Social connections and tertiary health‐care utilization

Abstract

The use of tertiary health care by socially proximate peers helps individuals learn about program and treatment procedures, signals that using such care is socially appropriate, and could support the use of formal health care, all of which could increase program utilization. Using complete administrative claims data from a publicly financed tertiary care program in India, we estimate that the elasticity of first‐time claims with respect to claims by members of caste groups within the village is 0.046, with smaller effects of more socially distant individuals. The point elasticity of inpatient care expenditure with respect to claims filed by the same group in village peers in the previous quarter is −0.035. We find support for an information channel as peers increase awareness of the program and its features. Our findings have implications for the development of network‐based models to determine health‐care demand, as well as in use of network‐based targeting to boost tertiary health‐care utilization.

Caste, Social Networks and Variety Adoption

“…In this paper, we use the approach of ‘ random matching within samples’ to measure social networks (Conley & Udry 2010; Maertens 2010; Maertens & Barrett 2012; Santos & Barrett 2010). This method can also lead to an omitted variable bias if an important node of a network is ignored by the random matching.…”

“…The author cautions that ignoring these interactions between farmers could lead one to overestimate the effect of household characteristics on adoption decisions. In a similar study, Conley and Udry (2010) found that in the case of pineapple cultivation in Ghana, farmers adjust their inputs in accordance with information from neighbours who were successful in earlier periods. The authors highlight the importance of social learning, and the network connections through which information flows, in farmers’ cultivations decisions.…”

“…The Indian caste system is a system of closed social stratification and occupational transmission through generations, wherein a person's status in society is largely based on the caste into which he or she is born (Debnath & Jain, 2015). Freitas (2006) mentions that a caste possesses five characteristics: occupational specialization, purity scale, hierarchy, commensality and ascription.…”

“…In our study, we have classified the farmers into these four groups. We have also used a 5th category, 'Minority', 1 which consists of all those who belong to non-Hindu religious groups (Debnath & Jain, 2015).…”

“…Social transactions such as marriage (Bidner & Eswaran, 2015;Debnath & Jain, 2015) and economic transactions such as risk pooling and investments (Banerjee & Munshi, 2004;Ligon, 1998) also tend to be concentrated within the sub-caste. Desai and Dubey (2011) argue that a social structure based on caste has over the years translated into unequal access to land, education, business ownership and occupation.…”