Skip to main content

Advertisement

SpringerLink
Log in

Determinants of household health expenditure on western institutional health care

  • Original papers
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

We try to identify determinants of illness reporting, provider choice and resulting expenditure with different econometric models using data from a representative household panel survey of 800 households in Nouna health district, Burkina Faso, during 2000–2001. The factors “being an adult”, “married”, “illness occurred in rainy season” and “severe illness” significantly increased the magnitude of health expenditure. Compared to malaria, individuals spent more on other infectious diseases, injury and the other disease category. In contrast, people were less likely to spend on chronic illness. An individual who belonged to a household headed by a female, a literate household head and with a higher household expenditure had a significantly positive association with the magnitude of expenditure. Findings from this study can be used for policy implication to improve health system performance in Burkina Faso through enhancing health care utilization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Akin JS, Guilkey DK, Denton EH (1995) Quality of services and demand for health care in Nigeria: a multinomial probit estimation. Soc Sci Med 40: 1527–1537

    Article  PubMed  Google Scholar 

  2. Asenso-Okyere WK, Anum A, Osei-Akoto I, Adukonu A (1998) Cost recovery in Ghana: are there any changes in health care seeking behavior? Health Policy Planning, 13: 181–188

  3. Burkina Faso Ministry of Health (1996) Statistiques Sanitaires 1996. Burkina Faso Ministry of Health, Ouagadougou

  4. Burkina Faso Ministry of Health (1998) District Sanitaires de Nouna—Plan d’Action 1999. Burkina Faso Ministry of Health, Ouagadougou

  5. Coreil J (1983) Allocation of family resources for health care in rural Haiti. Soc Sci Med 17: 709–719

    Article  PubMed  Google Scholar 

  6. De Allegri M, Sanon M, Bridges J, Sauerborn R (2005) Understanding consumers’ preferences and decision to enroll in community-based health insurance in rural West Africa. Health Policy 76: 58–71

    PubMed  Google Scholar 

  7. Dong H, Mugisha F, Gbangou A, Kouyate B, Sauerborn R (2004) The feasibility of community-based health insurance in Burkina Faso. Health Policy 69: 45–53

    Article  PubMed  Google Scholar 

  8. Ekman B (2004) Community-based health insurance in low-income countries: a systematic review of the evidence. Health Policy Plan 19: 249–270

    Article  PubMed  Google Scholar 

  9. Flessa S (2002) Gesundheitsreformen in Entwicklungsländern (Health sector reform in developing countries). Lembeck, Frankfurt am Main

  10. Greene W (1997) Econometric analysis. Prentice Hall, Upper Saddle River

  11. Hjortsberg C (2003) Why do the sick not utilize health care? The case of Zambia. Health Econ 12: 755–770

    Article  PubMed  Google Scholar 

  12. Hosmer DW, Lemeshow S (2000) Applied logistic regression. John Wiley, New York

  13. Jack W (1999) Principles of health economics for developing countries. World Bank, Washington D.C.

  14. Lee L (1983) Generalized econometric models with selectivity. Econometrica 51: 507–512

    Google Scholar 

  15. Maddala G (1985) A survey of the literature on selectivity bias as it pertains to health care markets. Adv Health Econ Health Serv Res 6: 3–18

    PubMed  Google Scholar 

  16. Manning WG, Duan N, Rogers WH (1987) Monte Carlo evidence on the choice between sample selection and two-part models. J Econometr 35: 59–82

    Article  Google Scholar 

  17. Mugisha F, Kouyate B, Gbangou A, Sauerborn R (2002) Examining out-of-pocket expenditure on health care in Nouna, Burkina Faso: implication for health policy. Trop Med Int Health 7: 187–196

    Article  PubMed  Google Scholar 

  18. Mugisha F, Bocar K, Dong H, Chepng’eno G, Sauerborn R (2004) The two faces of enhancing utilization of health-care services: determinants of patient initiation and retention in rural Burkina Faso. Bull World Health Organ 82: 572–579

    PubMed  Google Scholar 

  19. Nieswiadomy M, Rubin RM (1995) Change in expenditure patterns of retirees: 1972–1973 and 1986–1987. J Gerontol B Psychol Sci Soc Sci. 50: S274–290

    Google Scholar 

  20. Nougtara A, Sauerborn R, Oepen C, Diesfeld HJ (1989) Assessment of MCH services offered by professional and community health workers in the district of Solenzo, Burkina Faso. I. Utilization of MCH services. J Trop Pediatr 35 [Suppl 1]: 2–9

  21. Pokhrel S, Sauerborn R (2004) Household decision-making on child health care in developing countries: the case of Nepal. Health Policy Plan 19: 218–233

    Article  PubMed  Google Scholar 

  22. Pokhrel S, Hidayat B, Flessa S, Sauerborn R (2005) Modelling the effectiveness of financing policies in addressing underutilization of child health care in Nepal. Bull World Health Organ 83: 338–344

    PubMed  Google Scholar 

  23. Ranson MK (2002) Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges. Bull World Health Organ 80: 613–621

    PubMed  Google Scholar 

  24. Rous JJ, Hotchkiss DR (2003) Estimation of the determinants of household health care expenditures in Nepal with controls for endogenous illness and provider choice. Health Econ 12: 431–451

    Article  PubMed  Google Scholar 

  25. Routh S, Thwin AA, Barb N, Begum A (2004) Cost efficiency in maternal and child health and family planning service delivery in Bangladesh: implications for NGOs. Health Policy Plan 19: 11–21

    Article  PubMed  Google Scholar 

  26. Sauerborn R, Nougtara A, Diesfeld HJ (1989) Low utilization of community health workers: results from a household interview survey in Burkina Faso. Soc Sci Med. 29: 1163–1174

    Google Scholar 

  27. Sauerborn R, Nougtara A, Latimer E (1994) The elasticity of demand for health care in Burkina Faso: differences across age and income groups. Health Policy Plan 9: 185–192

    PubMed  Google Scholar 

  28. Sauerborn R, Ibrango I, Nougtara A, Borchert M, Hien M, Benzler J, Koob E, Diesfeld HJ (1995) The economic costs of illness for rural households in Burkina Faso. Trop Med Parasitol 46: 54–60

    PubMed  Google Scholar 

  29. Sauerborn R, Adams A, Hien M (1996) Household strategies to cope with the economic costs of illness. Soc Sci Med 43: 291–301

    Article  PubMed  Google Scholar 

  30. Sauerborn R, Berman P, Nougtara A (1996) Age bias, but no gender bias, in the intra-household resource allocation for health care in rural Burkina Faso. Health Transit Rev 6: 131–145

    PubMed  Google Scholar 

  31. Sauerborn R, Nougtara A, Hien M, Diesfeld HJ (1996) Seasonal variations of household costs of illness in Burkina Faso. Soc Sci Med 43: 281–290

    Article  PubMed  Google Scholar 

  32. Sauerborn R, Zombre S, Some F et al. (2001) The rationale and feasibility of community-based insurance in rural Burkina Faso. Discussion paper, Department of Tropical Hygiene and Public Health, University of Heidelberg, Heidelberg

  33. Secretariat General du Ministère de la Santé du Burkina Faso (2002) Annuaire statistique de la santé. 2002. Ministère de la Santé, Ouagadougou .

  34. Sommerfeld J, Sanon M, Kouyate BA, Sauerborn R (2002) Perceptions of risk, vulnerability, and disease prevention in rural Burkina Faso: implication for community-based health care and insurance. Human Organ 61: 139–146

    Google Scholar 

  35. StataCorp (2001) Stata Statistical Software: Release 7.0. College Station Stata, Dallas

    Google Scholar 

  36. World Bank. (2002) World Development Indicators Database. (http://devdata.worldbank.org/exernal/CPProfile).

  37. World Health Organisation (2000) The World Health Report 2000, Health systems: improving performance. World Health Organisation, Geneva

  38. Würthwein R, Gbangou A, Sauerborn R, Schmidt CM. (2001) Measuring the local burden of disease. A study of years of life lost in sub-Saharan Africa. Int J Epidemiol. 30: 501–508

    Google Scholar 

  39. Würthwein R, Gbangou A, Kouyate B et al. (2001) The Nouna Health District household survey: design and implementation. SFB 544; Control of Tropical Infectious Diseases, University of Heidelberg Discussion Paper 3/2001 (http://www.hyg.uni-heidelberg.de/sfb544/)

Download references

Acknowledgements

This study was supported by the collaborative research grant SFB 544 of the German Research Foundation (Deutsche Forschungsgemeinschaft). The authors would like to thank Mr. Jack Han-Hsing Lin for language editing and two anonymous reviewers for their comments and constructive suggestions.

Conflict of interest

No information supplied.

Author information

Authors and Affiliations

  1. Department of Tropical Hygiene and Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany

    Tin Tin Su

  2. School of Health Sciences and Social Care, Brunel University, West London, UK

    Subhash Pokhrel

  3. Centre de Recherche en Santé de Nouna (CRSN), BP 02, Nouna District, Burkina Faso

    Adjima Gbangou

  4. Department of Health Care Management, University of Greifswald, Friedrich-Loeffler-Strasse 70, 17489 Greifswald, Germany

    Steffen Flessa

Authors
  1. Tin Tin Su
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Subhash Pokhrel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adjima Gbangou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Steffen Flessa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steffen Flessa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Su, T.T., Pokhrel, S., Gbangou, A. et al. Determinants of household health expenditure on western institutional health care. Eur J Health Econ 7, 195–203 (2006). https://doi.org/10.1007/s10198-006-0354-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-006-0354-1

Keywords

Search

Navigation