Predictors of Demand for Healthcare from Private and Public Care Providers in Uganda

Abstract

This research bases on the healthcare demand function in the Grossman investment model for healthcare to establish the demographic, socio-economic and access factors associated with demand for healthcare. Demand for healthcare was modelled using the derived demand approach as the monetary investment in the curative service sought from the provider of choice. Chi-squares were used to test the relationship between care seeker characteristics and the choice of provider. A multi-level logistic regression was used to establish the relationship between the choice of provider and the predictors. A Gaussian multi-level model was used to draw the relationship between the aggregate monetary investment in seeking a curative service and the predictors. To establish the predictors of demand from the public or private providers, findings from both models were then compared to establish what factors predicted the choice of the care provider and how these also predicted the overall investment in the curative services sought. Younger care seekers in the 0-14 year category were less likely to visit a public facility while those 45 years and above had higher odds of visiting a public facility as compared to those in the 35-44 year category. This came with lower and higher expenditure respectively. Care seekers in the fourth and highest quintile were less likely to visit public facilities as compared to their counterparts in the lowest quintile. This was also associated with higher expenditure. In communities where public facilities had distance and waiting times as an access concern, care seekers were less likely to visit the public facility. This still came with higher expenditure. Concerns of lack of medicines and supplies and limited services were found not to be significant. In communities where the preferred private facility was located far away, care seekers had higher odds of visiting a public facility. This was also associated with higher expenditures. The concerns of having limited or expensive services were found not to be significant. Care seekers will opt for the nearer facility and that with less waiting hours whether private or public and that always increases the investment they have to make. This could mean that the facilities closest to them whether public or private are perhaps providing inferior services.