Comparison of Public and Private Healthcare Seekers in a Resource-Limited Country: Utility Indices, Consequences, Associations, and Predictors
Mandreker Bahall, George Legall
University of the West Indies
Even with free 24-hour public healthcare (PHC), many choose not to access healthcare. This study explored the use/non-use of PHC, the consequences of non-utilisation, and the factors associated with and predictors of PHC access. The study included 308 adults seeking medical attention using prescriptions or seeking over-the-counter medications at pharmacies for personal use. Through convenience sampling, data were collected face-to-face at selected pharmacies from 10 March to 31 May 2024 using an 18-item questionnaire. Data were analysed using SPSS based on descriptive and inferential methods. Most participants were female; many reported comorbidities, including depression, overweight, diabetes mellitus, and hypertension. The utility index (PHC) was 0.296; the affordability index was 0.328. The absolute non-affordability index was 0.603. The affordability of private healthcare was limited to one-third of participants and was strongly associated with higher income and socioeconomic status. Place of treatment (public or private) was associated with education level, employment status, and monthly income. Consequences that were higher among non-afforders included being less able to engage in vacations/socializing/leisure time because of funds, increased burden on family who may have to use their own funds, interruptions to daily routines or activities of daily living, and reduced hobbies/activities. Many reported resorting to home remedies or alternative treatments. The low utility index of PHC and low affordability reflect systemic imbalances in the health systems of a resource-limited country. Negative consequences were particularly prevalent among non-afforders.
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