Socio-economic factors influencing health care utilisation in South Africa : an investigation using the national income dynamics study.

Abstract

The study aims to understand the socio-economic factors that influence health care utilisation in South Africa. Health care utilisation for the purpose of this study is defined as visits for treatment to a hospital, clinic, health centre or traditional healer. Utilisation of health care services can be analysed using a health economics model. The typical economic theory of demand and supply in the context of health care defines supply factors as those that come from the production of health care; and demand factors are those linked to individual and household characteristics. Ensoor and Cooper (2004) suggest the decision to seek treatment, or where to go for treatment, is greatly influenced by demand side factors. Socio-economic factors in this study were defined by variables which incorporated demographic, economic and social references which formed the independent study variables that would be used to report on health care utilisation. The study population was drawn from all adult respondents who took part in the 1st Wave of NIDS, and 3922 of those respondents formed part of this study sample. The study sample comprised respondents who had reported consulting about their health in the last 30 days against which further analysis was conducted. Results from the study show that utilisation is driven by access to a good social support system i.e. the support of a spouse and the income to access health care. Results show that utilisation of public sector health care providers is characterised by high numbers of poor, mainly female, users. The results from the study suggest that a poor majority face the burden of the costs associated with private health care. As much as 87% of the sample did not have medical aid coverage yet 60.6% users of private health care were not covered by medical aid. The study highlights the inequalities evident in our society and the effectiveness of the public sector reforms to date. Although democracy allowed equal access to private health care by all in terms of racial divides that had existed; an inadequate public health care sector has highlighted poorer, uninsured people utilising private health care.