The University of Western Ontario, London, Ontario, Canada.
Appl Health Econ Health Policy. 2009;7(4):265-77. doi: 10.1007/BF03256160.
Price, income and health status are likely to affect the demand for healthcare in developing countries, and their quantitative effects are unclear in the literature. Some studies report that prices are not important determinants, while others conclude that prices are important determinants of the demand for healthcare. Knowledge of the extent to which price, income and health status affect the demand for healthcare is crucial for the design of effective health policy in developing countries.
To examine the role of monetary and non-monetary price, income, and a variety of individual- and household-specific characteristics on the demand for healthcare in rural India.
Utilizing micro data from the 52nd round of India's National Sample Survey, a variable choice set based on geographical location, price, income and the severity of illness was constructed to reflect the underlying true choice-generating process in rural India. Nested multinomial logit models were estimated and simulations with respect to prices and income were conducted to estimate price and income elasticities.
Contrary to many earlier studies on the demand for healthcare in developing countries, it was found that prices and income were statistically significant determinants of the choice of healthcare provider by individuals in rural India. Demand for healthcare was found to be price and income inelastic, corroborating the findings from other developing countries. Distance to formal healthcare facilities negatively affected the demand for outpatient healthcare, an effect that was mitigated as access to transportation improved. Age, sex, healthy days, educational status of the household members and the number of children and adults living in the household also affected the choice of healthcare provider in rural India.
After controlling for a number of sociodemographic factors, it was found that prices, income and distance are statistically significant determinants of the provider chosen by individuals; nevertheless, the demand for healthcare is price and income inelastic in rural India.
价格、收入和健康状况可能会影响发展中国家对医疗保健的需求，但其数量影响在文献中尚不清楚。一些研究报告称价格不是重要决定因素，而另一些研究则得出结论认为价格是医疗保健需求的重要决定因素。了解价格、收入和健康状况在多大程度上影响医疗保健需求，对于制定发展中国家有效的卫生政策至关重要。
检验货币和非货币价格、收入以及各种个人和家庭特定特征在印度农村地区对医疗保健需求的作用。
利用印度第 52 轮国家抽样调查的微观数据，根据地理位置、价格、收入和疾病严重程度构建了一个变量选择集，以反映印度农村地区潜在的真实选择生成过程。估计了嵌套多项逻辑斯特模型，并就价格和收入进行了模拟，以估计价格和收入弹性。
与许多关于发展中国家医疗保健需求的早期研究相反，研究发现价格和收入是印度农村个人选择医疗保健提供者的统计上显著决定因素。医疗保健需求对价格和收入缺乏弹性，这与其他发展中国家的研究结果一致。到正规医疗机构的距离对门诊医疗保健需求产生负面影响，但随着交通条件的改善，这种影响会减轻。年龄、性别、健康天数、家庭成员的教育程度以及家庭中儿童和成年人的数量也会影响印度农村地区的医疗保健提供者选择。
在控制了一些社会人口因素后，发现价格、收入和距离是个人选择的提供者的统计上显著决定因素；然而，印度农村地区的医疗保健需求对价格和收入缺乏弹性。
