Context: Provider-created demand has been found to be a component of out-of-pocket payments and consequent financial burden. Road traffic injuries are a classic case of medical uncertainty where treatment interventions could be induced especially when the provider’s income is dependant on the quantity of care provided. The debate on the existence and form of SID continues unabated for the last three decades with no clear signs of a consensus. The paper argues that under conditions of uncertainty and imperfect competition in health care market, SID is quite likely and it is possible to detect.

No abstract

Road traffic injuries represent a classic case of economic uncertainty for households. In the context of uncertainty, choice of health care facilities and care seeking process is interest of perennial concern. Understanding the injury care seeking process forms the central objective of the paper. It also tries to narrate the process of seeking care between different providers of care, levels of care and duration of treatment, determinants of choice of health care etc. The study utilised primary data collected from the injured (302 cases) who were discharged from selected public and private health facilities from three districts of Kerala, India. The injured had 488 overall interactions with medical care institutions/personnel yielding an average number of 1.6 interactions per injured person; 60.2 per cent of the interactions were accounted by public health care institutions with 54 per cent of the injured choosing them as their first point of contact. Length of treatment at different health facilities by the injured indicate that more than 70 per cent were treated as outpatient (including observation cases) and the rest were prescribed hospitalized treatment at the first pint of contact. Share of public sector health care institutions treating mild, moderate and severe injuries is 55.5 per cent, 54.6 per cent and 48.6 per cent respectively. In sum, public sector is the preferred choice of injury care seeking for moderate and severe road traffic injuries (cost of treatment, poor economic status) while mild injuries are primarily accounted for by the private sector.