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

Published online by Cambridge University Press:  13 August 2014

Simone Ghislandi ,
Wanwiphang Manachotphong  and
Viviana M.E. Perego
Simone Ghislandi*
Affiliation:
Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy
Wanwiphang Manachotphong
Affiliation:
Department of Economics, Thammasat University, Bangkok, Thailand
Viviana M.E. Perego
Affiliation:
Department of Economics, University of Oxford, Oxford, UK
*
*Correspondence to: Simone Ghislandi, Department of Policy Analysis and Public Management, Bocconi University, Via Roetgen 1, 20136 Milan, Italy. Email: simone.ghislandi@unibocconi.it
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Abstract

Thailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand’s UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals’ likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence of ex ante moral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC.

Type
Articles
Information
Health Economics, Policy and Law , Volume 10 , Issue 3 , July 2015 , pp. 251 - 266
Copyright
© Cambridge University Press 2014 

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