TOWARDS UNIVERSAL HEALTH COVERAGE: ACCESS AND UTILIZATION OF HEALTH CARE SERVICES IN BHUTAN

Abstract

This study aims to explore utilization of health care services in Bhutan, specifically assess how geographical and socio-demographic-economic factors influence the use of health care services and choice of health facilities for outpatient and inpatient basis. The study also investigates the effect of socio-economic and demographic factors on the drug expense and transportation expense that are related to medical use. In essence, this study on utilization of health care services will be able to shed some light on the prospect of the country in moving towards universal health coverage. A cross-sectional data, Bhutan Living and Standard Survey 2012, is used for the study. At the initial stage of the analysis, binary logit regression and multinomial logit regression are used to determine whether individuals use outpatient and inpatient services, and if used the type of health facilities visited. Thereafter, marginal effect corresponding to each factor is calculated to give the magnitude of the impact of each socio-economic and demographic factor on the probability of using services and the probability of choosing each health facilities. The result indicated that geographical factors are the critical factors determining the choice of using health care services at different levels of health facilities. Although income has some effect, its impact varies across different facility choice. The socio-economic and demographic factors were not sensitive to the out of pocket health expense.