New Delhi: India’s households’ out-of-pocket expenditure (OOPE) on health for the year 2021-22 was Rs 3,56,254 crores whereas private health insurance expenditure was Rs 66,975 crores registering a sharp increase in comparison to 2020-21, stated the National Health Account Estimates report released by the health ministry on Wednesday.
The households’ OOPE for the year 2020-21 was Rs 3,28,464 crores whereas private health Insurance expenditure is Rs 53,948 crores.
Health accounts describe health expenditures and the flow of funds for a financial year in India. It answers important policy questions such as what the sources of healthcare expenditures are, who manages these, who provides healthcare services, and which services are utilised.
Key Health Expenditure Estimates For India
For the year 2021-22, Total Health Expenditure (THE) for India is estimated to be Rs 9,04,461 crores (3.83% of GDP and Rs 6,602 per capita). THE constitutes current and capital expenditures incurred by Government and Private Sources including External/Donor funds. Current Health Expenditure (CHE) is Rs 7,89,760 crores (87.32% of THE) and capital expenditures are Rs 1,14,701 crores (12.68% of THE).
Capital expenditures are reported for all sources of Government (Union Government is Rs 49,707 crores; State Government Rs 59,550 crores; Corporations Rs 3,638 crores; External Donors Rs 1,806 crores). Government Health Expenditure (GHE) including capital expenditure is Rs 4,34,163 crores (48.00 % of THE, 1.84% GDP, and Rs. 3,169 per capita). This amounts to about 6.12% of General Government Expenditure in 2021-22.
The Union government’s share in THE is about 41.8% while the share of State Governments is about 58.2%. The Union Government’s Expenditure on the National Health Mission is Rs 36,371 crores,
Defense Medical Services is Rs 13,468 crores, Railway Health Services is Rs 5,866 crores, Central Government Health Scheme (CGHS) is Rs 5,167 crores, and Ex-Servicemen Contributory Health Scheme (ECHS) is Rs 4,595 crores. Expenditures by all Government Financed Health Insurance Schemes combined are Rs 20,808 crores.
Who contributes to current health expenditures?
Of the Current Health Expenditures, the Union Government’s share is Rs 1,25,854 crores (15.94% of CHE) and the State Government’s share is Rs 1,71,952 crores (21.77% of CHE). Local bodies’ share is Rs 8,601 Crores (1.08% of CHE), and Households’ share is (including insurance contributions) about Rs 3,99,136 crores (50.55% of CHE, OOPE being 45.11 % of CHE). Contribution by enterprises (including insurance contributions) is Rs 64,206 crores (8.13 % of CHE) and NGOs is Rs 12,013 crores (1.52% of CHE). External/donor funding contributes to about Rs 7,998 crores (1.01% of CHE).
Who provides health care services?
Current Health Expenditure attributed to Government Hospitals is Rs 1,49,900 crores (18.99% of CHE) and Private Hospitals is Rs 2,12,948 crores (26.96% of CHE). Expenditures incurred on other Government Providers (incl. PHC, Dispensaries, and Family Planning Centers) is Rs 56,477 crores (7.15% of CHE), Other Private Providers (incl. private clinics) is Rs 30,080 crores (3.81 % of CHE), Providers of Patient Transport and Emergency Rescue is Rs 28,906 crores (3.65 % of CHE), Medical and Diagnostic laboratories is Rs 26,238 crores (3.32 % of CHE), Pharmacies is Rs 1,52,910 crores (19.35 % of CHE), Other Retailers is Rs 837 crores (0.11% of CHE), Providers of Preventive care is Rs 82,325 crores (10.42% of CHE). About Rs 27,380 crores (3.48% of CHE) are attributed to Providers of Health System Administration and Financing and other healthcare providers (not classified elsewhere) is Rs 21,759 crores (2.76 % of CHE).
What services are consumed?
The current health expenditure attributed to Inpatient Curative Care is Rs 2,99,587 crores (37.94 % of CHE), Day Curative Care is Rs 7,327 crores (0.93% of CHE), Outpatient Curative Care is Rs 1,20,816 crores (15.30 % of CHE), Patient Transportation is Rs 28,906 crores (3.65 % of CHE), Laboratory and Imaging services is Rs 26,238 crores (3.32 % of CHE), Prescribed Medicines is Rs 1,26,225 crores (15.98 % of CHE), Over the Counter (OTC) Medicines is Rs 25,458 crores (3.22% of CHE), Therapeutic Appliances and Medical Goods is Rs 837 crores (0.11 % of CHE), Preventive Care of about Rs 1,07,048 Crores (13.55% of CHE), and others of about Rs 20,686 crores (2.63% of CHE).
About Rs 26,632 crores (3.37 % of CHE) are attributed to Governance and Health System and Financing Administration. Total Pharmaceutical Expenditure (TPE) is 30.84% of CHE (includes prescribed medicines, over-the-counter drugs, and those provided during an inpatient, outpatient, or any other event involving contact with the health system. Expenditure on Traditional, Complementary, and Alternative Medicine (TCAM) is 3.59% of CHE.
Current Health Expenditure attributed to Primary Care is around 46%, Secondary Care is 33%, Tertiary Care is 16%, and governance and supervision is 3%. The government’s Current Health Expenditure attributed to Primary Care is 50%, Secondary Care is 28%, and Tertiary care is 12%.
