HEALTH CARE SEEKING BEHAVIOUR OF NON-FATAL ROAD TRAFFIC INJURY VICTIMS IN KERALA, INDIA
Keywords:Health Care Seeking, Non-Fatal Road Traffic Injuries, Kerala, India
Road traffic injuries represent a classic case of economic uncertainty for households. In the context of uncertainty, choice of health care facilities and care seeking process is interest of perennial concern. Understanding the injury care seeking process forms the central objective of the paper. It also tries to narrate the process of seeking care between different providers of care, levels of care and duration of treatment, determinants of choice of health care etc. The study utilised primary data collected from the injured (302 cases) who were discharged from selected public and private health facilities from three districts of Kerala, India. The injured had 488 overall interactions with medical care institutions/personnel yielding an average number of 1.6 interactions per injured person; 60.2 per cent of the interactions were accounted by public health care institutions with 54 per cent of the injured choosing them as their first point of contact. Length of treatment at different health facilities by the injured indicate that more than 70 per cent were treated as outpatient (including observation cases) and the rest were prescribed hospitalized treatment at the first pint of contact. Share of public sector health care institutions treating mild, moderate and severe injuries is 55.5 per cent, 54.6 per cent and 48.6 per cent respectively. In sum, public sector is the preferred choice of injury care seeking for moderate and severe road traffic injuries (cost of treatment, poor economic status) while mild injuries are primarily accounted for by the private sector.
Abbs AA & Walker GJ (1986) Determinants of the utilisation of maternal and child health services in Jordan. International Journal of Epidemiology, 15: 404-407. Retrieved from https://doi.org/10.1093/ije/15.3.404 DOI: https://doi.org/10.1093/ije/15.3.404
Abel-Smith B & Rawal P. (1992).Can the poor afford 'free' health services? A case study of Tanzania. Health Policy and Planning, 7 (4): 329-341 Retrieved from https://doi.org/10.1093/heapol/7.4.329 DOI: https://doi.org/10.1093/heapol/7.4.329
Abel-Smith B (1994). An Introduction to Health Policy, Planning and Financing Longman Group Ltd, New York. (Chap.12; 164-177).
Acton (1975). Non-monetary factors in the demand for medical services: some empirical evidence, Journal of Political Economy, 83 (3): 595- 614. Retrieved from https://doi.org/10.1086/260342 DOI: https://doi.org/10.1086/260342
Adam R, Stedman M, Winn J, William JI & Ali J (1994) Improving trauma care in Trinidad and Tobago. West Indian Medical Journal. 43 (2): 36-38. Retrieved from https://europepmc.org/article/med/7941493
Aeron-Thomas (2000). Under-reporting of road traffic casualties in low-income countries, Unpublished Project Report PR/INT/199/00. TRL, Crownthorne.
Akin J. & Hutchinson P (1999) Health care facility choice and the phenomenon of bypassing. Health Policy and Planning 14 (2): 135-51. Retrieved from https://doi.org/10.1093/heapol/14.2.135 DOI: https://doi.org/10.1093/heapol/14.2.135
Amin M, Hanson K & Mills A (2004) Price discrimination in obstetric services - a case study in Bangladesh. Health Economics 13: 597-604. Retrieved from https://doi.org/10.1002/hec.848 DOI: https://doi.org/10.1002/hec.848
Arrow, KJ. (1963) Uncertainty and the Welfare Economics of Medical Care, The American Economic Review, 53 (5): 941-73. Retrieved from https://doi.org/10.1515/9780822385028-004 DOI: https://doi.org/10.1515/9780822385028-004
Barer ML (1982) Case mix adjustment in hospital cost analysis-Information theory revisited. Journal of Health Economics 1 53-80. Retrieved from https://doi.org/10.1016/0167-6296(82)90021-2 DOI: https://doi.org/10.1016/0167-6296(82)90021-2
Barnum H, Kutzin J & Saxenian H (1995) Incentives and Provider Payment Methods HRO Working Papers No. 51 March 1995. Retrieved from https://doi.org/10.1002/hpm.4740100104 DOI: https://doi.org/10.1002/hpm.4740100104
Bennett S, Dakpalla G, Garner P, et al (1994) Carrot and stick: state mechanisms to influence private provider behaviour. Health Policy and Planning: 9 (1): 1-13. Retrieved from https://doi.org/10.1093/heapol/9.1.1 DOI: https://doi.org/10.1093/heapol/9.1.1
Coase R (1960) The problem of social cost. Journal of Law and Economics. 3: 1-44. 26. Corbett J (1988). Poverty and sickness: the high costs of ill health. IDS Bulletin 20 (2) 58-62. Retrieved from https://doi.org/10.1111/j.1759-5436.1989.mp20002008.x DOI: https://doi.org/10.1111/j.1759-5436.1989.mp20002008.x
Deepa Sankar (2001). Access to health care. Unpublished PhD thesis submitted to Jawaharlal Nehru University, New Delhi. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.152.438&rep=rep1&type=pdf
Dilip TR & Duggal Ravi (2002). Incidence of non-fatal outcomes and debt in urban India: Paper presented at Urban Research Symposium, World Bank, Washington. December 2002. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.152.438&rep=rep1&type=pdf
Ensor T & San BP (1996). Health care charges and exemptions in Vietnam. Bamako Initiative Operations Programme. Research Paper No. 1. New York, UNICEF.
Fabricant SJ; Kamara CW & Mills A (1999). Why the poor pay more: household curative expenditures in rural Sierra Leone. International Journal of Health Planning and Management. 14: 179-199. 38. Feldstein PJ (1998) Health Care Economics Fifth Edition, New York: Wiley.
Retrieved from https://doi.org/10.1002/(SICI)1099-1751(199907/09)14:3<179::AID-HPM548>3.0.CO;2-N DOI: https://doi.org/10.1002/(SICI)1099-1751(199907/09)14:3<179::AID-HPM548>3.0.CO;2-N
Gaynor. M & Anderson GF (1995). Uncertain demand, the structure of hospital costs, and the cost of empty hospital beds. Journal of Health Economics, 14: 291-317. Retrieved from https://doi.org/10.1016/0167-6296(95)00004-2 DOI: https://doi.org/10.1016/0167-6296(95)00004-2
Gertler P & Solon O (2002). Who benefits from social health insurance in developing countries? (accessed on 29 Oct 2006). Retrieved from http://adfdell.pstc.brown.edu.classes/readings/gerso100.pdf
Gertler P; Locay L & Sanderson W (1987). Are user fees regressive? The welfare implications of health financing proposals in Peru. Journal of Econometrics 36: 67-88. Retrieved from https://doi.org/10.3386/w2299 DOI: https://doi.org/10.1016/0304-4076(87)90044-3
Gertler PJ (1988) A latent variable model of quality determination. Journal of Business and Economic Statistics, 6: 97-104. Retrieved from https://doi.org/10.2307/1391422 DOI: https://doi.org/10.1080/07350015.1988.10509641
Ghee G, Silcock D, Astrop A & Jacobs G (1997). Socio-economic aspects of road accidents in developing countries. TRL Report 247. Transport Research Laboratory, Crowthorne. Retrieved from http://worldcat.org/issn/09684107
Gilson L (1997). The lessons of user fee experience in Africa. Health Policy and Planning 12 (4): 273-285. Retrieved from https://doi.org/10.1093/oxfordjournals.heapol.a018882 DOI: https://doi.org/10.1093/oxfordjournals.heapol.a018882
GoI, NSSO (1996, 2004) Reports on morbidity and ailments in India. MoSPI, New Delhi
GoI, National Crime Records Bureau (2000, 2020). Accidental deaths and suicides in India, Ministry of Home Affairs, New Delhi.
Grossman (1972). A model of demand for health. Journal of Political Economy.72: 237-252.
Haddad S & Fournier P (1995) Quality, cost and utilisation of health services in developing countries. A longitudinal study in Zaire. Social Science and Medicine, 40: 743-753. Retrieved from https://doi.org/10.1016/0277-9536(94)00134-F DOI: https://doi.org/10.1016/0277-9536(94)00134-F
Haddon, W (1980) Options for the prevention of motor vehicle crash injury. Israel Journal of Medicine. 16. 45-68. Retrieved from https://www.safetylit.org/citations/index.php?fuseaction=citations.viewdetails&citationIds=citjournalarticle_588_19
Heller P (1982). A model on the demand for medical and health services in Peninsular Malaysia. Social Science and Medicine, 16: 267-84. Retrieved from https://doi.org/10.1016/0277-9536(82)90337-9 DOI: https://doi.org/10.1016/0277-9536(82)90337-9
Hensher M (2001) Financing Health Systems through Efficiency Gains. Commission of Macro Economics and Health WP Series No. WG 3: 2.
Himmelstein, DU, Warren, E et al. (2005). Market Watch: Illness and injury as contributors to bankruptcy. Health Affairs (Millwood). Retrieved from https://doi.org/10.2139/ssrn.664565 DOI: https://doi.org/10.2139/ssrn.664565
Hofman K, Primack A, Keusch G & Hrynkow (2005). Addressing the growing burden of trauma injury in low and middle-income countries. American Journal of Public Health 95: 13-17. Retrieved from https://doi.org/10.2105/AJPH.2004.039354 DOI: https://doi.org/10.2105/AJPH.2004.039354
Hotchkiss DR, Hutchinson PL, Malaj A & Berruti AA (2005) Out-of-pocket payments and utilisation of health care services in Albania: Evidence from three districts. Health Policy 30. Retrieved from https://10.1016/j. healthpol.2005.02.003
Kennedy, L, & Dumas, MB. (1983) Hospital closures and survivals: An analysis of operating characteristics and regulatory mechanisms in three states. Health Services Research, 18 (4), 489-512. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1068775/
Krug EG, Sharma GK & Lozano R (2000) The global burden of injuries. American Journal of Public Health 90 523-526 Retrieved from https://doi.org/10.2105/AJPH.90.4.523 DOI: https://doi.org/10.2105/AJPH.90.4.523
Litvack J & Bodart C (1993). User fees plus quality equals improved access to health care: results of a field experiment in Cameroon. Social Science and Medicine 39 (3): 35-42. Retrieved from https://doi.org/10.1016/0277-9536(93)90267-8 DOI: https://doi.org/10.1016/0277-9536(93)90267-8
Litvack, J. & Bodart C (1996) The Impact of raising fees and service quality: a field experiment in Cameroon', In Shaw, R P and M. Ainsworth (eds.) Financing Health Services through User Fees and Insurance, World Bank Discussion Paper No 249, Washington DC, World Bank 123-40.
Liu X & Mills A (1999) Evaluating payment mechanisms: how can we measure unnecessary care? Health Policy and Planning; 14 (4):409-13. Retrieved from https://doi.org/10.1093/heapol/14.4.409 DOI: https://doi.org/10.1093/heapol/14.4.409
Lo AY, Hedley AJ, Pei GK, Ong SG, Ho LM, Fielding R, et al. (1994) 194 Doctor-shopping in HongKong: implications for quality of care. International Journal of Quality Health Care 6: 371-81. Retrieved from https://doi.org/10.1093/intqhc/6.4.371 DOI: https://doi.org/10.1093/intqhc/6.4.371
Longo, DR., & Chase, GA. (1984) Structural determinants of hospital closure. Medical Care, 22 (5): 388-402. Retrieved from https://doi.org/10.1097/00005650-198405000-00003 DOI: https://doi.org/10.1097/00005650-198405000-00003
Lucas & Nuwagaba (1999) Household coping strategies in response to introduction of user charges for social service: a case study on health in Uganda. IDS Working Paper 86.
Lynch, JR., & Ozcan, YA. (1994). Hospital closure: An efficiency analysis. Hospital and Health Services Administration, 39 (2), 205-220.
Manjula Singh (2006) Exploring the perceptions of ultra poor for low utilization of micro-health insurance schemes, BRAC, Bangladesh: A Qualitative study (Unpublished Ph.D Thesis) BRAC University, Bangladesh.
Meng QY, Liu X & Shi Junshi (2000) Comparing the services and quality of private and public clinics in rural China. Health Policy and Planning 15 (4): 349-356. Retrieved from https://doi.org/10.1093/heapol/15.4.349 DOI: https://doi.org/10.1093/heapol/15.4.349
Meyer JD (1985) Household survey of health expenditures, Mali. Mimeo. Agency for International Development, Washington DC.
Mock CN, Gloyd S, Adjei S, Acheampong F & Gish O (2003) Economic consequences and resulting coping strategies in Ghana. Accident Analysis and Prevention, 35: 90-91. Retrieved from https://doi.org/10.1016/S0001-4575(01)00092-6 DOI: https://doi.org/10.1016/S0001-4575(01)00092-6
Muraleedharan, VR (1999) Characteristics and structure of the private hospital sector in urban India: a study of Madras city. Small Applied Research Paper No. 5, Partnership for Health Reform Project, Abt. Associates, Bethesda, USA. Retrieved from https://www.hfgproject.org/wp-content/uploads/2015/02/Characteristics-and-Structure-of-the-Private-Hospital-Sector-in-Urban-India-A-Study-of-Madras-City.pdf
Murray CJL & Lopez AD (1996) Global Health Statistics: A Compendium of Incidence, Prevalence and Mortality Estimates for Over 200 Conditions. Cambridge, Mass: Harvard University Press. Retrieved from https://pesquisa.bvsalud.org/portal/resource/pt/who-41848
Nantulya VM & Reich MR (2002). The neglected epidemic: road traffic injuries in developing countries. BMJ; 324: 1139-41. Retrieved from https://doi.org/10.1136/bmj.324.7346.1139 DOI: https://doi.org/10.1136/bmj.324.7346.1139
Nilambar Jha, Srinivasa DK, Gautam Roy & Jagdish S (2004). Epidemiological study of road traffic accident cases: a study from South India. Indian Journal of Community Medicine XXIX, No.1, Jan.-Mar. Retrieved from https://www.researchgate.net/profile/Sadasivan-Jagdish/publication/45261805_Epidemiological_Study_of_Road_Traffic_Accident_Cases_A_Study_from_South_India/links/00b7d5151bdd205352000000/Epidemiological-Study-of-Road-Traffic-Accident-Cases-A-Study-from-South-India.pdf
Odero W, Khayesi M & Heda PM (2003) Road traffic injuries in Kenya: magnitude, cause and status of intervention. Injury Control and Safety Promotion, 10: 53-61. Retrieved from https://doi.org/10.1076/icsp.10.1.53.14103 DOI: https://doi.org/10.1076/icsp.10.1.53.14103
Peden M, Scurfield R, Sleet D et al ( ed) (2004) The world report on road traffic injury prevention. World Health Organisation, Geneva.
Pramod Kumar Verma & Tewari KN (2004). Epidemiology of Road Traffic Injuries in Delhi: Result of a Survey. Regional Health Forum 8 (1). Retrieved from https://apps.who.int/iris/bitstream/handle/10665/205798/B0031.pdf#page=12
Sahdeva P., Lacqua MJ., Singh B & Dogra TD (1994). Road traffic fatalities in Delhi: causes, injury pattern and incidence of preventable deaths. Accident Analysis and Prevention, 26 (3) Jun 1994 p 377-384. Retrieved from https://doi.org/10.1016/0001-4575(94)90011-6
Trevino-Siller & Hijar (2005). Mexican mass information campaign for youngsters aimed to prevent RTAs. Conference paper at 8th World Conference on Injury Prevention and Safety Promotion, Durban, South Africa March-April 2006.
Tursz A (1986) Epidemiological studies of accident morbidity in children and young people: problems of methodology. World Health Statistics Quarterly 39:257- 268. Retrieved from https://pubmed.ncbi.nlm.nih.gov/3788202/
Vickrey W (1968) Automobile accidents, tort law, externalities, and insurance: an economist's critique. Law of Contemporary Problems. 33: 464-487. Retrieved from https://doi.org/10.2307/1190938 DOI: https://doi.org/10.2307/1190938
Zwi AB, Fotjouh S, Murugusampillay S, Odero W & Watts C (1996). Injuries in developing countries: policy responses needed now. Transactions of the Royal Society of Tropical Medicine and Hygiene 90: 593-595. Retrieved from https://doi.org/10.1016/S0035-9203(96)90399-5 DOI: https://doi.org/10.1016/S0035-9203(96)90399-5
van Beeck EF, Borsboom GJ & Machenbach JP (2000) Economic development and traffic accident mortality in the industrialised world, 1962-1990. International Journal of Epidemiology, 29 (3): 503-509. Retrieved from https://doi.org/10.1093/intjepid/29.3.503 DOI: https://doi.org/10.1093/ije/29.3.503
How to Cite
Copyright (c) 2021 Godwin S.K, Varatharajan D
This work is licensed under a Creative Commons Attribution 4.0 International License.
With the licence CC-BY, authors retain the copyright, allowing anyone to download, reuse, re-print, modify, distribute, and/or copy their contribution. The work must be properly attributed to its author.
It is not necessary to ask for further permission from the author or journal board.
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.