A mixed logit model of health care provider choice

Analysis of NSS data for rural India

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

In order to address the persistent problems of access to and delivery of health care in rural India, a better understanding of the individual provider choice decision is required. This paper is an attempt in this direction as it investigates the determinants of outpatient health care provider choice in rural India in the mixed multinomial logit (MMNL) framework. This is the first application of the mixed logit to the modeling of health care utilization. We also use the multiple imputation technique to impute the missing prices of providers that an individual did not visit when she was ill. Using data from National Sample Survey Organization of India, we find the following: price and distance to a health facility play significant roles in health care provider choice decision; when health status is poor, distance plays a less significant role in an adult's provider choice decision; price elasticity of demand for outpatient care varies with income, with low-income groups being more price-sensitive than high-income ones. Furthermore, outpatient care for children is more price-elastic than that for adults, which reflects the socio-economic structure of a typical household in rural India where an adult's health is more important than that of a child for the household's economic sustenance.

Original languageEnglish (US)
Pages (from-to)915-932
Number of pages18
JournalHealth Economics
Volume15
Issue number9
DOIs
StatePublished - Sep 2006
Externally publishedYes

Fingerprint

Health Personnel
India
Logistic Models
health care
outpatient care
Ambulatory Care
income
price elasticity
Patient Acceptance of Health Care
Economics
economic structure
role play
health
Health Services Accessibility
health status
Health Facilities
Elasticity
low income
utilization
Health Status

Keywords

  • Health
  • Mixed logit
  • Multiple imputation
  • Simulation

ASJC Scopus subject areas

  • Economics and Econometrics
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

A mixed logit model of health care provider choice : Analysis of NSS data for rural India. / Borah, Bijan J.

In: Health Economics, Vol. 15, No. 9, 09.2006, p. 915-932.

Research output: Contribution to journalArticle

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