The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand
The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand
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DOI：
10.1017/s1744133114000334
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发表时间：
2015-07-01
影响因子：
1.7
通讯作者：
Perego, Viviana M. E.
中科院分区：
文献类型：
--
作者：
Ghislandi, Simone;Manachotphong, Wanwiphang;Perego, Viviana M. E.
泰国是首批引入全民健康覆盖（UHC）的非经合组织国家之一。这项政策是一项自然实验，旨在评估公共健康保险对健康行为的影响。在本文中，我们研究泰国的全民健康覆盖计划对预防活动，不健康或危险行为和医疗保健消费的影响，使用泰国健康和福利调查的数据。我们使用双重稳健估计，结合联合收割机倾向得分和线性回归估计差异（DD）和差异的DD模型。我们的研究结果提供了重要的见解。首先，全民健康覆盖增加了个人进行年度体检的可能性，特别是妇女。关于医疗保健消费，我们观察到UHC使住院人数增加了2%以上，门诊量增加了13%。然而，没有证据表明全民健康覆盖会导致不健康行为的增加或预防工作的减少。换句话说，我们没有发现事前道德风险的证据。总体而言，这些研究结果表明，全民健康覆盖对泰国人口的健康产生了积极影响。
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.