Publication: Does your health care depend on how your insurer pays providers? Variation in utilization and outcomes in Thailand
Issued Date
2009-04-27
Resource Type
ISSN
15736962
13896563
13896563
Other identifier(s)
2-s2.0-67349287502
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Health Care Finance and Economics. Vol.9, No.2 (2009), 153-168
Suggested Citation
Sanita Hirunrassamee, Sauwakon Ratanawijitrasin Does your health care depend on how your insurer pays providers? Variation in utilization and outcomes in Thailand. International Journal of Health Care Finance and Economics. Vol.9, No.2 (2009), 153-168. doi:10.1007/s10754-009-9062-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/27530
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Title
Does your health care depend on how your insurer pays providers? Variation in utilization and outcomes in Thailand
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Abstract
Hospitals in Thailand operate in a multiple insurance payment environment. This paper examines (1) access to medicines and other medical technologies, (2) treatment outcomes, and (3) efficiency in resource use, among beneficiaries of the three government health insurance schemes in Thailand. Using 2003-2005 outpatient and inpatient data for patients with three tracer diseases from three government hospitals, we find that utilization of more expensive items differs between patients whose insurers pay on a closed- or open-ended basis. Where new vs. conventional drugs are both available, patients whose insurer pays on a fee-for-service basis tend to have greater access to new drugs, compared to patients whose insurer pays on a capitated or case basis. Similar patterns were found where there are options between originator versus generic drugs, drugs in different dosage forms, and more versus less advanced diagnostic technologies. Effects of insurance payment are more pronounced where price gaps among the medical technologies are significant. Efficiency results are mixed, depending on nature of the disease conditions and type of resources required for treatment. © The Author(s) 2009.