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Reports of inaccuracies in National Health Accounts estimates misleading: Health Ministry

Reports of inaccuracies in National Health Accounts estimates misleading: Health Ministry

New Delhi,  The Union Health Ministry on Friday dismissed media reports suggesting inaccuracies in National Health Accounts (NHA) especially the out-of-pocket expenditure reduction claim as "misleading and incorrect".

"The recent NHA estimates (2018-19) show a substantial reduction in out-of-pocket expenditure (OOPE), reaffirming the government's commitment towards easing the citizens' financial burden. Calling this data, a "mirage" by one expert of health economics working in a private Indian University and quoted in certain sections of media, is devoid of justification & rational basis", the ministry said in a statement.

The ministry said that National Health Accounts (NHA) provide detailed information on expenditure incurred within the health sector of the country. These estimates are crucial as they are not only a reflection of the existing health system of the country but also enable the government to monitor the progress made in different health financing indicators.

"Let's start with the questions raised on the very foundation of these estimates - National Statistical Organisation (NSO) data," said the ministry, adding that the main source of information for OOPE was based on NSO data of 2017-18 whereas the previous estimates were based on 2014. Both the surveys of the 71st and 75th rounds use the same sampling design for the selection of households so that it ensures comparability of both the rounds.

"Moreover, the 2017-18 data was a one-year survey whereas 2014 was done over a period of six months. Given that seasonality plays an important role, the 2017-18 survey was definitely more robust than the previous survey. And, while the same experts had unequivocally accepted the 2014 data, their assessment of the 2017-18 as "doubtful" is truly arbitrary," added the ministry.

Such criticism is based on flawed juxtaposition and selective picking of data to further their specious argument. Formulations like, "seems problematic/seems unlikely" as basis of a claim, is nothing if not hypothetical disagreement.

As per NSS, there has been an increase in utilisation of government facilities among those who took medical advice in the last 15 days by almost 5 per cent. In case of hospitalisation, this increase is around 4 per cent in rural areas and 3 per cent in urban areas. In case of childbirth, the share of government facilities has increased by 13 per cent in rural areas and in urban areas it has increased by 6 per cent.

Also, there has been a decline of more than 20 per cent in average medical expenditure in government facilities for hospitalisation. In case of institutional delivery, it has declined by 9 per cent in urban areas and 16 per cent in rural areas.

Some experts have also questioned the dip in hospitalisation rates, claiming to have found "no logical explanation" for the same. What they have failed to observe or acknowledge is the global shift from inpatient care to outpatient care, with many countries specifically designing policies to incentivise this shift, the ministry added.

Increase in the percentage of people seeking outpatient treatment among those who took treatment based on medical advice in the last 15 days. Among those who have taken treatment based on medical advice, the share of people seeking outpatient care has increased by almost 5 per cent. Between NSS 71st round and NSS 75th round. This increase indicates the shift towards outpatient services from inpatient services where people are substituting inpatient care with outpatient care.

The health ministry said that the ongoing criticism of NHA 2018-19, hence, is a typical prima facie example of ignoring facts and sound reason and leaving the mantle of justification to the others.

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