As per the National Health Accounts report released on Monday, the Total Health Expenditure (THE) on the country has been estimated Rs. 5,96,440 crores, which translates into 3.16 per cent of GDP and Rs. 4,470 per capita for the year 2018-19.
The Total Health Expenditure constitutes current and capital expenditures incurred by Government and private sources including external or donor funds. As per the report, the Current Health Expenditure (CHE) is Rs. 5,40,246 crores which is 90.58 per cent of THE and capital expenditures is Rs. 56,194 crores, which is 9.42 per cent of THE.
The Capital expenditures are reported for all sources of Government – Union Government is Rs. 18,468 crores; State Government Rs. 37,477 crores; external donors Rs. 249 crores, the report said. The Government Health Expenditure (GHE) including capital expenditure is Rs. 2,42,219 crores which is 40.61 per cent of THE, 1.28 per cent GDP, and Rs.1,815 per capita. This amounts to about 4.81 per cent of General Government Expenditure in 2018-19. Of the GHE, Union Government’s share is 34.3 per cent and State Governments’ share is 65.7 per cent.
The Expenditures by all Government Financed Health Insurance Schemes combined are Rs. 12,680 crores. Household’s Out of Pocket Expenditure on health (OOPE) is Rs. 2,87,573 crores (48.21 per cent of THE, 1.52 per cent of GDP, Rs. 2,155 per capita) Private Health Insurance expenditure is Rs. 39,201 crores (6.57 per cent of THE).
Of the Current Health Expenditures (CHE), the Union Government’s share is Rs. 63,256 crores (11.71 per cent of CHE) and the State Governments’ share is Rs.1,06,056 crores (19.6 per cent of CHE). Local bodies’ share is Rs. 5,451 crores (1.01 per cent of CHE), Households’ share (including insurance contributions) is about Rs. 3,24,717 crores (60.11 per cent of CHE, OOPE being 53.23.per cent of CHE). Contribution by enterprises (including insurance contributions) is Rs. 29,789 crores (5.51 per cent of CHE) and NGOs is Rs. 8,484 crores (1.57 per cent of CHE). External/donor funding contributes to about Rs. 2,493 crores (0.46 per cent of CHE).
The CHE attributed Rs. 93,689 crores to Government Hospitals (17.34 per cent of CHE) and Rs. 1,55,013 crores to Private Hospitals (28.69 per cent of CHE), the report has said.
The Current health expenditure attributed Rs. 1,86,625 crores to Inpatient Curative Care (34.55 per cent of CHE), Rs. 1,01,902 crores to outpatient curative care (18.86 per cent of CHE), Rs. 4,170 crores to Day Curative Care (0.77 per cent of CHE) Rs. 18,909 crores for patient transportation (3.50 per cent of CHE), Rs. 22,526 crores to Laboratory and Imaging services (4.17 per cent of CHE), Rs. 1,01,928 crores to Prescribed Medicines (18.87 per cent of CHE), Rs. 18,881 crores to Over the Counter (OTC) Medicines (3.49 per cent of CHE).
The Therapeutic Appliances and Medical Goods of about Rs. 643 crores (0.12 per cent of CHE), Preventive Care of about Rs. 50,991 crores (9.44 per cent of CHE), and others of about Rs. 12,258 crores (2.27 per cent of CHE) also constituted current health expenditure.
The total Pharmaceutical Expenditure is 33.81 per cent of CHE, while expenditure on Traditional, Complementary, and Alternative Medicine (TCAM) is 4.28 per cent of CHE. The CHE attributed to primary care is of around 47.4 per cent, secondary care of 31.7 per cent, tertiary care of 14.9 per cent and governance and supervision of 4.0 per cent.
As per the report, after disaggregation, government’s expenditure on primary care is 55.2 per cent, secondary care is 30.5 per cent and tertiary care is 5.9 per cent. Private expenditure on primary care is 36.9 per cent, secondary care is 33.3 per cent and tertiary care is 26.9 per cent, the NHA report said.