The household-level economic burden of heart disease in India

Trop Med Int Health. 2014 May;19(5):581-91. doi: 10.1111/tmi.12281. Epub 2014 Feb 24.


Objectives: To estimate healthcare use and financial burden associated with heart disease among Indian households.

Methods: Data from the 2004 round household survey of the National Sample Survey in India were used to assess the implications of heart disease for out-of-pocket health spending, spending on items other than health care, employment and healthcare financing patterns, by matching households with a member self-reporting heart disease (cardiovascular disease (CVD)-affected households) to (control) households with similar socio-economic and demographic characteristics. Propensity score matching methods were used.

Results: Compared with control households, CVD-affected households had more outpatient visits and inpatient stays, spent an extra INT$ (International Dollars) 232 (P < 0.01) per member on inpatient care annually, had lower non-medical spending (by INT$5 (P < 0.01) per member for a 15-day reference period), had a share of out-of-pocket health spending in total household expenditure that was 16.5% higher (P < 0.01) and relied more on borrowing and asset sales to finance inpatient care (32.7% vs. 12.8%, P < 0.01). Members of CVD-affected households had lower employment rates than members of control households (43.6% vs. 46.4%, P < 0.01), and elderly members experienced larger declines in employment than younger adults. CVD-affected households with lower socio-economic status were at heightened financial risk.

Conclusion: Non-communicable conditions such as CVD can impose a serious economic burden on Indian households.

Keywords: India; cardiovascular disease; economic burden; heart disease; matching.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cost of Illness*
  • Cross-Sectional Studies
  • Family Characteristics*
  • Female
  • Health Care Surveys / methods
  • Health Care Surveys / statistics & numerical data
  • Health Expenditures / statistics & numerical data*
  • Heart Diseases / economics*
  • Humans
  • India
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Socioeconomic Factors
  • Young Adult