Waiting time at health facilities and social class: Evidence from the Indian caste system
Waiting time for non-emergency medical care in developing countries is rarely of immediate concern to policy makers that prioritize provision of basic health services. However, waiting time as a measure of health system responsiveness is important because longer waiting times worsen health outcomes...
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| creator | Shaikh, Mujaheed Miraldo, Marisa Renner, Anna-Theresa |
| description | Waiting time for non-emergency medical care in developing countries is rarely of immediate concern to policy makers that prioritize provision of basic health services. However, waiting time as a measure of health system responsiveness is important because longer waiting times worsen health outcomes and affect utilization of services. Studies that assess socio-economic inequalities in waiting time provide evidence from developed countries such as England and the United States; evidence from developing countries is lacking. In this paper, we assess the relationship between social class i.e. caste of an individual and waiting time at health facilities-a client orientation dimension of responsiveness. We use household level data from two rounds of the Indian Human Development Survey with a sample size of 27,251 households in each wave (2005 and 2012) and find that lower social class is associated with higher waiting time. This relationship is significant for individuals that visited a male provider but not so for those that visited a female provider. Further, caste is positively related to higher waiting time only if visiting a private facility; for individuals visiting a government facility the relationship between waiting time and caste is not significant. In general, caste related inequality in waiting time has worsened over time. The results are robust to different specifications and the inclusion of several confounders. |
| doi_str_mv | 10.1371/journal.pone.0205641 |
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However, waiting time as a measure of health system responsiveness is important because longer waiting times worsen health outcomes and affect utilization of services. Studies that assess socio-economic inequalities in waiting time provide evidence from developed countries such as England and the United States; evidence from developing countries is lacking. In this paper, we assess the relationship between social class i.e. caste of an individual and waiting time at health facilities-a client orientation dimension of responsiveness. We use household level data from two rounds of the Indian Human Development Survey with a sample size of 27,251 households in each wave (2005 and 2012) and find that lower social class is associated with higher waiting time. This relationship is significant for individuals that visited a male provider but not so for those that visited a female provider. Further, caste is positively related to higher waiting time only if visiting a private facility; for individuals visiting a government facility the relationship between waiting time and caste is not significant. In general, caste related inequality in waiting time has worsened over time. The results are robust to different specifications and the inclusion of several confounders.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0205641</identifier><identifier>PMID: 30321215</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Caste ; Communication ; Consortia ; Cultural differences ; Developed countries ; Developing countries ; Education ; Emergency medical care ; Emergency medical services ; Ethnicity ; Gender ; Health aspects ; Health care ; Health care facilities ; Health economics ; Health facilities ; Health policy ; Health services ; Hospital waiting lists ; Households ; Immunization ; India ; Industrialized nations ; Inequality ; Internet ; LDCs ; Low income groups ; Medical care ; Medicine ; Medicine and Health Sciences ; Minority & ethnic groups ; Patient satisfaction ; People and Places ; Planning ; Policy making ; Population ; Public health ; Race ; Services ; Social aspects ; Social class ; Social classes ; Social inequality ; Social research ; Social Sciences ; Time</subject><ispartof>PloS one, 2018-10, Vol.13 (10), p.e0205641-e0205641</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Shaikh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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However, waiting time as a measure of health system responsiveness is important because longer waiting times worsen health outcomes and affect utilization of services. Studies that assess socio-economic inequalities in waiting time provide evidence from developed countries such as England and the United States; evidence from developing countries is lacking. In this paper, we assess the relationship between social class i.e. caste of an individual and waiting time at health facilities-a client orientation dimension of responsiveness. We use household level data from two rounds of the Indian Human Development Survey with a sample size of 27,251 households in each wave (2005 and 2012) and find that lower social class is associated with higher waiting time. This relationship is significant for individuals that visited a male provider but not so for those that visited a female provider. 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The results are robust to different specifications and the inclusion of several confounders.</description><subject>Caste</subject><subject>Communication</subject><subject>Consortia</subject><subject>Cultural differences</subject><subject>Developed countries</subject><subject>Developing countries</subject><subject>Education</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Ethnicity</subject><subject>Gender</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>Health economics</subject><subject>Health facilities</subject><subject>Health policy</subject><subject>Health services</subject><subject>Hospital waiting lists</subject><subject>Households</subject><subject>Immunization</subject><subject>India</subject><subject>Industrialized nations</subject><subject>Inequality</subject><subject>Internet</subject><subject>LDCs</subject><subject>Low income 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Lars-Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Waiting time at health facilities and social class: Evidence from the Indian caste system</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-10-15</date><risdate>2018</risdate><volume>13</volume><issue>10</issue><spage>e0205641</spage><epage>e0205641</epage><pages>e0205641-e0205641</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Waiting time for non-emergency medical care in developing countries is rarely of immediate concern to policy makers that prioritize provision of basic health services. However, waiting time as a measure of health system responsiveness is important because longer waiting times worsen health outcomes and affect utilization of services. Studies that assess socio-economic inequalities in waiting time provide evidence from developed countries such as England and the United States; evidence from developing countries is lacking. In this paper, we assess the relationship between social class i.e. caste of an individual and waiting time at health facilities-a client orientation dimension of responsiveness. We use household level data from two rounds of the Indian Human Development Survey with a sample size of 27,251 households in each wave (2005 and 2012) and find that lower social class is associated with higher waiting time. This relationship is significant for individuals that visited a male provider but not so for those that visited a female provider. Further, caste is positively related to higher waiting time only if visiting a private facility; for individuals visiting a government facility the relationship between waiting time and caste is not significant. In general, caste related inequality in waiting time has worsened over time. The results are robust to different specifications and the inclusion of several confounders.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30321215</pmid><doi>10.1371/journal.pone.0205641</doi><tpages>e0205641</tpages><orcidid>https://orcid.org/0000-0002-4231-6631</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Caste Communication Consortia Cultural differences Developed countries Developing countries Education Emergency medical care Emergency medical services Ethnicity Gender Health aspects Health care Health care facilities Health economics Health facilities Health policy Health services Hospital waiting lists Households Immunization India Industrialized nations Inequality Internet LDCs Low income groups Medical care Medicine Medicine and Health Sciences Minority & ethnic groups Patient satisfaction People and Places Planning Policy making Population Public health Race Services Social aspects Social class Social classes Social inequality Social research Social Sciences Time |
| title | Waiting time at health facilities and social class: Evidence from the Indian caste system |
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