An Evaluation of the Initial Impact of the Medical Assistance Program for the Poor in Georgia

Hou, Xiaohui ; Chao, Shiyan

World Bank, Washington, DC

关键词: ACCESS TO HEALTH CARE;    ACCESS TO HEALTH CARE SERVICES;    ACCESS TO HEALTH SERVICES;    ACUTE CARE;    ADDITIONAL MONIES;   

DOI  :  10.1596/1813-9450-4588
RP-ID  :  WPS4588

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

As part of the recent health reformeffort, the government of Georgia launched a MedicalAssistance Program in June 2006 to provide health insuranceto its poor population.So far the program covers slightlyover 50 percent of the poor and provides benefit coveragefor outpatient and inpatient care. This paper estimatesinitial impact of the Medical Assistance Program andassesses whether the benefits have reached the poorest amongthose eligible, using utilization data from June 2006 toDecember 2006.Based on the analysis using a regressiondiscontinuity design and a three-part model, the paperpresents two main findings. First, the Medical AssistanceProgram has significantly increased utilization of acutesurgeries/inpatient services by the poor. Second, thebenefits have successfully reached the poorest among thepoor.These two findings indicate that government effortsto improve the poor's access to and utilization ofhealth services are yielding results. The paper emphasizesthat the initial dramatic increase in surgeries must beinterpreted with caution, given the possiblemisclassification or misreporting of acute surgeries in thedata.The paper also stresses the need to continuemonitoring implementation of the Medical Assistance Programand further improve program design, particularly thetargeting mechanism, to achieve better efficiency,effectiveness and overall equity in access to health care services.