Why do the sick not utilise health care? The case of Zambia

• Published in: Health economics Vol. 12; no. 9; pp. 755 - 770
• Main Author: Hjortsberg, Catharina
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.09.2003; Wiley Periodicals Inc
• Series: Health Economics
• Subjects: Consumer behavior; Cost benefit analysis; Cost of Illness; Economic aspects; Economics; Economics and Business; Ekonomi och näringsliv; expenditure; Expenditures; Female; Health care; Health care access; Health care expenditures; Health economics; Health Expenditures - statistics & numerical data; Health services utilization; Helpseeking; Humans; Male; Models, Econometric; Nationalekonomi; Nonuse; Patient Acceptance of Health Care - statistics & numerical data; Patients; Personal income; Poverty; Regression analysis; Rural Health Services - economics; Rural Health Services - utilization; Samhällsvetenskap; Self Medication - economics; Self Medication - utilization; Self-medication; Selfmedication; Sick people; Sick Role; Social Sciences; Studies; Urban Health Services - economics; Urban Health Services - utilization; Users; utilisation; Zambia; Zambia
• ISSN: 1057-9230; 1099-1050; 1099-1050
• DOI: 10.1002/hec.839

When ill the individual faces the options of seeking health care, using self‐medication or doing nothing. In an economic perspective, an individual's propensity to utilise health care is determined by the costs of utilisation and the perceived benefits of health care. The propensity to utilise health care may hence be expected to vary between individuals. In this paper we attempt on the one hand to determine what factors influence sick individuals' propensity to seek health care at a health facility or use self‐medication (or do nothing), and on the other hand attempt to determine the factors that influence the magnitude of their expenditures for health care, in particular what other factors than just health status influence utilisation. For the empirical analysis, data, covering 9700 individuals, from the 1998 Living Conditions Monitoring Survey (LCMS) is used. We use a Multinomial Logit selection model to estimate the equation, which allows us to analyse health‐care utilisation through two separate processes, the decision to seek care and the magnitude of expenditures incurred. In general, we find that the individuals are influenced by income, insurance, type of illness and access variables such as distance and owning a vehicle. Copyright © 2003 John Wiley & Sons, Ltd.