As per the National Health Accounts report released on Monday, the total health expenditure (THE) on the country has been estimated at Rs5,96,440 crore which translates into 3.16% of GDP and Rs4,470 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 Rs5,40,246 crores which is 90.58% of THE and capital expenditures is Rs56,194 crores, which is 9.42% of THE.
The capital expenditure is reported for all sources of government - Union Government is Rs18,468 crores; State Government Rs37,477 crores; external donors Rs249 crores, the report said. The Government Health Expenditure (GHE) including capital expenditure is Rs2,42,219 crores which is 40.61% of THE, 1.28% GDP, and Rs1,815 per capita. This amounts to about 4.81% of General Government Expenditure in 2018-19. Of the GHE, Union Government's share is 34.3% and State Governments' share is 65.7%.
The Expenditures by all Government Financed Health Insurance Schemes combined are Rs12,680 crores. Household's Out of Pocket Expenditure on health (OOPE) is Rs ,87,573 crores (48.21% of THE, 1.52% of GDP, Rs2,155 per capita) Private Health Insurance expenditure is Rs39,201 crores (6.57% of THE).
Of the Current Health Expenditures (CHE), the Union Government's share is Rs63,256 crores (11.71% of CHE) and the State Governments' share is Rs1,06,056 crores (19.6% of CHE). Local bodies' share is Rs5,451 crores (1.01% of CHE), Households' share (including insurance contributions) is about Rs3,24,717 crores (60.11% of CHE, OOPE being 53.23% of CHE). Contribution by enterprises (including insurance contributions) is Rs29,789 crores (5.51% of CHE) and NGOs is Rs8,484 crores (1.57% of CHE). External/donor funding contributes to about Rs2,493 crores (0.46% of CHE).
The CHE attributed Rs93,689 crores to Government Hospitals (17.34% of CHE) and Rs1,55,013 crores to Private Hospitals (28.69% of CHE), the report has said.
The Current health expenditure attributed Rs1,86,625 crores to Inpatient Curative Care (34.55% of CHE), Rs1,01,902 crores to outpatient curative care (18.86% of CHE), Rs4,170 crores to Day Curative Care (0.77% of CHE) Rs18,909 crores for patient transportation (3.50% of CHE), Rs22,526 crores to Laboratory and Imaging services (4.17% of CHE), Rs1,01,928 crores to Prescribed Medicines (18.87% of CHE), Rs18,881 crores to Over the Counter (OTC) Medicines (3.49% of CHE).
The Therapeutic Appliances and Medical Goods of about Rs643 crores (0.12% of CHE), Preventive Care of about Rs50,991 crores (9.44% of CHE), and others of about Rs12,258 crores (2.27% of CHE) also constituted current health expenditure.
The total Pharmaceutical Expenditure is 33.81% of CHE, while expenditure on Traditional, Complementary, and Alternative Medicine (TCAM) is 4.28% of CHE. The CHE attributed to primary care is of around 47.4%, secondary care of 31.7%, tertiary care of 14.9% and governance and supervision of 4.0%.
As per the report, after disaggregation, government's expenditure on primary care is 55.2%, secondary care is 30.5% and tertiary care is 5.9%. Private expenditure on primary care is 36.9%, secondary care is 33.3% and tertiary care is 26.9%, the NHA report said.
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