A STRUCTURAL EQUATION MODEL OF THE DETERMINANTS OF HEALTH CARE IN THE SURVEYED HOUSEHOLDS IN RURAL AREA OF DHARWAD DISTRICT, KARNATAKA STATE, INDIA

Abstract

Introduction: Health and health care need to be distinguished from each other for no better reason than that the former is often incorrectly seen as a direct function of the latter. Hence, the good health confers on a person or groups freedom from illness and the ability to realize one's potential. However, a few studies had shown that health care is associated with socio-economic, demographic and ecological factors which are diverse and interrelated. Therefore, the purpose of this study to examine the causal relationships among factors determining how much care people are willing to purchase.

Method: A systematic random sample of 1408 persons interviewed from 320 households, in which 453 persons were reported with health problems. Out of this, 235 persons were reported with medical health problems and 218 persons were reported with oral health problems during reference period of study. The data on different factors were collected through direct personal interview method. The causal relationships were established by structural equation modeling (SEM) method using SPSS and AMOS statistical software.

Results: The SEM fitted to the medical and oral health care data adequately. The results indicated that, the age of sick person, duration of illness episode (in days) and the total number of visits made to source of health care during the reference period had significant effect on medical health care expenditure (p<0.05). But, the duration of illness episode (in days), total number of visits made to source of health care during the reference period and distance of care from the residence of the household (in km) had significant effect on oral health care expenditure (p<0.05).

Conclusions: The duration of illness episode (in days) and the total number of visits made to source of health care during the reference period are the main contributors to both medical and oral health care expenditure in surveyed households in rural area of Dharwad district, Karnataka State, India. It is proposed that to increase in the demand for health care, efforts should be made to reduce the duration of illness, the distance traveled by the sick person or patient and also the number of visits to health care providers. It may lead to improved health status at lower expenditure.