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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
Author(s) -
Shieh Mae,
Thompson Corinne,
Phan Vu Tra My,
Thi Thuy Linh Van,
Tediosi Fabrizio,
Merson Laura,
Farrar Jeremy J.,
Manh Tuan Ha,
Lu Viet Ho,
Thi Ngoc Tuyet Pham,
Baker Stephen
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12208
Subject(s) - medicine , population , interquartile range , health care , ho chi minh , environmental health , low income , pediatrics , demography , socioeconomics , surgery , economics , economic growth , sociology
Objective To assess the proportion of, and reasons for, households not utilising the policy of free healthcare for children under 6 years of age ( FCCU 6) for hospitalisation with diarrhoea, and assess the risk of catastrophic expenditure for households that forgo FCCU 6 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 FCCU 6. Associations between socio‐economic factors with non‐utilisation of FCCU 6 were evaluated. Results Overall, 29% of patients were FCCU 6 non‐users. The FCCU 6 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 FCCU 6 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 FCCU 6. Conclusions The rate of FCCU 6 non‐usage in this study population was 29%. A significant proportion of those that did not use FCCU 6 was from lower income households and may perceive a justifiable cost–benefit ratio when forgoing FCCU 6. Although a single diarrhoeal hospitalisation is unlikely to induce a catastrophic expenditure, FCCU 6 non‐usage may disproportionately increase the risk of catastrophic expenditure for lower income households over multiple illnesses.