The policy of free healthcare for children under the age of 6 years in Vietnam: assessment of the uptake for children hospitalised with acute diarrhoea in Ho Chi Minh City

Autor: Lu Viet Ho, Vu Tra My Phan, Manh Tuan Ha, Thi Thuy Linh Van, Thi Ngoc Tuyet Pham, Corinne N. Thompson, Jeremy Farrar, Stephen Baker, Mae Shieh, Laura Merson, Fabrizio Tediosi
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Diarrhea
Male
Financing
Personal
Pediatrics
medicine.medical_specialty
out-ofpocket expenditures
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
Universal Health Insurance
Interquartile range
Environmental health
Health care
Humans
health insurance utilisation
Medicine
social health insurance
030212 general & internal medicine
Lower income
Acute diarrhoea
Government
business.industry
Health Policy
030503 health policy & services
Age Factors
1. No poverty
Public Health
Environmental and Occupational Health
Infant
Health Care Costs
Hospitals
Pediatric
Hospital charge
Ho chi minh
acute diarrhoea
3. Good health
Hospitalization
hospital charges
Infectious Diseases
Vietnam
Child
Preschool
out-of-pocket expenditures
Income
child health
Population study
Female
Parasitology
0305 other medical science
business
Zdroj: Tropical Medicine & International Health
ISSN: 1365-3156
1360-2276
Popis: Objective: To assess the proportion of, and reasons for, households not utilising the policy of free healthcare for children under 6 years of age (FCCU6) for hospitalisation with diarrhoea, and assess the risk of catastrophic expenditure for households that forgo FCCU6 and pay out of pocket. Methods: Invoices detailing insurance information and charges incurred from 472 hospitalised diarrhoeal cases in one paediatric hospital in Ho Chi Minh City were retrieved. Hospital charges and the utilisation of elective services were analysed for patients utilising and not utilising FCCU6. Associations between socio-economic factors with non-utilisation of FCCU6 were evaluated. Results: Overall, 29% of patients were FCCU6 non-users. The FCCU6 non-users paid a median hospital charge of $29.13 (interquartile range, IQR: $18.57-46.24), consuming no more than 1.4% of a medium-income household's annual income. Seventy per cent of low-income FCCU6 non-users utilised less-expensive elective services, whereas only 43% of medium income patients and 21% of high-income patients did (P = 0.036). Patients from larger households and those with a parent working in government were more likely to use FCCU6. Conclusions: The rate of FCCU6 non-usage in this study population was 29%. A significant proportion of those that did not use FCCU6 was from lower income households and may perceive a justifiable cost-benefit ratio when forgoing FCCU6. Although a single diarrhoeal hospitalisation is unlikely to induce a catastrophic expenditure, FCCU6 non-usage may disproportionately increase the risk of catastrophic expenditure for lower income households over multiple illnesses. © 2013 John Wiley and Sons Ltd.
Databáze: OpenAIRE
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