Determinants of healthcare seeking and out-of-pocket expenditures in a “free” healthcare system: evidence from rural Malawi

Table 4 Heckman model for determinants of utilization formal care (n = 1884) and of OOPE on medical treatment (n = 494) run on a sample of 2740 acute ill episodes

	First part selection eqn.: Utilization of formal healthcare services (in the last 4 weeks)			Second part primary equation: Out-of-pocket expenditures¹ on medical treatment
Explanatory variables	Coeff	SE²	P-value	Coeff	SE²	P-value
Distance to the closest health facility (km)	−0.090**	0.037	0.015
Age
5–14 years	−0.509***	0.140	< 0.001	98.934	77.943	0.25
15–39 years	−0.722***	0.145	< 0.001	238.548**	99.862	0.017
39+ years	−0.973***	0.187	< 0.001	210.440	166.323	0.21
Female	0.172*	0.097	0.076	−56.623	72.883	0.44
Any formal education	0.109	0.100	0.28	−18.193	78.430	0.82
Being household head	0.170	0.141	0.23	304.119**	146.076	0.037
Chronic illness reported	−0.353***	0.121	0.004	286.869**	122.242	0.019
Illness duration (days)	0.031***	0.006	< 0.001	9.838**	4.013	0.014
Limitation imposed on routine activities	0.746***	0.094	< 0.001	−56.257	77.537	0.47
Hospitalization	7.006***	0.226	< 0.001	713.743***	235.554	0.002
Accompanying persons	0.016	0.083	0.85	162.949**	69.195	0.019
Socio economic status (wealth quartiles)
Poor (2nd wealth quartile)	−0.166	0.133	0.21	213.333***	90.557	0.018
Less poor (3rd wealth quartile)	0.080	0.133	0.55	322.699***	101.033	0.001
Least poor (4th wealth quartile)	0.234*	0.134	0.081	321.486***	102.957	0.002
Household size 5+ members	−0.212**	0.093	0.022	−75.62657	72.028	0.30
Urban	−0.126	0.196	0.52	692.753***	208.922	0.001

ISSN: 2191-1991