Human Development in India - NCAER

112 human development in indiaFigure 7.14Source: IHDS 2004–5 data.Medical Spending by Household Income (for all members)unlikely to vary by household income. However, major illnessesrequire more expensive tests and treatment options,which physicians may hesitate to recommend to poorpatients, and poor households may be less likely to undertake,even if recommended.Despite these striking income differences, relative tourban households, rural households spend more on minorillnesses and almost as much for major illnesses (TableA.7.2a). Medical care is least expensive in the major metropolitanareas despite the higher concentration of affluenthouseholds there. Part of the reason for their higher expensesis that villagers, more often, have to leave their local areasfor treatment and are slightly more likely to be hospitalized(Table A.7.2a), both of which raise costs. Leaving the villageor neighbourhood raises the median expense from Rs 95 toRs 200 for minor illnesses and from Rs 650 to Rs 2,700 formajor illnesses. Hospitalization, of course, results in majorexpenses. The rare cough, fever, or diarrhoea that requireshospitalization, typically costs Rs 1,000 compared to Rs110 for outpatient costs. Major illnesses cost Rs 5,400 withhospitalization and only Rs 1,200 without hospitalization.Overall, going to a public provider costs less than goingto a private provider, but these savings are frequently small.For minor illnesses, going to a public health centre results ina median expenditure of Rs 100 as compared with Rs 150for the private healthcare provider, but going to a pharmacistcosts only Rs 50 (Figure 7.15).For major illnesses, the median public provider expenseis Rs 1,970, which is Rs 580 less than the median private careexpense (Figure 7.16).Figure 7.15Source: IHDS 2004–5 data.Minor Ilness Expenses by Source of Treatment