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Billing system and health care utilization: Evidence from Thailand

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  • Damrongplasit, Kannika
  • Atalay, Kadir

Abstract

We examined the role of billing processes in health care utilization by exploiting a shift in provider payment from fee-for-service reimbursement towards fee-for-service direct disbursement for outpatient services in Thailand. Specifically, prior to October 2006, affected patients had to pay the full cost of outpatient treatment and subsequently received reimbursement; thereafter, these payments can be sent directly to the providers, without patients having to pay anything upfront. By using nationally representative micro-data and a difference-in-difference methodology, we show that the direct disbursement policy leads to an increase in outpatient utilization among the sick. This non-price change has long-lasting impacts and particularly increases the health care utilization of sick individuals who are living in rural areas, are less educated and earn low incomes. These findings suggest that direct disbursement helps to increase liquidity constraint individuals’ health care utilization. The results emphasize the effectiveness of behavioural interventions in health policy making.

Suggested Citation

  • Damrongplasit, Kannika & Atalay, Kadir, 2020. "Billing system and health care utilization: Evidence from Thailand," Journal of Health Economics, Elsevier, vol. 73(C).
    • Handle: RePEc:eee:jhecon:v:73:y:2020:i:c:s0167629618311809
    DOI: 10.1016/j.jhealeco.2020.102366
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    1. Wagstaff, Adam & Yu, Shengchao, 2007. "Do health sector reforms have their intended impacts?: The World Bank's Health VIII project in Gansu province, China," Journal of Health Economics, Elsevier, vol. 26(3), pages 505-535, May.
    2. Gebel, Michael & Voßemer, Jonas, 2014. "The impact of employment transitions on health in Germany. A difference-in-differences propensity score matching approach," Social Science & Medicine, Elsevier, vol. 108(C), pages 128-136.
    3. Jonathan Gruber & Nathaniel Hendren & Robert M. Townsend, 2014. "The Great Equalizer: Health Care Access and Infant Mortality in Thailand," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 91-107, January.
    4. Richard Blundell & Monica Costa Dias, 2009. "Alternative Approaches to Evaluation in Empirical Microeconomics," Journal of Human Resources, University of Wisconsin Press, vol. 44(3).
    5. Richard Blundell & Monica Costa Dias & Costas Meghir & John Van Reenen, 2004. "Evaluating the Employment Impact of a Mandatory Job Search Program," Journal of the European Economic Association, MIT Press, vol. 2(4), pages 569-606, June.
    6. Li, Xin & Zhang, Wei, 2013. "The impacts of health insurance on health care utilization among the older people in China," Social Science & Medicine, Elsevier, vol. 85(C), pages 59-65.
    7. Epp, Michael J. & Vining, Aidan R. & Collins-Dodd, Colleen & Love, Ernie, 2000. "The impact of direct and extra billing for medical services: evidence from a natural experiment in British Columbia," Social Science & Medicine, Elsevier, vol. 51(5), pages 691-702, September.
    8. Karen E. Dynan & Jonathan Skinner & Stephen P. Zeldes, 2004. "Do the Rich Save More?," Journal of Political Economy, University of Chicago Press, vol. 112(2), pages 397-444, April.
    9. Benjamin R. Handel & Jonathan T. Kolstad & Johannes Spinnewijn, 2019. "Information Frictions and Adverse Selection: Policy Interventions in Health Insurance Markets," The Review of Economics and Statistics, MIT Press, vol. 101(2), pages 326-340, May.
    10. 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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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 5th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-05 11:00:05

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    1. Damrongplasit, Kannika & Atalay, Kadir, 2021. "Payment mechanism and hospital admission: New evidence from Thailand healthcare reform," Social Science & Medicine, Elsevier, vol. 291(C).

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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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