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Modeling Consumer Choice between Public and Private Health Care in Russia

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  • Arsen P. Davitadze

Abstract

Demand for public and private health care services is formed through consumer decision-making in two situations: to seek or not to seek medical help and which medical institution to attend. Theory suggests that choices in these situations occur sequentially and are explained by Andersen's behavioral model. This study tests these theoretical assumptions using three econometric approaches on the Russian National Health Telephone Survey 2022 data: (1) two separate probit regressions, (2) sample selection probit, and (3) nested logit. Nested logit confirmed the relevance of all demand-side characteristics (Andersen's model factors). Being male, older, and having health problems were associated with decreased probability of seeking health care and choosing private clinics. Being married, having a high level of education, being employed, having a medium or high monthly income, and living in larger cities were associated with increased probability of seeking health care and attending private clinics. Robustness check of the nested logit model accounted for the varying levels of availability of health care facilities in different cities. Despite the differences in the availability of public and private medical organizations, trends in consumer behavior remained the same. The author proposes to expand the practice of using nested logit models to analyze the behavior of consumers of medical services using data from Russia and other countries. Recommendations for increasing the efficiency of the Russian health care system and reducing inequality in its use by different consumer groups include transforming attitudes of Russians to their own health and promoting the accessibility of health care.

Suggested Citation

  • Arsen P. Davitadze, 2024. "Modeling Consumer Choice between Public and Private Health Care in Russia," Journal of Applied Economic Research, Graduate School of Economics and Management, Ural Federal University, vol. 23(2), pages 499-521.
    • Handle: RePEc:aiy:jnjaer:v:23:y:2024:i:2:p:499-521
    DOI: https://doi.org/10.15826/vestnik.2024.23.2.020
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    References listed on IDEAS

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    1. Chan Shen, 2013. "Determinants of Health Care Decisions: Insurance, Utilization, and Expenditures," The Review of Economics and Statistics, MIT Press, vol. 95(1), pages 142-153, March.
    2. Green, Carla A & Pope, Clyde R, 1999. "Gender, psychosocial factors and the use of medical services: a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 48(10), pages 1363-1372, May.
    3. Davide Pianori & Elisa Maietti & Jacopo Lenzi & Mattia Quargnolo & Stefano Guicciardi & Kadjo Yves Cedric Adja & Maria Pia Fantini & Federico Toth, 2020. "Sociodemographic and health service organizational factors associated with the choice of the private versus public sector for specialty visits: Evidence from a national survey in Italy," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-12, May.
    4. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    5. Wang, Qing & Zhang, Donglan & Hou, Zhiyuan, 2016. "Insurance coverage and socioeconomic differences in patient choice between private and public health care providers in China," Social Science & Medicine, Elsevier, vol. 170(C), pages 124-132.
    6. Anne-Charlotte Bas & Sylvie Azogui-Lévy, 2022. "Socio-Economic Determinants of Dental Service Expenditure: Findings from a French National Survey," IJERPH, MDPI, vol. 19(3), pages 1-10, January.
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    More about this item

    Keywords

    consumer behavior; patient choice; healthcare system; public health care facilities; private health care facilities; discrete choice models.;
    All these keywords.

    JEL classification:

    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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