RESUMEN
BACKGROUND@#Health policies in the Philippines have evolved in response to increasing health demands of older adults. However, there is a lack of research on equity among the ageing population in low-middle income countries. The objective of this study was to identify the trends in National Health Insurance Program (NHIP) coverage and healthcare utilization among older adults in the Philippines for the period from 2003 to 2017, during which NHIP expansion policies were implemented, focusing on reductions in socio-economic inequalities.@*METHODS@#A literature search of policies for older adults and an analysis of four Philippine National Demographic and Health Surveys (2003, 2008, 2013, and 2017) with data from 25,217 older adults who were 60 years or older were performed. The major outcome variables were NHIP coverage, self-reported illness, outpatient healthcare utilization, and inpatient healthcare utilization. Inequalities in NHIP coverage and healthcare utilization according to wealth were evaluated by calculating the concentration index for individual years, followed by a regression-based decomposition analysis.@*RESULTS@#NHIP coverage among older adults increased from 9.4 (2003) to 87.6% (2017). Although inequalities according to wealth quintile were observed in all four surveys (all P < 0.001), the concentration index declined from 0.3000 (2003) to 0.0247 (2017), showing reduced inequalities in NHIP coverage over time as observed for self-reported illness and healthcare utilization. NHIP coverage expansion for older adults in 2014 enabled equal opportunity for access to healthcare.@*CONCLUSION@#The passage of mandatory NHIP coverage for older Filipino adults in 2014 was followed by a reduction in inequality in NHIP coverage and healthcare utilization according to wealth.
Asunto(s)
Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Disparidades en Atención de Salud , Cobertura del Seguro , Programas Nacionales de Salud , Filipinas , Factores SocioeconómicosRESUMEN
In late 2009, drastic budget cuts were recommended by a new cabinet-level government advisory unit. As part of these budget cuts, the Second Working Group of the Government Revitalization Unit moved to exclude Kampo medicines (traditional Japanese medicines) from reimbursement under the National Health Insurance program on Nov.11. A petition opposing the reform was initiated by Kampo physicians and patients on Nov.20. Three weeks later, 924,808 signatures had been collected and submitted to the Ministry of Health, Labor, and Welfare, and cancellation of the reform was announced on Dec.25. A total of 95,362 signatures were gathered on the web (http://kampo.umin.jp/). I report here an outline of signature-collecting campaign on the internet.
RESUMEN
In late 2009, drastic budget cuts were recommended by a new cabinet-level government advisory unit. As part of these budget cuts, the Second Working Group of the Government Revitalization Unit moved to exclude Kampo medicines (traditional Japanese medicines) from reimbursement under the National Health Insurance program on Nov.11. A petition opposing the reform was initiated by Kampo physicians and patients on Nov.20. Three weeks later, 924,808 signatures had been collected and submitted to the Ministry of Health, Labor, and Welfare, and cancellation of the reform was announced on Dec.25. A total of 95,362 signatures were gathered on the web (http://kampo.umin.jp/). I report here an outline of signature-collecting campaign on the internet.