scholarly journals An Econometric Analysis Of Health Care Utilization In Kenya

2016 ◽  
Vol 12 (16) ◽  
pp. 443 ◽  
Author(s):  
Diana N. Kimani ◽  
Mercy G. Mugo ◽  
Urbanus M. Kioko
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Healthcare Utilization ◽  
Household Head ◽  
Econometric Analysis ◽  
Health Facilities ◽  
Public Health Care ◽  
Care Utilization

Background: Increasing access to health care has been a policy concern for many governments, Kenya included. The Kenyan government introduced and implemented a number of initiatives in a bid to address the healthcare utilization challenge. These initiatives include 10/20 policy, exemptions for user fees for some specific health services (treatment of children less than five years, maternity services in dispensaries and health centers, Tuberculosis treatment in public health facilities), and increase in the number of health facilities and health workforce. These initiatives notwithstanding, healthcare utilization in Kenya remains a challenge. The Kenya Household Health Expenditure and Utilization Survey of 2007 found that 17 percent of those who needed health care services could not access the services from both government and private health facilities largely due to financial constraints. This paper employed econometric analysis to examine what could be constraining health care utilization in Kenya despite all the efforts employed. Methods: Using the 2007 Kenya Household Health Expenditures and Utilization Survey (KHHEUS) data (n = 8414), this paper investigates the factors that affect health care utilization in Kenya by estimating a count data negative binomial model. The model was also applied to public and private health facilities to better understand the specificities of poverty in these two facility types. Common estimation problems of endogeneity, heterogeneity, multicollinearity and heteroskedasticity are addressed. Findings: The econometric analysis reveals that out-of-pocket expenditures, waiting time, distance, household size, income, chronic illness area of residence and working status of the household head are significant factors affecting health care utilization in Kenya. While income and distance are significant factors affecting public health care utilization they are not significant in explaining healthcare utilization in private facilities. In addition, working status of the household head, insurance cover and education are significant in explaining private and not public health care utilization. A striking finding is the positive relationship between distance and health care utilization implying that people will travel long distances to obtain treatment. This is perhaps associated with expectations of higher quality of care at far away higher level facilities, especially in rural areas. Conclusion: The paper confirms the existing evidence of the negative effects of Out-of-Pocket (OOP) expenditures and other determinants of health care utilization. With a better understanding of why people use or do not use health services, health care organizations can seek to improve the quality of human life. The bypassing of health facilities for higher level far away facilities implies that it is not so much about availing health facilities, but the quality of the services offered in those facilities. The government should therefore assure quality to increase utilization of the lower level facilities, especially in the rural areas.

scholarly journals Patterns and predictors of private and public health care utilization in an informal settlement in Nairobi, Kenya: A cross-sectional study

2020 ◽  
Author(s):  
Elvis Wambiya ◽  
Peter O Otieno ◽  
Martin Kavao Mutua ◽  
Hermann Pythagore Pierre Donfouet ◽  
Shukri F Mohamed
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Informal Settlement ◽  
Cross Sectional Study ◽  
Public Health Care ◽  
Care Utilization ◽  
Health Seeking ◽  
Cross Sectional ◽  
Explanatory Variables

Abstract BackgroundKnowledge of health care utilization is particularly crucial in low-and middle-income countries where inequalities in burden of disease and access to primary health care exist. Inconclusive evidence exists on health-seeking and utilization of health facilities in the informal settlements in Kenya. This study assessed the patterns and predictors of private and public health care utilization in an urban informal settlement in Kenya.MethodsThis cross-sectional study used data from the Lown scholars study conducted between June and July 2018. It was nested within the Nairobi Urban Health and Demographic Surveillance System. Households were selected using simple random sampling and data obtained for all household members who reported having sought care for an illness in the 12 months preceding the study. Data were collected on health-seeking behaviour and explanatory variables (predisposing, enabling, and need) using an adaptation of Andersen’s conceptual framework. Health care utilization patterns by explanatory variables were described using proportions and multinomial logistic regression used to identify the predictors of private or public health care use.ResultsThree hundred and sixty-four members from 300 households sought care for an illness in the 12 months preceding the study. Almost half (47%) of the respondents sought care from private facilities while about 33% and 20% used public and other facilities, respectively. Health care utilization was influenced by enabling and need factors. Health insurance coverage was associated with private health facility use (aOR 3.06; 95% CI 1.48 – 6.31). Satisfaction with the quality of care was associated with lower use of public facilities (aOR 0.31; CI 0.11 – 0.84) while satisfaction with cost of care was associated with higher use of public facilities (aOR 2.09; CI 1.01 – 4.29). Members who reported an acute infection were more likely to use private facilities (aOR 3.07; 95% CI 1.52 – 6.18).ConclusionsHealth care utilization in the urban informal settlements favours private health facility use. As Kenya commits to achieving universal health coverage, interventions to improve health care access in informal and low-resource settlements should be modelled around enabling and need factors, particularly health care financing and quality of health care provision.

Factors associated with health care utilization by the elderly in a public health care system

Health Policy ◽  
2006 ◽  
Vol 75 (2) ◽  
pp. 131-139 ◽  
Author(s):  
C. Fernández-Olano ◽  
J.D. López-Torres Hidalgo ◽  
R. Cerdá-Díaz ◽  
M. Requena-Gallego ◽  
C. Sánchez-Castaño ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Health Care System ◽  
The Elderly ◽  
Public Health Care ◽  
Care Utilization ◽  
Public Health Care System ◽  
Factors Associated ◽  
Care System

scholarly journals Patterns and predictors of private and public health care utilization among residents of an informal settlement in Nairobi, Kenya: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elvis O. A. Wambiya ◽  
Peter O. Otieno ◽  
Martin Kavao Mutua ◽  
Hermann Pythagore Pierre Donfouet ◽  
Shukri F. Mohamed
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Informal Settlement ◽  
Acute Infection ◽  
Public Health Care ◽  
Care Utilization ◽  
Health Seeking ◽  
Public Facilities ◽  
Private And Public

Abstract Background Knowledge of health care utilization is important in low-and middle-income countries where inequalities in the burden of diseases and access to primary health care exist. Limited evidence exists on health seeking and utilization in the informal settlements in Kenya. This study assessed the patterns and predictors of private and public health care utilization in an urban informal settlement in Kenya. Methods This study used data from the Lown scholars study conducted between June and July 2018. A total of 300 households were randomly selected and data collected from 364 household members who reported having sought care for an illness in the 12 months preceding the study. Data were collected on health-seeking behaviour and explanatory variables (predisposing, enabling, and need factors). Health care utilization patterns were described using proportions. Predictors of private or public health care use were identified using multinomial logistic regression with the reference group being other providers. Results Majority of the participants used private (47%) and public facilities (33%) with 20% using other providers including local pharmacies/drug shops and traditional healers. In the model comparing public facilities vs other facilities, members who were satisfied with the quality of health care (vs not satisfied) were less likely to use public facilities (adjusted relative risk ratio (aRRR) 0.29; CI 0.11–0.76) while members who reported an acute infection (vs no acute infection) were more likely to use public facilities (aRRR 2.31; 95% CI 1.13–4.99) compared to other facilities. In the second model comparing private facilities to other facilities, having health insurance coverage (aRRR 2.95; 95% CI 1.53–5.69), satisfaction with cost of care (aRRR 2.08; CI 1.00–4.36), and having an acute infection (aRRR 2.97; 95% CI 1.50–5.86) were significantly associated with private facility use compared to other facilities. Conclusions The majority of urban informal settlement dwellers seek care from private health facilities. As Kenya commits to achieving universal health coverage, interventions that improve health care access in informal and low-resource settlements are needed and should be modelled around enabling and need factors, particularly health care financing and quality of health care.

scholarly journals Attitude of Rural Community Towards Health Care Utilization at Primary

1970 ◽  
Vol 9 (2) ◽  
pp. 69-74
Author(s):  
Md Ziaul Islam ◽  
Sanjoy Kumar Chowdhury ◽  
Sharmin Farjana
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Rural Community ◽  
Family Income ◽  
Health Facilities ◽  
Care Utilization ◽  
Primary Level ◽  
Public Health Facilities ◽  
Monthly Family Income

Objective: The study was conducted to assess the attitude of rural community towards health care utilization at primary level public health facilities. Study Design: Descriptive cross sectional study carried out over a period of six months from June to November 2007. Study Setting: A randomly selected village (Lohagach) of Sreepur Upazila under Gazipur district. Subjects: 305 randomly selected adult (age 15-60 years) household members who are permanent residents of the said area. Materials and methods: Data was collected by face to face interview with a semi-structured questionnaire. Results: Among the 305 respondents, 55.40% are male and 44.60% are female with mean age of 32.39 years (± SD 11.94). Most respondents have educational qualification up to secondary level (32.10%) while some up to primary level (21%). Majority of the respondents are housewives (35.40%) and Service holders (20.30%) having an average monthly family income of TK.7805.57 (± SD 6442.24). It is evident from the study that; females, respondents from older age group, and those from higher monthly family income has less appreciation for existing primary level public health facilities. Also, the higher the education level of the respondent, the lower was the level of satisfaction regarding healthcare received at primary level public health facilities. As regards to availability of healthcare; insufficiency of doctors (52.8%) & prescribed medicine supply (75.4%) and lack of appropriate and necessary laboratory investigation (64.6%) & surgical treatment facilities (62.6%) are identified by the respondents as major setbacks. The study reveals key impediments pointed out by the respondents which interfere with their easy access to quality healthcare at these facilities; including long waiting time (60.3%), insufficient waiting room facilities (64.9%) and inadequate duration of consultation with physician (50.2%). Major constraints associated with primary health care utilization are mostly due to lack of awareness (22.66%) and transportation problem (22.6%). Key words: Attitude of Rural Community, Health Care Utilization, Primary Level Public Health Facilities   DOI = 10.3329/jom.v9i2.1433 J MEDICINE 2008; 9 : 69-74

Health Care Utilization, Transition Readiness, and Quality of Life: A Latent Class Analysis

2020 ◽  
Author(s):  
Katherine A Traino ◽  
Christina M Sharkey ◽  
Megan N Perez ◽  
Dana M Bakula ◽  
Caroline M Roberts ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care Utilization ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Care Utilization ◽  
Class Membership ◽  
Transition Readiness ◽  
High Utilization

Abstract Objective To identify possible subgroups of health care utilization (HCU) patterns among adolescents and young adults (AYAs) with a chronic medical condition (CMC), and examine how these patterns relate to transition readiness and health-related quality of life (HRQoL). Methods Undergraduates (N = 359; Mage=19.51 years, SD = 1.31) with a self-reported CMC (e.g., asthma, allergies, irritable bowel syndrome) completed measures of demographics, HCU (e.g., presence of specialty or adult providers, recent medical visits), transition readiness, and mental HRQoL (MHC) and physical HRQoL (PHC). Latent class analysis identified four distinct patterns of HCU. The BCH procedure evaluated how these patterns related to transition readiness and HRQoL outcomes. Results Based on seven indicators of HCU, a four-class model was found to have optimal fit. Classes were termed High Utilization (n = 95), Adult Primary Care Physician (PCP)-Moderate Utilization (n = 107), Family PCP-Moderate Utilization (n = 81), and Low Utilization (n = 76). Age, family income, and illness controllability predicted class membership. Class membership predicted transition readiness and PHC, but not MHC. The High Utilization group reported the highest transition readiness and the lowest HRQoL, while the Low Utilization group reported the lowest transition readiness and highest HRQoL. Conclusions The present study characterizes the varying degrees to which AYAs with CMCs utilize health care. Our findings suggest poorer PHC may result in higher HCU, and that greater skills and health care engagement may not be sufficient for optimizing HRQoL. Future research should examine the High Utilization subgroup and their risk for poorer HRQoL.

scholarly journals Quality of Life and Health Care Utilization in the CIRCA-DOSE Study

2020 ◽  
Vol 6 (8) ◽  
pp. 935-944 ◽  
Author(s):  
Jason G. Andrade ◽  
Laurent Macle ◽  
Atul Verma ◽  
Marc W. Deyell ◽  
Jean Champagne ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Dose Study
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