The role of the public and private sectors in responding to older persons? needs for inpatient care: Evidence from Kerala, India

The Indian State of Kerala – known for its remarkable achievements in improving the health of its inhabitants – is now facing several challenges due to population ageing, which is coupled with a tremendous increase in chronic non-communicable diseases among older persons. This has resulted in great demand for inpatient care among older persons. Against this backdrop, an attempt is made in this article to understand the demand for inpatient care by older persons and to examine its implications in terms of direct and indirect monetary costs. The article uses India’s National Sample Survey data for Kerala. Results show that demand for inpatient care among older persons is heavily dependent on economic status, although the differences in utilization between the elderly and non-elderly in each income group are not significant. On average, the cost of inpatient care is higher for older persons when compared with other age cohorts, leading to a consequent greater loss of household income, especially for older persons belonging to poor households. It is concluded that the public health sector will not be able to address the health-care needs of poor older persons and that there is a need to evaluate and promote the capacity of the private health sector in meeting this need.