An Analysis of Public Health Expenditure in Bihar Based on Data from the National Sample Survey Rounds of 2004 and 2018

Dolly Kumari, International Institute for Population Sciences (IIPS)
Vineet Kumar Kamal, All India Institute of Medical Sciences

Background: Spending on social and development schemes is crucial for strengthening human resources in any country. In India, regional disparities result in significant variation in health expenditure and access to public health services. Bihar, a low-resource state, has steadily increased its public health spending, from 1.1% of GSDP in 2004 to 1.4% in 2016-17. This study aims to analyze the patterns of morbidity, health facility utilization, reasons for avoiding public health facilities, and the benefits of public health expenditure based on residence and economic status in Bihar. Data and Methods: Data from the National Sample Survey 60th (2004) and 75th (2017) rounds, as well as health budget data from 2004 and 2018, were analyzed. Results: The findings indicate that in rural areas, public health spending for outpatient and inpatient care is pro-poor, while in urban areas, the spending trend is more pro-rich. Overall, inpatient care spending is more pro-poor, while outpatient care is concentrated among wealthier individuals. Conclusion: Our study suggests that public spending in Bihar has not significantly favored the poor, particularly in urban areas. These insights can guide policymakers to improve resource allocation and enhance equity in health services, helping to achieve universal health coverage in India.

Keywords: Econometrics , Economic Demography, Health and Morbidity, Population Policies

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