Association Between Socioeconomic Status and Willingness to Pay for Medical Care Among Government School Teachers in Addis Ababa

Abstract

In low income countries households are the principal health financing agents. Their expense goes not without shrinking the basic consumptions of the household. This cost is not even enough to avert the consequences either. As a consequence it perpetuates the vicious cycle between sickness and poverty. Control of diseases or their outcome will depend on socioeconomic determinants. Understanding what affects willingness-to-pay (WTP) for medical care is very important to design choices about the allocation of scarce resources. The objective of this study was to assess the association between socioeconomic status and WTP for medical care among government school teachers in Addis Ababa. A cross sectional survey methodology was employed and a structured questionnaire was administered to 847 government school teachers between January to March 2011. The sample was generated by a two-stage probability proportional to size sampling (PPS) method. A dichotomous choice contingent valuation method (CVM) in the single bound formulation was used to elicit a “yes” or “no” answer by respondents when asked if they are WTP a given bid for medical care. Three hypothetical case scenarios: common cold (CC), glaucoma (BD) and heart attack (HAT) were designated. Both descriptive and analytic statistics were used to analyze the data. The degree and strength of association between the explanatory variables and willingness to pay were evaluated by logistic regression. Generally more respondents were WTP for CC, BD and HAT in government than private facilities. In government facilities WTP for CC and BD did not vary with socioeconomic status. However WTP for HAT was lower in the low income group and educational status. In private facilities WTP for CC varied with land ownership only.WTP for both BD and HAT was higher in those with better income and who own land. Educational level, proxy indicators of wealth, income level, lower medical care costs and seriousness of illness were found to positively influence the WTP for medical care. Improving employment benefits and establishing a mechanism to help raise the ability to pay are commendable policy measures.