Indians spend far less on hospitalizing women than men, a new study showed, indicating persisting gender discrimination in health issues. The study, Gender Disparities in Healthcare Expenditures and Financing Strategies (HCFS) for inpatient care in India, said the discrimination also shows up when families have to borrow or sell assets to pay for hospitalization.
“The inpatient healthcare expenditure (HCE) for men is substantially higher than for women ( ₹23,666 for men versus ₹16,881 for women). The percentage of women hospitalized with income or savings as healthcare financing is higher than that of men (51.02% versus 45.73%),” said the study, published in the special issue of Social Science and Medicine: Population Health Journal.
“Average HCE is lower for women in adult age groups, regardless of the type of disease and duration of stay in the hospital. Women are also discriminated against more when healthcare has to be paid for by borrowing, sale of assets, or contributions from friends and relatives (distressed financing),” the study said.
The study was conducted by the Centre for the Study of Regional Development (CSRD) of the School of Social Sciences (SSS) in Jawaharlal Nehru University (JNU), in association with the International Institute for Applied Systems Analysis, Austria. The researchers used data from the 25th schedule of the 71st round (2014) of the National Sample Survey Office (NSSO) under the ministry of statistics and programme implementation, the nationally representative, cross-sectional, population-based survey.
The researchers examined gender disparities in HCE and HCFS for inpatient care among adults aged 15 and older in India, which has seen gender-based discrimination in sex-selective abortion, nutrition and access to healthcare.
“There may be two reasons why women are facing discrimination in accessing distressed healthcare finance. Only 27% of Indian women are engaged in paid jobs and the rest is involved in unpaid household chores and care giving. Because household chores and care giving do not yield direct economic benefits, the relative importance of women’s health is underestimated. Second, a discriminatory attitude toward the health of women in India has existed for generations because of social hierarchy and deep-rooted patriarchal structures,” said Nandita Saikia, assistant professor of population studies, JNU, and the author of the study.
The study concluded that the predicted probability of using healthcare financing implies that the health of adult men is considered to be more important, in terms of resorting to distressed financing, than that of adult women.
“HCE on adult women inpatients is systematically lower than that of adult men inpatients. Further, women in India have less access to inpatient care through distressed HCFS,” the study said. It also found that the gender disparity in using borrowing as a healthcare financing strategy is higher among low-income households.
“Just like sex-selective abortion, discriminatory food allocation, or access to healthcare, the present evidence on HCF strategies may be yet another manifestation of centuries-old gender discrimination in India,” said Moradhvaj, co-author of the study.