Household demand for health care in El Salvador -- volume II : determinants of household demand for curative ambulatory medical care

The study identified all curative and preventive health services provided in both inpatient and ambulatory settings for an extensive sample of households in urban and rural areas. This report provides analyses of the data, focusing, however, only on curative ambulatory care provided by physicians, a critical component of the care-giving system. For these services, it examines patterns of utilization in depth and it explores the factors associated with differences in the demand for services. In particular, the influence of economic characteristics such as prices and patients" income on the use of outpatient services are examined to provide some insight into the sensitivity of utilization to changes in the costs of care to patients. Of importance is the great difference in the patterns of utilization between ambulatory and inpatient care. For the former, patients exercised a wide range of choices, with private sector and Social Security providers favored by many users. For inpatient services, however, even those with access to other providers significantly preferred publicly provided care. A recognition of such patterns of utilization and consumer preferences needs to be incorporated into the process of developing and strengthening the financial basis of the health care system.