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<p>Out-of-pocket expenditure (OOPE) is a major public health concern. This research estimated the direct economic burden of OOPE on health care among persons with disabilities (PWDs) across Indian states and Union Territories using the 76th round national sample survey unit-level data set. We assessed economic burden by catastrophic health expenditures, impoverishment, and inequality. Logit model used to detect the factors of OOPE-led economic burden. Geo-spatial analysis shows the variation of economic burden across states. The study estimated the average annual per capita OOPE in India as Rs 31,551, which varies between Rs 12,384 (Meghalaya) to Rs 53,076 (Himachal Pradesh). Over half of PWDs in almost all states suffered from catastrophic health expenditures. A significant proportion of PWDs in most states slipped into poverty and vulnerability due to OOPE. There was wide variation in inequality in OOPE among PWDs across Indian states. In poorer states with low per capita income and consumption expenditures, the extra economic burden of OOPE pushes a significant number of PWDs below the poverty line. PWDs belonging to rural areas, Scheduled Caste and Scheduled Tribe, less educated families, lower economic strata, and those who got no aid or help suffered most.</p>

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Out-of-pocket expenditure-led economic burden among persons with disabilities across Indian states

  • 期刊论文

  • 发表日期：

    2025年9月4日

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  • Uttam Haldar,
  • Santanu Bisai,
  • Subhadip Gupta

摘要

Out-of-pocket expenditure (OOPE) is a major public health concern. This research estimated the direct economic burden of OOPE on health care among persons with disabilities (PWDs) across Indian states and Union Territories using the 76th round national sample survey unit-level data set. We assessed economic burden by catastrophic health expenditures, impoverishment, and inequality. Logit model used to detect the factors of OOPE-led economic burden. Geo-spatial analysis shows the variation of economic burden across states. The study estimated the average annual per capita OOPE in India as Rs 31,551, which varies between Rs 12,384 (Meghalaya) to Rs 53,076 (Himachal Pradesh). Over half of PWDs in almost all states suffered from catastrophic health expenditures. A significant proportion of PWDs in most states slipped into poverty and vulnerability due to OOPE. There was wide variation in inequality in OOPE among PWDs across Indian states. In poorer states with low per capita income and consumption expenditures, the extra economic burden of OOPE pushes a significant number of PWDs below the poverty line. PWDs belonging to rural areas, Scheduled Caste and Scheduled Tribe, less educated families, lower economic strata, and those who got no aid or help suffered most.