Financial burden of injury care in India: evidence from a nationally representative sample survey

ObjectiveInjuries are a global public health concern, claiming a life every six seconds worldwide. Amidst the rising burden of injuries, this study comprehensively examines the out-of-pocket health expenditure (OOPE) and associated financial burden across seven categories of injuries in India.Data and methodologyThis study used data from the latest nationally representative health survey, conducted by the National Sample Survey Organization (2017-18). Descriptive statistics and multivariable logistic regression were employed.ResultsWe found that 49.3% of injury-affected households experienced catastrophic health expenditure, with 17.8% of households falling into poverty, and 52.1% of households using distressed sources due to OOPE for hospitalization. Injuries such as intentional self-harm, burns or corrosions, and accidental injuries, road traffic accidents and falls imposed a colossal financial burden on households. The average loss of household income due to any injury was INR 3911.5 (USD 57.3). The brunt of OOPE was substantially higher when care was sought from private hospitals rather than public hospitals. Households residing in rural areas, belonging to lower economic quintiles, primarily earning from casual and other work, utilizing private health facilities, and lacking insurance coverage were more likely to experience higher financial burden when seeking care for injuries.ConclusionHigh financial burden of injuries calls for policy measures such as increasing government health expenditure, strengthening public healthcare facilities, increasing health insurance enrolment, and prioritizing prevention strategies and safety interventions.