IDEAS home Printed from https://ideas.repec.org/a/aiy/jnjaer/v23y2024i2p499-521.html
   My bibliography  Save this article

Modeling Consumer Choice between Public and Private Health Care in Russia

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://journalaer.ru/fileadmin/user_upload/site_15934/2024/10_Davitadze.pdf
    Download Restriction: no
    File URL: https://libkey.io/https://doi.org/10.15826/vestnik.2024.23.2.020?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    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. 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.
    3. 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.
    4. 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.
    5. 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.
    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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Zhewen Pan, 2023. "On semiparametric estimation of the intercept of the sample selection model: a kernel approach," Papers 2302.05089, arXiv.org.
    2. Yanbing Zeng & Yuanyuan Wan & Zhipeng Yuan & Ya Fang, 2021. "Healthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors," IJERPH, MDPI, vol. 18(6), pages 1-18, March.
    3. Zan Yang & Ying Fan & Liqing Zhao, 2018. "A Reexamination of Housing Price and Household Consumption in China: The Dual Role of Housing Consumption and Housing Investment," The Journal of Real Estate Finance and Economics, Springer, vol. 56(3), pages 472-499, April.
    4. Massa, Massimo & Mataigne, Virginie & Vermaelen, Theo & Xu, Moqi, 2017. "Choices in Equity Finance A Global Perspective," CEPR Discussion Papers 11987, C.E.P.R. Discussion Papers.
    5. Goergen, M. & Renneboog, L.D.R. & Correia Da Silva, L., 2004. "Dividend Policy of German Firms," Other publications TiSEM 13d8dd39-20ab-48b4-991e-b, Tilburg University, School of Economics and Management.
    6. Darima Fotheringham & Michael A. Wiles, 2023. "The effect of implementing chatbot customer service on stock returns: an event study analysis," Journal of the Academy of Marketing Science, Springer, vol. 51(4), pages 802-822, July.
    7. Robert B. Ekelund & John D. Jackson & Robert D. Tollison, 2013. "Are Art Auction Estimates Biased?," Southern Economic Journal, John Wiley & Sons, vol. 80(2), pages 454-465, October.
    8. Aromolaran, Adebayo B., 2002. "Private Wage Returns to Schooling in Nigeria: 1996-1999," Center Discussion Papers 28489, Yale University, Economic Growth Center.
    9. Song, Wei-Ling & Uzmanoglu, Cihan, 2016. "TARP announcement, bank health, and borrowers’ credit risk," Journal of Financial Stability, Elsevier, vol. 22(C), pages 22-32.
    10. Piras, Claudia & Savedoff, William D., 1998. "How Much do Teachers Earn?," IDB Publications (Working Papers) 6078, Inter-American Development Bank.
    11. Xu, Shen & Yin, Bichao & Lou, Chunjie, 2022. "Minority shareholder activism and corporate social responsibility," Economic Modelling, Elsevier, vol. 116(C).
    12. Frank M. Fossen & Ray Rees & Davud Rostam-Afschar & Viktor Steiner, 2020. "The effects of income taxation on entrepreneurial investment: A puzzle?," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 27(6), pages 1321-1363, December.
    13. Saziye Gazioglu & Aysit Tansel, 2006. "Job satisfaction in Britain: individual and job related factors," Applied Economics, Taylor & Francis Journals, vol. 38(10), pages 1163-1171.
    14. Bierlen, Ralph W. & Parsch, Lucas D. & Dixon, Bruce L., 1999. "How Cropland Contract Type And Term Decisions Are Made: Evidence From An Arkansas Tenant Survey," International Food and Agribusiness Management Review, International Food and Agribusiness Management Association, vol. 2(1), pages 1-19.
    15. René Belderbos & Vincent Van Roy & Leo Sleuwaegen, 2021. "Does trade participation limit domestic firms’ productivity gains from inward foreign direct investment?," Eurasian Business Review, Springer;Eurasia Business and Economics Society, vol. 11(1), pages 83-109, March.
    16. Doreen Triebe, 2013. "Wo(men) at Work?: The Impact of Cohabiting and Married Partners' Earning on Women's Work Hours," SOEPpapers on Multidisciplinary Panel Data Research 614, DIW Berlin, The German Socio-Economic Panel (SOEP).
    17. Flore Gubert & Thomas Lassourd & Sandrine Mesplé-Somps, 2010. "Do remittances affect poverty and inequality? Evidence from Mali," Working Papers DT/2010/08, DIAL (Développement, Institutions et Mondialisation).
    18. Salardi, Paola & Ñopo, Hugo R., 2009. "Gender and Racial Wage Gaps in Brazil 1996-2006: Evidence Using a Matching Comparisons Approach," IDB Publications (Working Papers) 1649, Inter-American Development Bank.
    19. Hu, Yuanhong, 2020. "Heterogeneous Environmental Regulations, R&D Innovation and Manufacturing Enterprises' Export Technological Sophistication," EconStor Preprints 222983, ZBW - Leibniz Information Centre for Economics.
    20. Wegayehu Fitawek & Sheryl L. Hendriks, 2021. "Evaluating the Impact of Large-Scale Agricultural Investments on Household Food Security Using an Endogenous Switching Regression Model," Land, MDPI, vol. 10(3), pages 1-19, March.

    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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:aiy:jnjaer:v:23:y:2024:i:2:p:499-521. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Natalia Starodubets (email available below). General contact details of provider: https://edirc.repec.org/data/seurfru.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.