Essays on subsidized health insurance and health-related quality of life

Abstract

This dissertation comprises three main chapters, book-ended by an introduction and a concluding chapter. Chapters 2 and 3 examine the impacts of health insurance programs in the Philippines and Indonesia on healthcare utilization, healthcare expenditures, and health outcomes. Chapter 4 then examines the age-related trajectories of health-related quality of life of Canadians with diabetes. In Chapter 2, we examine the impact of the national health insurance program of The Philippines on maternal and health outcomes among poor mothers. We find that the program is associated with greater likelihood of prenatal care visits, facility-based birth delivery, and post-natal care, and the impact is most pronounced among the poorest women, but we do not observe improvements in birthweight. In Chapter 3, we evaluate the impact of Jamkesmas, the largest subsidized health insurance in Indonesia, on healthcare utilization, health outcomes, and healthcare expenditures. We find that Jamkesmas is associated with higher probability of using outpatient care and inpatient care and lower out-of-pocket healthcare expenditures, but no significant impact on catastrophic healthcare expenditures and health outcomes. In Chapter 4, we characterize the age-related-trajectories of health-related quality of life of Canadians with diabetes. We find that women and low-income individuals with diabetes experience a lower health-related quality of life trajectories, but there is no evidence that the rate of deterioration of their health-related quality of life is faster than their counterparts without diabetes.