The Utilization of Curative Health Care in Mozambique: Does Income Matter?
In Mozambique, easily treatable diseases such as malaria, diarrhea, and respiratory infections contribute to a heavy burden of disease. Notwithstanding efforts by the Mozambican government to promote access to health care, many who could benefit from simple cost-effective health care services do not currently receive treatment. Moreover, it is known that the utilization of health services varies considerably across spatial domains and socio-economic groups. This paper is concerned with understanding the determinants of utilization of curative health services, paying particular attention to the role of income. It provides a broad analytical framework for analyzing both the binary decision to seek formal health care in the event of illness, and the multinomial choice of health care provider. The results show that income is not an important determinant of health care choices in Mozambique. Rather, other factors, in particular education and physical access, are more important. Moreover, unlike in some studies, own (time) price elasticity does not vary notably with income. At a methodological level, the analysis shows that the general conclusions are robust to a number of estimation issues that are rarely addressed explicitly in the analysis of health care choices, including sample selection, the potential endogeneity of consumption, and cluster-level unobservables. For the analysis of provider choice, the paper demonstrates the merits of a 'flexible' behavioral model. In particular, the paper rejects some of the restrictions of the standard model of provider choice, and shows that both the level of the price elasticity and the extent to which the elasticity varies with income is sensitive to the empirical specification.
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- Wolfe, Barbara L & Behrman, Jere R, 1984. "Determinants of Women's Health Status and Health-Care Utilization in a Developing Country: A Latent Variable Approach," The Review of Economics and Statistics, MIT Press, vol. 66(4), pages 696-703, November.
- Heltberg, Rasmus & Simler, Kenneth & Tarp, Finn, 2001.
"Public Spending and Poverty in Mozambique,"
WIDER Working Paper Series
063, World Institute for Development Economic Research (UNU-WIDER).
- Heltberg, Rasmus & Simler, Kenneth & Tarp, Finn, 2003. "Public spending and poverty in Mozambique," FCND briefs 167, International Food Policy Research Institute (IFPRI).
- Heltberg, Rasmus & Simler, Kenneth & Tarp, Finn, 2003. "Public spending and poverty in Mozambique," FCND discussion papers 167, International Food Policy Research Institute (IFPRI).
- Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
- McFadden, Daniel L., 1984. "Econometric analysis of qualitative response models," Handbook of Econometrics, in: Z. Griliches† & M. D. Intriligator (ed.), Handbook of Econometrics, edition 1, volume 2, chapter 24, pages 1395-1457 Elsevier.
- Haddad, Slim & Fournier, Pierre, 1995. "Quality, cost and utilization of health services in developing countries. A longitudinal study in Zaïre," Social Science & Medicine, Elsevier, vol. 40(6), pages 743-753, March.
- Acton, Jan Paul, 1975. "Nonmonetary Factors in the Demand for Medical Services: Some Empirical Evidence," Journal of Political Economy, University of Chicago Press, vol. 83(3), pages 595-614, June.
- 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.
- Paul J. Gertler & Luis Locay & Warren C. Sanderson, 1987. "Are User Fees Regressive? The Welfare Implications of Health Care Financing Proposals in Peru," NBER Working Papers 2299, National Bureau of Economic Research, Inc.
- McPake, Barbara & Hanson, Kara & Mills, Anne, 1993. "Community financing of health care in Africa: An evaluation of the Bamako initiative," Social Science & Medicine, Elsevier, vol. 36(11), pages 1383-1395, June.
- Smith, Richard J & Blundell, Richard W, 1986. "An Exogeneity Test for a Simultaneous Equation Tobit Model with an Application to Labor Supply," Econometrica, Econometric Society, vol. 54(3), pages 679-685, May.
- Lavy, Victor & Quigley, John M., 1991. "Willingness to Pay for the Quality and Intensity of Medical Care: Evidence from Low Income Households in Ghana," Department of Economics, Working Paper Series qt4p02g6nq, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
- Victor Lavy and John M. Quigley., 1991. "Willingness to Pay for the Quality and Intensity of Medical Care: Evidence from Low Income Households in Ghana," Economics Working Papers 91-178, University of California at Berkeley.
- Lavy, Victor & Quigley, John M., 1991. "Willingness to Pay For the Quality and Intensity of Medical Care: Evidence from Low Income Households in Ghana," Berkeley Program on Housing and Urban Policy, Working Paper Series qt8237c6g3, Berkeley Program on Housing and Urban Policy.
- 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.
- BOLDUC, Denis & LACROIX, Guy & MULLER, Christophe, 1994. "The Choice of Medical Providers in Rural Bénin: a Comparison of Discrete Choice Model," Cahiers de recherche 9411, Université Laval - Département d'économique.
- Heller, Peter S., 1982. "A model of the demand for medical and health services in Peninsular Malaysia," Social Science & Medicine, Elsevier, vol. 16(3), pages 267-284, January.
- Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
- Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408 Elsevier.
- John S. Akin & David K. Guilkey & Paul L. Hutchinson & Michael T. Mcintosh, 1998. "Price elasticities of demand for curative health care with control for sample selectivity on endogenous illness: an analysis for Sri Lanka," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 509-531.
- 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.
- Jimenez, Emmanuel, 1995. "Human and physical infrastructure: Public investment and pricing policies in developing countries," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 43, pages 2773-2843 Elsevier.
- Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, June.
- Dow, W.H., 1996. "Unconditional Demand for Health Care in Cote d'Ivoire. Does Selection on Health Status Matter?," Papers 124, World Bank - Living Standards Measurement.
- Akin, John S. & Guilkey, David K. & Hazel?Denton, E., 1995. "Quality of services and demand for health care in Nigeria: A multinomial probit estimation," Social Science & Medicine, Elsevier, vol. 40(11), pages 1527-1537, June.
- Mwabu, Germano M, 1989. "Nonmonetary Factors in the Household Choice of Medical Facilities," Economic Development and Cultural Change, University of Chicago Press, vol. 37(2), pages 383-392, January.
- Litvack, Jennie I. & Bodart, Claude, 1993. "User fees plus quality equals improved access to health care: Results of a field experiment in Cameroon," Social Science & Medicine, Elsevier, vol. 37(3), pages 369-383, August.
- Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
- Dor, Avi & Gertler, Paul & van der Gaag, Jacques, 1987. "Non-price rationing and the choice of medical care providers in rural Cote d'Ivoire," Journal of Health Economics, Elsevier, vol. 6(4), pages 291-304, December.
- Akin, John S, et al, 1986. "The Demand for Primary Health Care Services in the Bicol Region of the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 34(4), pages 755-782, July.
- Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
- Gertler, Paul J. & Hammer, Jeffrey S., 1997. "Strategies for pricing publicly provided health services," Policy Research Working Paper Series 1762, The World Bank.
- Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118 Elsevier.
- David E. Sahn & Stephen D. Younger, 2000. "Expenditure incidence in Africa: microeconomic evidence," Fiscal Studies, Institute for Fiscal Studies, vol. 21(3), pages 329-347, September. Full references (including those not matched with items on IDEAS)