Household Demand for Health Care and Health Care Expenditure by Controlling Endogeneity Bias in Bangladesh

Md. Abdus Salam Akanda, Mari Minowa


This paper uses the data of Household Income and Expenditure Survey 2005, a nationally representative sample of 10,080 households in
Bangladesh from January, 2005 to December, 2005, to investigate the determinants of illness, choice of health care provider and household
out-of-pocket health care expenditures. Three models were used in this paper- logistic model for illness, multinomial logistic model for
provider choice and selection model for household health care expenditure. Endogeneity biases arising due to the selection of providers
were controlled in the selection model. Our results of this study show that individual, household and environmental characteristics has
substantial effects on illness, choice of health care providers as well as health care expenditures. The common perception is that the
decision of whether and where to seek care and the amount of expenditure depends on how serious the illness is. Our results also show that
illness is not the only factor involved in demand for health care. Other influences, such as individual, household and environmental
characteristics, are found to determine the magnitude of expenditure incurred. These findings call for policy makers to either design new
health policy or strengthen existing ones, taking into consideration various factors that are identified in this study in order to improve health
care system in developing countries like Bangladesh.


Choice of health care provider; Endogeneity bias; Health care expenditure; Selection model; Bangladesh

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Dhaka University Journal of Science ISSN 1022-2502 (Print) 2408-8528 (Online)