Doctoral Dissertations

Date of Award

8-1990

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Economics

Major Professor

William E. Cole

Committee Members

Hans E. Jensen, Anne Mayhew, Michael M. Betz

Abstract

A case study approach is used to assess informal sector health care for its ability to improve the health of the population and for its implications for economic development. Data on treatment outcomes are drawn from two anthropological studies of physicians in Mexico City and Spiritualist temple healers in rural Mexico. An indicative study of cost-effectiveness is conducted to compare physician and Spiritualist temple treatment; costs are derived from market prices collected in Mexico City and from government documents. The following are identified: Mexico's health care sectors; the kinds of health complaints responding to temple treatment; the nation's estimated aggregate health care resources and annual expenditures by sector; the public portion of expenditures and the population segments it covers; and institutional influences upon differential demand for each sector's services. A comparison of treatment outcomes indicated no significant difference between physician and temple treatment success rates (p>.05). Costs per successful treatment by physicians exceeded those by temple healers on average by 12% for prescriptions and by 2,569% for labor, capital, and materials. Cases reflecting somatized depression were most responsive to temple treatment. Curative and preventive services accounted for 33.27% of the estimated national total expenditures on health care, of which only .08% went to informal sector providers. The public sector accounted for 66.63% of total health care expenditures; 86.70% of the public expenditures went to health care coverage of the half of the population comprised of formal economic sector workers and their dependents. Conclusions are as follows: 1) informal sector health care is inexpensive relative to formal sector care and is able to ameliorate certain kinds of widely occurring health complaints; 2) it provides a treatment function not available in formal sector care; 3) the health care system in Mexico is unduly narrow in scope and extremely unequal in the distribution of its benefits; 4) informal sector care (as well as greater emphasis on preventive measures) is likely to improve and extend health care for the total population; and 5) a cost-effectiveness approach provides an economic basis for choosing one type of health care intervention over another regardless of sector of origin, but it is unable to address externalities which are beyond the scope of monetary evaluations but may negatively impact upon development.

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