A new study analyzed data from a household and facility survey from Chhattisgarh, India, to better understand patient bypassing behavior. The study, published in the June edition of Social Science & Medicine, was led by Dr. Krishna Rao, an assistant professor in international health at the Johns Hopkins Bloomberg School of Public Health and Ms. Ashley Sheffel, an international health doctoral student at the Bloomberg School.
The results show that over two-thirds of patients living in a vicinity of a primary healthcare center (PHC) chose to seek more expensive treatment somewhere other than their low-cost PHC. Factors other than distance and cost influenced patient choice of where to seek care because the PHC was located nearby and offered low-cost health services. Bypassing primary health centers fell as clinician ability increased; however, after a certain threshold, improving provider ability had no effect on bypassing. The quality of facility infrastructure had little impact on bypassing. Better clinician ability reduced bypassing more than better structural quality. Patients that bypassed PHCs had higher out-of-pocket health expenditures.