Health Insurance and Demand for Inpatient Services in Private Hospitals in Kenya

Abstract

Several studies have looked at the factors that play a role in determining whether an individual would use a health care provider, whether private or public, as well as whether or not to get health insurance. Costs of services and efficiency of access to services in either institution are the most researched elements thought to affect such choices. In Kenya, there is a persistent trend towards use of healthcare services in private hospitals even as the government invests huge amounts of resources annually in public health facilities. The main purpose of this study was to analyse the effect of health insurance ownership on demand for inpatient services in private hospitals in Kenya. The specific objectives include; to assess the patterns of inpatient services between the insured and the uninsured patients in private hospitals in Kenya, and to examine the effects of health insurance ownership on utilization of inpatient services in private hospitals in Kenya. Kenya Household Health Expenditure and Utilization Survey (KHHEUS, 2018) dataset was utilized. Binary probit regression model was used in estimation. From the findings, the demand for admissions in the private hospitals were 39.3 percent of the total inpatient admissions during the entire period preceding the survey or 1.31 percent of the total population surveyed. Those who consumed inpatient healthcare services in public hospitals, only 35.7 percent were insured compared to 77.2 percent in private hospitals. The study also concluded that medical insurance or health insurance coverage was significantly related to inpatient healthcare services use in private hospitals in Kenya. Among the control variables, it was revealed that age, age squared, education levels (primary, secondary and tertiary), employment, and awareness levels had a significant effect. To promote increased use of public healthcare services via admissions across the country, the study recommends for policy shift that is patient centred and cost friendly with effective service delivery for all age groups. It is important to understand that educational interventions can help increase knowledge of available healthcare services in public hospitals, enabling individuals to make informed decisions and use them more effectively. Lastly, there is need for public private sector partnership in health to empower community to access health services in public hospitals.