Open AccessImpact of Health Insurance on Health Care Treatment and Cost in Vietnam: A Health Capability Approach to Financial Protection
Author(s) -
Kim Thuy Nguyen,
Oanh Thi Hai Khuat,
Shuangge Ma,
Duc Cuong Pham,
Giang Thi Hong Khuat,
Jennifer Prah Ruger
Publication year - 2012
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.2011.300618
Subject(s) - health care , vietnamese , actuarial science , environmental health , vulnerability (computing) , medicine , inpatient care , underinsured , self insurance , business , health insurance , economic growth , economics , linguistics , philosophy , computer security , computer science
We applied an alternative conceptual framework for analyzing health insurance and financial protection grounded in the health capability paradigm. Through an original survey of 706 households in Dai Dong, Vietnam, we examined the impact of Vietnamese health insurance schemes on inpatient and outpatient health care access, costs, and health outcomes using bivariate and multivariable regression analyses. Insured respondents had lower outpatient and inpatient treatment costs and longer hospital stays but fewer days of missed work or school than the uninsured. Insurance reform reduced household vulnerability to high health care costs through direct reduction of medical costs and indirect reduction of income lost to illness. However, from a normative perspective, out-of-pocket costs are still too high, and accessibility issues persist; a comprehensive insurance package and additional health system reforms are needed.