Three essays on healthcare utilization, health promotion, and universal coverage in Thailand: Empirical analysis

The first chapter evaluates the impact of Universal Coverage Policy known as the Gold Card plan on healthcare utilization and out-of-pocket healthcare expense for outpatients in Thailand. A treatment effect with Propensity Score Matching is estimated using the 2002 Thai Socioeconomic Survey. The results indicate that those who are insured under the Gold Card plan significantly increased their visits to district public hospitals compared to the uninsured. The out-of-pocket healthcare expenses show that the Gold Card insured's spending at public healthcare providers is less than the uninsured.;The second chapter investigates the potential household income effect on public and private health care choices for outpatient and inpatient services. A multinomial logit model on choice of health care services is estimated using the 2006 Thai Health and Welfare Survey. The results show that the income elasticity of demand for outpatient and inpatient services at district hospitals is generally an inferior good. However, regressions by monthly household income quartiles show that the income elasticity of demand for inpatient services at district hospital is a normal good for low monthly household income group. The analysis also shows that the Gold Card plan can assist low and middle monthly household income members when they are in need for outpatient services at the district hospitals. However, the Gold Card plan shows insignificant results for all healthcare choices under inpatient services.;The third chapter analyzes the impact of health insurance coverage and other socioeconomic factors on the likelihood of receiving clinical breast examinations, mammograms, and cervical screening tests among adult female. A logistic regression is estimated using 2007 Thai Health and Welfare Survey. We find that among low income women with the Gold Card plan significantly increases the probability of utilizing cervical screening tests. While among women in the high monthly household income group having the Civil Servant Medical Benefit Scheme and private health insurance increase the propensity to get clinical breast examinations and cervical screening tests. The private health insurance is the only health insurance that has significant and positive probability of having mammograms among women from high monthly household income group.