Public expenditure on Non-Communicable Diseases & Injuries in India: A budget-based analysis
Autoři:
Indrani Gupta aff001; Avantika Ranjan aff001
Působiště autorů:
Health Policy Research Unit, Institute of Economic Growth (IEG), New Delhi, India
aff001
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0222086
Souhrn
Background
Resource allocation decisions for disease categories can be informed by proper estimates of the magnitude and distribution of total spending. In the backdrop of a high burden of Non-Communicable Diseases and Injuries (NCDI) in India, and a paucity of estimates on government spending on NCDI, this paper attempts to analyse public sector expenditure on NCDI spending in India.
Methods
Various recent budget documents of the Centre and States/Union Territories have been used to extract expenditure on NCDI. The aggregates thus arrived at have been analysed to estimate aggregate and state level per capita spending. State level spending have been compared against disease burden using DALYs. Patterns of spending on NCDI across states were also analysed together with state level poverty to observe possible patterns.
Findings
The total spending on NCDI by the government is low at less than 0.5% of GDP. NCDI spending is little more than one-fourth of total health spending of the country and most spending takes place at the state level (80%). The Ministry of Health and Family Welfare’s share in Central spending on NCDI is around 65%, and currently it spends 20% of its total health spending on NCDI. The gap between spending and DALYs is the most for the economically vulnerable states. Also, the states with high poverty levels also have low per capita expenditure on NCDI
Interpretation
India does not depend on donor funding for health. It will have to step up domestic funding to address the increasing disease burden of NCDIs and to reduce the high out-of-pocket expenditure on NCDI. Policies on NCDI need to focus on UHC, service integration and personnel gaps.
Klíčová slova:
Social sciences – People and places – Geographical locations – Medicine and health sciences – Health care – Health economics – Economics – Endocrinology – Endocrine disorders – Metabolic disorders – Public and occupational health – Socioeconomic aspects of health – Finance – Science policy – Asia – India – Financial management – Budgets – Research funding – Government funding of science
Zdroje
1. World Health Organization (WHO). India NCD Country Profile 2016. http://www.who.int/nmh/countries/ind_en.pdf
2. Srinath RK, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet 2005; 366:1744–49 doi: 10.1016/S0140-6736(05)67343-6 16291069
3. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), National Disease Control Program, National Health Mission (NHM). http://nhm.gov.in/images/pdf/NPCDCS.pdf
4. National Health Mission Himachal Pradesh. http://www.nrhmhp.gov.in/content/non-communicable-diseases-ncds
5. National Health Systems Resource Centre (2016). National Health Accounts (NHA) Estimates for India (2013–14). New Delhi: Ministry of Health and Family Welfare, Government of India. https://mohfw.gov.in/sites/default/files/National%20Health%20Accounts%20Estimates%20Report%202014-15.pdf
6. Garg CC, Evans BE. What is the impact of Non-Communicable diseases on National Health Expenditures: Department "Health Systems Financing" (HSF) Geneva 2011. http://www.who.int/healthsystems/NCDdiscussionpaper3.pdf.
7. Ministry of Health and Family Welfare (MOHFW), Demand for Grants, Expenditure Budget given in the Union Budget. http://indiabudget.nic.in/
8. Ministry of Health and Family Welfare, Government of India (MOHFW). Health Sector Financing by the Centre and States/UTs in India (2010-11-2014-15). http://www.mohfw.nic.in/documents/publication/publication-archives
9. Ministry of Health and Family Welfare, Government of India (MOHFW). Annexure to Health Sector Financing by Centre and States/UTs in India [2015–16 to 2017–18]. http://mohfw.nic.in/sites/default/files/14652956231454414982_0.pdf
10. Global Burden of Disease (GBD). Cause List 2015. http://www.healthdata.org/sites/default/files/files/Projects/GBD/GBDcause_list.pdf
11. All-India Institute of Medical Sciences (AIIMS). Department-wise admissions, discharges and death rates (Main Hospital), AIIMS Annual Reports (2011–12 to 2016–17). http://www.aiims.edu/aiims/annual_report.htm
12. Populations for All-India and States, UT’s taken from Population Projections for India and States 2001–2026, Census of India 2001, Office of the Registrar General & Census Commissioner(RGI), India. https://nrhm-mis.nic.in/Pages/HMIS-PeriodicReport.aspx.
13. Reserve Bank of India (RBI) Macro-Economic Aggregates, Handbook of Statistics of Indian Economy published by RBI annually. https://rbidocs.rbi.org.in/rdocs/Publications/PDFs/TABLE11BC2E287C4844BB792DA26F499968B21.PDF
14. State Domestic Product and other aggregates (MOSPI), 2011–2012 series. http://mospi.nic.in/data
15. World Bank indicators. PPP conversion for India. http://databank.worldbank.org/data/reports.aspx?source=2&series=PA.NUS.PPP&country=
16. Nation Health Mission (NHM) website- State PIP’s for each state- http://nhm.gov.in/nrhm-in-state/state-program-implementation-plans-pips.html
17. Institute for Health Metrics and Evaluation (IHME). GBD India. DALYS for NCDI. https://vizhub.healthdata.org/gbd-compare/india
18. Niti Aayog. Percentage of Below Poverty Line (BPL) Population based on Tendulkar Methodology (2011–12). http://niti.gov.in/state-statistics
19. World Health Organization (WHO). Global Health Expenditure Database. General government expenditure on health (GGHE) as % of THE, 2012. http://apps.who.int/gho/data/node.main.GHEDGGHEDCHESHA2011?lang=en
20. Henning K. Addressing the Gap In Non-communicable Disease Data With Technology And Innovation," Health Affairs Blog, September 21, 2017. https://www.healthaffairs.org/do/10.1377/hblog20170921.062094/full/
21. Elias MA, Pati MK, Aivalli P, et al. Preparedness for delivering non-communicable disease services in primary care: access to medicines for diabetes and hypertension in a district in south India BMJ Global Health 2018;2:e000519. Available from: https://gh.bmj.com/content/2/Suppl_3/e000519 29527334
22. Rising Health Expenditure Due to Non-Communicable Diseases in India: An Outlook Barik D, Arokiasamy P. Front Public Health. 2016; 4: 268. Published online 2016 Nov 29. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126101/ 27965952
23. National Rural Health Statistics 2017, Health management Information Systems (HMIS), NHM. https://nrhm-mis.nic.in/Pages/RHS2017.aspx?RootFolder=%2FRURAL%20HEALTH%20STATISTICS%2F%28A%29RHS%20-%202017&FolderCTID=0x01200057278FD1EC909F429B03E86C7A7C3F31&View={9029EB52-8EA2-4991-9611-FDF53C824827}
24. Dugee O, Palam E, Dorjsuren B, Mahal A. Who is bearing the financial burden of non-communicable diseases in Mongolia? Journal of Global Health. September 2017. Available from: http://www.jogh.org/documents/issue201801/jogh-08-010415.htm
25. Wieser S, Riguzzi M, Pletscher M, Huber CA, Telser H, Schwenkglenks M. How much does the treatment of each major disease cost? A decomposition of Swiss National Health Accounts. European Journal of Health Economics. November 2018. 19: 1149–1161. Available from: https://link.springer.com/article/10.1007/s10198-018-0963-5 29470673
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