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Density versus quality in health care provision : using household data to make budgetary choices in Ethiopia (Inglês)

Usage of health facilities in Ethiopia is among the lowest in the world; raising usage rates is probably critical for improving health outcomes. The government has diagnosed the principal problem as the lack of primary health facilities and is devoting a large share of the health budget to building more facilities. But household data suggest that usage of health facilities is sensitive not just to the distance to the nearest facility but also to the quality of health care provided. If the quality of weak facilities were raised to that currently provided by the majority of facilities in Ethiopia, usage would rise significantly. National data suggest that given the current density and quality of service provision, additional expenditure on improving the quality of service delivery will be more cost-effective than increasing the density of service provision. The budget allocation rule presented in the article can help local policymakers make decisions about how to allocate funds between improving the quality of care and decreasing the distance to the nearest health care facility.


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    Collier, Paul Dercon, Stefan Mackinnon, John

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    Density versus quality in health care provision : using household data to make budgetary choices in Ethiopia

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    marginal effect;World Bank Economic Review;quality health care;quality of health care;household demand for health care;age of head of household;health outcome;health facility;quality of service delivery;primary health care;quality of health services;public expenditure on health;primary health care services;revenue from user charges;random effects model;Public Facilities;public health facility;quality improvement;health production function;health care facilities;health care facility;increase in expenditure;fixed effect model;cost of quality;primary health facility;terms of consumption;development research group;public health service;substitution effect;effect of price;per capita expenditure;change in welfare;cost of drug;financing of drugs;increase in consumption;form of charges;cost of construction;per capita consumption;department of economics;health care financing;household survey data;quality of care;impact of health;nature of health;quality of facilities;real wage rate;supply of materials;adult mortality rate;health care demand;health care quality;health care budget;modern health care;annual unit cost;world health organization;rural development policy;Health care policies;health care policy;female household member;quality of public;health care choices;demand function;catchment area;health station;budget allocation;sample selection;point estimate;primary care;utility function;health budget;confidence interval;budget constraint;e-mail address;health knowledge;Social Sciences;representative household;local situation;health expenditure;income effect;opportunity cost;rural health;Public Services;drug supply;unit price;capital program;government expenditure;budgetary choice;Child Health;health provision;household behavior;demand responsiveness;public program;increased spending;econometric model;public policy;medical treatment;research observer;treatment effect;anthropometric outcomes;rural population;allocation decision;depreciation rate;potential users;household income;cultural change;average distance;public economics;marginal impact;marginal increase;maternal education;expenditure increase;local budget;empirical analysis;functional form;household size;small sample;shadow price;budget decision;composite index;capital expenditure;price reduction;government health;capital spending;selection model;improved health;normal good;seasonal movements;public pharmacy;marginal probability;discrete change;preventative treatment;regression results;budgetary cost;principal-agent problem;dynamic model;linear function;partial derivative;budget datum;curative visit;nutritional outcome;life expectancy;household data;usage rate;empirical work;Learning and Innovation Credit;good health;poor health;public provision;spare capacity;education variable;unobserved characteristic;econometric analysis;budget agency;discount rate;sectoral investment;Health cost;health program;risk sharing;private pharmacies;financial information;quantity rationing;Political Economy;construction cost;field experiment;frequency distribution;



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