Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-of-Pocket Expenditures in Thailand

35 Pages Posted: 12 Jun 2013

See all articles by Supon Limwattananon

Supon Limwattananon

International Health Policy Program (IHPP) - Thailand

Sven Neelsen

CESifo (Center for Economic Studies and Ifo Institute for Economic Research)

Owen A. O'Donnell

University of Macedonia

Phusit Prakongsai

International Health Policy Program (IHPP)

Viroj Tangcharoensathien

International Health Policy Program, Bureau of Policy and Strategy, Ministry of Public Health

Eddy van Doorslaer

Erasmus School of Economics

Vuthiphan Vongmongkol

Government of the Kingdom of Thailand, Ministry of Public Health, International Health Policy Program (IHPP)

Multiple version iconThere are 2 versions of this paper

Date Written: May 31, 2013

Abstract

We estimate the impact on health care utilization and out-of-pocket (OOP) expenditures of a major reform in Thailand that extended health insurance to one-quarter of the population to achieve universal coverage while keeping health spending below 4% of GDP. Identification is through comparison of changes in outcomes of groups to whom coverage was extended with those of public sector employees and their dependents whose coverage was not affected. The reform is estimated to have reduced the probability that a sick person goes without formal treatment by 3.2 percentage points (11%). It increased the probability of receiving public ambulatory care by 2.7 ppt (5%) and of admission to a public hospital by 1 ppt (18%). OOP expenditures were reduced by one-third on average, as was the probability of spending more than 10% of the household budget on health care, while spending at the very top of the OOP distribution was reduced by one-half representing substantial reductions in exposure to medical expenditure risk. Supply-side measures implemented with the coverage extension are likely to have helped realize these effects from an increased, but still very tight, budget.

Keywords: health insurance, health care, medical expenditures, universal coverage, Thailand

JEL Classification: H420, H510, I180

Suggested Citation

Limwattananon, Supon and Neelsen, Sven and O'Donnell, Owen A. and Prakongsai, Phusit and Tangcharoensathien, Viroj and van Doorslaer, Eddy and Vongmongkol, Vuthiphan, Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-of-Pocket Expenditures in Thailand (May 31, 2013). CESifo Working Paper Series No. 4262. Available at SSRN: https://ssrn.com/abstract=2277437

Supon Limwattananon

International Health Policy Program (IHPP) - Thailand ( email )

3rd Floor Health, Tiwanon road
Muang district
Nonthaburi 11000
Thailand

Sven Neelsen (Contact Author)

CESifo (Center for Economic Studies and Ifo Institute for Economic Research) ( email )

Poschingerstra├če 5
Munich, 81679
Germany
++498992241392 (Phone)
++498992241462 (Fax)

HOME PAGE: http://www.ifo.de

Owen A. O'Donnell

University of Macedonia ( email )

156 Egnatia St.
P.O. 1591
Thessaloniki, 54006
Greece

Phusit Prakongsai

International Health Policy Program (IHPP) ( email )

3rd Floor Health, Tiwanon road
Muang district
Nonthaburi 11000
Thailand

Viroj Tangcharoensathien

International Health Policy Program, Bureau of Policy and Strategy, Ministry of Public Health ( email )

3rd Floor Health, Tiwanon road
Muang district
Nonthaburi 11000
Thailand

Eddy Van Doorslaer

Erasmus School of Economics ( email )

Netherlands

Vuthiphan Vongmongkol

Government of the Kingdom of Thailand, Ministry of Public Health, International Health Policy Program (IHPP) ( email )

3rd Floor Health, Tiwanon road
Muang district
Nonthaburi 11000
Thailand

Here is the Coronavirus
related research on SSRN

Paper statistics

Downloads
83
Abstract Views
669
rank
95,950
PlumX Metrics