Payments for health care and its effect on catastrophe and impoverishment: Experience from the transition to Universal Coverage in Thailand

Somkotra, Tewarit; Lagrada, Leizel P.

doi:10.1016/j.socscimed.2008.09.047

Cited by 91 publications

(71 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The decrease in the OOP was mainly due to the fact that all needed drugs and equipment are now funded through the HSEP. A household survey conducted by Somkotra et al on payments for health care and its effect on catastrophe and impoverishment on Thai households, also revealed a fall in OOP after their UHC reforms (28).…”

Section: Discussionmentioning

confidence: 98%

Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

et al. 2017

View full text Add to dashboard Cite

Background: Protecting people from catastrophic health payments is widely recognized as an integral component of health systems and universal health coverage. Objectives: This study aimed to measure the financial protection against catastrophic health expenditure among hospitalized patients in Kermanshah, western Iran, after the implementation of the health sector evolution plan of Iran. Methods: This was a cross-sectional study. A total of 544 patients were selected using the proportional allocation to population size technique. A translated version of the world health survey questionnaire was used to collect data. Catastrophic health expenditure was calculated using WHO recommended methodology. Data were analyzed using STATA v.13. The statistical test performed included descriptive statistics and logistic regression. Results: About 4.8% of households with hospitalized patients were faced with catastrophic health expenditures. The total mean outof-pocket (OOP) medical expenditures of being hospitalized was 819,220 Rials per patient. Mean OOP in patients with catastrophic payment was 2,220,500 Rial. Major determinants of catastrophic payment were associated with surgical cost (OR: 8.09 P Value = 0.000), chronic disease (OR: 2.78 P Value = 0.025), household size (> 6) (OR: 6.70 P Value < 0.036), and economic status of households (Quintile 5; OR: 0.005 P Value = 0.000). Conclusions:The Health Sector Evolution Plan should target and extend aids especially for chronically ill patients, those who need surgery, and those at poorest quintile due to the fact that they are more vulnerable to catastrophic health expenditure. These groups should be the priorities in the health sector evolution plan revision to achieve a more desired outcome.

show abstract

Section: Discussionmentioning

confidence: 98%

Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The pro-poor nature of the scheme is evident from the consistently progressive Concentration Indexes pointed out by Tangcharoensathien et al (2010) and Limwatton et al (2011). Moreover, catastrophic payments appear to have dropped sharply in all the income quartiles (Somkotra and Lagrada, 2006).…”

Section: Background: the Universal Health Coverage In Thailandmentioning

confidence: 98%

The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand

Ghislandi

Manachotphong

Perego

2014

HEPL

View full text Add to dashboard Cite

Thailand is among one of the first non OECD countries to have successfully introduced a form of Universal Health Coverage (UHC) in 2002. This policy defines a natural experiment for the evaluation of the effects of public health insurance on health behaviours. In the present paper, we look at the impact of the Thai UHC on preventive activities, risky behaviours and healthcare consumption using data from the 1996, 2001 and 2003 Health and Welfare Survey of Thailand. We use double robust estimators combining propensity scores and linear regressions to estimate Difference-in-Differences (DD) and Difference in DD (DDD) models. Results offer important insights. First, previously uninsured men and women increased their preventive activities (check-ups) more than any other groups. At the same time, there is no evidence of either an increase in risky behaviours or a reduction of preventive efforts by the newly insured population. In other words, we find no evidence of ex ante moral hazard. Regarding healthcare consumption, we see that hospital admissions increased by 2% and outpatient visits increased by 13% due to the UHC. Overall, these findings imply positive health impacts among the Thai population who entered in the UHC.

show abstract

“…The Thai universal coverage reform is often trumpeted as a success (World Health Organization, 2010;Health Insurance System Research Office, 2012) but this claim is based simply on upward trends in health care utilization and downward trends in household OOP medical spending (Limwattananon et al, 2007;Somkotra T, 2008;Damrongplasit, Melnick, 2009;Panpiemras et al, 2011;Health Insurance System Research Office, 2012). Gruber et al (2012) present the only other evaluation of the reform's causal impact on health care utilization.…”

Section: Introductionmentioning

confidence: 99%

Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-of-Pocket Expenditures in Thailand

Limwattananon

O’Donnell

Prakongsai³

et al. 2013

SSRN Journal

View full text Add to dashboard Cite

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. We estimate the impact on health care utilization and out-of-pocket (OOP) expenditures of a major reform in Thailand that extended health insurance to one-quarter of the population to achieve universal coverage while keeping health spending below 4% of GDP. Identification is through comparison of changes in outcomes of groups to whom coverage was extended with those of public sector employees and their dependents whose coverage was not affected. The reform is estimated to have reduced the probability that a sick person goes without formal treatment by 3.2 percentage points (11%). It increased the probability of receiving public ambulatory care by 2.7 ppt (5%) and of admission to a public hospital by 1 ppt (18%). OOP expenditures were reduced by one-third on average, as was the probability of spending more than 10% of the household budget on health care, while spending at the very top of the OOP distribution was reduced by one-half representing substantial reductions in exposure to medical expenditure risk. Supply-side measures implemented with the coverage extension are likely to have helped realize these effects from an increased, but still very tight, budget. JEL-Code: H420, H510, I180. Terms of use: Documents in

show abstract

Payments for health care and its effect on catastrophe and impoverishment: Experience from the transition to Universal Coverage in Thailand

Cited by 91 publications

References 17 publications

Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand

Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-of-Pocket Expenditures in Thailand

Contact Info

Product

Resources

About