IDEAS home Printed from https://ideas.repec.org/p/sch/wpaper/317.html

Healthcare utilisation behaviour in India: Socio-economic disparities & the effect of health insurance

Author

Listed:
  • Sahoo, Anil Kumar
  • Madheswaran, S

    (Institute for Social and Economic Change)

Abstract

The purpose of this paper is to probe issues such as inequality in healthcare utilisation, impoverishment due to increasing out-of-pocket (OOP) health expenditure, growing dependence on informal sources of healthcare and strengthening the role of insurance, which has been gaining importance within the healthcare systems in low and middle-income countries, including India. The provision of health insurance (HI) is seen as one of the major agendas for policy makers for ensuring universal health coverage. However, little is known at the aggregate level whether HI leads to a change in the way healthcare facilities are used in India. Hence, this paper will analyse the impact of HI on healthcare utilisation behaviour of individuals using the nationally representative data of the Indian Human Development Survey (IHDS) 2004-05. Logit, Tobit and Multinomial Logit Models have been used to analyse the impact of HI along with socio-economic factors on healthcare utilisation behaviour. We found that in Logistic Regression health insurance does not have any statistically significant impact on utilisation behaviour whereas in Tobit and Multinomial Logit we found it to be significant. Nonetheless, the coefficients of health insurance status in different models show positive signs. This implies that insurance increases the probability of healthcare seeking behaviour. It is also found that insurance increases the probability of healthcare either in the private or in the public sector. However, people tend to use the private sector more than the public sector. However, in India the private sector is largely unregulated and very often it leads to unnecessary care and cost escalation. Therefore, on the policy perspective it will be wise on the part of government to bring in a sound regulatory mechanism to control the private sector to ensure the efficient functioning of the health insurance sector for the benefit of the insured people. The government should also educate the people about the benefits of health insurance and persuade the private sector to educate their insured members holistically about their insurance product.

Suggested Citation

  • Sahoo, Anil Kumar & Madheswaran, S, 2014. "Healthcare utilisation behaviour in India: Socio-economic disparities & the effect of health insurance," Working Papers 317, Institute for Social and Economic Change, Bangalore.
  • Handle: RePEc:sch:wpaper:317
    as

    Download full text from publisher

    File URL: http://www.isec.ac.in/WP%20317%20-%20Amit%20Kumar%20Sahoo_1.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. S V Subramanian & George Davey Smith & Malavika Subramanyam, 2006. "Indigenous Health and Socioeconomic Status in India," PLOS Medicine, Public Library of Science, vol. 3(10), pages 1-11, October.
    2. Onwujekwe, Obinna, 2005. "Inequities in healthcare seeking in the treatment of communicable endemic diseases in Southeast Nigeria," Social Science & Medicine, Elsevier, vol. 61(2), pages 455-463, July.
    3. Hugh R. Waters, 1999. "Measuring the impact of health insurance with a correction for selection bias-a case study of Ecuador," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 473-483.
    4. repec:wbk:wbpubs:14080 is not listed on IDEAS
    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. Subramanian, S.V. & Subramanyam, Malavika A. & Selvaraj, Sakthivel & Kawachi, Ichiro, 2009. "Are self-reports of health and morbidities in developing countries misleading? Evidence from India," Social Science & Medicine, Elsevier, vol. 68(2), pages 260-265, January.
    2. Ralf Krumkamp & Nimako Sarpong & Benno Kreuels & Lutz Ehlkes & Wibke Loag & Norbert Georg Schwarz & Hajo Zeeb & Yaw Adu-Sarkodie & Jürgen May, 2013. "Health Care Utilization and Symptom Severity in Ghanaian Children – a Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    3. Hidayat, Budi, 2007. "Are there differences between unconditional and conditional demand estimates? implications for future research and policy," MPRA Paper 30196, University Library of Munich, Germany.
    4. Jayanta Kumar Bora & Rajesh Raushan & Wolfgang Lutz, 2019. "The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    5. Giampiero Marra & Matteo Fasiolo & Rosalba Radice & Rainer Winkelmann, 2023. "A flexible copula regression model with Bernoulli and Tweedie margins for estimating the effect of spending on mental health," Health Economics, John Wiley & Sons, Ltd., vol. 32(6), pages 1305-1322, June.
    6. Swati Dutta, 2022. "Risk factors for child survival among tribal dominated states in India: a pooled cross sectional analysis," Journal of Population Research, Springer, vol. 39(3), pages 391-416, September.
    7. Nazmul Islam, Muhammed & Rabbani, Atonu & De Allegri, Manuela & Sarker, Malabika, 2024. "Medical treatment loans and their effects on health care utilization and out-of-pocket expenditure: Evidence from an experiment in northern Bangladesh," World Development, Elsevier, vol. 184(C).
    8. Anthony K Ngugi & Felix Agoi & Megan R Mahoney & Amyn Lakhani & David Mang’ong’o & Esther Nderitu & Robert Armstrong & Sarah Macfarlane, 2017. "Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-12, February.
    9. Omar Galárraga & Sandra Sosa-Rubí & Aarón Salinas-Rodríguez & Sergio Sesma-Vázquez, 2010. "Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 437-447, October.
    10. Adam Wagstaff, 2010. "Estimating health insurance impacts under unobserved heterogeneity: the case of Vietnam's health care fund for the poor," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 189-208, February.
    11. Sepehri, Ardeshir & Simpson, Wayne & Sarma, Sisira, 2006. "The influence of health insurance on hospital admission and length of stay--The case of Vietnam," Social Science & Medicine, Elsevier, vol. 63(7), pages 1757-1770, October.
    12. Hamid, Syed Abdul & Roberts, Jennifer & Mosley, Paul, 2011. "Evaluating the Health Effects of Micro Health Insurance Placement: Evidence from Bangladesh," World Development, Elsevier, vol. 39(3), pages 399-411, March.
    13. Satrughan Behera & Atish Kumar Dash & Rathi Kanta Kumbhar, 2023. "Disparities in the Health and Well-being of Scheduled Tribes and Non-Scheduled Tribes Populations in India," Shanlax International Journal of Economics, Shanlax Journals, vol. 12(1), pages 69-77, December.
    14. Kassahun, Habtamu Tilahun & Jacobsen, Jette Bredahl & Nicholson, Charles F., 2020. "Revisiting money and labor for valuing environmental goods and services in developing countries," Ecological Economics, Elsevier, vol. 177(C).
    15. Edward Asiedu & Dorcas Sowah & Amin Karimu, 2024. "Impact of national health insurance enrolment on farm investments in Sub-Saharan Africa: empirical evidence from Ghana," Agricultural Finance Review, Emerald Group Publishing Limited, vol. 84(4/5), pages 320-341, September.
    16. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low‐income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857, September.
    17. Sosa-Rubí, Sandra G. & Galárraga, Omar & Harris, Jeffrey E., 2009. "Heterogeneous impact of the "Seguro Popular" program on the utilization of obstetrical services in Mexico, 2001-2006: A multinomial probit model with a discrete endogenous variable," Journal of Health Economics, Elsevier, vol. 28(1), pages 20-34, January.
    18. Sato, Azusa, 2012. "Do Inequalities in Health Care Utilization in Developing Countries Change When We Take into Account Traditional Medicines?," World Development, Elsevier, vol. 40(11), pages 2275-2289.
    19. Laurie Brown & Binod Nepal, 2011. "Modelling Potential Impact of Improved Survival of Indigenous Australians on Work-Life Labour Income Gap Between Indigenous and Average Australians," NATSEM Working Paper Series 11/15, University of Canberra, National Centre for Social and Economic Modelling.
    20. June Y T Po & S V Subramanian, 2011. "Mortality Burden and Socioeconomic Status in India," PLOS ONE, Public Library of Science, vol. 6(2), pages 1-8, February.

    More about this item

    Keywords

    ;
    ;

    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:sch:wpaper:317. 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: B B Chand (email available below). General contact details of provider: https://edirc.repec.org/data/iseccin.html .

    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.