The Demand for Public and Private Medical Care Services: Evidence from Kuwait

The growing demand for medical care services (MCS) presents a major policy challenge for health authorities, particularly in the developing countries, as they attempt to manage resources for the health care delivery system. While the empirical literature on the subject has covered both the developed and the developing countries, one region that has been neglected or underrepresented is the oil exporting countries of the Middle East, a region that is different from other countries in terms of its socio-economic-demographic characteristics. This paper investigates determinants of demand for MCS in Kuwait by estimating a two-part model for out-patient services based on data from a household survey on the utilization of health care facilities (HCF) in the country. As the data on the utilization of HCF are known to be afflicted by restricted range, zero values, and skewness, prior to estimating the model, tests were conducted to determine presence of over-dispersion in the data and select an appropriate distribution of the dependent variable for the second part of the model. In addition, test was performed to determine if differences in the estimated coefficients across population groups were statistically significant. The findings of the study are expected to help authorities in Kuwait as well as other oil-exporting economies that share socio-economic and demographic characteristics and experience similar trends in the demand for MCS in formulating policies for the development of health care delivery system. La domanda di servizi sanitari pubblici e privati: evidenze dal Kuwait La crescente domanda per le cure sanitarie rappresenta una delle più importanti sfide per le autorità che gestiscono le risorse finanziarie, in particolare nei paesi in via di sviluppo. Questo studio analizza le determinanti della domanda per le cure sanitarie in Kuwait tramite la stima di un modello a due parti. Poiché è noto che tali dati sono influenzabili da intervalli ristretti, valori nulli e simmetrie, sono stati effettuati dei test prima di valutare il modello, per determinare la presenza di un’eventuale dispersione dei dati e selezionare un’appropriata distribuzione della variabile dipendente. Inoltre è stato effettuato un test per determinare se le differenze nei coefficienti stimati su gruppi di popolazione fossero statisticamente significative.