Elderly health care voucher scheme: Needs assessment and evaluation of outcomes

Abstract

Elderly Health Care Voucher Scheme represents as a form of demand-side subsidy given to the elders to choose a spectrum of medical services in the private medical sector. It was first introduced in 2009 and later regularized in 2014. The current paper aims at conducting a needs assessment with an analytical framework of 4As analysis and evaluating whether the outcome measures of the scheme (i.e., the use of private healthcare services, the use of primary care and the empowerment of the elders in the choice of services) were achieved. By incorporating a time-series data from 2009 to 2022, the needs assessment concluded that the utilization rate of the elders, awareness and satisfaction rate are both high albeit some problems such as the uneven distribution of enrolled service providers across different districts and small voucher amount. The positive sides concluded from the needs assessment, however, failed to turn into the fulfilment of outcome measures. The scheme failed to encourage elders to use primary care and private medical services due to the structural barriers emanating from underdeveloped primary healthcare system and health system fragmentation. Recommendations at short-term, medium-term and long-term are made.