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Expanding health insurance to increase health care utilization: Will it have different effects in rural vs. urban areas?

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  • Erlyana, Erlyana
  • Damrongplasit, Kannika Kampanya
  • Melnick, Glenn

Abstract

Objectives This study investigates the importance of medical fee and distance to health care provider on individual's decision to seek care in developing countries.Methods The estimation method used a mixed logit model applied to data from the third wave of the Indonesian family life survey (2000). The key variables of interest include medical fee and distance to different types of health care provider and individual characteristic variables.Results Urban dweller's decision to choose health care providers are sensitive to the monetary cost of medical care as measured by medical fee but they are not sensitive to distance. For those who reside in rural area, they are sensitive to the non-medical component cost of care as measured by travel distance but they are not sensitive to medical fee.Conclusions As a result of those findings, policy makers should consider different sets of policy instruments when attempting to expand health service's usage in urban and rural areas of Indonesia. To increase access in urban areas, we recommend expansion of health insurance coverage in order to lower out-of-pocket medical expenditures. As for rural areas, expansion of medical infrastructures to reduce commuting distance and costs will be needed to increase utilization.

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  • Erlyana, Erlyana & Damrongplasit, Kannika Kampanya & Melnick, Glenn, 2011. "Expanding health insurance to increase health care utilization: Will it have different effects in rural vs. urban areas?," Health Policy, Elsevier, vol. 100(2-3), pages 273-281, May.
  • Handle: RePEc:eee:hepoli:v:100:y:2011:i:2-3:p:273-281
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    Cited by:

    1. Raza, W.A. & Panda, P. & Van de Poel, E. & Dror, D.M. & Bedi, A.S., 2013. "Healthcare Seeking Behavior among Self-help Group Households in Rural Bihar and Uttar Pradesh, India," ISS Working Papers - General Series 50172, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    2. Richard Andrew Iles, 2013. "Demand for primary healthcare in rural north India," 2013 Papers pil50, Job Market Papers.
    3. Péter Elek & Balázs Váradi & Márton Varga, 2015. "Effects of Geographical Accessibility on the Use of Outpatient Care Services: Quasi‐Experimental Evidence from Panel Count Data," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1131-1146, September.
    4. Kannika Damrongplasit & Tshering Wangdi, 2017. "Healthcare utilization, bypass, and multiple visits: the case of Bhutan," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 51-81, March.
    5. Elek, P. & Varadi, B. & Varga, M., 2014. "Effects of geographical accessibility on the use of outpatient care services: quasi-experimental evidence from administrative panel data," Health, Econometrics and Data Group (HEDG) Working Papers 14/17, HEDG, c/o Department of Economics, University of York.
    6. Péter Elek & Balázs Váradi & Márton Varga, 2015. "Effects of Geographical Accessibility on the Use of Outpatient Care Services: Quasi‐Experimental Evidence from Panel Count Data," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1131-1146, September.
    7. Christopher J. Cronin & David K. Guilkey & Ilene S. Speizer, 2019. "Measurement error in discrete health facility choice models: An example from urban Senegal," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 34(7), pages 1102-1120, November.

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