Please use this identifier to cite or link to this item: http://hdl.handle.net/11718/25208
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dc.contributor.authorCernauskas V.
dc.contributor.authorAngeli F.
dc.contributor.authorJaiswal A.K.
dc.contributor.authorPavlova M.
dc.date.accessioned2022-02-11T10:13:55Z-
dc.date.available2022-02-11T10:13:55Z-
dc.date.issued2018
dc.identifier.citation?ernauskas, V., Angeli, F., Jaiswal, A. K., & Pavlova, M. (2018). Underlying determinants of health provider choice in urban slums: Results from a discrete choice experiment in Ahmedabad, India. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-3264-x
dc.identifier.issn14726963
dc.identifier.urihttps://www.doi.org/10.1186/s12913-018-3264-x
dc.identifier.urihttp://hdl.handle.net/11718/25208-
dc.description.abstractBackground: Severe underutilization of healthcare facilities and lack of timely, affordable and effective access to healthcare services in resource-constrained, bottom of pyramid (BoP) settings are well-known issues, which foster a negative cycle of poor health outcomes, catastrophic health expenditures and poverty. Understanding BoP patients' healthcare choices is vital to inform policymakers' effective resource allocation and improve population health and livelihood in these areas. This paper examines the factors affecting the choice of health care provider in low-income settings, specifically the urban slums in India. Method: A discrete choice experiment was carried out to elicit stated preferences of BoP populations. A total of 100 respondents were sampled using a multi-stage systemic random sampling of urban slums. Attributes were selected based on previous studies in developing countries, findings of a previous exploratory study in the study setting and qualitative interviews. Provider type and cost, distance to the facility, attitude of doctor and staff, appropriateness of care and familiarity with doctor were the attributes included in the study. A random effects logit regression was used to perform the analysis. Interaction effects were included to control for individual characteristics. Results: The relatively most valued attribute is appropriateness of care (?=3.4213, p = 0.00), followed by familiarity with the doctor (?=2.8497, p = 0.00) and attitude of the doctor and staff towards the patient (?=1.8132, p = 0.00). As expected, respondents prefer shorter distance (?= - 0.0722, p = 0.00) but the relatively low importance of the attribute distance to the facility indicate that respondents are willing to travel longer if any of the other statistically significant attributes are present. Also, significant socioeconomic differences in preferences were observed, especially with regard to the type of provider. Conclusion: The analyses did not reveal universal preferences for a provider type, but overall the traditional provider type is not well accepted. It also became evident that respondents valued appropriateness of care above other attributes. Despite the study limitations, the results have broader policy implications in the context of Indian government's attempts to reduce high healthcare out-of-pocket expenditures and provide universal health coverage for its population. The government's attempt to emphasize the focus on traditional providers should be carefully reconsidered. � 2018 The Author(s).
dc.language.isoen_US
dc.publisherBioMed Central Ltd.
dc.relation.ispartofBMC Health Services Research
dc.subjectBottom of the pyramid
dc.subjectDiscrete choice experiment
dc.subjectHealth provider choice
dc.subjectHealth-seeking behaviour
dc.subjectUrban slums
dc.titleUnderlying determinants of health provider choice in urban slums: Results from a discrete choice experiment in Ahmedabad, India
dc.typeArticle
dc.rights.licenseCC BY
dc.contributor.affiliationDepartment of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, Netherlands
dc.contributor.affiliationDepartment of Organization Studies, School of Social and Behavioural Sciences, Tilburg University, Warandelaan 2, Tilburg, 5000 LE, Netherlands
dc.contributor.affiliationIndian Institute of Management Ahmedabad, Vastrapur, Ahmedabad, 380015, India
dc.contributor.institutionauthor?ernauskas, V., Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, Netherlands
dc.contributor.institutionauthorAngeli, F., Department of Organization Studies, School of Social and Behavioural Sciences, Tilburg University, Warandelaan 2, Tilburg, 5000 LE, Netherlands
dc.contributor.institutionauthorJaiswal, A.K., Indian Institute of Management Ahmedabad, Vastrapur, Ahmedabad, 380015, India
dc.contributor.institutionauthorPavlova, M., Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, Netherlands
dc.description.scopusid57202582129
dc.description.scopusid36439152700
dc.description.scopusid24485500500
dc.description.scopusid7102023269
dc.identifier.doi10.1186/s12913-018-3264-x
dc.identifier.issue1
dc.identifier.volume18
Appears in Collections:Open Access Journal Articles

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