Abstract:
Aim. (is study aims to examine which factors influence the distance traveled by patients for inpatient care in Kenya. Methods. We
used data from the fourth round of the Kenya Household Health Expenditure and Utilization survey. Our dependent variable was
the self-reported distance traveled by patients to access inpatient care at public health facilities. As the clustered data were
correlated, we used the generalized estimating equations approach with an exchangeable correlation under a Tweedie distribution.
To select the best-fit covariates for predicting distance, we adopted a variable selection technique using the QIC u and R2 criteria,
wherein the lowest (highest) value for the former (latter) is preferred. Results. Using data for 451 participants from 47 counties, we
found that three-fifths were admitted between 1 and 5 days, two-thirds resided in rural areas, and 90% were satisfied with the
facilities’ service. Wealth quintiles were evenly distributed across respondents. Most admissions (81%) comprised < 15, > 65, and
25–54 years. Many households were of medium size (4–6 members) and had low education level (48%), and nine-tenths had no
access to insurance. While two-thirds reported employment-based income, the same number reported not having cash to pay for
inpatient services; 6 out of 10 paid over 3000 KES. (us, differences in employment, ability to pay, and household size influence
the distance traveled to access government healthcare facilities in Kenya. Interpretation. Low-income individuals more likely have
large households and live in rural areas and, thus, are forced to travel farther to access inpatient care. Unlike the unemployed, the
employed may have better socioeconomic status and possibly live near inpatient healthcare facilities, thereby explaining their
short distances to access these services. Policymakers must support equal access to inpatient services, prioritize rural areas, open
job opportunities, and encourage smaller families