The Future of Health Financing in Vietnam

Teo, Hui Sin; Bales, Sarah; Bredenkamp, Caryn; Cain, Jewelwayne S.

doi:10.1596/32187

Cited by 20 publications

(15 citation statements)

References 2 publications

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“…(1) extending coverage down from civil servants and the formal sector; (2) using a combination of prepayment and tax-based subsidies; and (3) extending coverage upward from schemes subsidizing the poor [7,27]. Four of the schemes fall into the second category, using a combination of prepaid insurance premiums and full (Lao PDR) or partial tax-based subsidies for IWs (Indonesia, Vietnam, and the Philippines) [24,56,[63][64][65][66][67][68][69][70]82]. Thailand's UCS and Cambodia's HEF extension employ a bottom-up approach, extending full government subsidies from the poor to IWs above the poverty line [54,58,59].…”

Section: Financing Arrangements Including Revenue Raising and Level O...mentioning

confidence: 99%

Extending universal health coverage to informal workers: A systematic review of health financing schemes in low- and middle-income countries in Southeast Asia

et al. 2023

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Achieving universal health coverage (UHC) is a priority of most low- and middle-income countries, reflecting governments’ commitments to improved population health. However, high levels of informal employment in many countries create challenges to progress toward UHC, with governments struggling to extend access and financial protection to informal workers. One region characterized by a high prevalence of informal employment is Southeast Asia. Focusing on this region, we systematically reviewed and synthesized published evidence of health financing schemes implemented to extend UHC to informal workers. Following PRISMA guidelines, we systematically searched for both peer-reviewed articles and reports in the grey literature. We appraised study quality using the Joanna Briggs Institute checklists for systematic reviews. We synthesized extracted data using thematic analysis based on a common conceptual framework for analyzing health financing schemes, and we categorized the effect of these schemes on progress towards UHC along the dimensions of financial protection, population coverage, and service access. Findings suggest that countries have taken a variety of approaches to extend UHC to informal workers and implemented schemes with different revenue raising, pooling, and purchasing provisions. Population coverage rates differed across health financing schemes; those with explicit political commitments toward UHC that adopted universalist approaches reached the highest coverage of informal workers. Results for financial protection indicators were mixed, though indicated overall downward trends in out-of-pocket expenditures, catastrophic health expenditure, and impoverishment. Publications generally reported increased utilization rates through the introduced health financing schemes. Overall, this review supports the existing evidence base that predominant reliance on general revenues with full subsidies for and mandatory coverage of informal workers are promising directions for reform. Importantly, the paper extends existing research by offering countries committed to progressively realizing UHC around the world a relevant updated resource, mapping evidence-informed approaches toward accelerated progress on the UHC goals.

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Section: Financing Arrangements Including Revenue Raising and Level O...mentioning

confidence: 99%

Extending universal health coverage to informal workers: A systematic review of health financing schemes in low- and middle-income countries in Southeast Asia

et al. 2023

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“…26 39 Cambodia’s scheme is pro-poor with the lower-income individuals paying less and receiving more PHC spending than higher-income individuals. 40 41 India 42 and Viet Nam 43 44 still have high levels of OOP payment. In India, this may involve paying upfront while waiting for reimbursement, or patients visiting a private hospital where they are required to pay for the packages not covered.…”

Section: Scheme Performancementioning

confidence: 99%

The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam

et al. 2023

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The Lancet Commission on Diagnostics highlighted a huge gap in access to diagnostic testing even for basic tests, particularly at the primary care level, and emphasised the need for countries to include diagnostics as part of their universal health coverage benefits packages. Despite the poor state of diagnostic-related services in low-income and middle-income countries (LMICs), little is known about the extent to which diagnostics are included in the health benefit packages. We conducted an analysis of seven Asian LMICs—Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, Viet Nam—to understand this issue. We conducted a targeted review of relevant literature and applied a health financing framework to analyse the benefit packages available in each government-sponsored scheme. We found considerable heterogeneity in country approaches to diagnostics. Of the seven countries, only India has developed a national essential diagnostics list. No country presented a clear policy rationale on the inclusion of diagnostics in their scheme and the level of detail on the specific diagnostics which are covered under the schemes was also generally lacking. Government-sponsored insurance expansion in the eligible populations has reduced the out-of-pocket health payment burden in many of the countries but overall, there is a lack of access, availability and affordability for diagnostic-related services.

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“…This addition is crucial as statistics indicate that while the average life expectancy of Vietnamese citizens is rising, the number of healthy years is dwindling. Additionally, the healthcare system in Vietnam is overly reliant on higher-level hospitals, neglecting primary healthcare (Teo et al, 2019). Thus, the basic path assumptions are displayed in Table 1.…”

Section: Research Model and Variable Descriptions A Research Modelmentioning

confidence: 99%

“…Moreover, the mediating effect of healthcare resources is significant, whereby various forms of healthcare resources such as funds, labor, and facilities all have significant effects. The analyses of the impact of population aging on health financing focus exclusively on the effects of population aging on health expenditures, while ignoring the impact of population aging on health revenues (Teo et al, 2019). However, the aging problem also reduces revenues and it affects the balance of the health insurance fund.…”

Section: Introductionmentioning

confidence: 99%

“…Data from different countries indicates that older individuals have a tendency to allocate a higher portion of their expenses towards healthcare in comparison to younger people. In Vietnam, medical expenditure for the elderly is 4.8 times greater than that of other age groups (Teo et al, 2019). As the proportion of elderly individuals in the population rises, healthcare expenses are expected to increase as well, presenting challenges for the health insurance system.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Population Aging on the Balance of Medical Insurance Fund in Vietnam

Pham

2023

IJMRA

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In recent years, Vietnam has made significant reforms to its health insurance system, resulting in great progress. However, changes in epidemiology and demographic shifts towards an aging population can impact the balance of the social medical insurance fund. Against this background, this paper aims to study the factors that affect the impact of population aging on the balance of the health insurance fund, by introducing seven mediating variables and subsequently analyzing the relationships between these variables to investigate the impact of population aging on the health insurance fund balance. The results indicate that population aging negatively affects the balance between revenue and expenditure of the medical insurance fund. Based on this analysis, we propose two corresponding recommendations to enhance fiscal sustainability: Enhancing healthcare resource efficiency and promoting economic development to increase income for workers.

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The Future of Health Financing in Vietnam

Cited by 20 publications

References 2 publications

Extending universal health coverage to informal workers: A systematic review of health financing schemes in low- and middle-income countries in Southeast Asia

Extending universal health coverage to informal workers: A systematic review of health financing schemes in low- and middle-income countries in Southeast Asia

The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam

The Impact of Population Aging on the Balance of Medical Insurance Fund in Vietnam

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