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Rural-urban inequalities in health care utilization in Bhutan: a decomposition analysis
Jayendra Sharma1,2, Milena Pavlova3, Wim Groot3
1Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands. j.sharma@maastrichtuniversity.nl.
International Journal for Equity in Health
|April 12, 2024
Summary
Bhutan
Area of Science:
- Health Services Research
- Health Equity Studies
- Socioeconomic Determinants of Health
Background:
- Universal health coverage in Bhutan faces challenges due to urban-rural health outcome disparities.
- Addressing health equity is crucial for policy development.
Purpose of the Study:
- To examine health services utilization patterns and inequalities in rural and urban Bhutan.
- To identify socioeconomic determinants of these differences.
Main Methods:
- Utilized Bhutan Living Standard Survey 2017 data.
- Employed Oaxaca-Blinder decomposition and recentered influence function regressions.
Main Results:
- Rural populations are 3.4 times more likely to use primary health centers than hospitals.
- Primary health care use is pro-poor; hospital care is concentrated among the affluent.
- Rural-urban utilization gaps are driven by income and region; inequality is influenced by household characteristics.
Conclusions:
- Significant differences exist in service type and inequality between rural and urban Bhutan, despite similar overall utilization.
- Factors driving utilization gaps differ from those influencing income-related inequality.
- Findings inform targeted policies for universal health coverage.
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