PhilHealth Coverage, Supply-Side Readiness, and Adolescent Healthcare Utilization in the Philippines: Evidence from the Longitudinal Cohort Study of the Filipino Child

The Universal Health Care Act of 2019 made PhilHealth membership universal and automatic for all Filipinos, but whether that membership translates into actual care for adolescents is not well understood. Adolescents are an understudied group in health financing, and their needs are largely for outpatient and preventive care rather than for hospital care. This paper uses seven rounds of the Longitudinal Cohort Study of the Filipino Child together with a within-child research design, and it estimates the effect of household PhilHealth coverage and of barangay supply-side readiness on adolescent utilization, hospitalization, and self-rated health. It also tests whether coverage and supply are complementary, which was the study’s main hypothesis. The results show that coverage, supply-side readiness, and their interaction are not associated with reported illness, outpatient consultation, or self-rated health. The clear exception is hospitalization conditional on illness, which is significantly higher for adolescents with coverage and for those in better-supplied areas, although the interaction remains statistically insignificant for every outcome. The cross-sectional association between coverage and use disappears once the design accounts for the kinds of families that select into coverage. This pattern is consistent with PhilHealth’s historical focus on inpatient care and with its thin outpatient coverage during the study period. Coverage moved the inpatient margin that PhilHealth financed, but it did not move outpatient use or general health, which is what adolescents mostly need. The paper offers several explanations for the absence of complementarity, and it draws implications for the design of adolescent outpatient benefits and for the measurement of effective coverage under universal health care. Comments to this paper are welcome within 60 days from the date of posting. Email publications@pids.gov.ph.