The household‐level economic burden of heart disease in India

OBJECTIVES: To estimate healthcare use and financial burden associated with heart disease among Indian households. METHODS: Data from the 2004 round household survey of the National Sample Survey in India were used to assess the implications of heart disease for out-of-pocket health spending, spending on items other than health care, employment and healthcare financing patterns, by matching households with a member self-reporting heart disease (cardiovascular disease (CVD) -affected households) to (control) households with similar socio-economic and demographic characteristics. Propensity score matching methods were used. RESULTS: Compared with control households, CVD-affected households had more outpatient visits and inpatient stays, spent an extra INT (International Dollars) 232 (P < 0. 01) per member on inpatient care annually, had lower non-medical spending (by INT5 (P < 0. 01) per member for a 15-day reference period), had a share of out-of-pocket health spending in total household expenditure that was 16. 5% higher (P < 0. 01) and relied more on borrowing and asset sales to finance inpatient care (32. 7% vs. 12. 8%, P < 0. 01). Members of CVD-affected households had lower employment rates than members of control households (43. 6% vs. 46. 4%, P < 0. 01), and elderly members experienced larger declines in employment than younger adults. CVD-affected households with lower socio-economic status were at heightened financial risk. CONCLUSION: Non-communicable conditions such as CVD can impose a serious economic burden on Indian households.