Private healthcare 20 times costlier than public healthcare: study

Despite high cost of treatment, private sector still takes care of 80 per cent of all outpatient care and about 60 per cent of all inpatient care

By Kundan Pandey
Published: Thursday 25 July 2013

A study on healthcare costs in India has reaffirmed what everyone knows—that private hospitals are not affordable for the common man. Getting treatment in these hospitals is at least 20 times costlier than the healthcare provided in district government hospitals, reveals the study published in PLOS ONE on July 23.

In times when a daily expenditure of Rs 27 has been set as the cut off mark for deciding whether a person is below or above the poverty line, the outpatient treatment (OPD) services in private hospitals charge as high as Rs 2,213. The cost of visiting an OPD in district hospital is Rs 94 which is also quite high for a poor person if one considers the poverty line decided by the Planning Commission.

Similarly, in-patient stay cost is  Rs 394 per day in a district hospital, Rs 614 in a tertiary care hospital, Rs 1,959 in a charitable hospital and Rs 6,997 in a private hospital.

According to the research, the emergency visit cost is the lowest in  charitable hospitals (Rs 385) and highest in private hospitals (Rs 21,873). Surgical procedures are very expensive, both in private and charitable hospitals—Rs. 24,016 and Rs. 27,430 per procedure. The emergency visit cost at a private hospital is also exceptionally high compared to that of other hospitals.

Compare costs
Hospitals/cost per case OPD IPD Emergency Major OT
Charitable hospital 115 1,959 385 27,430
District hospital 94 394 999 2,065
Tertiary care hospital 242 614 499 8,362
Private hospital 2,213 6,996 21,873 24,016
Private teaching hospital 188 345 787 17,196

The research was conducted by Susmita Chatterjee of Public Health Foundation of India, Carol Levin of Department of Global Health, University of Washington, USA and Ramanan Laxminarayan of Princeton Environmental Institute, Princeton University, New Jersey, USA.

The researchers considered five criteria, including cost per OPD case, cost per inpatient (IPD), cost per emergency room visit and cost per surgery. For this, they selected five hospitals, based on their willingness to cooperate and the accessibility of hospital data. Two hospitals were from north India and three were from the south. The findings are based on data collected from April 2010 to March 2011.

Despite the high cost of the treatment, the private sector  still takes care about 80 per cent of all outpatient care and about 60 per cent of all inpatient care concluded researchers. 
The researchers guess that focus on specialised cases could be the reason for the overall high cost at the outpatient and inpatient departments of private hospitals. The specialised cases refers to diseases related to eyes, skin and so on.

In India, government health care services is organised into several tiers. Primary health care is provided through a network of 146,036 health subcentres, 23,458 primary health centres (PHCs), and 4,276 community health centers (CHCs).

As they collected information related to expenditure by the hospitals on drugs, infrastructure, human resource and other, the researchers said the finding of the research many help hospital administrations to use their resources efficiently. Claiming that it has potential to help government in planning the different schemes, they emphasize on a large-scale study on the lines of this study.

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