Itinéraires thérapeutiques des patients dans un contexte de défaillances du marché de soins au Togo

Abstract

Introduction : Improving access to and the use of health services remains a challenge for the health system in Togo, given the confidence and quality of care perceived by Togolese citizens.Purpose of research : This study aims to analyze the determinants of the therapeutic itinerary of patients in Togo, with a particular focus on the institutions that regulate the health care market.Results : This is an empirical study, based on data from the Unified Survey of Basic Welfare Indicators (QUIBB, 2015) covering 2400 households. Issues of care market failures are addressed in terms of perceived quality of care and organizational quality. The patients’ care pathway includes self-medication, and the use of public or private health services. Within the framework of a multinomial probit model, the results show that improving the perceived quality of health services increases the probability of using public and private health services with a much higher marginal effect for the use of public services. Organizational quality of health services was also found to increase the probability of using private health services.Conclusions : In view of the results found, it is necessary to improve the regulatory institutions of the health care market in Togo. This improvement requires the implementation of health care policies aimed at improving the professionalism of health care personnel.