IDEAS home Printed from https://ideas.repec.org/p/sch/wpaper/317.html
   My bibliography  Save this paper

Healthcare utilisation behaviour in India: Socio-economic disparities & the effect of health insurance

Author

Listed:
  • Sahoo, Anil Kumar
  • Madheswaran, S

    (Institute for Social and Economic Change)

Abstract

The purpose of this paper is to probe issues such as inequality in healthcare utilisation, impoverishment due to increasing out-of-pocket (OOP) health expenditure, growing dependence on informal sources of healthcare and strengthening the role of insurance, which has been gaining importance within the healthcare systems in low and middle-income countries, including India. The provision of health insurance (HI) is seen as one of the major agendas for policy makers for ensuring universal health coverage. However, little is known at the aggregate level whether HI leads to a change in the way healthcare facilities are used in India. Hence, this paper will analyse the impact of HI on healthcare utilisation behaviour of individuals using the nationally representative data of the Indian Human Development Survey (IHDS) 2004-05. Logit, Tobit and Multinomial Logit Models have been used to analyse the impact of HI along with socio-economic factors on healthcare utilisation behaviour. We found that in Logistic Regression health insurance does not have any statistically significant impact on utilisation behaviour whereas in Tobit and Multinomial Logit we found it to be significant. Nonetheless, the coefficients of health insurance status in different models show positive signs. This implies that insurance increases the probability of healthcare seeking behaviour. It is also found that insurance increases the probability of healthcare either in the private or in the public sector. However, people tend to use the private sector more than the public sector. However, in India the private sector is largely unregulated and very often it leads to unnecessary care and cost escalation. Therefore, on the policy perspective it will be wise on the part of government to bring in a sound regulatory mechanism to control the private sector to ensure the efficient functioning of the health insurance sector for the benefit of the insured people. The government should also educate the people about the benefits of health insurance and persuade the private sector to educate their insured members holistically about their insurance product.

Suggested Citation

  • Sahoo, Anil Kumar & Madheswaran, S, 2014. "Healthcare utilisation behaviour in India: Socio-economic disparities & the effect of health insurance," Working Papers 317, Institute for Social and Economic Change, Bangalore.
  • Handle: RePEc:sch:wpaper:317
    as

    Download full text from publisher

    File URL: http://www.isec.ac.in/WP%20317%20-%20Amit%20Kumar%20Sahoo_1.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. S V Subramanian & George Davey Smith & Malavika Subramanyam, 2006. "Indigenous Health and Socioeconomic Status in India," PLOS Medicine, Public Library of Science, vol. 3(10), pages 1-11, October.
    2. David H. Peters & Abdo S. Yazbeck & Rashmi R. Sharma & G. N. V. Ramana & Lant H. Pritchett & Adam Wagstaff, 2002. "Better Health Systems for India's Poor : Findings, Analysis, and Options," World Bank Publications - Books, The World Bank Group, number 14080, December.
    3. Onwujekwe, Obinna, 2005. "Inequities in healthcare seeking in the treatment of communicable endemic diseases in Southeast Nigeria," Social Science & Medicine, Elsevier, vol. 61(2), pages 455-463, July.
    4. Hugh R. Waters, 1999. "Measuring the impact of health insurance with a correction for selection bias-a case study of Ecuador," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 473-483.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Subramanian, S.V. & Subramanyam, Malavika A. & Selvaraj, Sakthivel & Kawachi, Ichiro, 2009. "Are self-reports of health and morbidities in developing countries misleading? Evidence from India," Social Science & Medicine, Elsevier, vol. 68(2), pages 260-265, January.
    2. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    3. Dayashankar Maurya, 2019. "Understanding public health insurance in India: A design perspective," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1633-1650, October.
    4. Ralf Krumkamp & Nimako Sarpong & Benno Kreuels & Lutz Ehlkes & Wibke Loag & Norbert Georg Schwarz & Hajo Zeeb & Yaw Adu-Sarkodie & Jürgen May, 2013. "Health Care Utilization and Symptom Severity in Ghanaian Children – a Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    5. Rama Pal, 2012. "Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 63-85, March.
    6. Alok Bhargava & Sadia Chowdhury & K. K. Singh, 2006. "Healthcare infrastructure, contraceptive use and infant mortality in Uttar Pradesh, India," World Scientific Book Chapters, in: Econometrics, Statistics And Computational Approaches In Food And Health Sciences, chapter 23, pages 319-335, World Scientific Publishing Co. Pte. Ltd..
    7. Bonu, Sekhar & Rani, Manju & Jha, Prabhat & Peters, David H. & Nguyen, Son Nam, 2004. "Household tobacco and alcohol use, and child health: an exploratory study from India," Health Policy, Elsevier, vol. 70(1), pages 67-83, October.
    8. Hidayat, Budi, 2007. "Are there differences between unconditional and conditional demand estimates? implications for future research and policy," MPRA Paper 30196, University Library of Munich, Germany.
    9. Jayanta Kumar Bora & Rajesh Raushan & Wolfgang Lutz, 2019. "The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    10. Sonia Bhalotra, 2007. "Spending to save? State health expenditure and infant mortality in India," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 911-928, September.
    11. Swati Dutta, 2022. "Risk factors for child survival among tribal dominated states in India: a pooled cross sectional analysis," Journal of Population Research, Springer, vol. 39(3), pages 391-416, September.
    12. Anthony K Ngugi & Felix Agoi & Megan R Mahoney & Amyn Lakhani & David Mang’ong’o & Esther Nderitu & Robert Armstrong & Sarah Macfarlane, 2017. "Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-12, February.
    13. Rama Pal, 2010. "Analysing Catastrophic OOP Health Expenditure in India: Concepts, Determinants and Policy Implications," Working Papers id:2420, eSocialSciences.
    14. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    15. Salem Deenadayalan Vaishnavi & Umakant Dash, 2009. "Catastrophic payments for health care among households in urban Tamil Nadu, India," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 169-184.
    16. Adam Wagstaff, 2010. "Estimating health insurance impacts under unobserved heterogeneity: the case of Vietnam's health care fund for the poor," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 189-208, February.
    17. Kulbhushan Balooni & Kausik Gangopadhyay & Sudeep Turakhia & R.G. Karthik, 2012. "Challenges in the Sustainability of a Targeted Health Care Initiative in India," IIM Kozhikode Society & Management Review, , vol. 1(1), pages 21-32, January.
    18. Gotsadze, George & Zoidze, Akaki & Vasadze, Otar, 2005. "Reform strategies in Georgia and their impact on health care provision in rural areas: evidence from a household survey," Social Science & Medicine, Elsevier, vol. 60(4), pages 809-821, February.
    19. Peters, David H. & Muraleedharan, V.R., 2008. "Regulating India's health services: To what end? What future?," Social Science & Medicine, Elsevier, vol. 66(10), pages 2133-2144, May.
    20. De Costa, Ayesha & Diwan, Vinod, 2007. "`Where is the public health sector?': Public and private sector healthcare provision in Madhya Pradesh, India," Health Policy, Elsevier, vol. 84(2-3), pages 269-276, December.

    More about this item

    Keywords

    Health; Healthcare behaviour-India;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sch:wpaper:317. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: B B Chand (email available below). General contact details of provider: https://edirc.repec.org/data/iseccin.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.