title: Public hospital care: equal for all or equal for some? Evidence from the Philippines.
abstract: In low- and middle-income countries, government budgets are rarely sufficient to cover a public hospital's operating costs. Shortfalls are typically financed through a combination of health insurance contributions and user charges. The mixed nature of this financing arrangement potentially creates financial incentives to treat patients with equal health need unequally. Using data from the Philippines, the authors analyzed whether doctors respond to such incentives. After controlling for a patient's condition, they found that patients using insurance, paying more for hospital accommodation, and being treated in externally monitored hospitals were likely to receive more care. This highlights the worrying possibility that public hospital patients with equal health needs are not always equally treated.
authors: World Health Organization, Western Pacific Regional Office, Manila, Philippines chrisdjames@fastem.com.
authors: Chris D
authors: CD
authors: James
authors: University of California, San Francisco, CA, USA.
authors: John
authors: J
authors: Peabody
authors: London School of Hygiene and Tropical Medicine, London, UK.
authors: Kara
authors: K
authors: Hanson
authors: University of the Philippines, Manila, Philippines.
authors: Orville
authors: O
authors: Solon
mesh_terms: D005382:Financing, Personal; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D010679:Philippines; D012959:Socioeconomic Factors
keywords: Philippines; health care reforms; health equity; health insurance; heath economics and financing; incentives