Health experts said that the higher hospitalisation costs for Keralites are primarily due to changing demographics and disease patterns, with a large portion of the population diagnosed with lifestyle diseases at an early age. Kerala’s elderly population is rapidly increasing and there is a preference for treatment in private hospitals over govt facilities. Furthermore, fewer than 15% of the population has medical insurance.
Kerala’s average out-of-pocket expenditure for hospital treatment has been high compared to other states for the last two decades, said health economist Arun Nair. “Not only inpatient care but outpatient care, especially consumption of medicines, diagnostic and laboratory tests are also reasons for higher out-of-pocket spend. However, in the last few years, there has been a clear shift in people accessing the public health system due to various health system reform programs by the govt,” he said.
As hospitalisation costs place a significant burden on families, experts suggest that expenses can be reduced by increasing govt investment in primary healthcare sector, focussing on awareness and prevention of non-communicable diseases and enhancing infrastructure and manpower in secondary and tertiary care services in public sector, besides effectively regulating profiteering in private sector.
Dr Padmanabha Shenoy, a clinical immunologist and rheumatologist, pointed out that, although hospital treatment cost in Kerala is less compared to metro cities in India, annual hospital expenditure is very high due to high life expectancy and early diagnosis of lifestyle diseases, which necessitates prolonged treatment. “Increased literacy leads to increased awareness, which in turn leads to healthcare-seeking behaviour,” he added.