ANALYSIS OF THE FACTORS INFLUENCING HEALTHCARE SPENDING AMONG SELECTED HOUSEHOLD

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ANALYSIS OF THE FACTORS INFLUENCING HEALTHCARE SPENDING AMONG SELECTED HOUSEHOLD

ABSTRACT

This study investigates the determinants of healthcare spending among selected households, aiming to provide insights into the factors influencing healthcare expenditure patterns. With rising healthcare costs globally, understanding the drivers of healthcare spending is crucial for policymakers, healthcare providers, and households alike. Using a mixed-methods approach, including surveys and interviews, data are collected from a representative sample of households to examine various socio-economic, demographic, and health-related factors influencing healthcare expenditure.

The findings reveal significant associations between household characteristics, healthcare needs, and spending patterns. Factors such as income level, household size, age, and health status are found to have a substantial impact on healthcare spending behavior. Additionally, access to health insurance, availability of healthcare facilities, and preferences for healthcare services are identified as significant determinants of healthcare expenditure.

Moreover, qualitative insights from interviews provide a deeper understanding of the underlying reasons behind household healthcare spending decisions, including perceived quality of care, cultural norms, and healthcare-seeking behavior. The study highlights the complex interplay of socio-economic and health-related factors in shaping household healthcare spending patterns.

Overall, this research contributes to the existing literature by shedding light on the multifaceted nature of healthcare spending among households. The findings have implications for healthcare policy formulation, resource allocation, and the development of targeted interventions to improve healthcare affordability and accessibility. By addressing the underlying determinants of healthcare expenditure, policymakers and stakeholders can devise strategies to mitigate financial barriers and ensure equitable access to healthcare services.

Chapter One: Introduction

1.1 Background

Healthcare spending is a critical component of household budgets and a significant determinant of financial well-being. Globally, healthcare costs have been rising steadily, posing challenges for households, healthcare systems, and policymakers. In many countries, including [insert country], understanding the factors influencing healthcare spending among households is essential for developing effective healthcare policies, improving access to healthcare services, and ensuring financial protection for individuals and families.

Health is a fundamental human right, a lack of which causes financial hardship for many households through direct spending on treatment and/or by indirect labour supply limitation and undermining people’s income‑generating activities (World Bank 1997; Barnett et al., 2001). The development of a nation specifically anchored on the quality of its human capital resources, which in turn is very dependent on the well‑being (nutritional and health‑wise) of its population. This is evident from substantial agreement in the literature on the relationship between health and economic development through its relationship between capability and poverty (Awoyemi et al., 2011).

The need for healthcare facilities is the prerequisite for its utilisation. Most often healthcare need is initiated on identification of an ill‑health situation by an individual or household member. According to Chauhan et al. (2015) healthcare‑seeking behaviour is a decision or an action taken by an individual to maintain, attain, or regain good health or otherwise prevent illness, given all‑encompassing available healthcare options. Notable healthcare options recorded in the literature include; a public or private and modern or traditional health facility, self‑medication and use of home remedies or zero health services usage etc. (Chauhan et al., 2015). Healthcare‑seeking behaviour is a result of a complex interaction of provider, patient, illness, and household characteristics. It is influenced by a variety of socio‑economic variables, including gender, age, the social status of women, the type of illness, access to services, and perceived quality of the service (Webairand Bin‑Gouth, 2013; Omeire, 2017). Healthcare‑seeking behaviour has also been found to be associated with the type of illness and gender of the sick person, income group, and area of residence (rural or urban) (Pillai et al., 2003; Sudha et al., 2003; Webairand Bin‑Gouth, 2013; Latunji and Akinyemi, 2018).

Healthcare utilisation is simply the use of healthcare facilities by people. Utilisation is an outcome of complex interacting factors of physical, socio‑economic, cultural, and political contexts. Furthermore, factors, such as availability of health facilities, quality and cost of services, as well as social‑economic structure, and personal characteristics of the users are relevant healthcare utilisation explanatory parameters (Manzoor et al., 2009; Onah et al., 2009; Omeire, 2017). The utilisation of healthcare facilities is related to visiting, upon the ill‑health condition, the official channels in a formally recognised healthcare. The prevailing healthcare system in developing countries is the public and the private health facility. It is however a universal phenomenon that the public health services of almost all developing countries are underutilised (Zwi 2001; Awoyemi et al., 2011; Ofoli, 2019). Given that the distance between the locations of supply and demand adds further challenges to using the services, the unequal geographic distribution of healthcare facilities is a significant barrier to access to healthcare services. The location of current healthcare facilities and the limited resources consistently allocated to its provision by the government at all levels, particularly in Nigeria, were called into question by this alarming aspect of inequities in the distribution of healthcare services (Uwala, 2020).

Private care providers are usually preferred all around due to easy accessibility and quality of healthcare services (Sudharsanam, 2007) though with high cost of care which could be unaffordable (Ameh et al., 2021). Whereas public facilities are synonymous with low‑quality treatment, long waiting periods, long distances, inconvenient locations, and inadequate facilities. Further, some public health centers also charge money for free services (Vargese et al., 2013).

The rural households, however, are less privileged in terms of accessibility to both facilities than their urban household counterparts. Nearly 80 % of the health facilities, both public and private are concentrated in urban areas and are widely utilised by the urban communities (Ahmed et al., 2003; WHO, 2015; Umeh, 2018). They also lack sufficient money to access care at private hospitals. This is owing to little or no documented evidence from available literature of savings culture in the rural area (Obalola et al., 2018). Further, the indirect costs like those associated with travel to the health facilities act as deterrents for the rural population (Chuma et al., 2007; Awoyemi et al., 2011; Ameh et al., 2021). This is in spite of the farming livelihood associated with these households which tends to expose them to varieties of ill‑health conditions. In addition, health complaints and utilisation differ according to seasonal variations and weather conditions which have a strong implication on their agriculture‑based livelihood productivity (Fleming et al., 2000; Drayna et al., 2010). These poor rural households hence resort to additional health facility options of self‑treatment and bypass primary care providers (Gotsadze et al., 2005).

A good healthcare services provision planning depends on the health needs and healthcare‑seeking behaviour of the population. Understanding the healthcare‑seeking behaviour, as well as the choice of health facility utilisation, is essential to the provision of need‑based healthcare services to the population. While medical data remain the main information source regarding illness patterns, community‑based studies reflect better the preferences in seeking healthcare services (Chauhan et al., 2015). A volume of studies though had been carried out generally on the determining factors of healthcare service utilisation (Babar and Juanita, 2004; Chuma et al., 2007; Chauhan et al., 2015; Urama et al., 2020); little had been done with a specific focus on the choice of healthcare facility usage, especially from the rural household perspective. This study was thereby carried out to fill the gap. The study will help to understand the preference for healthcare facilities utilisation and the factors (household, individual, illness, and provider characteristics) influencing such preference among rural households. Specifically, the study described the demographic characteristics of the households; assessed the choice of health facilities available to the households, and determined factors influencing the choice of health facilities utilised by the households.

1.2 Problem Statement

Despite the importance of healthcare spending, there is a lack of comprehensive understanding of the factors influencing household healthcare expenditure in [insert country]. Existing studies often focus on aggregate healthcare spending at the national level, overlooking the heterogeneity in spending patterns among households. Moreover, the interplay of socio-economic, demographic, and health-related factors influencing household healthcare spending remains poorly understood.

1.3 Objectives of the Study

The primary objective of this study is to analyze the factors influencing healthcare spending among selected households in [insert country]. Specific objectives include:

To identify socio-economic factors affecting household healthcare spending patterns.

To assess the impact of demographic characteristics on healthcare expenditure among households.

To examine the association between health status and healthcare spending behavior.

To explore the role of health insurance coverage in shaping household healthcare spending.

To investigate household preferences and decision-making processes regarding healthcare utilization and spending.

1.4 Significance of the Study

Understanding the determinants of healthcare spending among households is crucial for policymakers, healthcare providers, and stakeholders in [insert country]. By identifying the factors influencing healthcare expenditure patterns, this study will contribute to the development of targeted interventions to improve healthcare affordability, accessibility, and quality. Additionally, the findings will inform healthcare policy formulation, resource allocation, and the design of health insurance programs to ensure financial protection for households.

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