Impact of Health Insurance on Health Care Utilisation and Out-of-Pocket Health Expenditure in Vietnam
| Autor: | Nguyen Thi Thu Thuong, Tran Quang Huy, Do Anh Tai, Tran Nhuan Kien |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Article Subject Vietnamese MEDLINE General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Ambulatory care Universal Health Insurance Environmental health Health care Health insurance Ambulatory Care Medicine Humans 030212 general & internal medicine Propensity Score Health policy Government Insurance Health General Immunology and Microbiology Inpatient care business.industry 030503 health policy & services General Medicine Middle Aged Patient Acceptance of Health Care language.human_language Hospitalization Vietnam Health Care Surveys language Female Health Expenditures 0305 other medical science business Research Article |
| Zdroj: | BioMed Research International BioMed Research International, Vol 2020 (2020) |
| ISSN: | 2314-6133 |
| DOI: | 10.1155/2020/9065287 |
| Popis: | Background. In recent years, health insurance (HI) has been chosen by many low- and middle-income countries to obtain an important health policy target—universal health coverage. Vietnam has recently introduced the Revised Health Insurance Law, and the effects of the voluntary health insurance (VHI) and heavily subsidised health insurance (HSHI) programmes have not yet been analysed. Therefore, this study is aimed at examining the impact of these HI programmes on the utilisation of health care services and out-of-pocket health expenditure (OOP) in general and across different health care providers in particular. Methods. Using the two waves of Vietnam Household Living Standard Surveys 2014 and 2016 and the difference-in-difference method, the impacts of VHI and HSHI on health care utilisation and OOP in Vietnam were estimated. Results. For both the VHI and HSHI groups, we found that HI increased the probability of seeking outpatient care, the mean number of outpatient visits, the total number of visits, and the mean number of visits at the district level of health care providers in the last 12 months. However, there was no evidence that the HSHI programmes increased the mean number of inpatient visits and the number of visits at the provincial hospital. We also found that while the VHI programme reduced OOP for both outpatient and inpatient care, the HSHI scheme did not result in a reduction in OOP for hospitalisation, although HI lowered the total OOP. Similarly, we found that for both groups, HI reduced OOP when the insured visited district and provincial hospitals. However, the statistically significant impact was not demonstrated when the enrolees of HSHI programmes visited provincial hospitals. Conclusion. The study offers evidence that the Vietnamese HI scheme increased health care service utilisation and decreased OOP for the participants of the VHI and HSHI programmes. Therefore, the government should continue to consider improving the HI system as a strategy to achieve universal health coverage. |
| Databáze: | OpenAIRE |
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