IDEAS home Printed from https://ideas.repec.org/p/phd/dpaper/dp_1998-03.html
   My bibliography  Save this paper

Macroeconomic Policy Change and Household Health Outomes: A Simulation of the Impact of the 1988-1992 Tariff Reform Program

Author

Listed:
  • Orbeta, Aniceto Jr. C.
  • Alba, Michael M.

Abstract

This paper estimates a discrete choice model of outpatient care using data drawn from a household survey covering 4 regions and 7 provinces involving 2,798 households and some 14,200 individuals. The choice alternatives include home care and formal care which consists of hospital outpatient clinics, independent private clinics, and public or charity clinics. Both simple logit model and nested logit specifications were estimated. Unlike the results in Gertler and van deer Gaag (1990), the data did not support rejection of the simple logit in favor of the nested logit model specification. The paper found that, contrary to early results (e.g., Akin et al. 1985), prices or user fees and income are important determinants of health care choice. The price elasticities, however, are small in magnitude compared to those in Ching (1995). However, just like the result in Ching (1995) there is a clear tendency for bigger price elasticities among lower income households compared to high income households. The estimated elasticities are also similar with those obtained by others using data from other developing countries reviewed in Gertler and Hammer (1997). These estimated elasticities imply that while price or user fee increases will not drastically affect the average demand for formal care, a uniform application of any price or user fee increase will hurt the poor more than the rich. This provides a case for shielding the poor from any uniform price increase in health care fees. The model was also used to simulate the impact of the 1990-2000 tariff reform program on household health outcomes which in this paper is measured by the probability of using a health facility when one is sick. The simulation results show that households in lower income quintiles are predicted to use less hospital outpatient and independent private clinics and depend more on home care, public and charity clinics while households in the highest income quintile are predicted to use more outpatient and independent private clinics. It appears that the progressive income effect of the tariff reform program is insufficient to counteract the expected price increase of health care in hospital outpatient and independent private clinics.

Suggested Citation

  • Orbeta, Aniceto Jr. C. & Alba, Michael M., 1998. "Macroeconomic Policy Change and Household Health Outomes: A Simulation of the Impact of the 1988-1992 Tariff Reform Program," Discussion Papers DP 1998-03, Philippine Institute for Development Studies.
  • Handle: RePEc:phd:dpaper:dp_1998-03
    as

    Download full text from publisher

    File URL: https://www.pids.gov.ph/publication/discussion-papers/macroeconomic-policy-change-and-household-health-outomes-a-simulation-of-the-impact-of-the-1988-1992-tariff-reform-program
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Brownstone, David & Small, Kenneth A, 1989. "Efficient Estimation of Nested Logit Models," Journal of Business & Economic Statistics, American Statistical Association, vol. 7(1), pages 67-74, January.
    2. Cororaton, Caesar B. & Reyes, Celia M., 1996. "Micro Impacts of Macroeconomic Adjustment Policies (MIMAP): The Philippine Case," Discussion Papers DP 1996-02, Philippine Institute for Development Studies.
    3. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    4. Gertler, Paul J. & Hammer, Jeffrey S., 1997. "Strategies for pricing publicly provided health services," Policy Research Working Paper Series 1762, The World Bank.
    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. Lindelow, Magnus, 2002. "Health care demand in rural Mozambique," FCND discussion papers 126, International Food Policy Research Institute (IFPRI).
    2. Magnus Lindelow, 2004. "The Utilization of Curative Health Care in Mozambique: Does Income Matter?," Development and Comp Systems 0409057, University Library of Munich, Germany.
    3. Awad Mataria & Stéphane Luchini & Yousef Daoud & Jean-Paul Moatti, 2007. "Demand assessment and price-elasticity estimation of quality-improved primary health care in palestine: a contribution from the contingent valuation method," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1051-1068.
    4. Sisira Sarma, 2009. "Demand for outpatient healthcare," Applied Health Economics and Health Policy, Springer, vol. 7(4), pages 265-277, December.
    5. Pokhrel, Subhash & De Allegri, Manuela & Gbangou, Adijma & Sauerborn, Rainer, 2010. "Illness reporting and demand for medical care in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 70(11), pages 1693-1700, June.
    6. Dow, W.H., 1995. "Welfare Impacts of Health Case User Fees : A Health- Valuation Approach to Analysis with Imperfect Markets," Papers 95-21, RAND - Labor and Population Program.
    7. Clarke, Philip M., 1998. "Cost-benefit analysis and mammographic screening: a travel cost approach," Journal of Health Economics, Elsevier, vol. 17(6), pages 767-787, December.
    8. de Bartolome, Charles A. M. & Vosti, Stephen A., 1995. "Choosing between public and private health-care: A case study of malaria treatment in Brazil," Journal of Health Economics, Elsevier, vol. 14(2), pages 191-205, June.
    9. Tiwari, Sandeep Kumar & Paltasingh, Kirtti Ranjan & Jena, Pabitra Kumar, 2020. "Caste-class association and school participation in Uttar Pradesh, India: Evidence from NSSO data," International Journal of Educational Development, Elsevier, vol. 79(C).
    10. Magnus Lindelow, 2003. "Understanding spatial variation in the utilization of health services: does quality matter?," Economics Series Working Papers WPS/2004-12, University of Oxford, Department of Economics.
    11. ILes, Richard, 2017. "Government Doctor Absenteeism And Its Effects On Consumer Demand In Rural North India," Working Papers 2018-9, School of Economic Sciences, Washington State University, revised 12 2018.
    12. Vos, R.P. & Cuesta, J.D. & León, M. & Lucio, R. & Rosero, J., 2005. "Reaching the millennium development goal for child mortality : Improving equity and efficiency in Ecuador's health budget," ISS Working Papers - General Series 19169, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    13. Birdsall, Nancy & James, Estelle, 1992. "Health, government, and the poor : the case for the private sector," Policy Research Working Paper Series 938, The World Bank.
    14. Martine Audibert & Yong He & Jacky Mathonnat, 2013. "Two-Period Comparison of Healthcare Demand with Income Growth and Population Aging in Rural China: Implications for Adjustment of the Healthcare Supply and Development," Working Papers halshs-00846088, HAL.
    15. Adhvaryu, Achyuta & Nyshadham, Anant, 2011. "Healthcare Choices, Information and Health Outcomes," Center Discussion Papers 107257, Yale University, Economic Growth Center.
    16. Mwabu, Germano, 1990. "Financing health services in Africa : an assessment of alternative approaches," Policy Research Working Paper Series 457, The World Bank.
    17. Gruber, Jonathan & Lin, Mengyun & Yi, Junjian, 2023. "The largest insurance program in history: Saving one million lives per year in China," Journal of Public Economics, Elsevier, vol. 226(C).
    18. Andy McKay, 2002. "Assessing the Impact of Fiscal Policy on Poverty," WIDER Working Paper Series DP2002-43, World Institute for Development Economic Research (UNU-WIDER).
    19. Mocan, H. Naci & Tekin, Erdal & Zax, Jeffrey S., 2004. "The Demand for Medical Care in Urban China," World Development, Elsevier, vol. 32(2), pages 289-304, February.
    20. Martine AUDIBERT & Yong HE & Jacky MATHONNAT, 2017. "What does demand heterogeneity tell us about health care provider choice in rural China?," Working Papers P193, FERDI.

    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:phd:dpaper:dp_1998-03. 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: Aniceto Orbeta (email available below). General contact details of provider: https://edirc.repec.org/data/pidgvph.html .

    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.