Impact of Health Insurance on Health Care Treatment and Cost in Vietnam: A Health Capability Approach to Financial Protection

American Journal of Public Health, 2012; 102(8):1450-61, doi:10.2105/AJPH.2011.300618

12 Pages Posted: 3 Dec 2009 Last revised: 19 Aug 2012

See all articles by Kim Thuy Nguyen

Kim Thuy Nguyen

Yale University - School of Medicine

Oanh Thi Hai Khuat

Institute for Social Development Studies

Steven Ma

Yale University - School of Public Health

Duc Cuong Pham

Institute for Social Development Studies

Giang Thi Hong Khuat

Institute for Social Development Studies

Jennifer Prah Ruger

University of Pennsylvania - School of Social Policy & Practice; University of Pennsylvania - Perelman School of Medicine

Date Written: January 23, 2012

Abstract

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.

Keywords: Vietnam, health capability, health insurance, health care costs, poverty

JEL Classification: I1

Suggested Citation

Nguyen, Kim Thuy and Khuat, Oanh Thi Hai and Ma, Shuangge and Pham, Duc Cuong and Khuat, Giang Thi Hong and Prah Ruger, Jennifer, Impact of Health Insurance on Health Care Treatment and Cost in Vietnam: A Health Capability Approach to Financial Protection (January 23, 2012). American Journal of Public Health, 2012; 102(8):1450-61, doi:10.2105/AJPH.2011.300618, Available at SSRN: https://ssrn.com/abstract=1515733

Kim Thuy Nguyen

Yale University - School of Medicine ( email )

333 Cedar Street
New Haven, CT 06520-8034
United States

Oanh Thi Hai Khuat

Institute for Social Development Studies ( email )

Hanoi
Vietnam

Shuangge Ma

Yale University - School of Public Health ( email )

PO Box 208034
60 College Street
New Haven, CT 06520-8034
United States

Duc Cuong Pham

Institute for Social Development Studies ( email )

Hanoi
Vietnam

Giang Thi Hong Khuat

Institute for Social Development Studies ( email )

Hanoi
Vietnam

Jennifer Prah Ruger (Contact Author)

University of Pennsylvania - School of Social Policy & Practice ( email )

3701 Locust Walk
Philadelphia, PA 19104-6214
United States

University of Pennsylvania - Perelman School of Medicine

423 Guardian Drive
Philadelphia, PA 19104
United States

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