Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis

Mwabu, Germano; Ainsworth, Martha; Nyamete, Andrew

doi:10.2307/146295

Cited by 176 publications

(163 citation statements)

References 22 publications

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“…Coffey [3] found similar results on ambulatory female medical care services and other authors have come to similar conclusions [49,50]. Concerning the positive travel time elasticity in both latent classes, this result also contradicts other empirical findings [1,2,5,51], although some other studies report that the utilization does not respond to travel time [52]. It should be noted, however, that most of these studies use discrete choice models to explain the choice of the medical provider and we used a total utilization variable.…”

Section: Time Costsmentioning

confidence: 68%

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Lourenço¹,

Ferreira²

2005

Health Economics

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SummaryThe impact of time costs on the utilization of medical care has been a subject of theoretical and empirical research since the early 1970s.The main goal of this paper is to show the effect of time costs on the number of visits to general practitioners (GP) in Portuguese public health centres. We measured the elasticity of primary health care utilization relative to the total time spent in the health centre and relative to travel time. We also provided evidence regarding the impact of an appointment delay on the utilization of public GP services.Our data resulted from the application of an endogenous sampling scheme, resulting in a truncated-at-zero data set. To model our dependent variable, number of visits, and accounting for the truncated nature of the data we used a finite mixture model specification.The data were obtained from the most recent implementation in Portugal of the 2003/2004 Europep Survey. The two-component negative binomial II finite mixture model led to the identification of two different latent classes of health centre users: a low-users class that comprises 88% of patients with an estimated utilization mean of 4.3 GP visits per year and a frequent-users class with an estimated utilization mean of 11.1 visits for the remaining 12% of the population.We failed to find any statistically significant elasticity of time cost utilization, when this variable is measured as the total time spent in the health centre. Regarding the effect of an appointment delay on health centre utilization we concluded that individuals respond to this variable by lowering the number of GP visits. This last finding may have policy implications, which will be discussed at the end of the paper.

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Section: Time Costsmentioning

confidence: 68%

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Lourenço¹,

Ferreira²

2005

Health Economics

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“…travel time) [21,23], access to a health care facility [24], quality of care [25], and epidemiological factors such as the prevalence of different malaria species and immunity levels. Evidence from Malawi [3] indicates that expenditure on malaria treatment can be highly regressive, consuming a much higher proportion of income in the poorest households.…”

Section: Alternative Malaria Treatments and Factors Affecting Choice mentioning

confidence: 99%

“…For example, the direct costs of treatment amounted to 28% of household income amongst low-income households and 2% amongst the rest. Mwabu et al [25] found that increase in household income shifts demand from the informal health care sector to the modern sector, with much of this demand ending up in private and mission-run clinics. Health care demand decreases with user fees and with greater distance to a health care facility, but increases with income.…”

Section: Alternative Malaria Treatments and Factors Affecting Choice mentioning

confidence: 99%

“…Health care demand decreases with user fees and with greater distance to a health care facility, but increases with income. Following Acton's [23] ground breaking work demonstrating the important role that time plays in the rationing of medicals services, several studies [5,20,21,[25][26][27][28] have reported the significant effect of time price on the demand for medical services.…”

Section: Alternative Malaria Treatments and Factors Affecting Choice mentioning

confidence: 99%

“…Unlike previous developing country studies that consider general outpatient demand [21,[25][26][27][29][30][31], this study considers a single disease -malaria. The study also differs from previous studies on malaria care demand [5,24,32] by comparing the behavior of rural and urban communities where the full range of treatment options are available.…”

Section: Alternative Malaria Treatments and Factors Affecting Choice mentioning

confidence: 99%

See 2 more Smart Citations

A study of malaria care provider choice in Ghana

Dzator

Asafu‐Adjaye

2004

Health Policy

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A mixed logit model of health care provider choice: analysis of NSS data for rural India

Borah

2006

Health Econ.

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In order to address the persistent problems of access to and delivery of health care in rural India, a better understanding of the individual provider choice decision is required. This paper is an attempt in this direction as it investigates the determinants of outpatient health care provider choice in rural India in the mixed multinomial logit (MMNL) framework. This is the first application of the mixed logit to the modeling of health care utilization. We also use the multiple imputation technique to impute the missing prices of providers that an individual did not visit when she was ill. Using data from National Sample Survey Organization of India, we find the following: price and distance to a health facility play significant roles in health care provider choice decision; when health status is poor, distance plays a less significant role in an adult's provider choice decision; price elasticity of demand for outpatient care varies with income, with low-income groups being more price-sensitive than high-income ones. Furthermore, outpatient care for children is more price-elastic than that for adults, which reflects the socio-economic structure of a typical household in rural India where an adult's health is more important than that of a child for the household's economic sustenance.

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Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis

Cited by 176 publications

References 22 publications

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

A study of malaria care provider choice in Ghana

A mixed logit model of health care provider choice: analysis of NSS data for rural India

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