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Моделирование поведения потребителя при выборе государственной и частной медицинской организации в России
Demand for public and private health care services is formed through consumer decision-
making in two situations: to seek or not to seek medical help and which medical institution to
attend. Theory suggests that choices in these situations occur sequentially and are explained by
Andersen's behavioral model. This study tests these theoretical assumptions using three
econometric approaches on the Russian National Health Telephone Survey 2022 data: (1) two
separate probit regressions, (2) sample selection probit, and (3) nested logit. Nested logit confirmed
the relevance of all demand-side characteristics (Andersen's model factors). Being male, older, and
having health problems were associated with decreased probability of seeking health care and
choosing private clinics. Being married, having a high level of education, being employed, having a
medium or high monthly income, and living in larger cities were associated with increased
probability of seeking health care and attending private clinics. Robustness check of the nested logit
model accounted for the varying levels of availability of health care facilities in different cities.
Despite the differences in the availability of public and private medical organizations, trends in
consumer behavior remained the same. The author proposes to expand the practice of using nested
logit models to analyze the behavior of consumers of medical services using data from Russia and
other countries. Recommendations for increasing the efficiency of the Russian health care system
and reducing inequality in its use by different consumer groups include transforming attitudes of
Russians to their own health and developing the accessibility of health care.