Changes in out-of-pocket payments for healthcare in Vietnam and its impact on equity in payments, 1992–2002

Chaudhuri, Anoshua; Roy, Kakoli

doi:10.1016/j.healthpol.2008.02.014

Cited by 50 publications

(29 citation statements)

References 19 publications

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“…It is the most frequently used yardstick to assess the equity of out-of-pocket payments in empirical studies [22,23]. In our analysis, progressivity is measured using concentration curve approach.…”

Section: Discussionmentioning

confidence: 99%

Catastrophic health expenditure and impoverishment in Turkey

Yardim¹,

Çilingiroğlu²,

Yardım³

2010

Health Policy

224

212

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Section: Discussionmentioning

confidence: 99%

Catastrophic health expenditure and impoverishment in Turkey

Yardim¹,

Çilingiroğlu²,

Yardım³

2010

Health Policy

224

212

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“…Vietnam had established a state-run health system that provided free universal access, after the reunification of the country under Socialist Party rule in 1975. Financing for this system had been indirectly supported by economic aid from the Soviet Union, which was terminated by the dissolution of the Soviet Union in 1990 [2]. In the late 1980s, Vietnam began Doi Moi (“New Era”), economic reforms which, among its other effects, legalized market enterprises in healthcare.…”

Section: Introductionmentioning

confidence: 99%

Effect of Health Expenses on Household Capabilities and Resource Allocation in a Rural Commune in Vietnam

Nguyen

Khuat

et al. 2012

PLoS ONE

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BackgroundSignificant health expenses can force households to reduce consumption of items required for daily living and long-term well-being, depriving them of the capability to lead economically stable and healthy lives. Previous studies of out-of-pocket (OOP) and other health expenses have typically characterized them as “catastrophic” in terms of a threshold level or percentage of household income. We aim to re-conceptualize the impact of health expenses on household “flourishing” in terms of “basic capabilities.”Methods and FindingsWe conducted a 2008 survey covering 697 households, on consumption patterns and health treatments for the previous 12 months. We compare consumption patterns between households with and without inpatient treatment, and between households with different levels of outpatient treatment, for the entire study sample as well as among different income quartiles. We find that compared to households without inpatient treatment and with lower levels of outpatient treatment, households with inpatient treatment and higher levels of outpatient treatment reduced investments in basic capabilities, as evidenced by decreased consumption of food, education and production means. The lowest income quartile showed the most significant decrease. No quartile with inpatient or high-level outpatient treatment was immune to reductions.ConclusionsThe effects of health expenses on consumption patterns might well create or exacerbate poverty and poor health, particularly for low income households. We define health expenditures as catastrophic by their reductions of basic capabilities. Health policy should reform the OOP system that causes this economic and social burden.

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“…The clients appeared to weigh the worthiness of access in respect of its totality such as quality, responsiveness, satisfaction with care and transportation convenience rather than merely the amount of out of pocket expenses incurred for the services. In this regard, several studies reported the different effects of out of pocket expenses that impeded the utilization of health services in different circumstances by delaying care seeking, limiting entrance to healthcare or increasing the discontent with services, especially affecting the poor [76–78]. User fees for health care in developing countries was found to affect adherence to treatments [79], while better interactions between the clients and care providers compensated the negative impacts of out of pocket expenses in some settings [43].…”

Section: Discussionmentioning

confidence: 99%

Correlates of perceived access and implications for health system strengthening – lessons from HIV/AIDS treatment and care services in Ethiopia

Yakob

Ncama

2016

PLoS ONE

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BackgroundAccess to healthcare is an important public health concept and has been traditionally measured by using population level parameters, such as availability, distribution and proximity of the health facilities in relation to the population. However, client based factors such as their expectations, experiences and perceptions which impact their evaluations of health care access were not well studied and integrated into health policy frameworks and implementation programs.ObjectiveThis study aimed to investigate factors associated with perceived access to HIV/AIDS Treatment and care services in Wolaita Zone, Ethiopia.MethodsA cross-sectional survey was conducted on 492 people living with HIV, with 411 using ART and 81 using pre-ART services accessed at six public sector health facilities from November 2014 to March 2015. Data were analyzed using the ologit function of STATA. The variables explored consisted of socio-demographic and health characteristics, type of health facility, type of care, distance, waiting time, healthcare responsiveness, transportation convenience, satisfaction with service, quality of care, financial fairness, out of pocket expenses and HIV disclosure.ResultsOf the 492 participants, 294 (59.8%) were females and 198 (40.2%) were males, with a mean age of 38.8 years. 23.0% and 12.2% believed they had ‘good’ or ‘very good’ access respectively, and 64.8% indicated lower ratings. In the multivariate analysis, distance from the health facility, type of care, HIV clinical stage, out of pocket expenses, employment status, type of care, HIV disclosure and perceived transportation score were not associated with the perceived access (PA). With a unit increment in satisfaction, perceived quality of care, health system responsiveness, transportation convenience and perceived financial fairness scores, the odds of providing higher rating of PA increased by 29.0% (p<0.001), 6.0%(p<0.01), 100.0% (p<0.001), 9.0% (p<0.05) and 6.0% (p<0.05) respectively.ConclusionPerceived quality of care, health system responsiveness, perceived financial fairness, transportation convenience and satisfaction with services were correlates of perceived access and affected healthcare performance. Interventions targeted at improving access to HIV/AIDS treatment and care services should address these factors. Further studies may be needed to confirm the findings.

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Changes in out-of-pocket payments for healthcare in Vietnam and its impact on equity in payments, 1992–2002

Cited by 50 publications

References 19 publications

Catastrophic health expenditure and impoverishment in Turkey

Catastrophic health expenditure and impoverishment in Turkey

Effect of Health Expenses on Household Capabilities and Resource Allocation in a Rural Commune in Vietnam

Correlates of perceived access and implications for health system strengthening – lessons from HIV/AIDS treatment and care services in Ethiopia

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