Underlying determinants of health provider choice in urban slums: results from a discrete choice experiment in Ahmedabad, India.

摘要: Severe underutilization of healthcare facilities and lack timely, affordable effective access to services in resource-constrained, bottom pyramid (BoP) settings are well-known issues, which foster a negative cycle poor health outcomes, catastrophic expenditures poverty. Understanding BoP patients’ choices is vital inform policymakers’ resource allocation improve population livelihood these areas. This paper examines the factors affecting choice care provider low-income settings, specifically urban slums India. A discrete experiment was carried out elicit stated preferences populations. total 100 respondents were sampled using multi-stage systemic random sampling slums. Attributes selected based on previous studies developing countries, findings exploratory study setting qualitative interviews. Provider type cost, distance facility, attitude doctor staff, appropriateness familiarity with attributes included study. effects logit regression used perform analysis. Interaction control for individual characteristics. The relatively most valued attribute (β=3.4213, p = 0.00), followed by (β=2.8497, p = 0.00) staff towards patient (β=1.8132, p = 0.00). As expected, prefer shorter (β= − 0.0722, but low importance facility indicate that willing travel longer if any other statistically significant present. Also, socioeconomic differences observed, especially regard provider. analyses did not reveal universal type, overall traditional well accepted. It also became evident above attributes. Despite limitations, results have broader policy implications context Indian government’s attempts reduce high out-of-pocket provide coverage its population. attempt emphasize focus providers should be carefully reconsidered.