Demand and Reimbursement Effects of Healthcare Reform: Health Care Utilization and Infant Mortality in Thailand
The Thai 30 Baht program was one of the largest health system reforms ever undertaken by a low-middle income country. In addition to lowering the cost of care for the previously uninsured in public facilities, it also entailed a fourfold increase in funding provided to hospitals to care for the poorest 30% of the population (who were already publicly insured). For the previously uninsured, we find that the 30 Baht program led to increased health care utilization, as well as a shift from private to public sources of care. But, we find a larger increase for the poor who were previously publicly insured, especially amongst infants and women of childbearing age. Using vital statistics records, we find that the increased access to healthcare by the publicly insured poor led to a reduction in their infant mortality of at least 6.5 per 1,000 births. This suggests significant improvements in infant mortality rates can be achieved through increased access to healthcare services for the poor and marginalized groups.
We thank the Townsend Thai Family Research Project and the University of Thai Chamber of Commerce for support and research assistance. We also thank the Thai National Statistics Office for data availability. Hendren acknowledges support from the NSF Graduate Research Fellowship and the NBER Health and Aging Fellowship, under NIA grant T32-AG000186. Townsend acknowledges support from the NICHD and the Bill and Melinda Gates Foundation through a grant to the Consortium on Financial Systems and Poverty at the University of Chicago. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.