ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1647871
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 87 articles
"Catastrophic Health Expenditure among Households with Differently Abled Children and Adolescents in Puducherry, India: A Mixed-Method Study"
Provisionally accepted
- Jawaharlal Institute of Post Graduate Medical Education and Research Department of Preventive and Social Medicine, Puducherry, India
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INTRODUCTION: Households with disabled members are at greater risk of CHE due to their continual medical visits and treatments, the consequence of which forces them into vicious cycles of impoverishment leading to distress financing. Additionally, they face various challenges in accessing healthcare which compromises the UHC. A significant gap exists in the cost of health expenditure for differently abled children in India. METHODS: A mixed-methods study was conducted among 192 households, 96 with differently abled children and 96 without. Quantitative data on health expenditures, insurance coverage, and utilization of disability benefits were collected through structured interviews. Catastrophic health expenditure was defined using the 40% of CTP threshold. Additionally, 10 IDIs were conducted among households with differently abled children to explore barriers and facilitators to healthcare access. RESULTS: Around 44.8% of the households experienced CHE at 40% of CTP. The most common type of disability addressed was Mental disability. Around 50% of the households did not have any insurance coverage and only 44.8% were availing disability benefits for their child. As high as 77.1% of the households experienced distress financing. A significant Compensating Variation was found. The barriers to health seeking included high medical expenses, poor accessibility, availability of specialized care, and continuum of care. Facilitators such as good access to information, availability of healthcare facilities, and social support were addressed. Various recommendations to improve health seeking were provided by the parents. DISCUSSION: This study has found a higher prevalence of CHE, distress financing, and numerous challenges for health seeking among households with differently abled children and suggests implementing prompt measures to address these issues.
Keywords: Disability, OOPE, Catastrophic health expenditure, Health seeking, Differently abled, Compensating variation
Received: 16 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Auroprem, Kar, Devaraj and Thulasingam. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mahalakshmy Thulasingam, Jawaharlal Institute of Post Graduate Medical Education and Research Department of Preventive and Social Medicine, Puducherry, India
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