November 20, 2010

86% of all medical trips are made by rural Indians

The story of India's international medical tourism industry is now well known, but the first ever figures on domestic medical tourism are simply staggering. Indians made 126 million domestic trips for medical purposes, spending over Rs 23,000 crore on such trips, over the span of one year (2008-9) alone. That, incidentally, is about 30% more than the Union health budget for the same year.

But just as international migration into India largely reflects a choice of greener pastures while domestic migration is more as a result of the lack of economic opportunity in rural areas, domestic medical tourism too is largely the outcome of poor health infrastructure in rural areas and small towns. 86% of all trips taken for medical purposes are by rural Indians and the poorest spend much more proportionally.

The data is part of the National Sample Survey Organisation's (NSSO) 65th round on tourism which estimates the number and purpose of "trips" taken by persons in its representative sample of seven lakh persons as well as the expenditure on them. The survey defines a "trip" as the movement - for a period of not more than six months - by one or more household members traveling to a place outside their usual environment and return to their usual place of residence for purposes other than migration or employment and which is outside their regular routine of life.

The survey data shows that trips for 'health and medical purposes' form 7% of overnight trips for the rural population and about 3.5% for the urban population. While "social" purposes were the main reason for travel for both rural and urban residents, holidaying and leisure accounted for even less than medical travel - 2% and 5% for rural and urban India respectively. Similarly, 17% of same-day trips for in rural India and 8% in urban India were for health reasons.

While calculating the expenditure on a trip, the NSSO includes all goods and services bought or consumed by the traveler. The high cost of healthcare is borne out by the fact that trips for health and medical purposes were four times as expensive as the average trip for both rural and urban populations. Medical trips were much more expensive for the family than even shopping trips, where the money spent on purchasing goods is included in the total cost of the trip. Trips for health and medical purposes were the most expensive of all types of trips in both urban and rural sectors.

Expenditure on medical trips accounted for 30% of all overnight trip expenditure for rural India and 15% for urban. In addition, a breakdown of expenditure by Monthly Per Capita Expenditure (MPCE) classes shows that in rural India, the poorer the person, the higher the proportion of all travel expenditure that goes to medical trips.

A visit to Delhi's public hospitals only bears out these statistics. On Tuesday and Wednesday mornings, hundreds of people from all over the country thronged the two hospitals' OPDs, with ailments ranging from tuberculosis to cancerous tumours. Subhash Majhi (52) and his wife came here from Orissa's Sambalpur district last week, seeking treatment for a tumour on his back. "I did not get good treatment in Bhubaneshwar and the problem recurred. Our relatives told us that we would have to go to AIIMS," said Majhi, who is living in west Delhi with acquaintances. AIIMS alone receives 10,000 patients every day, the bulk of them from outside Delhi, AIIMS officials said.

Others have come here with no place to stay. Kanti Devi and her husband Gyanchand Kumar, both in their 30s, have left their children in the custody of their relatives in western UP's Muzaffarnagar district. "It is harvest season at home and we are losing work, but I was not getting better, so we had to come to Delhi," says Kumar, an agricultural labourer, who has come here with respiratory problems. The couple, who were in Safdarjung's OPD having just arrived in the city, planned to sleep on the streets.

Unlike in international medical tourism, where transport and accommodation expenditures also form a significant proportion of the trip's cost, three-fourth of the expenditure on a domestic medical trip is on medical expenses alone.

There were roughly 300,000 international visits into India for health treatments in 2009 and the size of the industry is estimated at Rs 8,500 crore, less than a third of domestic 'medical tourism' spending.

Link: Original Article

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