Determinants of the choice of health care facility utilised by individuals in HIV/AIDS-affected households in the Free State province of South Africa

This paper analyses differences in the choice of health care facility by individuals in HIV/AIDS-affected households in the Free State province of South Africa. Illness is more prevalent and severe amongst poorer affected households. The probability that individuals seek private versus public health care conditional on individual and household specific socio-economic variables is investigated. Significant determinants of choice of health care facility are income, severity of illness, the burden of illness and death in the household, the number of people in the household with access to medical aid, and secondary education. The demand for private health care over public health care is sensitive to income, with those from the lowest income quintile on average being less likely to switch to private health care than those in the highest income quintile. The planned roll-out of anti-retroviral treatment in public health care facilities in South Africa therefore will be crucial in enabling infected persons from poor households access to treatment. The provision of free treatment at public facilities may also see health care shift from private to public providers in the longer term.