Elderly inpatient care utilization and financing in India: Is there a gender difference?

Abstract

This paper examines utilization and financing of elderly inpatient care in India with a specific objective to unravel intersecting inequalities in distressed financing. For this purpose, we draw insights from three broad theoretical perspectives namely, unitary, collective and intersectionality framework that are well-recognized in the literature on intra-household welfare and its distribution. The analysis reveals significant gender differentials as well as income gradient in both utilization and financing of elderly inpatient care in India. The econometric inferences are consistent with the theoretical inferences and unravel significant disadvantages for elderly females in accessing distressed financing. It is also observed that households are more likely to resort to means such as borrowings, asset selling and contributions from friends and relatives to support hospitalization of elderly male. Given the disutility associated with distressed financing, even richer households are less likely to incur debt for inpatient care of female elderly. In view of such intricacies, this paper argues for universal healthcare coverage and calls for policymaking to strengthen community-based elderly health care.