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Does health insurance coverage or improved quality protect better against out-of-pocket payments? Experimental evidence from the Philippines.
- Source :
-
Social Science & Medicine . May2018, Vol. 204, p51-58. 8p. - Publication Year :
- 2018
-
Abstract
- This paper explores whether health insurance coverage or improved quality at the hospital level protect better against out-of-pocket payments. Using data from a randomized policy experiment in the Philippines, we found that interventions to expand insurance coverage and improve provider quality both had an impact on out-of-pocket payments. The sample consists of 3121 child-patient patient observations across 30 hospitals either at baseline in 2003/04 or at the follow-up in 2007/08. Compared to controls, interventions that expanded insurance and provided performance-based provider payments to improve quality both resulted in a decline in out-of-pocket spending (21% decline, p-value = 0.061; and 24% decline, p-value = 0.017, respectively). With lower out-of-pocket payments for hospital care, monthly household spending on personal hygiene rose by 0.9 (p-value = 0.026) and 0.6 US$ (p-value = 0.098) under the expanded insurance and provider payment interventions, respectively, amounting to roughly a 40–60% increase relative to the controls. With the current surge for health insurance expansion in developing countries, our study suggests paying increased and possibly, equal attention to supply-side interventions will have similar impacts with operational simplicity and greater provider accountability. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 02779536
- Volume :
- 204
- Database :
- Academic Search Index
- Journal :
- Social Science & Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 129153794
- Full Text :
- https://doi.org/10.1016/j.socscimed.2018.03.024