Assessment of out-of–pocket health expenditure and prevalence of protective mechanisms against it among the households in an urban area, Bangalore: a longitudinal study

Background: Achieving Universal Health Coverage according to The World Health Assembly’s way to reinforce the principle of human right to health in 2005 has been a huge task for India. India has one of the highest proportions of household out-of-pocket expenditures on health in the world, estimated at 71.1% in 2008–09. The unpredictable payments are impoverishing an estimated 3.3% of India's population every year. In this regard various strategies have been adopted such as—reforming tax based health financing or introducing health insurance. This highlights the need for alternative finances which includes the provision of medical insurance. The study was conducted to assess the out-of-pocket health expenditure and estimate the prevalence of protective mechanisms against it in an urban area- Bangalore.Methods: A longitudinal study was conducted in the urban area of Bangalore. Sample size was calculated to be 350 households. Data regarding socio-demographic profile, protective mechanisms and other details were obtained by interview method using a pre-tested and semi-structured questionnaire.Results: Majority were in the productive age group i.e. 991 (62.68%) individuals. Female population was slightly higher in our study. Most of the households belonged to upper lower class (54.29%). A major burden of health care cost was experienced both in acute as well as chronic illness by the households. Only 8.9% (31 households) had one or the other type of health insurance.Conclusions: Population has profound chances of experiencing catastrophic health expenditure in times of severe illness.

Socioeconomic Cost of Obesity in Korea

With dramatic transitions from a traditionally food-insecure to a food-sufficient society, over weight and/or obesity are an increasing health concern in Korea. In 2000, 35.9% of Korean adults were over weight (BMI>25) with increasing trends. It is well known that obesity is highly correlated with chronic diseases, such as diabetes, hypertension, cardiovascular disease, cancer and high cholesterol. In 2003, the social cost of obesity is estimated at 529.5~799.3 billion won (direct cost) and at 1,200~1,817 billion won (including indirect cost). The share of the direct cost is estimated at 2.6~3.9% of total medical bill 20,742 billion won. These costs are underestimated and would surely be higher if the expenditures outside of the official medical insurance system of Korea were included. Based on the rapid increase of obesity rate among the Korean youth, it is crucial to develop and implement appropriate policies to curb the obesity epidemic.