PREFERENCE OF INDIVIDUAL TOWARDS PUBLIC AND PRIVATE

HEALTH CARE INSTITUTIONS

MARIA JOSEPH
B.Ed Student(Social Science)
Mount Carmel College for Teacher Education for Women Kottayam

ABSTRACT

The present article entitled “Preference of individuals towards public and private
health care institution” is based on a survey with an objective to identify the relation between
socio economic factors and preference on health care institution. The study is both descriptive
and analytical in nature and based on primary data. The sample is drawn from 40 house holds.
The findings of the study indicate that 47.5% house holds were giving more preference to public
health care institutions and 52.5% house holds give more preference to private health care
institutions.

INTRODUCTION

Healthcare is a part of social infrastructure. Availability and accessibility to health

facilities is inevitable for the acceleration of the economic development of a country. Health and
development are thus closely interrelated each other strongly. Health contributions to the process
of human capital formation making a major contribution to raise the productivity of labour.
Health can therefore be regarded both as a means and ends of development .When people are
more healthy they are more productive. Higher productivity ensures two important process
which are fundamental to economic growth. Better purchasing power signifying better
propensity to consume and save. Saving in turn promote investment and capital formation.

Objectives of the Study

1. To identify whether there is any relation between socio-economic factors and preferences
on health care institutions.
2. To explore the reasons for the preferences of individuals towards private Vs public
hospitals

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Methodology

The study is based on both Primary and secondary data. Primary data are collected
through interview schedule to 40households in the Vellavoor Grama Panchayat. Simple random
sampling technique is adopted for data collection.

Limitations of the Study

The study lacks depth and comprehensiveness as it is conducted within a limited time
span. The method of sampling and data collection was not very scientific.

DATA ANALYSIS AND INTERPRETATION

Health is one of the important determinants for economic development. Individuals are
more conscious about their health these days.The present work examines the preference of
individual household for public and private health facilities in VellavoorGrama Panchayat of
Kottayam District.

VellavoorGramapanchayat –A Glimpse
Vellavoor is a village with the area 23.46km2.As of 2011 census it had a population with
20436 with 8804 male and 11632 female. Three public health care institutions are at present
functioning regularly. Majority of the families lies below the poverty line.
To know about the household preference on public and private health care institutions in
VellavoorGramapanchayat, it is necessary to analyze the social and economic profile of the
respondents.

Monthly Income of the Respondents

Income level Frequency Percent
lessthan10000 13 32.5
10000-20000 14 35.0
above20000 13 32.5
Total 40 100.0
Source:Field Survey

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The table shows that 32.5 per cent of the respondent’s income level is below 10000.35 per cent
of respondents have income level between 10000 – 20000 and32.5 per cent of respondents have
income level above 20000

Monthly Income preference

public private Total
Monthly income Lessthan10000 Count 10 3 13
% within
76.9% 23.1% 100.0%
monthlyincome
% within
52.6% 14.3% 32.5%
preference
% of Total 25.0% 7.5% 32.5%
10000-20000 Count 8 6 14
% within
57.1% 42.9% 100.0%
monthlyincome
% within
42.1% 28.6% 35.0%
preference
% of Total 20.0% 15.0% 35.0%
Above20000 Count 1 12 13
% within
7.7% 92.3% 100.0%
monthlyincome
% within
5.3% 57.1% 32.5%
preference
% of Total 2.5% 30.0% 32.5%
Total Count 19 21 40
% within
47.5% 52.5% 100.0%
monthlyincome
% within
100.0% 100.0% 100.0%
preference

% of Total 47.5% 52.5% 100.0%

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The table shows the relation between the monthly income of the respondents and preference of health care
facilities. Among the respondents with monthly income less than 10000, 76.9 per cent of respondents choose
public hospitals and 23.1 per cent of respondents choose private hospitals. In the income category of 10000-
20000, 57.1 per cent of the respondents choose public hospitals and 42.9 percent of the respondents choose
private hospitals. In the income category of above 20000 only7.7 per cent of respondents chose public
hospital and 92.3 per cent of the respondents chose private hospitals.

Hospital Preference

PREFERENCE FREQUENCY PERCENTAGE

PUBLIC 19 47.5

PRIVATE 21 52.5

TOTAL 40 100

Source : Field survey

The table shows that 47.5 percent of households were giving more preference to public
health care institutions and 52.5 percent of households give more preference to private health
care institutions.

Attitude of people on Preference

Preference Services infrastructure affordability

public N Valid 19 19 19
Missing 0 0 0
Mean 3.2982 3.1842 3.0714
Std. Deviation .54566 .50581 .53938
Skewness 1.383 -.205 -2.006
Std. Error of Skewness .524 .524 .524
private N Valid 21 21 21
Missing 0 0 0
Mean 4.1693 4.0000 4.2763
Std. Deviation .23470 .25820 .41940
Skewness -.142 .535 .062
Std. Error of Skewness .501 .501 .501

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Source:Field Survey
The table narrates people’s preference on public and private healthcare institutions. Here
we are testing whether there is any significant relation between the means of public and private
hospitals by using, a non-parametric test, that is Mann-Whitney test. Mann–Whitney U test is a
nonparametric test of the null hypothesis that it is equally likely that a randomly selected value
from one sample will be less than or greater than a randomly selected value from a second
sample.
According to this test there is a significant difference between the means of services
infrastructure and affordability among public and private health care institutions. When there is a
significant difference between the means then we reject the null. Which means that there is a
relationship between the choice of hospital services and infrastructure they are providing and the
level of affordability of people.
The services includes skill and competency of the staff ,the room facilities provided ,the nursing
care, the friendliness of the staff, modern diagnosis and treatment equipment, consultation
without any delay, efficiency of doctors, availability of specialized doctors ,level of privacy and
transparency.
The infrastructure facilities includes the level of cleanliness, convenient location, availability of
transportation facilities, wheelchair and lift availability, canteen facility and number of beds .The
affordability includes expense of medicines, charges on various tests, charges of consultation and
rent on rooms.

Major Illness
Preference of hospitals on Major Illness
Preference Frequency Percent

public Valid Public 3 15.8

Private 4 21.1

Total 7 36.8

Missing
12 63.2
System

Total 19 100.0

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 private Valid Private 10 47.6

Missing
11 52.4
System

Total 21 100.0
Source :Field Survey
Table shows the preference of private and public health care institutions for major illness
.The respondents who give more preference to public healthcare institutions ,among them 15.8
percent preferred public hospitals while 21.1 per cent preferred private hospitals for major
illness.
Among the respondents who preferred private healthcare facilities 47.6 preferred private
hospitals while 52.4 percent did not offer any response.

Minor Illness
Preference of hospitals on Minor Illness
Preference Frequency Percent

Public Valid Public 18 94.7

Private 1 5.3

Total 19 100.0

Private Valid Private 21 100.0

Source :Field Survey

Table shows the preference of private and public health care facilities for minor illness by the
respondents. Among those preferred public healthcare, 94.7 per cent preferred public health care
and 5.3 per cent preferred private health care for minor illness.
But among those who preferred private hospitals, 100 per cent preferred over private
health care for minor illnesses.

FINDINGS AND CONCLUSION

FINDINGS

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The present study investigates about the preferences towards private versus public health care
institutions.

Major Findings

The major findings of the study can be summarized in the following subsections.

Socio-economic character and preference

 47.5 percent of households were giving more preference to public health care institutions and
52.5 percent of households give more preference to private health care institutions.
 Among the respondents with monthly income less than 10000, 76.9 per cent of respondents
choose public hospitals and 23.1 per cent of respondents choose private hospitals.
 In the income category of 10000-20000, 57.1 per cent of the respondents choose public
hospitals and 42.9 per cent of the respondents choose private hospitals.
 In the income category of above 20000 only 7.7 per cent of respondents chose public
hospital and 92.3 per cent of the respondents chose private hospitals.

Factors Determining the Preference

 There is a relationship between the choice of hospital and services, they are providing

like skill and competency of the staff, the room facilities provided, the nursing care, the
friendliness of the staff, modern diagnosis and treatment equipment, consultation
without any delay, efficiency of doctors, availability of specialized doctors, level of
privacy and transparency.
 There is a relationship between the choice of hospital and infrastructure they are
providing like level of cleanliness, convenient location, availability of transportation
facilities, wheelchair and lift availability, canteen facility and number of beds
Policy Implications

‘Health is Wealth’ and Good health of population is the ‘Wealth of Nation’.Health is a

multifaceted concept, it is not easy to prescribe policies to improve the health of the citizens in a
nation.In the case of health a major shift required from the current scenario .Decentralization of
health care services should be improved in order to improve the health status of the people.

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The central and state government introduce various schemes to support the health status ,but its
effect is not trickle down into each one in the society .The government needs to focus more on to
provide the facilities to all citizens especially the deprived ones.

Study also indicates the lack of awareness of people about various government policies and
programmes.

CONCLUSION

It can be concluded from the analysis of the responses of the respondents and the testing
individuals are concerned about their health and concerned about the preference of the health
care institutions. With private sector omnipresent across urban and rural India, it continues to be
preferred compared to the public sector. In a study conducted in the village of vellavoor, reasons
for preference of private sector facility included proximity, quality of care and convenient
timing. The choice is influenced by various socio-economic factors like income level ,social
group and economic category. The only factor that compelled socially backward classes to
access to public health services was ‘Affordability’. The data analysis has indicated that the
strength of the private sector includes accessibility and availability of medical care services
compared to the public sector. Though, affordability is a critical factor, the attitude of the people
towards their health and health care institutions is also an important factor in the choice of
hospital. The attitude is influenced by the services provided by the hospitals, and the
infrastructure facilities they are providing. Even if the private hospitals are more expensive
people give more preference to it, because better services and better infrastructure they are
providing.