The Impact of Price Subsidies on Child Health Care Use : Evaluation of the Indonesian Healthcard

Somanathan, Aparnaa

World Bank, Washington, DC

关键词: ACCESS TO HEALTH CARE;    AGE GROUPS;    BASIC HEALTH SERVICES;    CAPITAL INVESTMENTS;    CARE FOR CHILDREN;   

DOI  :  10.1596/1813-9450-4622
RP-ID  :  WPS4622

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Financial barriers to seeking care arefrequently cited as one of the main causes ofunderutilization of child health care services. This paperestimates the impact of Indonesia's healthcard onhealth care use by children. Evaluation of the healthcardeffect is complicated by the fact that card allocation wasnon-random. The analysis uses propensity score matching tocontrol for systematic differences between treatment andcontrol groups. A second potential source of bias is relatedto contemporaneous, exogenousinfluences on health care useunrelated to the healthcard itself. Using panel datacollected prior to and after the introduction of thehealthcard, a difference-in-differences estimator isconstructed to eliminate the effects of exogenous changesover time. The author finds that although health care usedeclined for all children during the crisis years of1997-2000, use of public sector outpatient services declinedmuch less for children with healthcards. The protectiveeffect of the healthcard on public sector use wasconcentrated among children aged 0-5 years. The healthcardhad no significant impact on use of private sector services.The results highlight the need to provide adequateprotection against the financial burden of health carecosts, particularly during economic crises.