Journal of the Academy of Hospital Administration, Volume 30, No. 2 July-December, 2018 5 ABSTRACT Introduction An estimated 29.5% population in India lives below poverty line. With meagre 1.2% of Gross Domestic Product government spending on health and necessary evil of user charges to fund healthcare in developing countries, out of pocket catastrophic expenditures restrict access at point of tertiary care due to non-affordability despite government schemes. This study explored the system established by hospital administration for waiver of user charges for poor indigent patients. Methods A descriptive and ambi-spective study was done in an apex referral public hospital in India. Direct observations and interviews with key stakeholders were conducted to study exemption model. Disease profile of in-patients needing financial assistance and utilisation of surgical consumables provided free were prospectively studied for six months. Results On request from treating doctors, waiver of user charges were authorized by hospital administrators through socio-economic assessment by medical social officers (both available at all times). All requests were honoured irrespective of documentary evidence of poverty. Waiver for surgical consumables was 27100 rupees (427 dollars) per patient and 837 rupees (13 dollars) per patient per day. Most prevalent were cancers (35.92%) and kidney diseases (24.65%). These poor patients had longer length of stay (22.3 days). Majority belonged to Bihar and Uttar Pradesh states. Conclusions The model, which can be adopted in similar settings, demonstrated increased access as all requests were honoured. Financial expenditures revealed can help in budget projections. Disease profile and types of consumables revealed can be used as basis for strengthening healthcare delivery systems of referring states. INTRODUCTION Health Expenditure Affordability is an important dimension of access to healthcare. (1) With a meagre Government spending of 1.2% of Gross Domestic Product (GDP) on health (2) and necessity of user charges in developing countries (3) (4), out of pocket expenditure is a major healthcare financing mechanism (5). Households use loans or mortgages and sell assets or livestock to meet out of pocket health spending (6) (7) (8) (9). To worsen the situation, there is an estimated 29.5% population living below poverty line (BPL) in India. (10) (11) Balasubramanian et al found that the poorest 20% population also coped through borrowing money and the prevalence of catastrophic expenditure was 5.6% in patients undergoing surgeries in Haryana state of India. (12) Prinja et al had earlier found significantly higher prevalence of catastrophic health Original Article “ENHANCING HEALTHCARE ACCESS FOR POOR PATIENTS THROUGH FINANCIAL WAIVER AT POINT OF CARE, THE MODEL, UTILIZATION AND DISEASE PROFILE IN AN APEX TERTIARY CARE PUBLIC HOSPITAL IN INDIA” M. Kausar*, Mahesh R.**, D.K. Sharma*** * Senior Resident, Department of Hospital Administration, All India Institute of Medical Sciences (AIIMS), Room No. 6-A, Ground floor. Old Private Ward Block, New Delhi-29, Email-dr.mohammad.kausar@gmail.com ** Associate Professor, Department of Hospital Administration, All India Institute of Medical Sciences (AIIMS), Room No. 5-A, Ground floor. Old Private Ward Block, New Delhi-29, E-mail address: maheshbelagere@gmail.com *** Medical Superintendent, All India Institute of Medical Sciences (AIIMS), New Delhi-29, Email-123dks@gmail.com Keywords : Length of Stay; Health Expenditure; Poverty; User fee; Waivers