Determinants of Health Service Utilization by Urban Households in India

Abstract

In this article, an attempt has been made to examine the factors associated with the utilization of health care services among the urban households in India based on NSS case-level data of 42nd (1986–1987) and 60th round (2004–2005). The result of multivariate logistic regression analysis reveals that the education level of household head is not only an important positive predictor in the utilization of health services in general but is also found as a negative predictor to determine the utilization of public facilities in particular (National Sample Survey, 1998). It is also found that the weaker social class like scheduled caste (SC) is less likely to use curative health care facilities but the chances of using public facilities are much higher compared to non-SC households (National Sample Survey, 2006). It is found that the influence of household income for accessing health care services has been sharpened over the period. The study also reveals that the utilization of public health facilities is much higher in low-income states but the rate of improvement of public health care utilization is much higher in case of outpatient care services. The size of town has shown a significant impact on the utilization of health services. The chances of using public facilities have increased in small- and medium-sized town compared to metro cities. The level of intra-household disparities in access to health facilities with respect to age and gender has increased in urban India. Significant gender disparities are found in case of public health service utilization both for inpatient and outpatient care services in urban India.