Ways of Health Financing during Illness Events at household level; and its determinants among Rural Community of Delhi, India

Background: In developing countries like India, where coverage of health insurance schemes is low, most healthcare costs are meted by out-of-pocket expenditure by people which leads to the vicious cycle of indebtness and impoverishment. The present study was done to identify the various ways of financing illness events and examine their relationship with health insurance and socio-demographic factors of a rural population of Delhi, India. Materials and method: The study was conducted in five randomly selected villages of Najafgarh, Delhi. Probability proportional to size was used to decide the samples to be taken from each of the five villages and systematic random sampling was done for selection of households in each village. The head of household (HoH) of the selected households were included in the study. Data was collected using pretested semi structured questionnaire through personal interview method. Results: A total of 370 HoH were interviewed. Out of these, 25.9% were covered by health insurance schemes. A total of 39.7% study subjects had history of illness in family (chronic disease or hospitalization for any duration / treatment for any illness lasting 1 week and more within the past one year). Only 23.1% of these subjects met the medical expenses by health insurance scheme while the remaining 76.9% made out-of-pocket expenditure (OOP) to meet the medical expenses. OOP was more significantly more common in study subjects who were less educated, employed in unorganised sector and belonged to low socio-economic status. Conclusion: There is need to increase the health insurance/ social security net to the larger section of rural population to decrease out-of-pocket expenditure on health.