Health Care Expenditure of Rural Households in Pondicherry, India

  • Poornima Varadarajan Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
  • Lopamudra Moharana Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
  • Murugan Venkatesan Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India
Keywords: Health expenditures, health services needs and demand, India


Background: Shortcomings in healthcare delivery has led people to spend a substantial proportion of their incomes on medical treatment. World Health Organization (2005) estimates reveal that every year 25 million households are forced into poverty by illness and the stru­ggle to pay for healthcare. Thus we planned to calculate the health care expenditure of rural households and to assess the households incurring catastrophic health expenditure. Methods: A cross-sectional study was conducted in the service area of Sri Manakula Vinayagar Medical College and Hospital from May to August 2011. A total of 100 households from the 4 adjoining villages of our Institute were selec­ted for operational and logistic feasibility. The household’s capacity to pay, out of pocket expenditure and catastrophic health expenditure were calculated. Data collection was done using a pretested questionnaire by the principal investigator and the analysis was done using SPSS (version 16). Results: The average income in the highest income quintile was Rs 51,885 but the quintile ratio was 14.98. The median subsistence expenditure was Rs 4,520. About 18% of households got impoverished paying for health care. About 81% of households were incurring out of pocket expenditure and 66% were facing catastrophic health expenses of 40%. Conclusion: There was very high out of pocket spending and a high prevalence of catastrophic expenditure noted. Providing quality care at affordable cost and appropriate risk pooling mechanism are warranted to protect households from such economic threats.

Author Biography

Poornima Varadarajan, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India

Poornima Varadarajan is a 4th year medical student at Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, India


1. Report of the National Commission on Macroeconomics and Health, Ministry of Health and Family Welfare, Government of India, New Delhi, August, 2005. Available online at Report%20of%20the%20National%20Commission.pdf
2. The World Health Report 2008: Primary Health Care, Now more than Ever, The World Health Organization, 2008. Available online at whr/2008/08_overview_en.pdf
3. Government Health Expenditure in India: A Benchmark Study Undertaken for the MacArthur Foundation, India by Economic Research Foundation, New Delhi, August 2006; 42-2.
4. World Health Report 2005. Make every mother and child count. Geneva: World Health Organization; 2005. Available online at whr/2005/whr2005_en.pdf
5. Xu KD, Evans D, Karrin G, Aguilar-Rivera AM. Technical Brief for Policy Makers. Designing health financing systems to reduce catastrophic health expenditure. World Health Organization, Department of Health Systems Financing, Health Financing Policy, 2005; 1-4.
6. Draft Annual Plan, Puducherry. 2011-2012. Available online at http://pandr. pdffiles/int/int.pdf
7. Profile of Union Territory of Pondicherry, 2005; 1-90. Available online at
8. Xu K, Anguliar A, Carrin G, Evans DB, Hanvoravongchai P, Kawabata K, Klavus J, Knaul F, Murray CMJ, Ortiz JP, Zeramdini R, Annan S, Doorslear EV. Distribution of Health Payments and Catastrophic Expenditures Methodology: Discussion Paper. World Health Organization, Department of Health System Financing and Cluster Evidence and Information for Policy, 2005.
9. Pal R. Analysing Catastrophic OOP Health Expenditure in India: Concepts, Determinants and Policy Implications, Indira Gandhi Institute of Development Research, Mumbai, 2010; 1-25. Available online at publication/WP-2010-001.pdf
10. Su TT, Kouyate B, Flessa S. Catastrophic Household expenditure for Health Care in a Low Income Society: A Study from Nouna District, Burkina Faso. Bulletin of the World Health Organization 2006; 84 (1); 21-27.
11. Healthcare in India: Emerging market report. 2007; 1-22. Available online at
12. National Health Accounts. National Health Accounts Cell, Ministry of Health and Family Welfare, Govt. of India (in collaboration with WHO country office for India). 2004-2005.
13. Gupta I. Draft of Out-of-pocket Expenditures and Poverty: Estimates from NSS 61st Round. Paper presented for consideration of the Expert Group on Poverty, Planning Commission.12 May 2009. Available online from
14. Patil SS, Berad AS, Angadi MM. A Study to Assess Catastrophic Household Expenditure on Childhood Illness in an Urban Slum in Bijapur. Indian J Community Med 2009;34(4):335-7.
How to Cite
Varadarajan, P., Moharana, L., & Venkatesan, M. (2013). Health Care Expenditure of Rural Households in Pondicherry, India. International Journal of Medical Students, 1(2), 74-79.
Original Article