Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-28T12:23:38.502Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of universal health insurance for children in Vietnam

Published online by Cambridge University Press:  09 May 2017

Binh T. Nguyen  and
Anthony T. Lo Sasso
Binh T. Nguyen
Affiliation:
Independent Research Consultant, Mountain View, CA, USA
Anthony T. Lo Sasso*
Affiliation:
Professor, Health Policy and Administration Division, University of Illinois at Chicago, Chicago, IL, USA
*
*Correspondence to: Professor Anthony T. Lo Sasso, Health Policy and Administration Division, University of Illinois at Chicago, 1603 W Taylor, Chicago, IL 60612-4394, USA. Email: losasso@uic.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Our research investigates the effects of the 2005 universal health insurance program for children under age 6 in Vietnam on health care utilization, household out-of-pocket (OOP) spending and self-reported health outcomes using data from the Vietnam Household Living Standard Survey in 2002–2004–2006–2008. We use difference-in-differences to compare children eligible for the program to older children who are ineligible for the program. Results indicate that the program increased insurance coverage by 250% for children age 0–5 relative to the pre-policy period. We found large increases in both outpatient visits and hospital admissions. Health insurance availability also increased outpatient visits at both public and private facilities, suggesting that public and private health care services are complements. Although health insurance was associated with a decrease in inpatient OOP spending for children aged 3–5, it did not reduce outpatient OOP spending for children in general. Health insurance was associated with modest improvements in self-reported health outcomes. Our research suggests that expanded access to insurance among Vietnamese children improved access to care and health outcomes, though it did not necessarily reduce OOP spending.

Type
Articles
Information
Health Economics, Policy and Law , Volume 14 , Issue 3 , July 2019 , pp. 299 - 314
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almond, D. and Currie, J. (2011), ‘Human Capital Development before Age Five’, in O. Ashenfelter and D. Card (eds), Handbook of Labor Economics, Volume 4, North Holland: Elsevier, 1315--1486.Google Scholar
Buntin, M. B. and Zaslavsky, A. M. (2004), ‘Too much ado about two-part models and transformation? Comparing methods of modeling medicare expenditures’, Journal of Health Economics, 23(3): 525–542.Google Scholar
Case, A., Fertig, A. and Paxson, C. (2005), ‘The lasting impact of childhood health and circumstance’, Journal of Health Economics, 24(2): 365–389.Google Scholar
Currie, J., Culyer, A. and Newhouse, J. (2000), ‘Child Health in Developed Countries’, in A. J. Culyer and J. P. Newhouse (eds), Handbook of Health Economics, North Holland: Elsevier, 1053–1090.Google Scholar
Finkelstein, A., Taubman, S., Wright, B., Bernstein, M., Gruber, J. and Joseph, P. (2012), ‘The Oregon health insurance experiment: evidence from the first year’, Quarterly Journal of Economics, 127: 1057–1106.Google Scholar
General Statistics Office (2012), Result of the Vietnam Household Living Standards Survey 2010, http://www.gso.gov.vn/default_en.aspx?tabid=515&idmid=5&ItemID=12426 [25 April 2017].Google Scholar
Gertler, P. and Sturm, R. (1997), ‘Private health insurance and public expenditures in Jamaica’, Journal of Econometrics, 77: 237–257.Google Scholar
Grosh, M. E. (1997), ‘The policymaking uses of multitopic household survey data: a primer’, World Bank Research Observer, 2: 137–160.Google Scholar
Gruber, J., Hendren, N. and Townsend, R. M. (2014), ‘The great equalizer: health care access and infant mortality in Thailand’, American Economic Journal Applied Economics, 6: 91–107.Google Scholar
Ha, D. (2011), Social health insurance as a means to achieving universal coverage and more equitable health outcome, https://www.unicef.org/vietnam/Global_survey_on_SHI-En.pdf [25 April 2017].Google Scholar
Lagomarsino, G., Garabrant, A., Adyas, A., Muga, R. and Otoo, N. (2012), ‘Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia’, Lancet, 380: 933–943.Google Scholar
Lieberman, S. and Wagstaff, A. (2009), Health Financing and Delivery in Vietnam, Washington, DC: The World Bank.Google Scholar
Mitra, S., Palmer, M., Mont, D. and Groce, N. (2016), ‘Can households cope with health shocks in Vietnam?’, Health Economics, 25: 888–907.Google Scholar
Nguyen, H. and Wang, W. (2013), ‘The effects of free government health insurance among small children – evidence from the free care for children under six policy in Vietnam’. The International Journal of Health Planning and Management, 28(1): 3–15.Google Scholar
Nguyen, Q. T., Duong, H. L., Nguyen, H. L., Pham, T. T., Bales, S. and Duong, D. T. (2008), ‘Joint Annual Health Review 2008 – Health Financing in Vietnam’. Ministry of Health, Health Partnership Group, Hanoi.Google Scholar
Sachs, J. D. (2012), ‘Achieving universal health coverage in low-income settings’, Lancet, 380: 944–947.Google Scholar
Somanathan, A. (2008), ‘The Impact of Price Subsidies on Child Health Care Use: Evaluation of the Indonesian Healthcard’. World Bank Policy Research Working Paper Series, https://ssrn.com/abstract=1149125 [25 April 2017].Google Scholar
Trivedi, P. K. and Hall, W (2002), ‘Patterns of Health Care Utilization in Vietnam: Analysis of 1997-98 Vietnam Living Standards Survey Data’. No 2775, Policy Research Working Paper Series, The World Bank, http://documents.worldbank.org/curated/en/480911468761347026/pdf/multi0page.pdf [25 April 2007].Google Scholar
UNICEF (2007), Midterm review on Vietnam’s implementation Of Document entitled ‘A world fit for children’, https://www.unicef.org/worldfitforchildren/files/Vietnam_WFFC5_Report.pdf [25 April 2017].Google Scholar
Venkataramani, A. S. (2011), ‘The intergenerational transmission of height: evidence from rural Vietnam’, Health Economics, 1467: 1448–1467.Google Scholar
Wehby, G. L. (2013), ‘Child health insurance and early preventive care in three South American countries’, Health Policy and Planning, 28(3): 328–338.Google Scholar