National Sample Survey finds that it’s more than three times the national average

The findings of the 75th round of the National Sample Survey (NSO), released earlier this week, lay bare the paradox that Kerala which is the most progressive State on the health front is also the sickest in the country. The survey, Household Social Consumption in India: Health, conducted by the NSO, Ministry of Statistics and Programme Implementation during the July 2017-June 2018 period has reported that the morbidity in Kerala is more than three times the national average.

Main ailments

The percentage of persons that responded as ailing (PPRA) in a 15-day period across the country was 7.5 %. In Kerala, this was 24.5 %. In comparison, the PPRA in Tamil Nadu, Gujarat, and Maharashtra was between 6% and 9.9%.

The ailments reported were mainly infections, endocrine or metabolic disorders, cardiovascular and respiratory ailments.

The survey also assessed the proportion of persons treated as inpatients anytime during a 365-day period. If the number of cases of hospitalisation per 1,000 persons (excluding child birth) across India was 29, this was the highest in Kerala at 105. In most States, this figure hovers between 29 and 40.

In Kerala, 47.5% of outpatient (OP) care was managed by government hospitals, while 31.4% was managed by private hospitals . When it came to inpatient care (excluding child birth), private hospitals managed 57.9 % cases, while the public sector managed 38.3 % cases.

This would mean that while the public sector share of OP care has gone up, the public still depended on the private sector for efficient hospitalisation care.

The average outpatient expenditure for treating a spell of ailment in Kerala has been estimated at ₹480, against ₹636 at the national level.

The survey also estimated the average medical expenditure incurred for treatment, per case of hospitalisation, in Kerala at ₹4,469 for public sector hospitals, while this was ₹28,775 in private sector. At the national level, this was ₹4,452 for the public sector and ₹31,845 for private hospitals.

Predictably, medicines and diagnostics accounted for the chunk of the treatment expense. “The morbidity levels in Kerala is alarming and calls for a review of all programmes and policies to assess if the State’s approach is actually working and if we are overlooking the impact of underlying issues such as alcoholism or unhealthy eating. Despite attempts at universal health coverage, the out-of-pocket expenditure is substantial and calls for a comprehensive health financing cover for all sections of society,” a public health expert said.