This paper attempts to find out the correlates of health shock vulnerabilities for in-patient care seekers and understanding the process through which the impact of immediate determinants change after controlling for different basic and underlying factors in West Bengal, India. Ordinary probit and instrumental variable probit regression methods are used to analyze the primary data, collected through a household survey from three districts of West Bengal in 2007. A total of 3150 households with 565 cases on information of status deterioration due to the incidence of hospitalization are considered as the subject of interest. A total of 71 percent experienced status deterioration after incurring medical expenditure due to hospitalization. Vulnerability to status deterioration is observed higher for the poor. Similar risks are also noticed in case of unemployed or marginally employed workers, for the households that reported having considerable burden of existing debts and for illiterate individuals. Income loss resulting due to absence from work due to hospitalization is not a significant cause of vulnerability. It is mainly because of the absence of social protection, a household has to compromise its monthly consumption to meet the medical expenditure for hospitalization. Since absence of social protection is one main reason of becoming vulnerable due to health shocks, efforts should be made to increase the social protection through some community initiative. Specific focus needs to be given to the poor to protect them against higher risks of status deterioration during post-hospitalization phases.
Future Health Systems Working Paper III, India Series, 24 pp.