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Household Size and the Decision to Purchase Health Insurance in Cambodia: Results of a Discrete-Choice Experiment with Scale Adjustment

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  • Sachiko Ozawa

    (Johns Hopkins Bloomberg School of Public Health)

  • Simrun Grewal

    (University of Washington)

  • John F.P. Bridges

    (Johns Hopkins Bloomberg School of Public Health
    Johns Hopkins Bloomberg School of Public Health)

Abstract

Background Community-based health insurance (CBHI) schemes have been introduced in low- and middle-income countries to increase health service utilization and provide financial protection from high healthcare expenditures. Objective We assess the impact of household size on decisions to enroll in CBHI and demonstrate how to correct for group disparity in scale (i.e. variance differences). Methods A discrete choice experiment was conducted across five CBHI attributes. Preferences were elicited through forced-choice paired comparison choice tasks designed based on D-efficiency. Differences in preferences were examined between small (1–4 family members) and large (5–12 members) households using conditional logistic regression. Swait and Louviere test was used to identify and correct for differences in scale. Results One-hundred and sixty households were surveyed in Northwest Cambodia. Increased insurance premium was associated with disutility [odds ratio (OR) 0.61, p

Suggested Citation

  • Sachiko Ozawa & Simrun Grewal & John F.P. Bridges, 2016. "Household Size and the Decision to Purchase Health Insurance in Cambodia: Results of a Discrete-Choice Experiment with Scale Adjustment," Applied Health Economics and Health Policy, Springer, vol. 14(2), pages 195-204, April.
    • Handle: RePEc:spr:aphecp:v:14:y:2016:i:2:d:10.1007_s40258-016-0222-9
    DOI: 10.1007/s40258-016-0222-9
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    References listed on IDEAS

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    Cited by:

    1. Anna Nicolet & Clémence Perraudin & Joël Wagner & Ingrid Gilles & Nicolas Krucien & Isabelle Peytremann-Bridevaux & Joachim Marti, 2022. "Patient and Public Preferences for Coordinated Care in Switzerland: Development of a Discrete Choice Experiment," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 15(4), pages 485-496, July.
    2. Nguyen, Trung Thanh & Do, Truong Lam & Halkos, George & Wilson, Clevo, 2020. "Health shocks and natural resource extraction: A Cambodian case study," Ecological Economics, Elsevier, vol. 169(C).
    3. Denis Charles & Magali Dumontet & Meglena Jeleva & Johanna Etner, 2024. "Behavioral drivers of individuals’ Term Life Insurance Demand: evidence from a Discrete Choice Experiment," EconomiX Working Papers 2024-23, University of Paris Nanterre, EconomiX.
    4. Sachiko Ozawa & Tatenda T. Yemeke & Alie F. Tawah & Vivek Kulkarni & Manuela Villar Uribe, 2018. "Out-of-Pocket Household Expenditures on Medical Injections in Cambodia," PharmacoEconomics - Open, Springer, vol. 2(4), pages 415-421, December.
    5. Thiptaiya Sydavong & Daisaku Goto & Keisuke Kawata & Shinji Kaneko & Masaru Ichihashi, 2019. "Potential demand for voluntary community-based health insurance improvement in rural Lao People’s Democratic Republic: A randomized conjoint experiment," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-21, January.
    6. Vikas Soekhai & Esther W. Bekker-Grob & Alan R. Ellis & Caroline M. Vass, 2019. "Discrete Choice Experiments in Health Economics: Past, Present and Future," PharmacoEconomics, Springer, vol. 37(2), pages 201-226, February.

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