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Underlying Factors of Healer Shopping Behaviour of Visceral Leishmaniasis Patients in Nepal

Shiva Raj Adhikari

Background: The existing literature on demand for health care primarily deals with first consultation of health care providers; however, in reality, the consumers may make several visits to find the standard health care.

Objective: The objective of the study is to identify the pattern of utilization of health care of visceral leishmaniasis (VL) through the use of sequential visits to different health care providers and to examine factors determining the healer shopping behavior of the patients.

Methods: The data for this study were collected from the six public hospitals where diagnosis and treatment services for VL are available located in VL endemic districts. Poisson regression model was used in pragmatic approach of demand function to investigate the utilization pattern of health care services.

Results: Among the total patients, 16 percent visited to public hospital, 19 percent visited to public clinic, 22 percent visited to private hospitals of clinics and 23 percent subjects used home treatment. One to more than five sequential visits to the providers was found in this study. The forward looking provider’s price is significantly responsible to increase the event of healer shopping; however income has no effect on multiple visits. Information but not education has a greater role to reduce the number of healer shopping events. Information, service obtaining costs and forward looking provider’s prices have robustly determined the healer shopping behaviour of the patients.

Conclusion:The demand analysis which captures the multiple care seeking events is appropriate for producing the better information for policy maker.