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Health care utilisation in a developing country -the case of Zambia

Hjortsberg, Catharina LU (2004) In Lund Economic Studies No. 118.
Abstract (Swedish)
Popular Abstract in Swedish

Syftet med denna avhandling är att bidra till vår förståelse för vårdutnyttjande och dess förklaringsfaktorer i utvecklingsländer, speciellt i sub-sahariska Afrika. Detta görs genom att fokusera på sjukvårdsutgifter och dess förklaringsfaktorer, samt valet att söka vård för att bota åkomman. Datamaterialete som används kommer från en hushållsundersökning från 1998 omfattande 16000 hushåll. I den första artikeln undesöks ett hushålls utgifter för sjukvård. Syftet är att undersöka vilka förklaringsfaktorer som påverkar Zambiska hushålls vårdutnyttjan och om andra faktorer än hälsostatus påverkar vårdsökande i utvecklingsländer. Resultaten visar en signifikant skillnad mellan hushåll i städer... (More)
Popular Abstract in Swedish

Syftet med denna avhandling är att bidra till vår förståelse för vårdutnyttjande och dess förklaringsfaktorer i utvecklingsländer, speciellt i sub-sahariska Afrika. Detta görs genom att fokusera på sjukvårdsutgifter och dess förklaringsfaktorer, samt valet att söka vård för att bota åkomman. Datamaterialete som används kommer från en hushållsundersökning från 1998 omfattande 16000 hushåll. I den första artikeln undesöks ett hushålls utgifter för sjukvård. Syftet är att undersöka vilka förklaringsfaktorer som påverkar Zambiska hushålls vårdutnyttjan och om andra faktorer än hälsostatus påverkar vårdsökande i utvecklingsländer. Resultaten visar en signifikant skillnad mellan hushåll i städer jämfört med hushåll på landsbygden, samt skillander mellan fattiga och icke fattiga hushåll, angående deras utgifter för vård. Generellt tyder resultaten på att hushåll påverkas av sin privata ekonomi, typ av sjukdom och tillgångsvariabler såsom avstånd. I artikel två analyseras en sjuk individs val av sjukvård och de utgifter som hon eller han har i samband med sjukdomsepisoden. I denna artikel är syftet å ena sidan att avgöra vilka faktorer som påverkar en sjuk individs benägenhet att söka vård eller använda själv-medicinering (eller att inte göra något), å andra sidan att undersöka vilka faktorer som påverkar individens sjukvårdsutgifter. Vi finner att individernas vårdutnyttjan påverkas av inkomst, utbildning, försäkring, typ av sjukdom och tillgång till vård. I den tredje artikeln fokuseras endast på barn under två år och samma frågeställning som i föregående artikel undersöks. Resultaten pekar på att barns sjukvårdsutnyttjan påverkas av hushållets inkomster, mammans utbildning och det faktum att mamman lever, ålder och tillgångsfaktorer. I den sista artikeln undersöks hushålls tillgång till sjukvård. Resultaten tyder på orättvisor mellan olika socioekonomiska grupper. (Less)
Abstract
The aim of this thesis is to contribute to our understanding of health care utilisation and its determinants in developing countries, especially in sub-Saharan Africa. This is done by explicitly focusing on health care expenditures and its determinants as well as the choice to seek health care to cure the illness. Firstly, the focus is on a household’s expenditures for health care. The aim of this paper is to explore the determinants of health care utilisation of Zambian households and in particular whether other factors than just health status influence utilisation in developing countries. The results point out a significant difference between households in rural and urban areas as well as between poor and non-poor households regarding... (More)
The aim of this thesis is to contribute to our understanding of health care utilisation and its determinants in developing countries, especially in sub-Saharan Africa. This is done by explicitly focusing on health care expenditures and its determinants as well as the choice to seek health care to cure the illness. Firstly, the focus is on a household’s expenditures for health care. The aim of this paper is to explore the determinants of health care utilisation of Zambian households and in particular whether other factors than just health status influence utilisation in developing countries. The results point out a significant difference between households in rural and urban areas as well as between poor and non-poor households regarding the magnitude of health care expenditures. In general, results show that the households are influenced by economic status, illness and access variables such as distance and owning a vehicle. Secondly, a sick individual’s choice of health care and expenditures related to it are analysed. In this paper the aim is on the one hand to determine what factors influence sick individuals’ propensity to seek health care at a health facility or to use self-medication (or do nothing), and on the other hand to determine the factors that influence the magnitude of the expenditures they incur for health care. We find that the individuals’ utilisation is influenced by economic status, education, insurance, type of illness and access variables such as distance and owning a vehicle.Thirdly, only children are focused on in analysing the determinants of those being taken to professional health care when sick, and then, given that health care is provided, estimating determinants of the level of expenditures incurred. The results show that children’s utilisation of professional health care is influenced by the household’s economic status, mother’s education, age, household ownership of motor transportation, child being an orphan (mother dead), distance to health care and living in a rural area. Then, in the last paper, Zambian households’ access to health care facilities are analysed. The results of the analysis indicate that there are inequalities among socio-economic groups, especially between rural and urban areas. In particular these differences exist because of differing distances to the nearest health facility.With these papers on Zambia and their different angles, a comprehensive picture of health care utilisation and factors influencing it in a sub-Saharan context is given. Interestingly, we can conclude that health care utilisation among individuals in developing countries is greatly influenced by the same factors as have been shown to influence individuals in developed countries. (Less)
Please use this url to cite or link to this publication:
author
opponent
  • Jones, Andrew
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Public health, Utvecklingsekonomi, Economics of development, access, health care, utilisation, epidemiology, Folkhälsa, epidemiologi
in
Lund Economic Studies
volume
No. 118
pages
160 pages
publisher
Department of Economics, Lund Universtiy
defense location
Department of Economics
defense date
2004-03-27 10:00
ISSN
0460-0029
language
English
LU publication?
yes
id
3c30fb5d-7a94-4762-8f5d-06effebd6ddc (old id 466745)
date added to LUP
2007-09-27 11:34:15
date last changed
2016-09-19 08:44:52
@phdthesis{3c30fb5d-7a94-4762-8f5d-06effebd6ddc,
  abstract     = {The aim of this thesis is to contribute to our understanding of health care utilisation and its determinants in developing countries, especially in sub-Saharan Africa. This is done by explicitly focusing on health care expenditures and its determinants as well as the choice to seek health care to cure the illness. Firstly, the focus is on a household’s expenditures for health care. The aim of this paper is to explore the determinants of health care utilisation of Zambian households and in particular whether other factors than just health status influence utilisation in developing countries. The results point out a significant difference between households in rural and urban areas as well as between poor and non-poor households regarding the magnitude of health care expenditures. In general, results show that the households are influenced by economic status, illness and access variables such as distance and owning a vehicle. Secondly, a sick individual’s choice of health care and expenditures related to it are analysed. In this paper the aim is on the one hand to determine what factors influence sick individuals’ propensity to seek health care at a health facility or to use self-medication (or do nothing), and on the other hand to determine the factors that influence the magnitude of the expenditures they incur for health care. We find that the individuals’ utilisation is influenced by economic status, education, insurance, type of illness and access variables such as distance and owning a vehicle.Thirdly, only children are focused on in analysing the determinants of those being taken to professional health care when sick, and then, given that health care is provided, estimating determinants of the level of expenditures incurred. The results show that children’s utilisation of professional health care is influenced by the household’s economic status, mother’s education, age, household ownership of motor transportation, child being an orphan (mother dead), distance to health care and living in a rural area. Then, in the last paper, Zambian households’ access to health care facilities are analysed. The results of the analysis indicate that there are inequalities among socio-economic groups, especially between rural and urban areas. In particular these differences exist because of differing distances to the nearest health facility.With these papers on Zambia and their different angles, a comprehensive picture of health care utilisation and factors influencing it in a sub-Saharan context is given. Interestingly, we can conclude that health care utilisation among individuals in developing countries is greatly influenced by the same factors as have been shown to influence individuals in developed countries.},
  author       = {Hjortsberg, Catharina},
  issn         = {0460-0029},
  keyword      = {Public health,Utvecklingsekonomi,Economics of development,access,health care,utilisation,epidemiology,Folkhälsa,epidemiologi},
  language     = {eng},
  pages        = {160},
  publisher    = {Department of Economics, Lund Universtiy},
  school       = {Lund University},
  series       = {Lund Economic Studies},
  title        = {Health care utilisation in a developing country -the case of Zambia},
  volume       = {No. 118},
  year         = {2004},
}