Medical Cost and Out-of-Pocket Expenditure for Preterm Infants: Evidence From Vietnam

Abstract

Background The large health costs associated with preterm births have been well documented in high income countries. Relatively little data on this issue is currently available from developing countries. The aim of this study was to assess private and public costs associated with preterm births in Vietnam. Methods This cross-sectional study used medical and financial data from one provincial and one national hospital in Vietnam. Cost data for all infants discharged from the two hospitals in 2017 was collected and analyzed. Results Average total medical cost per child was USD 1643.52 in the national hospital and USD 668.94 in the provincial hospital. Mean medical out-of-pocket expenditure was USD 60 at the national hospital. No medical out-of-pocket expenditure was reported at the provincial hospital when parents complied with national health insurance policies. Substantial out-of-pocket expenditure was incurred by those who bypassed lower-level facilities. Parents seeking care at specialized hospitals without medical authorization paid on average an additional USD 240, which equates to 111% of the average monthly wage in Vietnam. Conclusions This study suggests that the average medical costs of preterm infants in Vietnam are substantial. The average co-payment for families who complied with national health insurance policy was USD 39. The average out-of-pocket costs of preterm infants who bypassed lower-level facilities without referral authorization were about six times higher than those of infants who had a proper transfer.