This thesis investigates the factors that determine demand for healthcare in Ghana by placing emphasis on price, income, and opportunity cost (the price of time). The study uses data from the sixth round of Ghana Living Standards Survey (GLSS 6) conducted in 2012/2013. The thesis is organized in a paper-based approach. The first paper aims at finding the sensitivity of demand for healthcare services to price and income, as well as finding the benefit incidence of the payment for healthcare services in Ghana. The paper estimates how changes in price and income of the consumer affect their demand for a particular healthcare provider – public, private and alternative healthcare, and concludes that overall, demand for healthcare is found to be price and income inelastic. That is, price and income elasticities of overall healthcare provider were estimated to be -0.016 and 0.01 respectively, indicating that demand for healthcare is less sensitive to changes in both price and income. The three types of healthcare – public, private, and alternative healthcare services are all price and income inelastic, though the coefficient of alternative healthcare is not statistically significant. A concentration index of 0.119 shows that payment of healthcare services in Ghana fall on the rich more than the poor. Based on the findings that there exist inequality and inequity in demand for healthcare measured by healthcare payment, it is recommended to policymakers to restructure the health system in such a way that such inequalities and inequities are removed or reduced substantially. Unlike the traditional Price Theory where demand for a commodity is largely determined by price and income, demand for healthcare in Ghana is found to be less sensitive to changes in price and income after controlling for the National Health Insurance Scheme. This suggests that in an attempt to find the determinants of demand for healthcare services, more attention should be given to other influential factors such as health insurance. iii Following from the conclusions of the first paper, the second paper then investigates the effect of the National Health Insurance Scheme on demand for healthcare. The finding is that enrolment onto the National Health Insurance Scheme (NHIS) increases healthcare utilization. Using Propensity Score Matching, the predicted probability of the effect of NHIS on healthcare utilization is 0.243 but decreases no care by the same magnitude (-0.243). In terms of where the individual seeks healthcare, the predicted probabilities for visiting public, private, and alternative healthcare providers are 0.231, 0.014, and -0.002 respectively. This means that NHIS increases public and private healthcare but decreases alternative healthcare utilization. People who sought healthcare did so for the purposes of treating illness, injury, check-up and follow-up, childbirth-related issues (prenatal, delivery, and antenatal), and vaccination. The Propensity Score Matching (PSM) predicted probability for treating illness, injury, check-up, childbirth-related issues, and vaccination purposes are 0.022, -0.001, 0.009, 0.002, and -0.032 respectively. The interpretation is that enrolling in NHIS increases healthcare utilization to treat illness, check-up, and childbirth-related purposes, but decreases utilization for injury and vaccination purposes. The PSM predicted probability of the effect of NHIS on out-of-pocket payment is -6.309. This means that NHIS decreases out-of-pocket payment by 6.309. The findings, therefore,suggest the importance of improving the National Health Insurance Scheme to increase access to healthcare. The National Health Insurance Scheme was established in 2003 with the aim of reducing the cost of healthcare provision and increase access to healthcare. However, the paper finds that even when the price is assumed to be “zero”, there still remain some economic costs for choosing a particular healthcare provider over the other. This is called the price of time or opportunity cost. In analyzing the effect of the price of time on choice of healthcare provider, the study finds that travel time and waiting time have a significant effect on the choice of iv healthcare provider, but not travel cost. An hour increase in the time taken to travel to the healthcare facility is likely to decreases the probability of seeking healthcare from public modern, private modern, and chemical shop by 3.1, 0.5, and 3.6 percentage points. The effect of the time spent at the healthcare facility on the choice of a particular healthcare provider is also significant. For instance, if waiting time increases by 1 hour, the effect on visiting public modern and traditional health centers will increase by 6.0 percentage points and 1.3 percentage points respectively. However, the effect on private modern and chemical store will be a decrease in probabilities by 5.0 and 2.8 percentage points respectively. Based on the findings of the study, it is recommended to policymakers to institute measures aimed at reducing the cost of providing healthcare, increasing access to healthcare especially to the poor, and also raising incomes of consumers. Health insurance is found to significantly increases healthcare utilization and decrease out-of-pocket payment. Therefore, the National Health Insurance scheme should be well resourced in order to provide quality services to subscribers, and also encourage the poor to enroll. It is also recommended to policymakers to make effort to decrease travel time and waiting time at the health facilities in the country to improve healthcare delivery
SARKODIE, A (2021). Demand and Benefit Incidence of Healthcare Services in Ghana. Afribary. Retrieved from https://afribary.com/works/demand-and-benefit-incidence-of-healthcare-services-in-ghana
SARKODIE, ADU "Demand and Benefit Incidence of Healthcare Services in Ghana" Afribary. Afribary, 04 Apr. 2021, https://afribary.com/works/demand-and-benefit-incidence-of-healthcare-services-in-ghana. Accessed 10 Dec. 2023.
SARKODIE, ADU . "Demand and Benefit Incidence of Healthcare Services in Ghana". Afribary, Afribary, 04 Apr. 2021. Web. 10 Dec. 2023. < https://afribary.com/works/demand-and-benefit-incidence-of-healthcare-services-in-ghana >.
SARKODIE, ADU . "Demand and Benefit Incidence of Healthcare Services in Ghana" Afribary (2021). Accessed December 10, 2023. https://afribary.com/works/demand-and-benefit-incidence-of-healthcare-services-in-ghana