Demand and Reimbursement Effects of Healthcare Reform: Health Care Utilization and Infant Mortality in Thailand

33 Pages Posted: 14 Jan 2012 Last revised: 17 Jan 2012

See all articles by Jonathan Gruber

Jonathan Gruber

Massachusetts Institute of Technology (MIT) - Department of Economics; National Bureau of Economic Research (NBER)

Nathaniel Hendren

Harvard University - Department of Economics

Robert M. Townsend

Massachusetts Institute of Technology (MIT)

Date Written: January 2012

Abstract

The Thai 30 Baht program was one of the largest health system reforms ever undertaken by a low-middle income country. In addition to lowering the cost of care for the previously uninsured in public facilities, it also entailed a fourfold increase in funding provided to hospitals to care for the poorest 30% of the population (who were already publicly insured). For the previously uninsured, we find that the 30 Baht program led to increased health care utilization, as well as a shift from private to public sources of care. But, we find a larger increase for the poor who were previously publicly insured, especially amongst infants and women of childbearing age. Using vital statistics records, we find that the increased access to healthcare by the publicly insured poor led to a reduction in their infant mortality of at least 6.5 per 1,000 births. This suggests significant improvements in infant mortality rates can be achieved through increased access to healthcare services for the poor and marginalized groups.

Suggested Citation

Gruber, Jonathan and Hendren, Nathaniel and Townsend, Robert M., Demand and Reimbursement Effects of Healthcare Reform: Health Care Utilization and Infant Mortality in Thailand (January 2012). NBER Working Paper No. w17739. Available at SSRN: https://ssrn.com/abstract=1985072

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Nathaniel Hendren

Harvard University - Department of Economics ( email )

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Robert M. Townsend

Massachusetts Institute of Technology (MIT) ( email )

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