An assessment of a substitute or complement for inpatient and outpatient care of visceral leishmaniasis in Nepal

摘要

Background & objectives: The burden of visceral leishmaniasis (VL) in Nepal, as in other developing countries, falls disproportionately upon the rural poor. Promoting use of outpatient (OP) care, an alternative to inpatient (IP) care has long been advocated to reduce cost of care in both the demand and supply sides as substitution of relatively cheaper resources for expensive resources in the production of health care services. The paper aims to assess the intensity of demand for VL care and explore possibilities of the substitutability or complementation patterns between OP care and IP care of VL. Methods: In order to explore the possibility of substitute (or complement) of OP care for IP care, we exploited the ordinary least squared method by utilizing recently collected data from the VL endemic districts of Nepal. The sample size represented >25% of the population of VL of the country. The paper measured the sensitivity analysis of demand for OP and IP cares using appropriate demand models. Results: The coefficients of demand models gave negative relationship between quantity demanded for health care and their prices. It is plausible that OP price has strong power than IP price to determine the respective quantity demanded for health care. As expected, income has negative sign, but not significant that means income has no effect on determining the demand for health care because VL is a disease of poor. Conclusion: Recently, improvements in treatment and diagnostic techniques suggest a substitute of OP care for IP care; however, the OP and IP cares are complements due to behavioural factors.