The objectives of our study were to examine the (1) trends and patterns of caesarean deliveries in India and; (2) differentials in catestrophic household expenditure on caesarean deliveries. The paper used data from 71st round of the National Sample Survey, India. The analysis included 14,310 women, hospitalised for delivery during the last 365 days preceding the survey. The proportion of caesarean sections among institutional deliveries in India was 2.5% in 1992–1993, which increased to 23.9% in 2014. In private facilities, 47.8% deliveries were conducted through caesarean section, while in public facilities, this proportion was 8%. OOPE per delivery was US$157 which was 64.9% of the total cost of maternal health care. OOPE varied by type of delivery; US$283 for caesarean and US$77 for non-caesarean delivery. About 60% of households incurred the expenditure on caesarean section exceeding 40% of their capacity to pay. The incidence of catastrophic delivery expenditure declined with increased education and per-capita expenditure. Caesarean delivery in private facilities and a hospital stay of more than 48 h increased the chances of catastrophic expenditure. Interventions and regulations are necessary for both public and private sector to check unwarranted caesarean deliveries and hospital stays to reduce catastrophic expenditure.

中文翻译：

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印度剖腹产的家庭灾难性支出

我们研究的目的是检验（1）印度剖腹产的趋势和模式；以及 （2）剖宫产分门别类的家庭支出差异。该论文使用了来自印度国家抽样调查第71轮的数据。分析包括14310名妇女，她们在调查前的最后365天住院分娩。在1992–1993年间，剖宫产在机构分娩中所占的比例为2.5％，在2014年增加到23.9％。在私人机构中，剖宫产分娩的比例为47.8％，而在公共机构中，这一比例为8％。每次分娩的OOPE为157美元，占孕产妇保健总费用的64.9％。OOPE因交付类型而异；剖腹产为283美元，非剖腹产为77美元。大约60％的家庭在剖腹产方面的支出超过了其支付能力的40％。随着教育和人均支出的增加，灾难性交付支出的发生率有所下降。在私人机构中剖腹产和住院超过48小时增加了灾难性支出的机会。公共部门和私营部门都必须采取干预措施和法规，以检查不必要的剖腹产和住院时间，以减少灾难性支出。