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

Author

Listed:
  • 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.

Suggested Citation

  • Jonathan Gruber & Nathaniel Hendren & Robert Townsend, 2012. "Demand and Reimbursement Effects of Healthcare Reform: Health Care Utilization and Infant Mortality in Thailand," NBER Working Papers 17739, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:17739
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    References listed on IDEAS

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    1. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    2. Joseph P. Kaboski & Robert M. Townsend, 2011. "A Structural Evaluation of a Large‐Scale Quasi‐Experimental Microfinance Initiative," Econometrica, Econometric Society, vol. 79(5), pages 1357-1406, September.
    3. Pascaline Dupas, 2011. "Health Behavior in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 3(1), pages 425-449, September.
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    1. Moreno-Serra, R & Smith, PC, 2012. "Towards an index of health coverage," Working Papers 10422, Imperial College, London, Imperial College Business School.
    2. Resul Cesur & Erdal Tekin & Aydogan Ulker, 2017. "Air Pollution and Infant Mortality: Evidence from the Expansion of Natural Gas Infrastructure," Economic Journal, Royal Economic Society, vol. 127(600), pages 330-362, March.
    3. Zhou, Wenhui & Wan, Qiang & Zhang, Ren-Qian, 2017. "Choosing among hospitals in the subsidized health insurance system of China: A sequential game approach," European Journal of Operational Research, Elsevier, vol. 257(2), pages 568-585.
    4. Midori Matsushima & Hiroyuki Yamada & Yasuharu Shimamura, 2020. "Analysis on demand‐ and supply‐side responses during the expansion of health insurance coverage in Vietnam: Challenges and policy implications toward universal health coverage," Review of Development Economics, Wiley Blackwell, vol. 24(1), pages 144-166, February.
    5. Rutger Daems & Edith Maes, 2014. "Global Pharmaceutical Management: Building a Fair Pricing Policy," Working Papers 2014/05, Maastricht School of Management.
    6. 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.
    7. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.

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    More about this item

    JEL classification:

    • I0 - Health, Education, and Welfare - - General
    • I1 - Health, Education, and Welfare - - Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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