IDEAS home Printed from https://ideas.repec.org/a/spr/jqecon/v21y2023i3d10.1007_s40953-023-00354-x.html
   My bibliography  Save this article

Healthcare Costs, Choice of Providers and Patient Satisfaction: Survey Evidence from India

Author

Listed:
  • Prateek Arora

    (Union College)

  • Nirvikar Singh

    (University of California)

  • Abhijit Visaria

    (Centre for Ageing Research and Education, Duke-NUS Medical School)

Abstract

In this paper, we study the factors that influence the choice of healthcare providers in the rural areas of a highly developed Indian state, Punjab. In particular, we examine the choice between government and private providers, and between medical professionals and informal providers. We also examine the joint choice of provider type and distance travelled, and possible factors influencing reported satisfaction with the quality of care received. We use data from a household survey of 489 households from 10 villages around the town of Nabha. We construct a measure of anticipated treatment cost in order to account for the endogeneity of actual costs in healthcare choices. Our results indicate that respondents who identified costs as a primary factor in their choice of provider were more likely to choose a nearby government provider and less likely to choose a distant private provider. Additionally, higher anticipated treatment costs were associated with a greater likelihood of choosing a government provider compared to a private provider and choosing a professional versus non-professional provider. Overall, cost sensitivity was negatively associated with patient satisfaction. Our results have important implications for understanding household decisions in the choice of government and private healthcare providers.

Suggested Citation

  • Prateek Arora & Nirvikar Singh & Abhijit Visaria, 2023. "Healthcare Costs, Choice of Providers and Patient Satisfaction: Survey Evidence from India," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 21(3), pages 593-616, September.
  • Handle: RePEc:spr:jqecon:v:21:y:2023:i:3:d:10.1007_s40953-023-00354-x
    DOI: 10.1007/s40953-023-00354-x
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40953-023-00354-x
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s40953-023-00354-x?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
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Nyamongo, I. K., 2002. "Health care switching behaviour of malaria patients in a Kenyan rural community," Social Science & Medicine, Elsevier, vol. 54(3), pages 377-386, February.
    2. Jishnu Das & Jeffrey Hammer & Kenneth Leonard, 2008. "The Quality of Medical Advice in Low-Income Countries," Journal of Economic Perspectives, American Economic Association, vol. 22(2), pages 93-114, Spring.
    3. Abhijit Banerjee & Angus Deaton & Esther Duflo, 2004. "Wealth, Health, and Health Services in Rural Rajasthan," American Economic Review, American Economic Association, vol. 94(2), pages 326-330, May.
    4. Richard Williams, 2012. "Using the margins command to estimate and interpret adjusted predictions and marginal effects," Stata Journal, StataCorp LP, vol. 12(2), pages 308-331, June.
    5. Abusaleh Shariff & Geeta Singh, 2002. "Determinants of Maternal Health Care Utilisation in India: Evidence from a Recent Household Survey," NCAER Working Papers 85, National Council of Applied Economic Research.
    6. Lakhwinder Singh & Nirvikar Singh (ed.), 2016. "Economic Transformation of a Developing Economy," India Studies in Business and Economics, Springer, edition 1, number 978-981-10-0197-0, March.
    7. Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter.
    8. Lakhwinder Singh & Nirvikar Singh, 2016. "Economic Transformation and Development Experience of Indian Punjab—An Introduction," India Studies in Business and Economics, in: Lakhwinder Singh & Nirvikar Singh (ed.), Economic Transformation of a Developing Economy, edition 1, chapter 0, pages 1-25, Springer.
    9. Khetrapal, Sonalini & Acharya, Arnab & Mills, Anne, 2019. "Assessment of the public-private-partnerships model of a national health insurance scheme in India," Social Science & Medicine, Elsevier, vol. 243(C).
    10. Khemani,Stuti & Chaudhary,Sarang & Scot,Thiago, 2020. "Strengthening Public Health Systems : Policy Ideas from a Governance Perspective," Policy Research Working Paper Series 9220, The World Bank.
    11. Shankar Prinja & Akashdeep Singh Chauhan & Anup Karan & Gunjeet Kaur & Rajesh Kumar, 2017. "Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-19, February.
    12. Pascaline Dupas, 2011. "Health Behavior in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 3(1), pages 425-449, September.
    13. Karan, Anup & Yip, Winnie & Mahal, Ajay, 2017. "Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out of pocket spending for healthcare," Social Science & Medicine, Elsevier, vol. 181(C), pages 83-92.
    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. Grant Miller & Kimberly Singer Babiarz, 2013. "Pay-for-Performance Incentives in Low- and Middle-Income Country Health Programs," NBER Working Papers 18932, National Bureau of Economic Research, Inc.
    2. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
    3. Dhaliwal, Iqbal & Hanna, Rema, 2017. "The devil is in the details: The successes and limitations of bureaucratic reform in India," Journal of Development Economics, Elsevier, vol. 124(C), pages 1-21.
    4. Haenssgen, Marco J., 2018. "The struggle for digital inclusion: Phones, healthcare, and marginalisation in rural India," World Development, Elsevier, vol. 104(C), pages 358-374.
    5. Dizon-Ross, Rebecca & Dupas, Pascaline & Robinson, Jonathan, 2017. "Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda," Journal of Public Economics, Elsevier, vol. 156(C), pages 150-169.
    6. Edward N. Okeke & Amalavoyal V. Chari, 2015. "Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda," Working Papers WR-1072, RAND Corporation.
    7. Haenssgen, Marco J. & Ariana, Proochista, 2017. "The Social Implications of Technology Diffusion: Uncovering the Unintended Consequences of People’s Health-Related Mobile Phone Use in Rural India and China," World Development, Elsevier, vol. 94(C), pages 286-304.
    8. Das, Jishnu & Daniels, Benjamin & Ashok, Monisha & Shim, Eun-Young & Muralidharan, Karthik, 2022. "Two Indias: The structure of primary health care markets in rural Indian villages with implications for policy," Social Science & Medicine, Elsevier, vol. 301(C).
    9. Friedman, Willa & Keats, Anthony & Mutua, Martin Kavao, 2022. "Disruptions to healthcare quality and early child health outcomes: Evidence from health-worker strikes in Kenya," Journal of Health Economics, Elsevier, vol. 86(C).
    10. Baulia, Susmita, 2024. "Is household shock a boon or bane to the utilisation of preventive healthcare for children? Evidence from Uganda," Economics & Human Biology, Elsevier, vol. 52(C).
    11. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    12. Aggarwal, Shilpa, 2021. "The long road to health: Healthcare utilization impacts of a road pavement policy in rural India," Journal of Development Economics, Elsevier, vol. 151(C).
    13. Zachary Wagner & Somalee Banerjee & Manoj Mohanan & Neeraj Sood, 2023. "Does the market reward quality? Evidence from India," International Journal of Health Economics and Management, Springer, vol. 23(3), pages 467-505, September.
    14. Kjell Hausken & Mthuli Ncube, 2013. "Working Paper 172 - Political Economy of Service Delivery: Monitoring versus Contestation," Working Paper Series 468, African Development Bank.
    15. Santosh, Kumar, 2009. "Childhood Immunization, Mortality and Human Capital Accumulation: Micro-Evidence from India," MPRA Paper 27127, University Library of Munich, Germany.
    16. O'Donnell, Owen, 2024. "Health and health system effects on poverty: A narrative review of global evidence," Health Policy, Elsevier, vol. 142(C).
    17. Tessa Bold & Jakob Svensson, 2013. "Policies and Institutions for Effective Service Delivery: The Need of a Microeconomic and Micropolitical Approach," Journal of African Economies, Centre for the Study of African Economies, vol. 22(suppl_2), pages -38, August.
    18. Richard A. Iles, 2019. "Government doctor absenteeism and its effects on consumer demand in rural north India," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 475-491, April.
    19. Bernal Lobato, N., 2014. "Essays in applied microeconomics," Other publications TiSEM 9b638b3d-2f83-452a-b2c8-c, Tilburg University, School of Economics and Management.
    20. Joshi, Shareen & Sivaram, Anusuya, 2014. "Does it Pay to Deliver? An Evaluation of India’s Safe Motherhood Program," World Development, Elsevier, vol. 64(C), pages 434-447.

    More about this item

    Keywords

    Healthcare utilization; Provider choice; Cost sensitivity; Healthcare policy; India;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

    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:spr:jqecon:v:21:y:2023:i:3:d:10.1007_s40953-023-00354-x. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.