According to the outcomes of a study conducted by the Centre of Technology and Policy at IIT Madras, it has been observed that improving the basic infrastructure, availability of medicines and presence of trained personnel at health sub-centres could ensure drastic reduction in out-of-pocket (OOP) expenses on healthcare as well as the number of out-patient visits to clinics and private hospitals.
The pilot phase of the study was implemented in three blocks in Tamil Nadu for ensuring universal health coverage. The inferences derived from the pilot project indicated that the extent of reduction in expenses varied from 77% to 92%. Even though the scope of the study was limited to the pilot project, the outcomes of the study have been found to imply considerable significance for policy development at the national level. The study indicated that instead of emphasizing on insurance coverage, the best option for obtaining prolific value on investment is to improve the basics of the public healthcare system.
After eight months of the launch of the pilot project last year, there was a considerable drop in the share of private hospitals for outpatient care. In the Viralimalai block the share dropped from 48% to 24% while in the Veppur block the reduction was from 41% to 24% and in the Shoolagiri block, the drop was from 51% to 21%. It was also observed that there is substantial reduction in the expenses by patients while accessing public healthcare facilities. The findings showed drops in expenditure for every outpatient visit such as from Rs. 351 to Rs. 26 in Viralimalai, from Rs. 395 to Rs.67 in Veppur from Rs. 261 to Rs. 59 in Shoolagiri block.
The total valuation of drugs facilitated free of cost through these sub-centres leveraging the government’s bulk procurement price was estimated to be Rs. 10.5 lakhs. This price could have been accounted as Rs. 57 lakh in accordance to current market price. Since medication is responsible for major share of out-of-pocket expenses, the provision of free medicines could foster the utilization of sub-centres by people.
