Are user fees regressive?

Gertler, Paul; Locay, Luis; Sanderson, Warren C.

doi:10.1016/0304-4076(87)90044-3

Cited by 145 publications

(19 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The theoretical framework is based on discrete choice models following the examples of [23, 24]. Discrete choice models are derived from the hypothesis that the choice of the individual follows a maximisation behaviour of the random utility [25, 26].…”

Section: Methodsmentioning

confidence: 99%

“…(4). Gertler et al [23] develop a random utility model in which the demand for medical care is modeled as the decision to seek care and, conditional on that, the decision of which provider to use. The corresponding econometric specification is the nested multinomial logit model, which relaxes the independence of non relevant alternatives (IIA) assumption [27].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The determinants of the choice of treatment of pregnant women in Cameroon

Anya

Yene

2016

Health Econ Rev

View full text Add to dashboard Cite

This paper seeks to identify the determinants of the choice of treatment of pregnant women in Cameroon. Theoretically, the methodology is based on a discrete choice model with random utility. Empirically, the econometric specification is a Nested Multinomial Logit Model. The data used comes from the Demographic Health Survey (DHS) organized in 2011 by the National Institute of Statistics. The results reveal that uneducated women or those having only a primary education prefer to meet the traditional midwives than seek modern maternal health services. Moreover, the absence of a paid job for the pregnant woman, the large size of the household, Islamic or animist religion, poverty, high costs of healthcare and transportation are constraints which make the pregnant woman to prefer the services of traditional midwives to modern services of maternal health. The use of modern healthcare services by pregnant women in Cameroon can therefore be improved by at least two means: firstly, by improving on the level of education of women and economically empowering them. Secondly, in a context where the costs of healthcare services are paid directly by the pregnant women themselves or by their families, it is important to put in place health insurance schemes in order to guarantee proper follow-up of pregnant women until delivery as well as taking care of complicated cases.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The determinants of the choice of treatment of pregnant women in Cameroon

Anya

Yene

2016

Health Econ Rev

View full text Add to dashboard Cite

show abstract

“…The benefits minus the costs provide a latent utility for each alternative and each individual. Hence, the observed alternative (the selected healthcare provider) is the one that has the highest expected latent utility for that specific individual [34,35]. …”

Section: Methodsmentioning

confidence: 99%

Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

2011

View full text Add to dashboard Cite

BackgroundA common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization.MethodsBy using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization).ResultsPoorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status.ConclusionsOverall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services.

show abstract

“…12 For equity, because health care has been argued to be an essential good, the demand for it will not fall with price (ie, price inelasticity), and people in the lowest income quintile have shown to be highly responsive to even small changes in price. 13 Hence, even very small fees can reduce their access, and exemption mechanisms for these groups have repeatedly failed. 9 Médecins Sans Frontières studied prices paid in several subSaharan African countries at public-health centres that applied user fees for primary care, [14][15][16] and found that the fees represented a substantial share of household expenditure (equivalent to 12-30 days of expenses), forcing many families to borrow money or sell goods.…”

Section: Field Hospital In Burkina Fasomentioning

confidence: 99%