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Background <p>In India healthcare expenses push &gt; 55&#xa0;million households into poverty annually. Costs for treating non-communicable diseases (NCDs) are major source of this impoverishment. We conducted this study to investigate the household economic condition, catastrophic health expenditures (CHE) and impoverishment among older adult households with NCDs.</p> Methods <p>We conducted a sequential explanatory mixed-methods study with a secondary analysis of older adult households with at least one NCD (<i>N</i> = 14067), drawn from Longitudinal aging study in India (LASI), followed by qualitative interviews of 26 purposively sampled older adults living with NCDs. The proportion of CHE, impoverishment and household economic condition were estimated, and the associated factors were identified through regression analysis. Qualitative interviews were analysed thematically using framework approach.</p> Results <p>Among the 14,067 households, 77.93% reported last one year healthcare use, and 16.5% (16.0%-17.0%) reported worsening economic condition. Among the households with healthcare use, 41.2%(40.4–42.0) experienced CHE, 28.4%(27.7–29.2) experienced impoverishment. NCD multimorbidity was associated with worsening household economic condition (AOR = 1.16, 95%CI = 1.05–1.27) and experiencing CHE (AOR = 1.29, 95%CI = 1.20–1.39), and those seeking both inpatient and outpatient care were more likely to be impoverished (AOR = 1.37, 95%CI = 1.23–1.52). Coverage with government health insurance did not protect households from impoverishment (AOR = 1.43, 95%CI = 1.06–1.92) compared to private health insurance. The qualitative themes revealed participant lived experiences which included (i) living with NCD as a financial nightmare, (ii) income source and financial distress, (iii) cost of care and choice of provider, and (iv) family support and lack thereof.</p> Conclusions <p>The NCDs exacerbate healthcare inequities with socio-economically vulnerable older adult households at greater risk of CHE, impoverishment and worsened economic condition. Public funded health insurance programmes offered limited protection compared to private schemes.</p>

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Financial impact of non-communicable diseases on households with older adults in india: a mixed methods study

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  • 发表日期：

    2026年4月18日

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  • Abraham Prince D E,
  • Prakash Babu Kodali

摘要

Background

In India healthcare expenses push > 55 million households into poverty annually. Costs for treating non-communicable diseases (NCDs) are major source of this impoverishment. We conducted this study to investigate the household economic condition, catastrophic health expenditures (CHE) and impoverishment among older adult households with NCDs.

Methods

We conducted a sequential explanatory mixed-methods study with a secondary analysis of older adult households with at least one NCD (N = 14067), drawn from Longitudinal aging study in India (LASI), followed by qualitative interviews of 26 purposively sampled older adults living with NCDs. The proportion of CHE, impoverishment and household economic condition were estimated, and the associated factors were identified through regression analysis. Qualitative interviews were analysed thematically using framework approach.

Results

Among the 14,067 households, 77.93% reported last one year healthcare use, and 16.5% (16.0%-17.0%) reported worsening economic condition. Among the households with healthcare use, 41.2%(40.4–42.0) experienced CHE, 28.4%(27.7–29.2) experienced impoverishment. NCD multimorbidity was associated with worsening household economic condition (AOR = 1.16, 95%CI = 1.05–1.27) and experiencing CHE (AOR = 1.29, 95%CI = 1.20–1.39), and those seeking both inpatient and outpatient care were more likely to be impoverished (AOR = 1.37, 95%CI = 1.23–1.52). Coverage with government health insurance did not protect households from impoverishment (AOR = 1.43, 95%CI = 1.06–1.92) compared to private health insurance. The qualitative themes revealed participant lived experiences which included (i) living with NCD as a financial nightmare, (ii) income source and financial distress, (iii) cost of care and choice of provider, and (iv) family support and lack thereof.

Conclusions

The NCDs exacerbate healthcare inequities with socio-economically vulnerable older adult households at greater risk of CHE, impoverishment and worsened economic condition. Public funded health insurance programmes offered limited protection compared to private schemes.