1 Introduction
2 Philippine social health program
2.1 Description and objective
Sector | Members | Dependents | Beneficiaries |
---|---|---|---|
Members in the Formal Economy | |||
- Private | 12,465,283 | 10,839,327 | 23,304,610 |
- Government | 2,102,361 | 3,783,503 | 5,885,864 |
- Household help | 67,598 | 49,952 | 117,550 |
- Enterprise owners and family drivers | 946 | 1321 | 2267 |
Members in the informal economy | |||
- Migrant worker | 659,311 | 951,543 | 1,610,854 |
- Informal sector | 2,177,414 | 3,349,326 | 5,526,740 |
- Self-earning individual | 409,751 | 586,676 | 996,427 |
- Organized group and others | 14,335 | 19,855 | 34,190 |
Indigents | 14,641,685 | 28,844,119 | 43,485,804 |
Sponsored members | 1,217,941 | 1,560,458 | 2,778,399 |
Senior citizens | 6,245,583 | 1,328,749 | 7,574,332 |
Overseas filipino workers | 1,229,641 | 854,183 | 2,083,824 |
Total | 41,231,849 | 52,169,012 | 93,400,861 |
2.2 Access to health Care Services for Indigents
Background characteristic | Average travel time in minutes | Number |
---|---|---|
Residence | ||
Urban | 27.5 | 3081 |
Rural | 37.9 | 4339 |
Region | ||
National Capital Region (4.1) | 24.5 | 842 |
Cordillera Admin Region (22.6) | 49.6 | 162 |
I - Ilocos Region (18.8) | 20.7 | 443 |
II - Cagayan Valley (17.6) | 47.3 | 318 |
III - Central Luzon (10.4) | 31.8 | 828 |
IVA – CALABARZON (12.2) | 29.9 | 938 |
IVB – MIMAROPA (24.8) | 43.7 | 255 |
V – Bicol (39.5) | 26.5 | 625 |
VI - Western Visayas (24.4) | 35.4 | 628 |
VII - Central Visayas (29.1) | 45.1 | 459 |
VIII - Eastern Visayas (41.2) | 32.2 | 376 |
IX - Zamboanga Peninsula (37.5) | 33.4 | 292 |
X - Northern Mindanao (38.4) | 29.1 | 320 |
XI – Davao (23.5) | 48.2 | 260 |
XII – SOCCSKSARGEN (38.2) | 36.7 | 377 |
XIII – Caraga (39.5) | 33.3 | 164 |
ARMM (58.9) | 60.9 | 132 |
Background characteristic | Distance to health facility | Number of women |
---|---|---|
Residence | ||
Urban | 17.9 | 8585 |
Rural | 38.1 | 7570 |
Region | ||
National Capital Region | 15.4 | 2924 |
Cordillera Admin Region | 27.7 | 252 |
I - Ilocos Region | 37.5 | 691 |
II - Cagayan Valley | 33.9 | 550 |
III - Central Luzon | 24.1 | 1720 |
IVA - CALABARZON | 18.9 | 2293 |
IVB - MIMAROPA | 42.2 | 372 |
V - Bicol | 34.7 | 798 |
VI - Western Visayas | 30.0 | 996 |
VII - Central Visayas | 25.5 | 1030 |
VIII - Eastern Visayas | 24.5 | 571 |
IX - Zamboanga Peninsula | 38.5 | 725 |
X - Northern Mindanao | 33.3 | 697 |
XI - Davao | 28.2 | 893 |
XII - SOCCSKSARGEN | 35.3 | 744 |
XIII - Caraga | 34.2 | 435 |
ARMM | 63.9 | 465 |
Wealth quintile | ||
Poorest | 51.7 | 2620 |
Poorer | 34.9 | 2886 |
Middle | 26.6 | 3199 |
Richer | 19.4 | 3572 |
Richest | 13.2 | 3878 |
Total | 27.4 | 16,155 |
3 Methodology and data
3.1 Data
Group | Covered households | Non-covered households |
---|---|---|
Characteristics | ||
Number of households | 6304 | 6341 |
Sex of head of household | 73% are male | 49% are male |
Age of head of household | 43.3 | 42 |
Education of head of household (Years of schooling) | 5.58 | 5.65 |
3.2 Methodology
3.2.1 Matching method
Dependent variable | Participation or lack of participation in PhilHealth | ||
---|---|---|---|
Independent variables | |||
Estimated Coefficients (Model 1) | Estimated Coefficients (Model 2) | Estimated Coefficients (Model 3) | |
Sex of head of household | 0.047 (5.21)∗∗∗ | 0.035 (4.94)∗∗∗ | 0.427 (8.25)∗∗∗ |
Age of head of household | 0.000 (0.90) | 0.000 (1.39) | 0.003 (2.87)∗∗ |
Education level of head of household | 0.011 (1.44) | ||
Telephone ownership | 0.006 (0.33) | −0.027 (1.75)∗ | |
Motorcycle ownership | −0.000 (0.03) | −0.011 (−1.66)∗ | |
Time to obtain drinking water | 0.011 (2.71)∗∗ | 0.003 (2.71)∗∗ | 0.01 (2.22)∗∗ |
Television ownership | 0.003 (0.23) | −0.004 (−1.67)∗ | |
Bicycle ownership | −0.010 (0.87) | −0.005 (0.68) | −0.004 (−0.60) |
Type of toilet facilities | −0.002 (2.63)∗∗∗ | −0.001 (3.22)∗∗∗ | −0.002 (−4.86)∗∗∗ |
Boat ownership | −0.042 (2.32)∗∗ | −0.026 (2.89) ∗∗∗ | −0.027 (−3.18)∗∗ |
Use of traditional medicine | 0.006 (0.27) | 0.016 (1.67)∗ | 0.002 (2.98)∗∗∗ |
Presence of medical history | 0.050 (2.86)∗∗∗ | ||
Number of household members | 0.005 (2.64)∗∗∗ | 0.003 (2.90)∗∗∗ | 0.002 (2.72)∗∗∗ |
Number of children killed by diseases | 0.138 (3.54)∗∗∗ | ||
Access to health centers | −0.002 (3.37) | ||
Region | 0.002 (3.52)∗∗ | 0.001 (3.11)∗∗ | 0.002 (3.42)∗∗ |
Adjusted R-squared | 0.2110 | 0.1140 | 0.5551 |
Number of observations | 3006 | 4650 | 4820 |
3.2.2 Regression discontinuity design
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For dependents aged under 21 years:
-
For dependents aged above 21 years:
4 Impact evaluation results
4.1 Impact of PhilHealth indigent program: A matching approach
4.1.1 Effects on heads of participating indigent households
Matching method | Treated group size | Control group size | Impact \estimate | Standard deviation estimated by bootstrapping method* (N = 100) | t-value |
---|---|---|---|---|---|
Nearest neighbor matching | 2219 | 2206 | 0.021 | 0.062 | 0.330 |
Radius matching (r = 0.0001) | 2002 | 2029 | 0.060 | 0.052 | 1.151 |
Kernel matching | 2219 | 2322 | 0.044 | 0.036 | 1.237 |
Stratification | 2218 | 2323 | 0.008 | 0.032 | 0.252 |
Treated group Size | Control group Size | Impact estimate | Standard deviation estimated by bootstrapping method (N = 100) | t-value | |
---|---|---|---|---|---|
Questions asked: | |||||
Is there a cure for leprosy? | 4180 | 4323 | 0.008 | 0.032 | 0.252 |
Is there a cure for dengue? | 4180 | 4323 | 0.014 | 0.023 | 0.609 |
Can dengue disease be prevented? | 4180 | 4323 | 0.022 | 0.034 | 0.647 |
Is malaria contagious or not? | 4180 | 4323 | 0.098 | 0.072 | 1.367 |
Is malaria disease transmissible via mosquitoes? | 4180 | 4323 | 0.008 | 0.032 | 0.252 |
Can we prevent malaria disease? | 4180 | 4323 | 0.108 | 0.111 | 0.973 |
Is malaria treatable? | 4180 | 4323 | 0.203 | 0.192 | 1.057 |
Can we protect ourselves against sexual diseases? | 4180 | 4323 | 0.214 | 0.172 | 1.244 |
Is AIDS sexually transmissible? | 4180 | 4323 | 0.069 | 0.051 | 1.353 |
4.1.2 Impacts on indigent women
Treated group size | Control group size | Average effect of treatment | Standard deviation estimated by bootstrapping method | t-value | |
---|---|---|---|---|---|
Prenatal care | 1807 | 1841 | 0.085 | 0.109 | 0.778 |
Time prior to prenatal diagnosis | 1807 | 1841 | −0.324 | 0.145 | −2.234 |
Professional assistance during delivery | 1807 | 1841 | 0.234 | 0.074 | 3.161 |
Postnatal check-up | 1807 | 1841 | 0.093 | 0.156 | 0.596 |
Vaccine | Treated group size | Control group size | Average effect of treatment | Standard deviation estimated by bootstrapping method | t-value |
---|---|---|---|---|---|
BCG | 1807 | 1841 | 0.094 | 0.244 | 0.385 |
DPT1 | 1807 | 1841 | 0.119 | 0.086 | 1.383 |
Polio1 | 1807 | 1841 | 0.184 | 0.113 | 1.628 |
DPT2 | 1807 | 1841 | 0.103 | 0.113 | 0.911 |
DPT3 | 1807 | 1841 | 0.149 | 0.156 | 0.955 |
Polio3 | 1807 | 1841 | 0.112 | 0.137 | 0.818 |
Measles | 1807 | 1841 | 0.103 | 0.145 | 0.710 |
4.2 Impact of the PhilHealth indigent program: A discontinuity regression design
Characteristics | Group of dependents aged between 16 and 20 years (Covered) | Group of dependents aged between 21 and 25 years (Non-covered) | p value (Difference of means test) |
---|---|---|---|
Number of dependents | 8433 | 8387 | – |
Sex | 65% are male | 73% are male | 0.811 |
Number of years of schooling | 8.64 | 8.96 | 0.141 |
Health status: | |||
Dependents who had used traditional health care in the 12 months preceding the survey | 32% | 30% | 0.912 |
Dependents who had used alternative health care in the 12 months preceding the survey | 96% | 94% | 0.973 |
Proportion of smokers | 12% | 9% | 0.814 |
Socioeconomic status: | |||
Time spent collecting source water (number of minutes per week) | 180 | 178 | 0.995 |
Access to electricity | 43% | 53% | 0.137 |
Television ownership | 20% | 18% | 0.812 |
Telephone ownership | 8% | 12% | 0.621 |
Radio ownership | 57% | 63% | 0.619 |
Refrigerator ownership | 2% | 4% | 0.811 |
Tractor ownership | 0% | 1% | 0.971 |
Boat ownership | 1% | 4% | 0.617 |
Dependent variable (Y): Use of health services in the 12 months preceding the survey. | Coefficients (β1 and β2) | Standard deviation | Observed value of “z” |
---|---|---|---|
Independent variables: | |||
Age (X1) | −0.029 (β2) | 0.016 | −1.82 |
Medical coverage (T) | 0.135 (β1) | 0.084 | 1.61 |