Bypassing health providers : the quest for better price and quality of health care in Chad
AbstractThis paper investigates individuals'bypassing behavior in the health sector in Chad and the determinants of individuals'facility choice. The authors introduce a new way to measure bypassing using the patients'own knowledge of alternative health providers available to them instead of assuming that information as previously done. The authors analyze how perceived health care quality and prices impact patients'bypassing decisions. The analysis uses data from a Quantitative Service Delivery Survey in Chad's health sector carried out in 2004. The survey covers 281 primary health care centers and 1,801 patients. The matching of facility data and patient data allows the analysis to control for a wide range of important patient and facility characteristics, such as income, severity of illness, quality of health care, or price of services. The findings show that income inequalities translate into health service inequalities. There is evidence of two distinct types of bypassing activities in Chad: (1) patients from low-income households bypass high-quality facilities they cannot afford to go to low-quality facilities, and (2) rich individuals bypass low-quality facilities and aim for more expensive facilities that also offer a higher quality of care. These significant differences in patients'facility choices are observed across income groups as well as between rural and urban areas.
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Bibliographic InfoPaper provided by The World Bank in its series Policy Research Working Paper Series with number 4462.
Date of creation: 01 Jan 2008
Date of revision:
Health Monitoring&Evaluation; Health Systems Development&Reform; Health Law; Housing&Human Habitats; Gender and Health;
Other versions of this item:
- Gauthier, Bernard & Wane, Waly, 2011. "Bypassing health providers: The quest for better price and quality of health care in Chad," Social Science & Medicine, Elsevier, vol. 73(4), pages 540-549, August.
- NEP-AFR-2008-01-12 (Africa)
- NEP-ALL-2008-01-12 (All new papers)
- NEP-DEV-2008-01-12 (Development)
- NEP-HEA-2008-01-12 (Health Economics)
- NEP-KNM-2008-01-12 (Knowledge Management & Knowledge Economy)
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
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- Lourdes Diaz Olvera & Didier Plat & Pascal Pochet, 2011. "Se déplacer pour se soigner. Pratiques et obstacles à Conakry et Douala," Post-Print halshs-00733353, HAL.
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