Saturday, August 8, 2015

India's health care challenge in two graphics

Two graphics from a Livemint inforgraphic series on India's health care system sums up the enormity of the challenge that the country's health sector may be facing.

First, like with suppressed demand of electricity (which, ironically, makes state governments who resort to 12-14 hour power cuts claim that they are power surplus!), India appears to have a massive suppressed demand for health care services, which may be reflection of the public health care access deficit. Cross-state data on illness reporting and hospitalization rates from the NSSO national health survey 2014 reveals an inverse correlation between illness reporting and hospitalization rates and the state's social indicators (and presumably per capita incomes). 

In other words, a large share of people in the country's poorest and most backward areas do not even report illness or show up in hospitals. Describing them as "missing patients", Livemint writes,
The NSSO report put the average figure for people reporting illnesses in rural India at 8.9%. But if one assumes that the true extent of under-reporting is the difference between the national average and that between the top five states in terms of reported illnesses (excluding Kerala, given that it is likely to be an outlier), the true national average will then be 15.6%. In other words, 6.7% of the rural population, or roughly 55 million people, is missing from the official estimate of the ill.
The graphic below captures the same data stratified based on rural and urban incomes and shows the inverse relationship (admittedly, some of the difference may be a measure of differences in lifestyles etc) between incomes and health outcomes,
Since poor quality of public health care facilities and affordability are arguably important contributors, this graphic on the rate of increase in health care costs is a cause of great concern.
In simple terms, even as there exists massive under-reporting of illness, undoubtedly atleast partially due to access problems, the rising health care costs are pricing more people out from accessing health care. 

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