IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v15y2006i9p915-932.html
   My bibliography  Save this article

A mixed logit model of health care provider choice: analysis of NSS data for rural India

Author

Listed:
  • Bijan J. Borah

Abstract

In order to address the persistent problems of access to and delivery of health care in rural India, a better understanding of the individual provider choice decision is required. This paper is an attempt in this direction as it investigates the determinants of outpatient health care provider choice in rural India in the mixed multinomial logit (MMNL) framework. This is the first application of the mixed logit to the modeling of health care utilization. We also use the multiple imputation technique to impute the missing prices of providers that an individual did not visit when she was ill. Using data from National Sample Survey Organization of India, we find the following: price and distance to a health facility play significant roles in health care provider choice decision; when health status is poor, distance plays a less significant role in an adult's provider choice decision; price elasticity of demand for outpatient care varies with income, with low‐income groups being more price‐sensitive than high‐income ones. Furthermore, outpatient care for children is more price‐elastic than that for adults, which reflects the socio‐economic structure of a typical household in rural India where an adult's health is more important than that of a child for the household's economic sustenance. Copyright © 2006 John Wiley & Sons, Ltd.

Suggested Citation

  • Bijan J. Borah, 2006. "A mixed logit model of health care provider choice: analysis of NSS data for rural India," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 915-932, September.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:9:p:915-932
    DOI: 10.1002/hec.1166
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.1166
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.1166?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Dubin, Jeffrey A & McFadden, Daniel L, 1984. "An Econometric Analysis of Residential Electric Appliance Holdings and Consumption," Econometrica, Econometric Society, vol. 52(2), pages 345-362, March.
    2. Walker, Joan & Ben-Akiva, Moshe, 2002. "Generalized random utility model," Mathematical Social Sciences, Elsevier, vol. 43(3), pages 303-343, July.
    3. Brownstone, David & Train, Kenneth, 1998. "Forecasting new product penetration with flexible substitution patterns," Journal of Econometrics, Elsevier, vol. 89(1-2), pages 109-129, November.
    4. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    5. Hajivassiliou, Vassilis A. & Ruud, Paul A., 1986. "Classical estimation methods for LDV models using simulation," Handbook of Econometrics, in: R. F. Engle & D. McFadden (ed.), Handbook of Econometrics, edition 1, volume 4, chapter 40, pages 2383-2441, Elsevier.
    6. Aviv Nevo, 2000. "A Practitioner's Guide to Estimation of Random‐Coefficients Logit Models of Demand," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 9(4), pages 513-548, December.
    7. Bolduc, Denis & Lacroix, Guy & Muller, Christophe, 1996. "The choice of medical providers in rural Benin: A comparison of discrete choice models," Journal of Health Economics, Elsevier, vol. 15(4), pages 477-498, August.
    8. Abhijit Banerjee & Angus Deaton & Esther Duflo, 2004. "Wealth, Health, and Health Services in Rural Rajasthan," American Economic Review, American Economic Association, vol. 94(2), pages 326-330, May.
    9. Germano Mwabu & Martha Ainsworth & Andrew Nyamete, 1993. "Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 28(4), pages 838-862.
    10. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics,, Palgrave Macmillan.
    11. Harris, Katherine M. & Keane, Michael P., 1998. "A model of health plan choice:: Inferring preferences and perceptions from a combination of revealed preference and attitudinal data," Journal of Econometrics, Elsevier, vol. 89(1-2), pages 131-157, November.
    12. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521747387, Enero-Abr.
    13. David Hensher & William Greene, 2003. "The Mixed Logit model: The state of practice," Transportation, Springer, vol. 30(2), pages 133-176, May.
    14. Bhat, Chandra R., 2001. "Quasi-random maximum simulated likelihood estimation of the mixed multinomial logit model," Transportation Research Part B: Methodological, Elsevier, vol. 35(7), pages 677-693, August.
    15. David Revelt & Kenneth Train, 1998. "Mixed Logit With Repeated Choices: Households' Choices Of Appliance Efficiency Level," The Review of Economics and Statistics, MIT Press, vol. 80(4), pages 647-657, November.
    16. Berry, Steven & Levinsohn, James & Pakes, Ariel, 1995. "Automobile Prices in Market Equilibrium," Econometrica, Econometric Society, vol. 63(4), pages 841-890, July.
    17. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
    18. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    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. Haghani, Milad & Bliemer, Michiel C.J. & Hensher, David A., 2021. "The landscape of econometric discrete choice modelling research," Journal of choice modelling, Elsevier, vol. 40(C).
    2. Campbell, Danny & Hutchinson, W. George & Scarpa, Riccardo, 2006. "Using Discrete Choice Experiments to Derive Individual-Specific WTP Estimates for Landscape Improvements under Agri-Environmental Schemes: Evidence from the Rural Environment Protection Scheme in Irel," Sustainability Indicators and Environmental Valuation Working Papers 12220, Fondazione Eni Enrico Mattei (FEEM).
    3. Bliemer, Michiel C.J. & Rose, John M., 2010. "Construction of experimental designs for mixed logit models allowing for correlation across choice observations," Transportation Research Part B: Methodological, Elsevier, vol. 44(6), pages 720-734, July.
    4. 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.
    5. Chiou, Lesley & Walker, Joan L., 2007. "Masking identification of discrete choice models under simulation methods," Journal of Econometrics, Elsevier, vol. 141(2), pages 683-703, December.
    6. Laura Mørch Andersen, 2013. "Obtaining reliable Likelihood Ratio tests from simulated likelihood functions," IFRO Working Paper 2013/1, University of Copenhagen, Department of Food and Resource Economics.
    7. Campbell, Danny, 2007. "Combining mixed logit models and random effects models to identify the determinants of willingness to pay for rural landscape improvements," 81st Annual Conference, April 2-4, 2007, Reading University, UK 7975, Agricultural Economics Society.
    8. Kalouptsidis, N. & Psaraki, V., 2010. "Approximations of choice probabilities in mixed logit models," European Journal of Operational Research, Elsevier, vol. 200(2), pages 529-535, January.
    9. Danny Campbell & George Hutchinson & Riccardo Scarpa, 2006. "Using mixed logit models to derive individual-specific WTP estimates for landscape improvements under agri-environmental schemes: evidence from the Rural Environment Protection Scheme in Ireland," Working Papers 0607, Rural Economy and Development Programme,Teagasc.
    10. Stefano Mainardi, 2021. "Preference heterogeneity, neighbourhood effects and basic services: logit kernel models for farmers’ climate adaptation in Ethiopia," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 23(5), pages 6869-6912, May.
    11. Stephane Hess, 2014. "Latent class structures: taste heterogeneity and beyond," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 14, pages 311-330, Edward Elgar Publishing.
    12. Danny Campbell & George Hutchinson & Riccardo Scarpa, 2006. "Integrating landscape improvement indices and discrete choice experiments: evidence from the Rural Environment Protection Scheme in Ireland," Working Papers 0609, Rural Economy and Development Programme,Teagasc.
    13. Paleti, Rajesh, 2018. "Generalized multinomial probit Model: Accommodating constrained random parameters," Transportation Research Part B: Methodological, Elsevier, vol. 118(C), pages 248-262.
    14. Frick, Bernd & Barros, Carlos Pestana & Prinz, Joachim, 2010. "Analysing head coach dismissals in the German "Bundesliga" with a mixed logit approach," European Journal of Operational Research, Elsevier, vol. 200(1), pages 151-159, January.
    15. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2008. "Policy Analysis in Health-Services Market: Accounting for Quality and Quantity," Annals of Economics and Statistics, GENES, issue 91-92, pages 293-319.
    16. Basu, Debasis & Hunt, John Douglas, 2012. "Valuing of attributes influencing the attractiveness of suburban train service in Mumbai city: A stated preference approach," Transportation Research Part A: Policy and Practice, Elsevier, vol. 46(9), pages 1465-1476.
    17. Falco, Paolo & Maloney, William F. & Rijkers, Bob & Sarrias, Mauricio, 2015. "Heterogeneity in subjective wellbeing: An application to occupational allocation in Africa," Journal of Economic Behavior & Organization, Elsevier, vol. 111(C), pages 137-153.
    18. Deka, Devajyoti & Carnegie, Jon, 2021. "Predicting transit mode choice of New Jersey workers commuting to New York City from a stated preference survey," Journal of Transport Geography, Elsevier, vol. 91(C).
    19. Solomon Tarfasa & Roy Brouwer, 2013. "Estimation of the public benefits of urban water supply improvements in Ethiopia: a choice experiment," Applied Economics, Taylor & Francis Journals, vol. 45(9), pages 1099-1108, March.
    20. Susan Athey & Guido W. Imbens, 2007. "Discrete Choice Models With Multiple Unobserved Choice Characteristics," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 48(4), pages 1159-1192, November.

    More about this item

    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:wly:hlthec:v:15:y:2006:i:9:p:915-932. 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: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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.