GOVERNMENT OF MAHARASHTRA A REPORT ON ‘MORBIDITY AND HEALTH CARE’ BASED ON DATA COLLECTED IN CENTRAL, STATE AND POOLED SAMPLES OF 60TH ROUND OF NATIONAL SAMPLE SURVEY (JANUARY – JUNE, 2004) Directorate of Economics and Statistics, Planning Department, Government of Maharashtra, Mumbai PREFACE The Directorate of Economics and Statistics has prepared a report on ‘Morbidity and Health Care’ based on the data of state, central & pooled (central & state) samples collected in the 60th round (January – June, 2004) of National Sample Survey. 2. The report contains important findings of the survey in ‘Executive Summary’ while detailed results are given in ‘Survey Findings’. 3. I hope the results of this survey will be useful to senior officers of the Government involved in policy framing, researchers, economists and academicians. (Smt. S.R.Mehta) Additional Director Mumbai: Director of Economics and Statistics, Date: June, 2010 Planning Department, Government of Maharashtra P.H.Bhagoorkar Deputy Director Team associated with report: S.R. Shingade, Statistical Officer CONTENTS Sr. No. Description Page No. (1) (2) (3) 1 Executive Summary 1 2 Survey Findings 2 3 Annexure I : Procedure of pooling 19 4 Annexure II : List of tables 21 Chapter – One EXECUTIVE SUMMARY The pooled estimates based on the central and state samples taken together for the survey on ‘Morbidity and Health Care’ done under the 60th round of National Sample Survey (January – June, 2004) show that the percentage of ailing persons is 6.3 for the rural areas of the state, being 5.7 percent for men and 6.9 percent for females. The same is 7.9 percent for urban areas of the state, being 7.5 and 8.5 percent respectively for men and women. Survey findings 1. The average household size is found to be 4.8 and 4.3 persons respectively for the rural and urban areas of the state. Aurangabad division has the highest (5.1) household size in rural while Nashik and Amravati have the highest (5.0) household size in the urban areas. 2. The sex ratio is observed to be 967 and 904 for rural and urban areas of the state respectively. Konkan division ranks first with sex ratio of 1026 in rural areas while Amravati division ranks first with sex ratio of 969 in urban areas of the state. In all the divisions, the rural areas fair better than the urban areas as far as the sex ratios are concerned. 3. The percentage of ailing persons (PAP) is in general higher for females than men. In Konkan division, the PAP for females is found to be very high at 13.4 in rural and 11.9 in urban areas. 4. The proportion of persons reporting commencement (PPC) of ailment during last 15 days is lower in rural areas (2.9) compared to urban areas (3.6) of the state. However, the same is not true for sub-state level estimates. 5. The average medical expenditure per hospitalization case in the state is found to be Rs. 6538 for rural and Rs. 9477 for urban areas. This particular expenditure is highest in Pune division for rural and in Konkan division for urban areas. 6. The average total expenditure per treated person during last 15 days in the state is Rs. 270 for rural and Rs. 332 for urban areas. This particular expenditure is found to be highest in Aurangabad division (Rs. 375) for rural areas and Amravati division (Rs. 461) for urban areas. -- X -- Page | 1 \\a47\soat\Final Reports\Report\STATE\morbpooled(180610).doc Chapter – Two SURVEY FINDINGS Introduction 2.1 An enquiry on morbidity and health care was conducted in the 60th round (January – June, 2004) of National Sample Survey. It covered the curative aspects of the general health care system and also the utilization of health care services provided by the public and private sector together with the expenditure incurred by the households for availing these services. The present report is based on the survey results of central, state and the pooled (central + state together) samples. 2.2 Detailed tables on which the report is based are separately presented in Volume II and are listed in Annexure II. The procedure of pooling is presented in Appendix I which is a standard procedure. A detailed report based on the state sample data is separately prepared and published on the website of the Directorate of Economics and Statistics, Maharashtra. Sample Size 2.3 The sample sizes are presented for the first stage units (FSU viz. villages/urban frame survey blocks) as well as ultimate stage units (USU viz. households) in table 1 and table 2 respectively, separately for revenue divisions and districts. The sample size in terms of FSUs at the revenue division level is found to be fairly sufficient. However, at the district level, it is seen that even after pooling of both the samples, the districts Sindhudurg, Nandurbar, Hingoli, Parbhani, Akola, Washim, Wardha, Bhandara, Gondiya and Gadchiroli have less number of FSUs (less than 15 villages) in the rural areas while Raigad, Ratnagiri, Sindhudurg, Satara, Ahmadnagar, Nandurbar, Hingoli, Parbhani, Jalna, Bid, Latur, Osmanabad, Buldhana, Akola, Washim, Yavatmal, Wardha, Bhandara, Gondiya, Gadchiroli and Chandrapur districts have less number of FSUs (less than 15 UFS blocks) in the urban areas. This may be due to the sampling design used for selection of units for this round. In the rural areas, apart from two special strata, each district of the state has been treated as a separate stratum. But for the urban areas, strata were formed within each NSS region (which are based on agro-climatic conditions and are slightly different from the revenue divisions) on the basis of size class of towns as per Population Census 2001. The details may be seen in the Volume II of the state sample report on the same subject separately published on Directorate’s website. Although there is not much gain in sample size at district level for these districts, the region level sample size after pooling of the state and central sample data may be treated as sufficient for generating region level estimates. Similar is the situation in the case of USUs i.e. sample number of households in both the rural and urban areas. Therefore, districtwise estimates for above mentioned districts are not provided in the report. Page | 2 \\a47\soat\Final Reports\Report\STATE\morbpooled(180610).doc Table 1A Divisionwise Sample size: Number of first stage units (Villages/urban frame survey blocks) Division Rural Urban State Central Pooled State Central Pooled Konkan 28 28 56 180 115 295 Pune 62 61 123 79 50 129 Nashik 57 58 115 45 30 75 Aurangabad 55 56 111 36 24 60 Amravati 34 32 66 27 21 48 Nagpur 32 30 62 41 27 68 State 268 265 533 408 267 675 Table 1B Districtwise Sample size: Number of first stage units (Villages/urban frame survey blocks) District Rural Urban State Central Pooled State Central Pooled Thane 8 8 16 56 36 92 Mumbai N o t ap p l i c a b l e 116 75 191 Raigad 8 8 16 5 2 7 Ratnagiri 8 8 16 2 2 4 Sindhudurg 4 4 8 1 - 1 Pune 17 16 33 41 27 68 Solapur 13 12 25 18 6 24 Satara 12 12 24 3 3 6 Kolhapur 12 13 25 7 9 16 Sangli 8 8 16 10 5 15 Ahmadnagar 16 17 33 5 6 11 Nandurbar 4 4 8 4 - 4 Dhule 8 8 16 11 4 15 Jalgaon 13 12 25 8 8 16 Nashik 16 17 33 18 14 32 Nanded 8 8 16 11 4 15 Hingoli 6 6 12 2 - 2 Parbhani 2 2 4 3 2 5 Jalna 8 8 16 3 3 6 Aurangabad 8 8 16 9 7 16 Bid 8 8 16 2 5 7 Latur 8 8 16 5 2 7 Osmanabad 7 8 15 1 1 2 Buldhana 8 8 16 5 1 6 Akola 7 3 10 10 2 12 Washim 1 5 6 - 1 1 Amravati 8 8 16 9 14 23 Yavatmal 10 8 18 3 3 6 Wardha 4 4 8 6 1 7 Nagpur 8 7 15 23 14 37 Bhandara 3 5 8 2 3 5 Gondiya 5 3 8 2 1 3 Gadchiroli 4 4 8 1 1 2 Chandrapur 8 7 15 7 7 14 State total 268 265 533 408 267 675 Page | 3 \\a47\soat\Final Reports\Report\STATE\morbpooled(180610).doc Table 2A Divisionwise Sample size: Number of ultimate stage units (households) Division Rural Urban State Central Pooled State Central Pooled Konkan 280 280 560 1,798 1,146 2,944 Pune 612 610 1,222 789 500 1,289 Nashik 570 580 1,150 448 300 748 Aurangabad 550 560 1,110 360 240 600 Amravati 334 320 654 270 210 480 Nagpur 320 300 620 408 268 676 State 2,666 2,650 5,316 4,073 2,664 6,737 Table 2B Districtwise Sample size: Number of ultimate stage units (households) District Rural Urban State Central Pooled State Central Pooled Thane 80 80 160 560 358 918 Mumbai Not applicable 1,158 748 1,906 Raigad 80 80 160 50 20 70 Ratnagiri 80 80 160 20 20 40 Sindhudurg 40 40 80 10 - 10 Pune 162 160 322 409 270 679 Solapur 130 120 250 160 60 240 Satara 120 120 240 30 30 60 Kolhapur 120 130 250 70 90 160 Sangli 80 80 160 100 50 150 Ahmadnagar 160 170 330 50 60 110 Nandurbar 40 40 80 40 - 40 Dhule 80 80 160 98 20 118 Jalgaon 130 120 250 80 80 160 Nashik 160 170 330 180 140 320 Nanded 80 80 160 110 40 150 Hingoli 60 60 120 20 - 20 Parbhani 20 20 40 30 20 50 Jalna 80 80 160 30 30 60 Aurangabad 80 80 160 30 30 60 Bid 80 80160 20 50 70 Latur 80 80 160 50 20 70 Osmanabad 70 80 150 10 10 20 Buldhana 80 80 160 50 10 60 Akola 70 30 100 100 20 120 Washim 10 50 60 - 10 10 Amravati 80 80 160 90 140 230 Yavatmal 94 80 174 30 30 160 Wardha 40 40 80 60 10 70 Nagpur 80 70 150 228 140 368 Bhandara 30 50 80 20 29 49 Gondiya 50 30 80 20 9 29 Gadchiroli 40 40 80 10 10 20 Chandrapur 80 70 150 70 70 140 State total 2,666 2,650 5,316 4,073 2,664 6,737 Page | 4 \\a47\soat\Final Reports\Report\STATE\morbpooled(180610).doc Household Size 2.4 In the survey of morbidity and health care, age and sex particulars of each of the member of the sample household were recorded.