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Impact of Universal Health Care Coverage on patient demand for health care services in Thailand

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  • Panpiemras, Jirawat
  • Puttitanun, Thitima
  • Samphantharak, Krislert
  • Thampanishvong, Kannika

Abstract

Fully implemented in Thailand in 2002, the Universal Health Care Coverage (UC) Program aimed to provide cheap access to health care services, for 30 baht (less than 1 U.S. dollar) per visit, to all uninsured Thais. In this paper, we studied the impact of the UC in Thailand on the demand for health care services using hospital level data. We found that the UC program was successful in increasing outpatient demand for health care, particularly the demand from the elderly and the poor. However, outpatient demand for health care dramatically increased during the first year of the program and faded away quickly in subsequent years. In contrast to outpatient demand, the number of inpatient visits and the number of days for which the inpatients were admitted at hospitals declined after the UC program was launched. In this paper, we offer our explanation of these phenomena, highlight problems associated with the UC program, and provide policy recommendations to improve the program.

Suggested Citation

  • Panpiemras, Jirawat & Puttitanun, Thitima & Samphantharak, Krislert & Thampanishvong, Kannika, 2011. "Impact of Universal Health Care Coverage on patient demand for health care services in Thailand," Health Policy, Elsevier, vol. 103(2), pages 228-235.
    • Handle: RePEc:eee:hepoli:v:103:y:2011:i:2:p:228-235
    DOI: 10.1016/j.healthpol.2011.08.008
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    References listed on IDEAS

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    1. Hughes, David & Leethongdee, Songkramchai & Osiri, Sunantha, 2010. "Using economic levers to change behaviour: The case of Thailand's universal coverage health care reforms," Social Science & Medicine, Elsevier, vol. 70(3), pages 447-454, February.
    2. Joseph P. Newhouse & Charles E. Phelps, 1976. "New Estimates of Price and Income Elasticities of Medical Care Services," NBER Chapters, in: The Role of Health Insurance in the Health Services Sector, pages 261-320, National Bureau of Economic Research, Inc.
    3. Suraratdecha, Chutima & Saithanu, Somying & Tangcharoensathien, Viroj, 2005. "Is universal coverage a solution for disparities in health care?: Findings from three low-income provinces of Thailand," Health Policy, Elsevier, vol. 73(3), pages 272-284, September.
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    1. Rieger, Matthias & Wagner, Natascha & Bedi, Arjun S., 2017. "Universal health coverage at the macro level: Synthetic control evidence from Thailand," Social Science & Medicine, Elsevier, vol. 172(C), pages 46-55.
    2. Supon Limwattananon & Sven Neelsen & Owen O'Donnell & Phusit Prakongsai & Viroj Tangcharoensathien & Eddy van Doorslaer & Vuthiphan Vongmongkol, 2013. "Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand," CESifo Working Paper Series 4262, CESifo.
    3. Natthani Meemon & Seung Chun Paek, 2020. "Analysis of Composition Change of Public Facility Care Users After the Universal Coverage Scheme in Thailand," SAGE Open, , vol. 10(3), pages 21582440209, July.
    4. Chaw-Yin Myint & Milena Pavlova & Khin-Ni-Ni Thein & Wim Groot, 2019. "A systematic review of the health-financing mechanisms in the Association of Southeast Asian Nations countries and the People’s Republic of China: Lessons for the move towards universal health coverag," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    5. Jianyun Wang & Yaolin Pei & Renyao Zhong & Bei Wu, 2020. "Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter?," IJERPH, MDPI, vol. 17(12), pages 1-12, June.
    6. Salaheddine El Omari & Mahmoud Karasneh, 2021. "Social health insurance in the Philippines: do the poor really benefit?," Journal of Economics and Finance, Springer;Academy of Economics and Finance, vol. 45(1), pages 171-187, January.
    7. 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.
    8. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    9. Roengrudee Patanavanich & Stanton A Glantz, 2020. "Association between tobacco control policies and hospital admissions for acute myocardial infarction in Thailand, 2006-2017: A time series analysis," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-13, December.
    10. Rieger, M. & Wagner, N. & Bedi, A.S., 2015. "Macroeconomic impacts of Universal Health Coverage : Synthetic control evidence from Thailand," ISS Working Papers - General Series 609, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    11. Nada Wasi & Jirawat Panpiemras & Wanwiphang Manachotphong, 2016. "The Impacts of the Billing System on Healthcare Utilization: The Case of Thai Civil Servant Medical Benefit Scheme," PIER Discussion Papers 48, Puey Ungphakorn Institute for Economic Research.
    12. Limwattananon, Supon & Neelsen, Sven & O'Donnell, Owen & Prakongsai, Phusit & Tangcharoensathien, Viroj & van Doorslaer, Eddy & Vongmongkol, Vuthiphan, 2015. "Universal coverage with supply-side reform: The impact on medical expenditure risk and utilization in Thailand," Journal of Public Economics, Elsevier, vol. 121(C), pages 79-94.

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