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

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  • Ghislandi, Simone
  • Manachotphong, Wanwiphang
  • Perego, Viviana M.E.

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.

Suggested Citation

  • Ghislandi, Simone & Manachotphong, Wanwiphang & Perego, Viviana M.E., 2015. "The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand," Health Economics, Policy and Law, Cambridge University Press, vol. 10(3), pages 251-266, July.
    • Handle: RePEc:cup:hecopl:v:10:y:2015:i:03:p:251-266_00
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    Cited by:

    1. Ji Luo & Yuanxiang Zhou, 2019. "How Individual Characters Affect the Ex ante Moral Hazard of Basic Medical Insurance: Evidence from China," Applied Economics and Finance, Redfame publishing, vol. 6(5), pages 53-69, September.
    2. Wanyue Dong & Jianmin Gao & Zhongliang Zhou & Ruhai Bai & Yue Wu & Min Su & Chi Shen & Xin Lan & Xiao Wang, 2018. "Effects of China’s urban basic health insurance on preventive care service utilization and health behaviors: Evidence from the China Health and Nutrition Survey," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-14, December.
    3. Kathrin Durizzo & Kenneth Harttgen & Fabrizio Tediosi & Maitreyi Sahu & August Kuwawenaruwa & Paola Salari & Isabel Günther, 2022. "Toward mandatory health insurance in low‐income countries? An analysis of claims data in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 31(10), pages 2187-2207, October.
    4. Cui, Chengsen & Zhang, Yue & Ding, Ruoxi & He, Ping, 2024. "Impact of the Essential Public Health Service program on financial protection and health outcomes among hypertensive patients: A quasi-experimental study in China," Social Science & Medicine, Elsevier, vol. 345(C).
    5. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.

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