Health Insurance and Healthcare Utilisation of Rural Farm Households in the Akuapem South District of Ghana

Abstract

The study examined the effect of health insurance on the healthcare utilization of rural farm households in the Akuapem South District of Ghana. A household survey, conducted in 2013, gathered information on 384 farm households using direct interviews. Multinomial logistic regression was used to address factors determining health insurance enrollment. Utilization of healthcare services was operationalized as the choice of healthcare which indicated the type of facility respondents visited when ill and had access to prescription drugs, either fully or partially. On the basis of the Andersen’s behavioural model of health services, a hierarchical multinomial logit and logistic models were formulated. Potential endogeneity of insurance was accounted for, acknowledging that confounding factors may affect insurance purchase, choice of healthcare provider and access to prescription drugs. The results revealed that even though health insurance coverage was low for farmers in the study area, it had a robust, significantly positive effect on the choice of public health facilities, while it had a negative effect on access to prescription drugs at the health facility.