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  • Patients’ choice of healthcare providers and predictors of modern healthcare utilisation in Bangladesh: Household Income and Expenditure Survey (HIES) 2016–2017 (BBS)

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Health economics
Original research
Patients’ choice of healthcare providers and predictors of modern healthcare utilisation in Bangladesh: Household Income and Expenditure Survey (HIES) 2016–2017 (BBS)
  1. Asif Imtiaz1,2,
  2. Noor Muhammad Khan3,
  3. Emran Hasan4,
  4. Shanthi Johnson5,
  5. Hazera Tun Nessa6
  1. 1Department of Management Information Systems, University of Dhaka, Dhaka, Bangladesh
  2. 2Department of Health Policy, The London School of Economics and Political Science (LSE), London, UK
  3. 3Department of Statistics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
  4. 4Department of Economics, Bangladesh University of Professionals (BUP), Dhaka, Bangladesh
  5. 5School of Public Health, University of Alberta, Edmonton, Alberta, Canada
  6. 6Department of International Business, University of Dhaka, Dhaka, Bangladesh
  1. Correspondence to Asif Imtiaz; asifimtiaz.mis{at}du.ac.bd

Abstract

Objectives The number of modern healthcare providers in Bangladesh has increased and they are well equipped with modern medical instruments and infrastructures. Despite this development, patients seeking treatment from alternative healthcare providers are ongoing. Hence, this study aims to determine the underlying predictors of patients’ choosing modern healthcare providers and health facilities for getting treatments.

Setting Data from the nationally representative Household Income and Expenditure Survey 2016–2017 conducted by the Bangladesh Bureau of Statistics were used.

Participants 34 512 respondents sought treatment for their illnesses from different types of available healthcare providers.

Primary and secondary outcome measure Patients’ choice of healthcare providers (primary) and predictors of patients’ choice of modern healthcare providers (secondary).

Results The study found that 40% of the patients visit modern healthcare providers primarily on having symptoms of illness, and the remainder goes to alternative healthcare providers. Patients living in urban areas (adjusted OR (AOR)=1.11, 95% CI 1.05 to 1.17, p<0.01), and if the travel time was between 1 and 2 hours (AOR=1.11, 95% CI 1.00 to 1.22, p<0.05) compared with travel time less than 1 hour, were positively associated to utilisation of modern healthcare facilities for their first consultation. The statistical models show that the predisposing and need factors do not significantly impact patients’ choice of modern healthcare providers.

Conclusions The distribution of modern healthcare providers should be even across the country to eliminate the rural–urban divide in modern healthcare utilisation. Enhancing the digital provision of modern healthcare services could reduce travel time, omit transportation costs and save waiting time for treatment by the modern healthcare providers. Policymakers can think of introducing a national health insurance programme in Bangladesh as a potential policy instrument.

  • health policy
  • health economics
  • health economics
  • health services administration & management

Data availability statement

Data are available upon reasonable request. The data that support the finding of this study are available from the BBS. Data are available from the authors with the permission of BBS.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2021-051434

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    Data availability statement

    Data are available upon reasonable request. The data that support the finding of this study are available from the BBS. Data are available from the authors with the permission of BBS.

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    Footnotes

    • Contributors AI: conceptualisation, methodology, writing—original draft preparation, writing—reviewing and editing, guarantor. NMK: data curation, formal application, visualisation and investigation. EH: writing—original draft preparation, writing—reviewing and editing. SJ: supervision, writing—reviewing and editing and approvals of final draft. HTN: supervision, writing—reviewing and editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.