Impact of Public Health Insurance on Out-of-Pocket Health Expenditures of the Near-Poor in Vietnam

Thành, Nguyễn Đức; Anh, Bui Thi My; Hung, Phung Thanh; Anh, Pham Quynh; Xiem, Chu Huyen

doi:10.1177/11786329211017411

Cited by 10 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…particularly the out-of-pocket costs. Although, social health insurance has been shown to decrease the out-of-pocket costs of patients (21,22), they can still be notable (23,24). These out-of-pocket costs are particularly important to investigate in the context of critical care, due to its potentially high costs; which may mean they remain significant even for patients that are covered by insurance.…”

Section: Introductionmentioning

confidence: 99%

Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam

Hung

Hảo²,

Yen³

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

BackgroundCritically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the different diseases.MethodsWe calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients.ResultsICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity.ConclusionThis study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care.

show abstract

Section: Introductionmentioning

confidence: 99%

Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam

Hung

Hảo²,

Yen³

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…At present, China's basic medical insurance system still does not provide a high reimbursement level for outpatient care. It is universally accepted that a reasonable OOP proportion is 30%–40% for health expenditures [ 54 ], but, as of 2018, the OOP proportion of outpatient care for middle-aged and elderly people in China was 86.79% according to this study. Additionally, there are still dramatical discrepancies in security level between different insurance insurances in China—for example, the reimbursement level of resident medical insurance is lower than that of employee medical insurance [ 35 , 38 ], which may lead to different IOp of health service utilization for middle-aged and elderly people having different medical insurances.…”

Section: Discussionmentioning

confidence: 65%

Inequality of opportunity in health service utilization among middle-aged and elderly community-dwelling adults in China

et al. 2023

View full text Add to dashboard Cite

Background The inequality caused by circumstances is known as "inequality of opportunity" (IOp). Many scholars have studied IOp in the health field, but few studies have quantified contributors to the IOp of health service utilization among middle-aged and elderly people. This study measured the IOp of health service utilization and decomposed the contributors to IOp present among Chinese middle-aged and elderly people. Methods Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015 and 2018. A mean-based regression method was adopted to measure the IOp of health service utilization. Shapley–Shorrocks decomposition was used to analyze the main contributors to IOp seen among the middle-aged and elderly. Results Although the absolute IOp of health service utilization decreased over time, IOp still explains the total inequality to a large extent. The absolute IOp and relative IOp were greatest in the areas of self-treatment and inpatient care utilization, respectively. Shapley decomposition results showed that the out-of-pocket (OOP) ratio contributed most to the IOp of outpatient care utilization; and the residence area highly explains the IOp of inpatient service utilization. Meanwhile, social and economic factors such as work status and income contribute more to the IOp of inpatient care utilization than outpatient and self-treatment. Conclusions Strategies aimed at achieving equal opportunities remain necessary to ensure the fairness of health service utilization. Policies and measures should further adjust the medical insurance compensation policies, and pay more attention to the middle-aged and elderly residents in rural areas, optimize health resource allocation, improve the social security systems, and narrow the socioeconomic gap between urban and rural areas in China.

show abstract

“…Under Decision 139/2002/QD-TTg, dated 15 October 2002, the Healthcare Fund for the Poor was introduced, where the poor and ethnic minorities had SHI premium exemption and medical treatments. Decree 63/2005/ND-CP, dated 16 May 2005, expanded the compulsory groups, particularly, children aged under six had free medical treatments, and the poor and ethnic minorities were fully subsidised by the government budget in purchasing SHI cards. The SHI Law was first introduced in 2008 under Law No.…”

Section: Introductionmentioning

confidence: 99%

“…A number of studies have been conducted to estimate the incidence of CHEs and impoverishment in Vietnam (see, for instance, [ 12 , 13 , 14 , 15 , 16 ]). Using data sets from the Vietnam Household Living Standard Survey (VHLSS) conducted in 1993 and 1998, [ 13 ] found that CHEs in Vietnam decreased from 9.3 per cent to 7.8 per cent in this period.…”

Section: Introductionmentioning

confidence: 99%

Healthcare Services Utilisation and Financial Burden among Vietnamese Older People and Their Households

Giang

Pham

Phi

et al. 2023

IJERPH

View full text Add to dashboard Cite

Background: This research examined differences in the utilisation of healthcare services and financial burden between and within insured and uninsured older persons and their households under the social health insurance scheme in Vietnam. Methods: We used nationally representative data from the Vietnam Household Living Standard Survey (VHLSS) conducted in 2014. We applied the World Health Organization (WHO)’s financial indicators in healthcare to provide cross-tabulations and comparisons for insured and uninsured older persons along with their individual and household characteristics (such as age groups, gender, ethnicity, per-capita household expenditure quintiles, and place of residence). Results: We found that social health insurance was beneficial to the insured in comparison with the uninsured in terms of utilization of healthcare services and financial burden. However, between and within these two groups, more vulnerable groups (i.e., ethnic minorities and rural persons) had lower utilization rates and higher rates of catastrophic spending than the better groups (i.e., Kinh and urban persons). Conclusion: Given the rapidly ageing population under low middle-income status and the “double burden of diseases”, this paper suggested that Vietnam reform the healthcare system and social health insurance so as to provide more equitable utilisation and financial protection to all older persons, including improving the quality of healthcare at the grassroots level and reducing the burden on the provincial/central health level; improving human resources for the grassroots healthcare facilities; encroaching public–private partnerships (PPPs) in the healthcare service provision; and developing a nationwide family doctor network.

show abstract

Impact of Public Health Insurance on Out-of-Pocket Health Expenditures of the Near-Poor in Vietnam

Cited by 10 publications

References 18 publications

Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam

Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam

Inequality of opportunity in health service utilization among middle-aged and elderly community-dwelling adults in China

Healthcare Services Utilisation and Financial Burden among Vietnamese Older People and Their Households

Contact Info

Product

Resources

About