IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v124y2020i2p189-198.html
   My bibliography  Save this article

An evaluation of universal vouchers as a demand-side subsidy to change primary care utilization: A retrospective analysis of longitudinal services utilisation and voucher claims data from a survey cohort in Hong Kong

Author

Listed:
  • Yeoh, Eng-Kiong
  • Yam, Carrie H.K.
  • Chong, Ka-Chun
  • Chow, Tsz-Yu
  • Fung, Valerie L.H.
  • Wong, Eliza L.Y.
  • Griffiths, Sian M.

Abstract

To incentivize private primary care utilization and reduce reliance on public healthcare services, Elderly Healthcare Voucher Scheme has been implemented to provide a voucher entitlement to entire older resident population for subsidising their purchase of unspecified primary healthcare services in the private sector. Our study assessed whether voucher usage is associated with reduced utilization of public healthcare services. We retrieved the public healthcare services utilization and voucher transaction data of a survey cohort of 551 participants, who were age eligible for the scheme since 2009, over the period 2009–2015. Our results showed that voucher usage was not associated with reduced utilization of public healthcare services and has encouraged dual utilization of public and private healthcare. It may be due to a generated supply-induced demand and price inflation. The finding suggests the voucher is specifically designed to address the health systems issues to achieve the effective policy objectives. Defining the specific services to be provided and the prices at which they should be offered based on the needs of specified populations is a fundamental design parameter which needs to be incorporated. The alternatives of whether primary care services should be expanded and provided in the public sector or purchased using supply/demand side instruments should be considered taking the context and goals of the health system into account.

Suggested Citation

  • Yeoh, Eng-Kiong & Yam, Carrie H.K. & Chong, Ka-Chun & Chow, Tsz-Yu & Fung, Valerie L.H. & Wong, Eliza L.Y. & Griffiths, Sian M., 2020. "An evaluation of universal vouchers as a demand-side subsidy to change primary care utilization: A retrospective analysis of longitudinal services utilisation and voucher claims data from a survey coh," Health Policy, Elsevier, vol. 124(2), pages 189-198.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:2:p:189-198
    DOI: 10.1016/j.healthpol.2019.12.009
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851019303033
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2019.12.009?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Nachtnebel, Matthias & O'Mahony, Ashleigh & Pillai, Nandini & Hort, Kris, 2015. "Effectively engaging the private sector through vouchers and contracting – A case for analysing health governance and context," Social Science & Medicine, Elsevier, vol. 145(C), pages 193-200.
    2. Nguyen, Ha T.H. & Hatt, Laurel & Islam, Mursaleena & Sloan, Nancy L. & Chowdhury, Jamil & Schmidt, Jean-Olivier & Hossain, Atia & Wang, Hong, 2012. "Encouraging maternal health service utilization: An evaluation of the Bangladesh voucher program," Social Science & Medicine, Elsevier, vol. 74(7), pages 989-996.
    3. Yam, Ho-Kwan & Mercer, Stewart W. & Wong, Lai-Yi & Chan, Wan-Kin & Yeoh, Eng-Kiong, 2009. "Public and private healthcare services utilization by non-institutional elderly in Hong Kong: Is the inverse care law operating?," Health Policy, Elsevier, vol. 91(3), pages 229-238, August.
    4. John Tayu Lee & Fozia Hamid & Sanghamitra Pati & Rifat Atun & Christopher Millett, 2015. "Impact of Noncommunicable Disease Multimorbidity on Healthcare Utilisation and Out-Of-Pocket Expenditures in Middle-Income Countries: Cross Sectional Analysis," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-18, July.
    5. Schmidt, Jean-Olivier & Ensor, Tim & Hossain, Atia & Khan, Salam, 2010. "Vouchers as demand side financing instruments for health care: A review of the Bangladesh maternal voucher scheme," Health Policy, Elsevier, vol. 96(2), pages 98-107, July.
    6. Benjamin M Hunter & Sean Harrison & Anayda Portela & Debra Bick, 2017. "The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-37, March.
    7. Wong, Eliza L.Y. & Yeoh, Eng-kiong & Chau, Patsy Y.K. & Yam, Carrie H.K. & Cheung, Annie W.L. & Fung, Hong, 2015. "How shall we examine and learn about public-private partnerships (PPPs) in the health sector? Realist evaluation of PPPs in Hong Kong," Social Science & Medicine, Elsevier, vol. 147(C), pages 261-269.
    8. Claire Watt & Timothy Abuya & Charlotte E Warren & Francis Obare & Lucy Kanya & Ben Bellows, 2015. "Can Reproductive Health Voucher Programs Improve Quality of Postnatal Care? A Quasi-Experimental Evaluation of Kenya’s Safe Motherhood Voucher Scheme," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-20, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kuwawenaruwa, August & Ramsey, Kate & Binyaruka, Peter & Baraka, Jitihada & Manzi, Fatuma & Borghi, Josephine, 2019. "Implementation and effectiveness of free health insurance for the poor pregnant women in Tanzania: A mixed methods evaluation," Social Science & Medicine, Elsevier, vol. 225(C), pages 17-25.
    2. Benjamin M Hunter & Sean Harrison & Anayda Portela & Debra Bick, 2017. "The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-37, March.
    3. Seohyun Lee & Abdul-jabiru Adam, 2021. "Designing a Logic Model for Mobile Maternal Health e-Voucher Programs in Low- and Middle-Income Countries: An Interpretive Review," IJERPH, MDPI, vol. 19(1), pages 1-37, December.
    4. Nachtnebel, Matthias & O'Mahony, Ashleigh & Pillai, Nandini & Hort, Kris, 2015. "Effectively engaging the private sector through vouchers and contracting – A case for analysing health governance and context," Social Science & Medicine, Elsevier, vol. 145(C), pages 193-200.
    5. Sayedur Rahman & Aziz Ahmed Choudhury & Rasheda Khanam & Syed Mamun Ibne Moin & Salahuddin Ahmed & Nazma Begum & Nurun Naher Shoma & Md Abdul Quaiyum & Abdullah H Baqui & for the Projahnmo Study Group, 2017. "Effect of a package of integrated demand- and supply-side interventions on facility delivery rates in rural Bangladesh: Implications for large-scale programs," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-13, October.
    6. Fabre, Anaïs & Straub, Stéphane, 2019. "The Impact of Public-Private Partnerships (PPPs) in Infrastructure, Health and Education: A Review," TSE Working Papers 19-986, Toulouse School of Economics (TSE), revised Sep 2021.
    7. Hiroyuki Egami & Tomoya Matsumoto, 2020. "Mobile Money Use and Healthcare Utilization: Evidence from Rural Uganda," Sustainability, MDPI, vol. 12(9), pages 1-34, May.
    8. He, Alex Jingwei & Tang, Vivien F.Y., 2021. "Integration of health services for the elderly in Asia: A scoping review of Hong Kong, Singapore, Malaysia, Indonesia," Health Policy, Elsevier, vol. 125(3), pages 351-362.
    9. Mozhaeva, Irina, 2022. "Inequalities in utilization of institutional care among older people in Estonia," Health Policy, Elsevier, vol. 126(7), pages 704-714.
    10. Ricardo Ocaña-Riola & Carmen Pérez-Romero & Mª Isabel Ortega-Díaz & José Jesús Martín-Martín, 2021. "Multilevel Zero-One Inflated Beta Regression Model for the Analysis of the Relationship between Exogenous Health Variables and Technical Efficiency in the Spanish National Health System Hospitals," IJERPH, MDPI, vol. 18(19), pages 1-18, September.
    11. Pulok, Mohammad Habibullah & Sabah, Md Nasim-Us Sabah & Uddin, Jalal & Enemark, Ulrika, 2015. "Progress in utilization of antenatal and delivery care services in Bangladesh: Where does the equity gap lie?," MPRA Paper 63496, University Library of Munich, Germany.
    12. Junjie Huang & Chun-Ho Ngai & Man-Sing Tin & Qingjie Sun & Pamela Tin & Eng-Kiong Yeoh & Martin C. S. Wong, 2021. "Healthcare Voucher Scheme for Screening of Cardiovascular Risk Factors: A Population-Based Study," IJERPH, MDPI, vol. 18(20), pages 1-16, October.
    13. von Haaren, Paula & Klonner, Stefan, 2020. "Maternal cash for better child health? The impacts of India’s IGMSY/PMMVY maternity benefit scheme," Working Papers 0689, University of Heidelberg, Department of Economics.
    14. Anupa Rijal & Tara Ballav Adhikari & Jahangir A M Khan & Gabriele Berg-Beckhoff, 2018. "The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-23, November.
    15. Natalya Krivenko & Vladimir Elishev & Liudmila Kriventsova, 2019. "The Impact of Innovation on the Performance of Health Care in the Economic Security System of the Region," Economy of region, Centre for Economic Security, Institute of Economics of Ural Branch of Russian Academy of Sciences, vol. 1(1), pages 164-177.
    16. Silvana Secinaro & Luigi Corvo & Valerio Brescia & Daniel Iannaci, 2019. "Hybrid Organizations: A Systematic Review of the Current Literature," International Business Research, Canadian Center of Science and Education, vol. 12(11), pages 1-21, November.
    17. Nguyen, Ha & Knowles, James, 2010. "Demand for voluntary health insurance in developing countries: The case of Vietnam's school-age children and adolescent student health insurance program," Social Science & Medicine, Elsevier, vol. 71(12), pages 2074-2082, December.
    18. Fredrick Manang & Chikako Yamauchi, 2015. "The impact of access to health facilities on maternal care use and health status: Evidence from longitudinal data from rural Uganda," GRIPS Discussion Papers 15-19, National Graduate Institute for Policy Studies.
    19. Amal Almalki & Mohammed Al-Hanawi, 2018. "Public Private Partnerships and Collaboration in the Health Sector in the Kingdom of Saudi Arabia: A Qualitative Study," Global Journal of Health Science, Canadian Center of Science and Education, vol. 10(6), pages 1-10, June.
    20. Yuta Yokobori & Hiroyuki Kiyohara & Nadila Mulati & Kaung Suu Lwin & Truong Quy Quoc Bao & Myo Nyein Aung & Motoyuki Yuasa & Masami Fujita, 2023. "Roles of Social Protection to Promote Health Service Coverage among Vulnerable People toward Achieving Universal Health Coverage: A Literature Review of International Organizations," IJERPH, MDPI, vol. 20(9), pages 1-16, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:124:y:2020:i:2:p:189-198. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.