Abstract
Introduction: The growing older adults’ population is associated with increasing chronic disease prevalence and inequitably distributed healthcare expenditure. The primary aim was to estimate average monthly healthcare expenditure among older adults and explore equity or inequity in its distribution.
Methods: We conducted a secondary analysis of cross-sectional data from 400 adults aged≥60 years in Raipur, India. Self-reported healthcare expenditure over the preceding six months was averaged to obtain monthly healthcare expenditure and compared across PROGRESS and PROGRESS-Plus factors, with adjustment for comorbidities and depression. Information on insurance, reimbursement, and source of payment was unavailable.
Results: Mean monthly healthcare expenditure was INR 763.15 (SD 967.36). Expenditure was significantly higher among participants with depression than among those without depression (adjusted mean difference: INR 868.4; 95% CI: 699.5–1037.3; P<.001). Depression scores showed a moderate positive correlation with expenditure (Spearman’s ρ=0.674; P<.001).
Conclusion: Among older adults residing in the urban slum studied, monthly healthcare expenditure differed across several equity-relevant characteristics, while depression was strongly associated with higher expenditure. These findings indicate potentially important expenditure inequalities; however, incomplete measurement of healthcare need precludes definitive attribution of the observed differences to inequity.