The elimination of user fees in Uganda - World Health Organization

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The regression models are applied to pooled data from all the surveys with survey year asa dummy variable to determine if there was a significant difference between the resultsbefore and after user fees were abolished. The analysis was undertaken firstly usingunrestricted (full) models on the total pooled sample with a dummy variable designating ifa household was poor or non-poor. It was also estimated using restricted models estimatedseparately for the poor and the non-poor. This allows a statistical test, the log likelihoodratio Chow test, to be used to test whether the coefficients of the equations aresignificantly different for the poor and non-poor compared to the pooled equations. Thenull hypothesis that the regression coefficients are the same is then rejected at a 0.05significance level.The analysis unit for considering catastrophic expenditure is the household. Thedependent variable (cata) is defined as 1 where a household incurred catastrophicexpenditure, and 0 otherwise. The probability of a household facing catastrophicexpenditure is Pr( cata = 1| X ) , the odds ratio (OR) isPr( cata = 1| X ) Pr( cata = 1| X )OR = =(1)Pr( cata = 0 | X ) 1−Pr( cata = 1| X )where X is a vector of independent variables.The odds ratio indicates how often catastrophic expenditure occurs relative to how often itdoes not occur for a household in a particular situation. It ranges from 0 whenPr( cata = 1| X ) = 0 to ∞ when Pr( cata = 1| X ) = 1. An odds ratio smaller than 1 for adependent variable indicates that this factor protects a household from facing catastrophic
expenditure while an odds ratio greater than 1 indicates that the factor is linked to a higherprobability that a household faces catastrophic expenditure.After logit transformation, the linear model can be written asPr( cata = 1| X )ln( ) = Xβ(2)1−Pr( cata = 1| X )where β is a vector of parameters.Multinominal logistic regression is used in analyzing the utilization of services. Data areprovided in the surveys at the individual level. The model is applied to people whoreported illness during the last 30 days. The probability that a person seeks care at aparticular type of facility can be written as:( k )exp( Xβ)Pr( use = k | X ) =4( i)exp( Xβ)∑i=1(3)1 publick= 2 privateWhere k denotes 3 others choice and X is a vector of independent variables and β is a vector of4 not useparameters.(4)In this study, we set 'not used' as the base category, namely β = 0 . According toequation (5), the probability of Pr(use=4|X) becomesPr( 1use = 4 | X ) =(4)(1)(2)(31+exp( Xβ) + exp( Xβ) + exp( Xβ) )
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The elimination of user fees in Uganda - World Health Organization

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