Household Size and the Decision to Purchase Health Insurance in Cambodia: Results of a Discrete-Choice Experiment with Scale Adjustment

Sachiko Ozawa, Simrun Grewal, John F P Bridges

Research output: Contribution to journalArticle


Background: Community-based health insurance (CBHI) schemes have been introduced in low- and middle-income countries to increase health service utilization and provide financial protection from high healthcare expenditures. Objective: We assess the impact of household size on decisions to enroll in CBHI and demonstrate how to correct for group disparity in scale (i.e. variance differences). Methods: A discrete choice experiment was conducted across five CBHI attributes. Preferences were elicited through forced-choice paired comparison choice tasks designed based on D-efficiency. Differences in preferences were examined between small (1–4 family members) and large (5–12 members) households using conditional logistic regression. Swait and Louviere test was used to identify and correct for differences in scale. Results: One-hundred and sixty households were surveyed in Northwest Cambodia. Increased insurance premium was associated with disutility [odds ratio (OR) 0.61, p 

Original languageEnglish (US)
Pages (from-to)195-204
Number of pages10
JournalApplied Health Economics and Health Policy
Issue number2
Publication statusPublished - Apr 1 2016


ASJC Scopus subject areas

  • Economics and Econometrics
  • Health Policy

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