health status of the people helps the
process of economic development in a positive way. The planning of health in India started as
early as in 1943, when the Bhore committee was appointed to go into health and medical needs of
India. In the time of independence in 1947, the health infrastructure was mainly urban and clinic
based, and it providing curative services only.

The final of the third five year plan, India laid the foundation of basic health care services and the
subsequent fiver plans focused on the need to integrate family planning with maternal and child
health and nutrition services. The sixth five year plan adopted the goal of ‶health for all″. In 1983
the first National Health Policy (NHP) was announced. In the period of seventh five year plan the
major thrust was laid on the consolidation of health infrastructure already developed. The eight
five year plan objective is that the health facilities must reach the curative population by the end
of the plan period and also the ninth five year plan observed that inappropriate location, poor
access, poor maintenance, gaps in critical manpower, mismatch between personnel and equipment,
lack of essential drugs, diagnostics, poor referred linkages were some of the factors responsible
for sub-optimal functioning of primary health care institutions. Most recently, the ministry of
health government of India prepared the National Health Policy 2002, (NHP).

The main objective of NHP 2002 is to achieve an acceptable standard of good health among the
general population of the country. The NHP is being worked upon further in 2015 and a draft for
public consultation has been release. The primary aim of the NHP 2015 is to inform, clarify,
strengthen and prioritize the role of the government in shaping health systems in all its dimensions
investment in health organization and financing of health care services, prevention of diseases and
promotion of good health through cross sectorial action access to technologies, developing human
resources, encouraging medical pluralism, building the knowledge base required for better health,
financial protection strategies and regulation and legislation for health, (Draft of NHP, 2015).

In India, there is a significantly large public health care sector; the larger provide health sector
mostly for curative care completely weakness the former presence. The National Sample Survey
Organization (NSSO) data clearly shows a major decline in utilization of the public health care
facilities for inpatient care and a corresponding increase in utilization of the same from public

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[Maneesh et. al., Vol.6 (Iss.5): May 2018] ISSN- 2350-0530(O), ISSN- 2394-3629(P)
(Received: May 09, 2018 - Accepted: May 30, 2018) DOI: 10.5281/zenodo.1291082

Figure 2: Diagnostic charges paid by the respondents, %

Table 2 shows that 35.8% of the government hospital and private hospital spend more than Rs600
as diagnostic charges, followed by 22.5% paid below Rs 200, 10% paid between Rs 201and Rs
600, and 21.7% had no expenses for diagnostic services.

Table 2: Diagnostic charges

Amount (Rs) Government hospital Private hospital Total
Effective (Eff.) %
Below 200 19 8 27 22,5%
201-400 5 7 12 10,0%
401-600 4 8 12 10,0%
More than 600 19 24 43 35,8%
No charges 18 8 26 21,7%
Total 65 55 120 100,0%
Source: Field data

• Medicine Charges
Medicine is the art and science of healing the illness or injuries. It covers a range of health care
practices evolved to maintain and regenerate health by the prevention and treatment of sickness.
Indigenous medicine for hospitalized patients and preventive medicine refers to measures taken to
prevent sickness or injury rather than healing them. The individual has to pay based on their illness.
The price of medication is too high these days and the patients have to yield a heavy sum of money
towards this. The medical charges paid by the respondents for the treatment in the study area are
given in Table 3.

Table 3: Medicine charges

Amount (Rs) Government hospital Private hospital
Eff. % Eff. %
Below 500 21 32.3 9 16.4
501-1000 8 12.3 12 21.8
Above 1000 36 55.4 34 61.8
Total 65 100.0 55 100.0
Source: Field data

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[Maneesh et. al., Vol.6 (Iss.5): May 2018] ISSN- 2350-0530(O), ISSN- 2394-3629(P)
(Received: May 09, 2018 - Accepted: May 30, 2018) DOI: 10.5281/zenodo.1291082
job as coolie and they spend more than Rs 10000, and (v) 16.4% respondents are unemployed and
they spend below Rs 4000. It is quite interesting that business men are spending more for treatment
in government hospitals whereas, coolie workers are incurred more money for treatment in private
hospitals.

3. Concluding Remarks

The study revealed that the private hospital has provided good facilities compared to government
hospital, but the private hospital is more expensive as compared to the government hospital. Other
main results of this study are represented as follows:
• There is a positive association between costs of treatment and type of health care facility
preferred. The cost of treatment in private hospital is more expensive as compared to the
government hospital. The healthcare expenditure is indirectly related to the income of the
respondents.
• The major reason for selection of healthcare services by respondents utilizing government
hospital were specifically free service and less expensive than those utilizing private
hospital respondents.
• The main intention in selection of hospital is especially nearing to the residence and the
reputation of the hospital;
• Age, education and income have a negative impact on the healthcare expenditure of users
of the government and private hospital. The service provided by the government hospital
is not satisfied by the respondents. The private hospital provides good service delivery, but
the cost is not affordable to all sections of the society.

This study suggests that there should be available, equity and quality of health care services, which
will ensure basic care to the poor and the marginalized for protecting them against ill health and
exploitation.

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