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

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  • Jonathan Gruber
  • Nathaniel Hendren
  • Robert Townsend

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.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 17739.

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Date of creation: Jan 2012
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Publication status: published as The Great Equalizer: Health Care Access and Infant Mortality in Thailand (with Jonathan Gruber and Robert M. Townsend), American Economic Journal: Applied Economics. 2014; 6(1): 91-107
Handle: RePEc:nbr:nberwo:17739

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  1. Robert M. Townsend & Joseph P. Kaboski, 2009. "A Structural Evaluation of a Large-Scale Quasi-Experimental Microfinance Initiative," 2009 Meeting Papers 717, Society for Economic Dynamics.
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Cited by:
  1. Ghislando, S & Manachotphong, W & Perego, VME, 2013. "The impact of Universal Health Coverage on healthcare consumption and risky behaviours: evidence from Thailand," Working Papers 11200, Imperial College, London, Imperial College Business School.
  2. Cesur, Resul & Tekin, Erdal & Ulker, Aydogan, 2013. "Air Pollution and Infant Mortality: Evidence from the Expansion of Natural Gas Infrastructure," IZA Discussion Papers 7179, Institute for the Study of Labor (IZA).
  3. Moreno-Serra, R & Smith, PC, 2013. "Towards an index of health coverage," Working Papers 10422, Imperial College, London, Imperial College Business School.

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