Out-of-pocket Expenditure on Healthcare among the Urban Poor in India

Focus on healthcare patterns and their determinants among the urban poor is crucial in order to move towards universal health coverage. However, published literature on these aspects in India is scarce. This study was undertaken to estimate out-of-pocket healthcare expenditures and resultant catastrophic health expenditure rates among the urban poor. It has been found that CHE rates are significantly higher among males, illiterates, older age groups, those hospitalised at private facilities and those reporting non-communicable diseases as the reason for hospitalisation. The study not only indicates high OOP expenditure incurred by the urban poor, but also points to many socio-economic inequalities.

More than 54% of the population globally lives in urban areas, and this percentage is set to increase to 68% by 2050 (Gupta and Mondal 2015; DESA 2018). Much of this expected urban growth is taking place in developing countries, where a large proportion of new arrivals can only afford to live in informal settlements. This population represents the lowest socio-economic stratum in the cities, which faces many challenges, including but not limited to the access to infrastructure, housing, healthcare services, education and employment. The United Nations estimates around 10 crore people living in urban slums in India (DESA 2018).