Self-Reported Ailments and Hospitalisation: Differentials in Utilisation of Health Care




(1)
Institute of Economic Growth, Delhi University, Delhi, India

 



Abstract

This chapter brings two interesting issues into focus. And both of them have been treated with considerable interest in the contemporary literature on utilisation of health services (Rahman and Rao 2004; Kumar 2001; Fernandez et al. 1999; Ganatra and Hirve 1994; Koenig et al. 2001, etc.). First, the gender differentials in health-care access including hospitalisation and outpatient care. The second follows from the first and relates to similar differentials between the rich and the poor or, as we have been terming in this analysis, above-poverty (APL) and below-poverty (BPL) populations. In the remainder of this chapter, it is attempted to provide a few empirical details covering both of these issues, and once again our value addition lies in our focus on high-poverty areas of two major states and an exclusive, though small, sample of slum households in Delhi. Alongside, it may also be noted that self-reported data on health, morbidity and utilisation of health care require cautious interpretation because of variations in perceptions about one’s own health, suffering and healing by individual respondents (Rahman and Barsky 2003; Sen 2002).


This chapter brings two interesting issues into focus. And both of them have been treated with considerable interest in the contemporary literature on utilisation of health services (Rahman and Rao 2004; Kumar 2001; Fernandez et al. 1999; Ganatra and Hirve 1994; Koenig et al. 2001, etc.). First, the gender differentials in health-care access including hospitalisation and outpatient care. The second follows from the first and relates to similar differentials between the rich and the poor1 or, as we have been terming in this analysis, above-poverty (APL) and below-poverty (BPL) populations.2 In the remainder of this chapter, it is attempted to provide a few empirical details covering both of these issues, and once again our value addition lies in our focus on high-poverty areas of two major states and an exclusive, though small, sample of slum households in Delhi. Alongside, it may also be noted that self-reported data on health, morbidity and utilisation of health care require cautious interpretation because of variations in perceptions about one’s own health, suffering and healing by individual respondents (Rahman and Barsky 2003; Sen 2002).


4.1 Interstate and Gender-Wise Differentials in Health Care


Despite years of hard work and long-drawn conviction to raise an inclusive society, India continues to remain a country with all forms of inequities and socio-economic divides. In health too, it is common to observe such divides. Preferential treatment given to males is particularly high in medical care, and there are studies by doctors to reveal that boys receive more prompt attention than girls in medical contingencies and cases of hospitalisation (Kumar 2001). It may however be interesting to note that the results drawn in this study supplant a few of these arguments and portray a reverse picture. Table 4.1 indicates a significantly large share of women in utilisation of hospitalised treatment. In addition, it happens almost across the board. More or less the same is true for the nonhospitalised care as well. The reason why we draw an excess of health care by women over men in this analysis is however not very difficult to identify. Our sample is inclusive of women in child-bearing ages as well, and the overall hospitalisation cases are based on all forms of ailments including pre- or postnatal care, delivery and gynaecological problems along with most other normal health-related issues and injuries. The same explanation holds for the nonhospitalised cases as well. This point is reiterated further by Fig. 4.1 that gives a distribution of women accessing both hospitalised and nonhospitalised health care across five broad age categories, i.e. 0–4, 5–14, 15–39, 40–49 and 60 years or above. We notice from this figure that the share of women in the 15–39 age group—normally considered as the prime years in the reproductive lifespan of women—is the highest followed by those in the 5–14 and 40–59 age groups.


Table 4.1
Hospitalised and nonhospitalised care by gender and socioreligious groups (N = 11,063)

























































































































Operational variables

Sample population (N) (numbers)

Hospitalisation (%) (recall period: past 365 days)

Nonhospitalised treatments (%) (recall period: past 30 days)

Male

Female

Total

Male

Female

Total

Male

Female

Total

Tot. sample

5,810

5,253

11,063

2.2

3.8

3.0

14.6

16.9

15.7

UP

2,972

2,631

5,603

1.9

3.4

2.6

15.2

17.6

16.3

Unnao

1,833

1,603

3,436

2.1

3.4

2.7

15.1

17.2

16.1

Jhansi

1,139

1,028

2,167

1.5

3.4

2.4

15.3

18.2

16.7

Rajasthan

1,852

1,671

3,523

2.7

4.1

3.3

13.2

14.2

13.7

Dausa

898

806

1,704

2.8

3.2

3.0

14.6

16.5

15.5

Dungarpur

954

865

1,819

2.6

4.9

3.7

11.8

12.0

11.9

Delhi

986

951

1,937

2.3

4.6

3.5

15.5

19.8

17.6

Non-slum

716

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Nov 25, 2016 | Posted by in PHARMACY | Comments Off on Self-Reported Ailments and Hospitalisation: Differentials in Utilisation of Health Care

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