Socioeconomic and Institutional Determinants of Healthcare Provider Choice in India

Authors: Arindam Nandi, Ashvin Ashok, Itamar Megiddo, Ramanan Laxminarayan


The healthcare delivery system in India has been broadly characterized, yet micro-evidence on the determinants of healthcare provider choice is inadequate. Using nationally representative data from the District Level Household Survey (DLHS-3) 2007–08 of India, we built a multinomial probit model to examine the determinants of a household’s choice of treatment provider among a government hospital, primary or community health center, other public healthcare facility, and a private provider.

We find that poorer or ethnic and religious minorities are more likely to visit a public healthcare provider than a private provider. Supply-side and quality perception data on public facilities suggest that supply-side inputs, such as medical staff, hospital equipment, and availability of drugs, do not have a strong association with choice patterns, but quality perception is positively correlated with choice. Additionally, distance to facilities and the level of dissatisfaction with public providers within the community have a strong negative influence on a household’s choice of public healthcare facilities.