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A Path Analysis Examining the Relationship Between Access Barriers to Health Services and Healthcare Utilization Among the Publicly Insured: Insights from a Multiprovince Survey in the Philippines

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  • Alipio, Mark

Abstract

Although the National Health Insurance Act (NHIA) of 2013 has been widely successful in expanding coverage, insurance alone may not translate into access to quality healthcare for everyone. Even among the insured, substantial barriers to accessing services inhibit health care utilization. This study was focused on examining the influence of selected health services access barriers to the healthcare utilization among the publicly insured residents in the Philippines. A cross-sectional survey was conducted with a sample of 7,234 Filipino residents chosen using multi-stage cluster sampling. Path analysis was used to determine the connections among the study variables. Descriptive analysis revealed that the respondents always perceive approachability and ability to reach as supply-side and demand-side access barriers, respectively, among others. Correlation analysis revealed that supply-side and demand-side access barriers to care and the healthcare utilization of the respondents are positively interrelated from each other, suggesting that respondents who always perceive the mentioned factors as access barrier to care utilize low level of healthcare services for the past three months. A further path analysis was conducted and revealed that the supply-side determinant with the largest total causal effect on healthcare utilization is approachability while the demand-side determinant with the largest total causal effect is ability to reach. The findings showed better fit of the conceptual model in predicting healthcare utilization. Approximately 93% of the variance in the healthcare utilization is explained by the model. The results of the study may enable policy makers and health planners to identify the different dimensions and aspects of barriers to access to health services, and to devise specific interventions or combination of interventions that can best address these barriers.

Suggested Citation

  • Alipio, Mark, 2020. "A Path Analysis Examining the Relationship Between Access Barriers to Health Services and Healthcare Utilization Among the Publicly Insured: Insights from a Multiprovince Survey in the Philippines," SocArXiv d6vbm, Center for Open Science.
    • Handle: RePEc:osf:socarx:d6vbm
    DOI: 10.31219/osf.io/d6vbm
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    References listed on IDEAS

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    1. Han, X. & Call, K.T. & Pintor, J.K. & Alarcon-Espinoza, G. & Simon, A.B., 2015. "Reports of insurance-based discrimination in health care and its association with access to care," American Journal of Public Health, American Public Health Association, vol. 105, pages 517-525.
    2. repec:mpr:mprres:7725 is not listed on IDEAS
    3. Garcia-Subirats, Irene & Vargas, Ingrid & Mogollón-Pérez, Amparo Susana & De Paepe, Pierre & da Silva, Maria Rejane Ferreira & Unger, Jean Pierre & Vázquez, María Luisa, 2014. "Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil," Social Science & Medicine, Elsevier, vol. 106(C), pages 204-213.
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