| dc.description.abstract | Under-utilization of medical facilities in African countries is believed to be a
result of the high cost of medical care services. This paper uses data from a random
survey of users of health facilities, enriched with exogenous information on health
facility attributes, to examine more deeply the accessibility factor in health care demand
in rural Kenya.
We find that income increase demand for medical care although by an
insignificant margin. Thus large increases in income are required to increase demand
significantly. Gender and education are important determinants of the choice of health
facility. Quality is another major determinant of health care demand. Improvement in
service quality significantly increases demand and therefore can be used as a policy tool
to drive more people into the health sector. Drug availability increases demand in
hospitals and reduces demand for ambulatory care services.
Distance, waiting time, and user fees reduce demand, particularly in the private
care sector. Insurance increases demand in the hospital and dispensaries (where
insurance pays for the medical care costs of the patients) and reduces demand in the
private physician option. It increases the accessibility for the insured by reducing the
money prices of medical care. On the other hand, it makes time prices and distance
significant determinants of medical care demand.
Thus to increase access to medical care for the low-income earners, the insurance
institution should be able to organize consumer's entry into the health system and remove
the financial incentive that may encourage providers to increase volume and cost of
services. | en |
