NEW DELHI: A new study on access to healthcare facilities shows that rural areas remain significantly underdeveloped in terms of health infrastructure: about half the people in India and over three-fifths of those who live in rural areas have to travel beyond 5 km to reach a healthcare centre.
Availability of healthcare services is skewed towards urban centres with these residents, who make up only 28% of the country’s population, enjoying access to 66% of India’s available hospital beds, while the remaining 72%, who live in rural areas, have access to just one-third of the beds.
Insufficiencies in public healthcare services have driven people across socio-economic strata to private healthcare facilities leading to issues of affordability challenges. In 2012, 61% of rural patients and 69% of urban patients chose private in-patient service providers, up from 40% reported in a 1986-87 government survey.
But since the cost of treatment at private healthcare facilities is at least 2 to 9 times higher than at public facilities, it leads to the factor. Poor patients receiving outpatient care for chronic conditions at a private facility spent on an average 44% of their monthly household expenditure per treatment, against 23% for those using a public facility, says the study conducted by IMS Institute for Healthcare Informatics.
“The healthcare system in India is not delivering affordable, acceptable and accessible healthcare to all Indians – which must be the test of its quality,” said Arun Maira, member, Planning Commission. “In fact, some fixes to only a part, without considering their effects on other parts of the system, can backfire as indeed some are.”
According to the IMS study, the lack of accessible healthcare facilities in rural areas, the difficulty in accessing transport and the loss of earnings means patients postpone treatment, or make do with facilities that may be closer but are not cost-effective or even suited to their needs.
The study, which was based on a survey of nearly 15,000 households across 12 states, says that a 40-45% reduction in out-of-pocket expenditures for both outpatient and inpatient treatments can be achieved by addressing physical accessibility of healthcare facilities, availability and capacity of needed resources; quality and functionality of service, and affordability of treatment relative to a patient’s income.
“While expanding, healthcare access is a critical priority for the Indian government and the private sector, the gap between aspiration and today’s reality is all too apparent,” said Murray Aitken executive director, IMS Institute for Healthcare Informatics