Dear All

Pl find attached an Article on Utilization of outpatient care in Odisha: factors determining the choice of Public or Private Health care Facility. This is based on a primary study conducted in the two districts of Odisha. An abstract is given here for your reference.

Background: Comparative studies analysing the user’s perception about the services and reasons for selecting a public or private facility are crucial for improving service delivery. In India, there is consid­erable debate regarding public versus private sector. In this context, this study examines the factors determining utilisation of either public or private health care institutions in Odisha.

Methods: The study is based on primary data collected from the outpatients visiting public and private health care institutions in the two districts of Odisha. Information on socio economic status (SES) and patient’s perception on service delivery were collected through a questionnaire. Association between health care utilization either from a public or private facility and the predicator variables–SES and facili­ties related variables was determined using multivariate logistic regression analysis.

Results: A higher proportion of patients belonging to the low SES utilized public facility than the private facility. The scheduled tribes (STs) were five times more likely to visit public facility than the general caste (OR = 5.042, CI = 1.0538–24.130). Physical accessibility was main the reason to access a public facility. However, quality of care remained a major constraint in the public facility. Due to quality reasons, patients were 50 % less likely to utilise a public facility (OR = 0.506, CI = 0.289–0.886).

Conclusion: This study concludes people from the low SES are more likely to visit a public health facility than private. However, due to quality reasons the likelihood of visiting a public health facility is reduced significantly. Further, people incur expenditure out of their pocket on drugs and diagnostic tests in the public health system. Therefore, only physical access may not ensure higher utilization unless quality is ensured to protect the interest of the poor in the public health care system.


Dr Sarit Kumar Rout, PhD

Assoc Professor



11_JHM589244 – Odisha Article.pdf