Bypassing Health Providers : The Quest for Better Price and Quality of Health Care in Chad
This paper investigates individuals' bypassing behavior in the health sector in Chad and the determinants of individuals' facility choice. The authors introduce a new way to measure bypassing using the patients' own knowledge of alte...
Main Authors: | , |
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Format: | Policy Research Working Paper |
Language: | English |
Published: |
World Bank, Washington, DC
2012
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Subjects: | |
Online Access: | http://documents.worldbank.org/curated/en/2008/01/8913823/bypassing-health-providers-quest-better-price-quality-health-care-chad http://hdl.handle.net/10986/6456 |
Summary: | This paper investigates
individuals' bypassing behavior in the health sector in
Chad and the determinants of individuals' facility
choice. The authors introduce a new way to measure bypassing
using the patients' own knowledge of alternative health
providers available to them instead of assuming that
information as previously done. The authors analyze how
perceived health care quality and prices impact
patients' bypassing decisions. The analysis uses data
from a Quantitative Service Delivery Survey in Chad's
health sector carried out in 2004. The survey covers 281
primary health care centers and 1,801 patients. The matching
of facility data and patient data allows the analysis to
control for a wide range of important patient and facility
characteristics, such as income, severity of illness,
quality of health care, or price of services. The findings
show that income inequalities translate into health service
inequalities. There is evidence of two distinct types of
bypassing activities in Chad: (1) patients from low-income
households bypass high-quality facilities they cannot afford
to go to low-quality facilities, and (2) rich individuals
bypass low-quality facilities and aim for more expensive
facilities that also offer a higher quality of care. These
significant differences in patients' facility choices
are observed across income groups as well as between rural
and urban areas. |
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