Pandey, A;
Ploubidis, GB;
Clarke, L;
Dandona, L;
(2017)
Hospitalisation trends in India from serial cross-sectional nationwide surveys: 1995 to 2014.
BMJ Open
, 7
(12)
, Article e014188. 10.1136/bmjopen-2016-014188.
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Abstract
OBJECTIVES: We report hospitalisation trends for different age groups across the states of India and for various disease groups, compare the hospitalisation trends among the older (aged 60 years or more) and the younger (aged under 60 years) population and quantify the factors that contribute to the change in hospitalisation rates of the older population over two decades. DESIGN: Serial cross-sectional study. SETTING: Nationally representative sample, India. DATA SOURCES: Three consecutive National Sample Surveys (NSS) on healthcare utilisation in 1995-1996, 2004 and 2014. PARTICIPANTS: Six hundred and thirty-three thousand four hundred and five individuals in NSS 1995-1996, 385 055 in NSS 2004 and 335 499 in NSS 2014. METHODS: Descriptive statistics, multivariable analyses and a regression decomposition technique were used to attain the study objectives. RESULT: The annual hospitalisation rate per 1000 increased from 16.6 to 37.0 in India from 1995-1996 to 2014. The hospitalisation rate was about half in the less developed than the more developed states in 2014 (26.1 vs 48.6 per 1000). Poor people used more public than private hospitals; this differential was higher in the more developed (40.7% vs 22.9%) than the less developed (54.3% vs 40.1%) states in 2014. When compared with the younger population, the older population had a 3.6 times higher hospitalisation rate (109.9 vs 30.7) and a greater proportion of hospitalisation for non-communicable diseases (80.5% vs 56.7%) in 2014. Among the older population, hospitalisation rates were comparatively lower for females, poor and rural residents. Propensity change contributed to 86.5% of the increase in hospitalisation among the older population and compositional change contributed 9.3%. CONCLUSION: The older population in India has a much higher hospitalisation rate and has continuing greater socioeconomic differentials in hospitalisation rates. Specific policy focus on the requirements of the older population for hospital care in India is needed in light of the anticipated increase in their proportion in the population.
| Type: | Article |
|---|---|
| Title: | Hospitalisation trends in India from serial cross-sectional nationwide surveys: 1995 to 2014 |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2016-014188 |
| Publisher version: | http://doi.org/10.1136/bmjopen-2016-014188 |
| Language: | English |
| Additional information: | © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/ licenses/by/4.0/ |
| Keywords: | Ageing, decomposition, hospitalization, non-communicable diseases, older population, propensity |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10040613 |
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