Raza Wameq A, Van de Poel Ellen, Panda Pradeep, Dror David, Bedi Arjun
Institute of Health Policy and Management, Erasmus University Rotterdam, J5-23, P.O. Box 1738, 3000, DR, Rotterdam, The Netherlands.
Research and Evaluation Division, BRAC, Dhaka, Bangladesh.
BMC Health Serv Res. 2016 Jan 4;16:1. doi: 10.1186/s12913-015-1254-9.
In recent years, supported by non-governmental organizations (NGOs), a number of community-based health insurance (CBHI) schemes have been operating in rural India. Such schemes design their benefit packages according to local priorities. This paper examines healthcare seeking behaviour among self-help group households with a view to understanding the implications for the benefit packages offered by such schemes.
We use cross-sectional data collected from two of India's poorest states and estimate an alternative-specific conditional logit model to examine healthcare seeking behaviour.
We find that the majority of respondents do access some form of care and that there is overwhelming use of private providers. Non-degree allopathic providers (NDAP) also called rural medical practitioners are the most popular providers. In the case of acute illnesses, proximity plays an important role in determining provider choice. For chronic illnesses, cost of care influences provider choice.
Given the importance of proximity in determining provider choice, benefit packages offered by CBHI schemes should consider coverage of transportation costs and reimbursement of foregone earnings.
近年来,在非政府组织的支持下,印度农村地区开展了一些基于社区的健康保险(CBHI)计划。这些计划根据当地优先事项设计其福利套餐。本文研究了自助团体家庭的就医行为,以了解此类计划提供的福利套餐的影响。
我们使用从印度两个最贫困邦收集的横断面数据,并估计一个特定选择条件logit模型来研究就医行为。
我们发现,大多数受访者确实获得了某种形式的医疗服务,并且绝大多数人选择了私立医疗机构。非正规西医提供者(NDAP),也称为乡村医生,是最受欢迎的提供者。在急性疾病的情况下,距离在决定提供者选择方面起着重要作用。对于慢性病,医疗费用影响提供者选择。
鉴于距离在决定提供者选择方面的重要性,CBHI计划提供的福利套餐应考虑交通费用的覆盖范围和放弃收入的报销。