. The services to be included at the district hospitals
include general and specialist out-patient department (OPD), inpatient
department (IPD) and emergency services; laboratory and
diagnostic services; preventive services and; other administrative
and support services. These services were applicable to serve all
sections, and were defined after stratification of hospitals according
to number of beds, i.e. 100, 200, 300, 400 and 500 [22].
Disease Burden Estimation. Morbidity rates were derived
from National Sample Survey (NSS) data (2004–05) for India to
estimate the probability of falling ill and reporting to hospital to
receive medical care on a monthly basis [10]. Morbidity rate
derived from NSS data was increased by a factor of 1.5, to
develop a conservative estimate of patient need. This incremental
factor was applied considering that there would be increased
demand for services following a reform, whereby no price is
attached to service delivery (Text S1). NSS data from 60th round
(2004–05) shows that about 30% of those who did not access
curative service following an illness, cite financial reasons for not
seeking treatment for a given episode of illness [6]. We believe
that this 30% of non-users would also start using treatment
services.