Healthcare Expenditure and Household Financial Hardship among Public and Private Hospital Patients in Haryana

Abstract

Treatment payments can disrupt household needs even when a hospital bill appears modest. Financial responses from 350 adult patients in five Haryana districts were examined through expenditure summaries, household coping responses and reported facility-clustered models. Mean combined reported payments were ₹1,269.14 in the public group and ₹3,359.14 in the private group. Public patients spent more on outside medicines and tests, while private patients paid more at the hospital. Financial hardship affected 127 patients, or 36.29%; 103 reduced essential household spending and 75 borrowed money. Private-sector use was associated with ₹1,859.46 higher payments after adjustment. Income below ₹20,000 was associated with higher hardship odds, whereas named scheme coverage was associated with lower odds. The payment-hardship association did not remain significant under the four-outcome Holm adjustment. Priorities include dependable medicine supplies, clear billing and assistance for financially vulnerable families. Future monitoring should connect payments with household circumstances over time.