Public hospital health care utilization in Jamaica

Type Journal Article - Australian Journal of Basic and Applied Sciences
Title Public hospital health care utilization in Jamaica
Volume 3
Issue 4
Publication (Day/Month/Year) 2009
Page numbers 3067-3080
Objective: Health is a crucible component in any discussion on development, and public-
p riv ate h o s p ital h ealth care u tilizatio n acco mmo d ates th is man d ate o f
governments. The aim of the
current study is to examine factors that account for people’s public hos pital health care facilities
u tilizatio n in Jamaica, an d to as certain wh eth er is a d ifferen ce b e t w e e n p u b lic h o s p ital care u tilizatio n
and income qu in tile and area of residence. Method: The current study has extracted a sub-sample of
1,936 res
pondents from a
national surv ey of 25,018 res
pondents. The sub-sample constitutes those
respondents who had ind icated visits to public hospital facilities for health care or private hospital
health care facilit ie s o w in g t o s elf-reported ill-health. It is taken from a larger cros s -s ectional s urvey
which was conducted between June and October 2002. It was a
nationally representativ e s tratified
p ro b ab ility s u rv ey o f 25,018 res
pondents . The d
ata were collected by a comprehensive self-
administered questionnaire, which was primarily completed by heads of households on all household
members. The questi
onnaire is adopted from the World Bank’s Living Standards Measurement Study
(LSMS) household surveys and was modified b y th e Statis tical Institute of Jamaica with a narrower
focus and reflects policy impacts. Chi-s q uare, t-test and analysis of variance (ANOVA) were used for
bivariate relationships, and logistic regression was used to explain factors that determine who attended
p u b lic h o s p ital h ealth care facilities . Fin d in g s : T h e c u rren t fin d in g s rev ealed th at 6 facto rs d etermin e
35.6% o f th e v a ria b ilit y in v is it s to p u b lic h o s p it al h e a lt h c a r e f a c i l it ie s u t iliza t io n in Jama ic a . Two
majo r findings from this study are 1) health seeking behaviour and health insurance coverage are the
two most significant factors that determine public hospital health care facilities utilizatio n , and that
2) the two aforementioned factors and pos itive affective conditions inversely correlate with public
h o s p it a l h e a lt h c are fa c il i t y u t iliza t io n . In a d d it io n t o t h e a
bove, there is no statistical difference
between the utilization of public hospital health care facilities and area o f residence while lower
income quintile becomes the greater public hospital health care fac
ilities u tilizatio n h as b een .
Co n clu s io n : Th e d eman d s fo r p u b lic h o s p ital h ealth care facility u tilizatio n in Jamaic a a r e p rimarily
based on inaffordability and low perceived quality of patient care. The issue of low qu ality of patient
care speaks not to medical care, but to the custo mer service care offered to clients. The greater
percentage of Jamaicans who access private health care is not owing to plethora of services, higher
specialized doctors, more advanced medical equipment, or low, b u t th is is due to social environment
– customer service and social interaction between staffers and clients- and physical
milie u – mo re th a n
o n e p ers o n p er b ed s o metimes , u n clean s iles s o f th e facilities .

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