What do we know about health service utilisation in South Africa?

Abstract

This paper compares data from two household surveys to assess the effect of questionnaire design on estimated use of health services and analyses this across geographic areas and different groups. Deficiencies in the design of Statistics South Africa's General Household Survey led to a substantial underestimation of utilisation (capturing less than a third of visits). The South Africa Consortium for Benefit Incidence Analysis survey, which was more comprehensive, indicated that three out of four outpatient visits are to public sector facilities. Medical scheme membership is the most important predictor of using a private provider, particularly for inpatient care. Socioeconomic status and rural versus urban residence also influence overall utilisation rates and use of public versus private providers. It is critical to improve the design of routine household surveys to monitor utilisation patterns during the implementation of the proposed health system reform.